Mental Health Support: Wirral

Maria Caulfield Excerpts

Monday 24th April 2023 Commons Chamber

[The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)]

I congratulate the hon. Member for Wirral South (Alison McGovern) on securing this important debate. I am always pleased to have the opportunity to talk about the progress that we are making with mental health services, not only locally but throughout England.

Mental health affects us all, and for those of us who experience poor mental health, its impacts can be detrimental to the ability to live well, thrive and achieve personal goals. That is why improving mental health outcomes, particularly for those who experience worse outcomes than the general population, is a top priority for me and, in particular, for the Government. As the hon. Lady said, mental health still has some way to go before it is put on a par with physical health in terms of expectations, help, support and treatment, but we are making progress, in the Wirral and across the country.

The NHS long-term plan commits an additional £2.3 billion a year to the expansion and transformation of mental health services in England by 2024, which means that that 2 million more people will be able to receive NHS-funded mental health support than were able to receive it in 2018-19. For instance, we will have invested nearly £1 billion every year in community mental health care for adults with severe mental illnesses by the end of the current financial year, which will give 370,000 adults with such illnesses—including older adults—more choice and control over their care and support.

Let us not be under any illusion. We have seen a tsunami of referrals as older adults, children and young people have sought help and asked to be referred. In a way we have been successful in breaking some of the taboos and stereotypes related to mental health, which means that people are willing to come forward and ask for help, but our challenge now is to ensure that the services are able to meet that growing demand.

The hon. Lady mentioned targets as a way of being able to give people an indication of how long they should be waiting. Until fairly recently, mental health did not involve any waiting time standards, but we have introduced targets for children and young people with eating disorders. Let me give an example to illustrate the sheer scale of the current demand. The number of children and young people entering urgent treatment for eating disorders has increased by 11% in the last two years, and in the previous year it increased by 73%. A record number of people now need help, and our challenge is to provide the services that will provide it.

NHS England is currently consulting on the introduction of five new access waiting time standards for mental health services, which we hope will address some of the concerns expressed by the hon. Lady. They include introducing a target for urgent referral to a community-based mental health crisis service that patients across all ages should be seen within 24 hours of referral. For very urgent referrals to a community-based mental health crisis service, a patient should be seen within four hours of referral across all ages. Patients referred from A&E should be seen face to face within one hour by a mental health liaison or equivalent children and young people’s service. Children, young people and their families presenting to community-based mental health services should start to receive care within four weeks. Those are the standards we are trying to introduce, and I will commit to updating the House on the progress we are making, because the standards in the Wirral that the hon. Lady has talked about in her speech are the standards that we would like to see across the country.

[Alison McGovern]

All those targets are about emergencies, which is important, but I hope that the Government will also be looking at targets for non-urgent care, because that is the way we prevent people from getting to the urgent bit in the first place.

--- Later in debate ---

[Maria Caulfield]

I absolutely agree and I will come on to talk about some of the work we are doing in that space in a moment.

We know that the number of children and young people experiencing mental health problems is rising, and that many of them risk continuing to experience mental health problems throughout their life as a result. This has been exacerbated by the pandemic, which is why there is a further £79 million to address the impact of covid on children’s and young people’s mental health. That has allowed around 22,500 more children and young people to access community health services in order to support them as early as possible.

One of the most exciting things we are doing relates to getting in at an earlier stage, as the hon. Lady has just suggested, and talking about mental health rather than just talking about mental illness. This involves our programme of mental health support teams that have been rolled out in schools and colleges. As of spring last year, there were 287 mental health support teams in place in around 4,700 schools and colleges across the country. The type of support they are able to provide to the young people and the teachers in those schools means that children who need help through early intervention can be signposted to it and that those with more complex needs can get into the system a lot quicker.

Our challenge now is to roll that out across all schools, and we are hoping to be able to do that as quickly as possible. In the hon. Lady’s patch, there are 25 mental health support teams in place or planned in the area covering Cheshire and Merseyside, four of which are in the Wirral. I am hoping that she will start to see them being rolled out and that she will feel they make a difference. Mental health support teams now cover 26% of pupils a year earlier than originally planned, but we fully recognise that that is still a long way off 100%.

