NHS England
NHS / Health Body
Action Planned
NHS England is addressing mental health bed availability through investment in community, crisis, and acute mental health services, and directing systems to reduce average length of stay in adult acute mental health wards. They are supplementing this with further investment to recommission inpatient care and have established a Quality Transformation Programme to improve access and quality of mental health pathways. (AI summary)
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Dear Coroner, Re: Regulation 28 Report to Prevent Future Deaths – Martyn Harvey Stringer who died on 29 March 2023.
Thank you for your Report to Prevent Future Deaths (hereafter “Report”) dated 7 August 2024 concerning the death of Martyn Harvey Stringer on 29 March 2023. In advance of responding to the specific concerns raised in your Report, I would like to express my deep condolences to Martyn’s family and loved ones. NHS England are keen to assure the family and the Coroner that the concerns raised about Martyn’s care have been listened to and reflected upon.
Your Report raises concerns over the issue of availability of inpatient mental health beds.
The number of mental health beds required to support a local population is dependent on both local mental health need and the effectiveness of the whole local mental health system, in providing timely access to care and supporting people to stay well in the community, therefore reducing the likelihood of an admission being necessary.
In some local areas there is a need for more beds. This is being addressed in part through investment in new units, however, this should be considered as part of a transformational approach. This is supported by the NHS Long Term Plan (LTP), which has seen an additional £2.3 billion funding invested in mental health services from 2019/20 to 2023/24, around £1.3 billion of which is for adult community, crisis and acute mental health services to help people get quicker access to the care they need, and to prevent avoidable deterioration and hospital admission. NHS England’s 2024/25 priorities and operational planning guidance reinforces this focus on improving patient flow as a key priority – with systems directed to reduce the average length of stay in adult acute mental health wards, in order to deliver more timely access to local beds.
To address the wider system issues that impact on health services, a further £1.6 billion has been made available via the Better Care Fund from 2023-2025. This funding can be used to support mental health inpatient services as well as the wider system, National Medical Director NHS England Wellington House 133-155 Waterloo Road London SE1 8UG
26/09/2024
which should help to reduce pressures on local inpatient services so that those who need to access beds can do so quickly and locally.
This is being supplemented by a further £42 million recurrent investment from 2024/25 for all Integrated Care Boards (ICBs) in the country, to recommission inpatient care in line with local models that provide the best evidence of therapeutic support.
NHS England’s South East region have also established a Quality Transformation Programme relating to Urgent and Emergency Care and Flow. The aim of this programme is to improve access and quality of the mental health crisis and acute adult pathway, including improving patient flow and capacity. The region is engaged with the national Quality Transformation Programme designed to help systems transform their current service offer. The national programme is built upon the cornerstones of good mental healthcare, continuity of care, therapeutic relationships and a relentless commitment to mental health care, meeting the needs of all people.
I would also like to provide further assurances on the national NHS England work taking place around the Reports to Prevent Future Deaths. All reports received are discussed by the Regulation 28 Working Group, comprising Regional Medical Directors, and other clinical and quality colleagues from across the regions. This ensures that key learnings and insights around events, such as the sad death of Martyn, are shared across the NHS at both a national and regional level and helps us to pay close attention to any emerging trends that may require further review and action.
Thank you for bringing these important patient safety issues to my attention and please do not hesitate to contact me should you need any further information.
Thank you for your Report to Prevent Future Deaths (hereafter “Report”) dated 7 August 2024 concerning the death of Martyn Harvey Stringer on 29 March 2023. In advance of responding to the specific concerns raised in your Report, I would like to express my deep condolences to Martyn’s family and loved ones. NHS England are keen to assure the family and the Coroner that the concerns raised about Martyn’s care have been listened to and reflected upon.
Your Report raises concerns over the issue of availability of inpatient mental health beds.
The number of mental health beds required to support a local population is dependent on both local mental health need and the effectiveness of the whole local mental health system, in providing timely access to care and supporting people to stay well in the community, therefore reducing the likelihood of an admission being necessary.
In some local areas there is a need for more beds. This is being addressed in part through investment in new units, however, this should be considered as part of a transformational approach. This is supported by the NHS Long Term Plan (LTP), which has seen an additional £2.3 billion funding invested in mental health services from 2019/20 to 2023/24, around £1.3 billion of which is for adult community, crisis and acute mental health services to help people get quicker access to the care they need, and to prevent avoidable deterioration and hospital admission. NHS England’s 2024/25 priorities and operational planning guidance reinforces this focus on improving patient flow as a key priority – with systems directed to reduce the average length of stay in adult acute mental health wards, in order to deliver more timely access to local beds.
To address the wider system issues that impact on health services, a further £1.6 billion has been made available via the Better Care Fund from 2023-2025. This funding can be used to support mental health inpatient services as well as the wider system, National Medical Director NHS England Wellington House 133-155 Waterloo Road London SE1 8UG
26/09/2024
which should help to reduce pressures on local inpatient services so that those who need to access beds can do so quickly and locally.
This is being supplemented by a further £42 million recurrent investment from 2024/25 for all Integrated Care Boards (ICBs) in the country, to recommission inpatient care in line with local models that provide the best evidence of therapeutic support.
NHS England’s South East region have also established a Quality Transformation Programme relating to Urgent and Emergency Care and Flow. The aim of this programme is to improve access and quality of the mental health crisis and acute adult pathway, including improving patient flow and capacity. The region is engaged with the national Quality Transformation Programme designed to help systems transform their current service offer. The national programme is built upon the cornerstones of good mental healthcare, continuity of care, therapeutic relationships and a relentless commitment to mental health care, meeting the needs of all people.
I would also like to provide further assurances on the national NHS England work taking place around the Reports to Prevent Future Deaths. All reports received are discussed by the Regulation 28 Working Group, comprising Regional Medical Directors, and other clinical and quality colleagues from across the regions. This ensures that key learnings and insights around events, such as the sad death of Martyn, are shared across the NHS at both a national and regional level and helps us to pay close attention to any emerging trends that may require further review and action.
Thank you for bringing these important patient safety issues to my attention and please do not hesitate to contact me should you need any further information.