CQC to write to NHS trusts that are worse than other providers for community mental health care

The deputy chief inspector of hospitals and the quality regulator’s lead for mental health, Dr Paul Lelliott will be writing to a number of NHS and community mental health providers demanding action following their performance in this year’s survey of community mental healthcare, published today (Tuesday 15 November).

Overall, the results – which are based on the views of over 13,000 people canvased in 2016 – show that people’s experiences of being cared for in the community for their mental health problems, ranging from depression to psychosis, have not improved since last year’s publication.

One in three people (35%) reported that their overall experience of care was poor, rating it as six or below out of ten, which is similar to the results in 2015 (36%) and 2014 (34%).

Also around a third of people (32%) said that did not know who to contact out of office hours if they have a crisis. Furthermore, around a quarter (24%) of those people who went on to try and contact that person or team because their condition was getting worse said that they did not get the help they needed during a mental health crisis, in which a person may have experiences ranging from suicidal thoughts, self- harming behaviour, panic attacks, psychotic episodes to other behaviours that feel ‘out of control’. This compares to 21% for 2014.

Not knowing who to contact or not getting the help they need could affect their recovery, as well as put them at increased risk of harming themselves or even, others.

The Care Quality Commission (CQC) has collected the survey findings from 58 providers of mental health services in the community such as in specialist clinics and in peoples own homes. Of these, four providers performed significantly worse than other providers within the survey based on their collective responses. They are:

• Isle of Wight NHS Trust ( CQC rating Requires Improvement)
• West London Mental Health NHS Trust (CQC rating Requires Improvement)
• Norfolk and Suffolk NHS Foundation Trust (CQC rating Requires Improvement)
• Coventry and Warwickshire Partnership NHS Trust (CQC rating Requires Improvement)

CQC has written to these NHS trusts today to urge them to review their results and to outline what actions they will take to address the areas of concern. CQC will review their progress on their next planned inspections.

Dr Paul Lelliott Deputy Chief Inspector of Hospitals (lead for mental health) said: “There are around 1.7 million people across the country who are currently being funded by the NHS, for treatment for a mental health condition in the community funded by the NHS. These services are vital in supporting their recoveries and preventing their conditions from deteriorating.

“While the survey results highlight many positive aspects of care, I am deeply concerned by the lack of improvement overall in trusts in England.

“I am grateful for the 13,000 people who took the time to share their experiences. Providers of community mental health services must now take the time to review what they have said and to act on any areas of concern.

“I have written to the four providers that have been identified as performing worse than other providers within the survey for their reassurance on what they propose to do in response.

“People’s feedback is a vital way of identifying problems and improving care. We will check up on how these trusts are progressing during our next planned inspections.”

CQC carries out this survey every year with the NHS and asks people for their views on aspects of their care, such as whether they felt they were treated with dignity and respect and on whether they felt involved in decisions about their care.

This year’s results highlight positive aspects of people’s mental healthcare in the community, such as:

• Around three-quarters (74%) of respondents said that they were ‘always’ treated with respect and dignity
• 76% reported that they had been told who was in charge of organising their care and services. Of these people, the vast majority (97%) said that they knew how to contact this person, if they had a concern.

In addition to this, one provider out of the 58 surveyed was significantly better than other providers within the survey from people who use their services. It is:

• NAVIGO Health and Social Care CIC (CQC rating Good)

The findings are important as they feed into CQC’s wider monitoring of the NHS and alongside other evidence, are used to inform CQC’s inspections.