Source · Select Committees · Public Accounts Committee
Recommendation 19
19
Accepted
Funding pressures and physical health backlogs risk Integrated Care Boards deprioritising mental health services.
Conclusion
More immediately, the Centre for Mental Health and other bodies told us that, in the face of funding pressures and the need to reduce backlogs for physical health services, ICBs and ICPs could struggle to prioritise mental health services and support, and potentially even place some of the recent progress made in jeopardy.36 When questioned, NHSE assured us there is no doubt that “mental health services will remain an absolute priority” for the NHS, and that it has a number of mechanisms in place to ensure that this is the case for ICBs, for example, the mental health investment standard for improving the share of local funding for mental health services.37
Government Response Summary
The government agrees with the recommendation, noting that from 2023-24, ICBs must include mental health expenditure in annual reports to increase accountability and that the Health and Care Act 2022 requires mental health expertise on ICB Boards. NHS England will continue to oversee ICBs using existing frameworks and monitor this approach.
Government Response
Accepted
HM Government
Accepted
3.1 The government agrees with the Committee’s recommendation Target implementation date: Summer 2024 3.2 The NHS Oversight Framework outlines NHS England’s approach to overseeing Integrated Care Boards (ICBs) and trusts, utilising 63 metrics, 6 of which relate to mental health. NHS England will continue to undertake delivery assurance within the new model outlined in the NHS Operating Framework, which is complemented by central data repositories that provide an overview of performance at a national, regional, ICB and sub-ICB level. NHS England segments ICBs and NHS trusts on a scale of 1 to 4 and provides mandated support for the most challenged providers and systems. NHS England also conducts annual performance evaluation of ICBs. 3.3 From 2023-24, all ICBs are also required to include a statement of the amount and proportion of expenditure incurred by the ICB in relation to mental health in their annual report, increasing ICBs’ public accountability for their decisions on mental health investment. NHS England will assure ICB spending plans and actual spend. To ensure mental health is sufficiently prioritised, the Health and Care Act 2022 requires that ICBs must have a member who has mental health expertise on the Board. 3.4 NHS England is working within the new operating model to ensure systems are empowered to self-assure spending and delivery, but significant risks and issues will continue to be escalated to support a strategic response. 3.5 NHS England and the department will continue to monitor this approach to ensure that appropriate support is being offered to ICBs.