Government strategy

1
Introduction

• Government strategy
• NSF Developments
• Future Priorities
• Drivers
• Problems

2
Government Strategy

• Investment
• Reform of services
• Reform of legislation
• System reform

3
The Past

• National Service Framework (1999)
• NHS Plan (2000)
• National Institute for Mental Health (2002)
• Detailed targets

4
Spending on services for adults with mental
illness
M
NIMHE Mapping- Total planned investment includes
estimate for unreported investment
5
NHS Plan Teams
AO Assertive Outreach CR Crisis Resolution
EI Early Intervention
6
Mental Health TargetDeath rates from Intentional
Self-harm and Injury of Undetermined Intent
excluding Verdict Pending in England 1993-2004
and target for the year 2010All persons
Death rate per 100,000 population
3 year average rates
Target 20 minimum reduction from 1995-97
baseline rate
9.2
8.6
7.3
baseline
Progress
target
Rates are calculated using population estimates
based on 2001 census, subsequent to amendments
resulting from the Local Authority Population
Study (LAPS). Rates are calculated using the
European Standard Population to take account of
differences in age structure. ICD9 data for 1993
to 1998 and 2000 have been adjusted to be
comparable with ICD10 data for 1999 and 2001
onwards. Early years of this trend have been
revised to Original cause mortality coding in
line with later years. The only discernable
difference in the data to one decimal place, is
that the target has been lowered by 0.1.
Source ONS (ICD9 E950-E959, plus E980-E989,
excluding E988.8 (inquest adjourned) ICD10
X60-X84, Y10-Y34 excl. Y33.9 (verdict pending))
7
Mortality from Intentional Self-harm and Injury
of Undetermined Intent in young men (aged 20-34)
in England
Age standardised death rate per 100,000 population
Single year data
Three year moving average, plotted against middle
year
There are discontinuities in the trend due to the
change from ICD8 to ICD9 between 1978 and 1979,
and the change to ICD10 over the period from 1999
to 2001. These discontinuities also appear in all
the three year averages that touch on these
years.
Source ONS Mortality Statistics (ICD X60-X84,
Y10-Y34 excl Y33.9)
Trends m69.ppt
Source ONS Mortality Statistics (ICD X60-X84,
Y10-Y34 excl Y33.9)
8
Health Reform
Better care Better patient experience Better
value for money
9
Psychological Therapies

• Improved access
• National pilots
• Pathfinder sites
• Clinical outcomes
• Employment

10
Delivering Race Equality

• Remains a key priority
• Focused Implementation Sites
• Staff training
• Community liaison
• Advocacy
• Commissioning commitment

11
Social Inclusion

• Stigma and Discrimination
• Dignity and Respect
• Recovery
• Housing
• Employment
• Valued social roles
• NICE guidance
• Exploring cross-government PSA target

12
Urgent Care

• Acute in-patient provision
• Crisis services
• Early intervention
• Liaison services
• Deliberate self-harm

13
Drivers

• System reform
• Service improvement
• Reflective practice

14
Data rich but information poor
15
Sick of data but...
hungry for information
16
The information vicious circle
Information is not used
Information is inaccurate incomplete late and
inconsistent
17
A Modern Mental Health Service
Integratedworking
18
Problems
Integrated working