We know that there is more to do in terms of capital investment in mental health services so that local communities can have the infrastructure to see people earlier, rather than waiting until they are in crisis and need to be seen in A&E or in-patient facilities. That is why recently we provided £150 million of capital investment to be rolled over in the next two years via NHS England. From that fund, £408,000 is being invested in improvements in NHS 111 and crisis line infrastructure at the Cheshire and Wirral Partnership NHS Foundation Trust, to try to start that process of getting early intervention to people as quickly as possible.

The hon. Lady has pointed out that waiting times for some mental health services are longer than we would like, and I am happy to put my hands up and admit that that is the case. I can assure her that both locally and nationally we are doing all we can to ensure that people are getting the support they need as quickly as possible. Her local foundation trust has implemented a series of measures to help reduce those waiting times, and the number of young people waiting for appointments has been reduced by 68% since March last year. Her trust has also recruited 13.4 whole-time equivalent roles and made provision for additional sessions of consultant psychiatry. Again, there is lots more to do, but we are starting to make inroads into some of those long waits.

I have already pointed out that NHS England is consulting on five new waiting time standards, and I will update the House as soon I have the information on when they are likely to be rolled out in practice. It is also important to note that many patients with mental health needs also suffer poorer physical health outcomes, which is why we announced in January that mental health will be part of the major conditions strategy so that we deal with both issues for people who are struggling with mental illness.

It is important that we talk about the local issues in Cheshire, Merseyside and the Wirral, and the hon. Lady’s local integrated care board is currently undertaking a transformation programme within its mental health services. I understand from NHS England that local services in the Wirral are establishing a community model of mental health as part of their long-term plan ambition, with the aim of removing the gap between primary and secondary mental health services.

We want people to be seen much earlier when they go into crisis. Nationally, we are already seeing fewer people turning up to A&E because crisis teams are able to see them in the community much quicker and much earlier, with better outcomes for managing their symptoms. Talking Together Wirral has achieved the national target of 50% recovering through talking services since January 2023, and the Every Mind Matters website enables people to self-refer to talking therapies. We are doing quite well in getting first appointments, but our challenge is where people need further sessions, which is often where the long waits occur. I reassure the hon. Lady that we want to make it as easy as possible for people to self-refer into the system and, locally, the Wirral is starting to recover the waiting times for such services, but of course I am happy to work with her to see what more can be done.

The hon. Lady mentioned the fantastic, proactive work of her local health system. Cafe Create is a pilot programme launched in April 2022 as a joint commissioning venture between health services and Wirral Borough Council, and it provides an informal place for young people at risk of mental health crisis to drop in and access support from professionals and peers, counselling and drug and alcohol support. We want to support more programmes like that.

The myHappymind programme is rolling out in the Wirral, reaching 22 primary schools by the end of last year. Plans, including a business case, are now in place to bring the programme to every primary school in the Wirral by 2024, and I am happy to work with the hon. Lady on that because it is important to establish in every school that mental health is on a par with physical health. We teach young people and children about the importance of a good diet and exercise, and it is equally important to teach them about what mental wellbeing looks like and when to reach out for help.

There is a lot of work to do, and I do not dismiss in any way the hon. Lady’s point about the significant number of people who want help and the sometimes long waits to access services, but we are making progress on trying to deal with the large number of cases coming forward and on supporting local communities such as the Wirral to roll out services.

I hope I have been able to reassure the hon. Lady of our commitment to improving mental health services, to introducing some of the standards she mentioned—I take her point that it needs to be about more than just urgent care standards—and to supporting local communities to address crises in the community rather than waiting for a person to need admission, sectioning or in-patient care. I hope we will be able to demonstrate the progress we have made.

Let me touch on one final point about staff. We have an ambition to recruit 27,000 more mental health workers and we are on track to meet that. That covers a wide range of mental health practitioners, from mental health nurses to psychiatrists, counsellors and psychologists. They are working in a wide range of roles, and I wish to reassure the hon. Lady that we are on track to meet that target. It is the key to providing these extra services; without the staff, we will not be able to provide the services we need. I hope I will be able to update the House fairly soon on further work we are doing, not only on recruitment, but on the retention of our fantastic staff, who do a really hard job. When we hear news about the health service being under pressure, we often hear about accident and emergency, intensive care units and hospital beds, but mental health workers do some of the hardest jobs in health and social care, and I pay tribute to them

I hope that I have reassured the hon. Lady that we are working hard. I absolutely identify with the points she has made and look forward to working with her to improve mental health services in the Wirral.

Question put and agreed to.