Source · Select Committees · Public Accounts Committee
Recommendation 27
27
Accepted
Major conditions strategy risks losing focus on wider mental health determinants.
Conclusion
We heard that, given the breadth of factors that affect good mental health, an effective preventive programme requires actions from across government.52 In April 2022, the government, led by the Department, consulted on plans for a new 10-year cross- government strategy on mental health and wellbeing. This has since been replaced by a planned major conditions strategy from the Department, aimed at tackling the six major conditions which contribute to ill health, including mental ill health, for the next five years.53 The Department explained that “people often have more than one condition at the same time” and “working in disease and condition silos is not always the best way forward”. The major conditions strategy will focus on service integration for six major conditions, including between mental health conditions and physical health conditions. The Department confirmed that interim conclusions on the strategy will be available from the summer.54 While we agree that the major conditions strategy offers opportunities to join up mental health care for patients, many stakeholders have expressed their disappointment that the new strategy, covering mental health as one of a number of conditions, represents a “downgrading” from a dedicated 10-year cross-government plan, and risks the loss of focus on addressing the wider social determinants for mental health.55 48 C&AG’s Report, para 1.18 49 Qq 6–7, 36–39,45,57,63, 132; PMS0026, pages 5–6; PMS0013, pages 2–3; PMS0011, pages 3–4; PMS0014, pages 4,9–10; PMS0025, pages 1 and 5 50 C&AG’s Report, paras 1.18–1.19; PMS0026, pages 5–6; PMS0025, page 5 51 Qq 132, 174,182–183 52 Qq 6–7, 45, 60; PMS0006, page 2; PMS0011, pages 2–3; PMS0014, pages 9–10; PMS0015, pages 2- 3; PMS0025, page 6; PMS0026, pages 1,2 and 8; PMS012, page 1 and 5 53 Q 94; C&AG’s Report, para 1.20 54 Qq 118, 170–172, 175 55 Qq 7,35, 63,171; PMS0009, page 2; PMS0026, pages 8–9; PMS0011, pages 1–3; PMS0014, pages 2 and 11; PMS0025, page 1; PMS0024, page 5; PMS0
Government Response Summary
The government, while stating agreement, responded by detailing its Major Conditions Strategy (published August 2023) and explaining how it addresses mental health, prevention, and cross-government support, effectively reaffirming its chosen approach despite the committee's concerns about the strategy replacing a 10-year plan.
Government Response
Accepted
HM Government
Accepted
6.1 The government agrees with the Committee’s recommendation Target implementation date: by spring 2024 6.2 The Major Conditions Strategy: case for change and our strategic framework was published on 14 August. This sets out the Department for Health and Social Care’s strategic approach to improving care for people living with six groups of conditions. As part of this, the department recognises the importance of mental ill-health as a major condition, as well as the importance of prevention, ensuring physical health needs of people with mental ill-health are addressed, and ensuring that mental health is included as a core part of how the other major conditions are treated. 6.3 To support this work, the department has set out multiple policies that can help to support mental health and wellbeing. These include the implementation of a new mental health and wellbeing impact assessment tool to support policy makers across government in considering and addressing the impacts of any new policies on mental health and wellbeing; outlining government’s role in supporting employers to improve the support they provide for the mental and physical health of themselves and their employees; and increasing the number of schools and colleges with an embedded mental health support team. 6.4 The final report will be published in early 2024 and will include consideration of how the right workforce may be secured. DHSC is working closely with NHS England, as part of the implementation of the NHS Long Term Workforce Plan, which included a commitment to grow the proportion of NHS staff working in mental health, primary and community care.