Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, what steps his Department is taking to improve the diagnosis of depression at GP surgeries when the patient has not presented with that condition in the first instance.

Spending on mental health is estimated to have increased by £302 million in 2014/15, with total mental health spending rising from £11.362 billion in 2013/14 to £11.664 billion planned in 2014/15, an increase of 0.6% in real terms. In the planning requirements for 2015/16, commissioners were required to invest additionally in mental health in line with their increase in allocation. The total planned additional spend is £376 million, an increase of 4.5%.

The Improving Access to Psychological Therapies (IAPT) programme aims to help adults with common mental health conditions, including anxiety and depression, to recover using a range of psychological therapies or “talking therapies” recommended by the National Institute for Health and Care Excellence (NICE) in their clinical guidelines. These include Cognitive Behavioural Therapy, Interpersonal Therapy, Brief Dynamic Interpersonal Therapy, Couple Therapy for depression and counselling for depression. The national roll out of the IAPT programme began in 2008.

In the spending review period 2010-2015 the IAPT programme received over £460 million of government investment.

The NHS Mandate for 2015/16 and ‘Achieving Better Access to Mental Health Services by 2020’ included the commitment to introduce the first access and waiting times for mental health in 2015/16. This was accompanied by a £120 million investment – an investment of £40 million new money in 2014/15 to lay the groundwork for introducing the standards, and £80 million in 2015/16 that will be released out of existing NHS England budgets. One of the standards is that 75% of people referred to the IAPT programme will be treated within six weeks of referral, and 95% will be treated within 18 weeks of referral.

Achieving better access to mental health services by 2020 published in October 2014, set the expectation that, by 2020, all acute trusts will have in place liaison psychiatry services for all ages appropriate to the size, acuity and specialty of the hospital, including in Emergency Departments. Liaison psychiatry services see mental health staff working alongside acute hospital staff including in Emergency Departments. NHS England is supporting this aim by targeting £30 million investment in 2015/16 to enable a greater number of acute hospitals to establish effective models of liaison psychiatry.

The Quality and Outcomes Framework (QOF) is the annual reward and incentive programme detailing GP practice achievements. A number of mental health indicators are included in the QOF. It rewards practices for the provision of quality care and helps to standardise improvements in the delivery of clinical care. The mental health indicators help to drive improvements in the care and monitoring of patients with depression, bipolar disorder, psychoses and other mental illnesses.

NICE published the guideline Depression in adults: The treatment and management of depression in adults in October 2009. The guidance recommends that healthcare professionals be alert to possible depression, particularly in people with a past history of depression or a chronic physical health problem with associated functional impairment. It also recommends that they consider asking people who may have depression two pertinent questions about their well-being in the past month. If a person answers ‘yes’ to either of these questions then the practitioner should either review the patient’s mental state and associated functional, interpersonal and social difficulties themselves or refer the patient to a competent mental health assessor to do so.