Care Quality Commission: Mental Health Care Waiting Times

Question

12:14:00

Asked by

To ask His Majesty’s Government how they intend to respond to the results of the survey undertaken by the Care Quality Commission, showing that people are waiting too long for mental health care.

My Lords, it is unacceptable that too many people are waiting too long for mental health care, as the Care Quality Commission survey makes clear. Mental health is a key priority for this Government. We are already transforming services, including through introducing new models of community-based care, recruiting 8,500 mental health workers and expanding mental health support teams so that we can provide access to specialist mental health professionals in every school.

I thank my noble friend the Minister for her reply, and I welcome the progress that is being made. As she will be aware, yesterday the NHS Confederation published a report, based on research by the Centre for Mental Health, setting out urgent tasks that need to be undertaken. I know that she understands the need for parity of esteem; that could be marked by her giving the recommendations early consideration with a favourable turn of mind.

I am aware of the very helpful report that my noble friend refers to. I acknowledge the challenges highlighted in that report and will certainly take into account the points it makes. I regularly meet with and listen to the sector on what we can do to improve outcomes and transform mental health services, and this report will of course feed into that.

My Lords, the NHS planning guidance for 2025-26 reduced the overall number of targets, including those for mental health, and the guidance given was of a fairly generalised and vague nature. In the absence of any such targets, what specific incentives are currently in the system for ICBs to prioritise improvements in mental health services?

As the noble Baroness says, we reduced the number of targets on the basis of the recommendation by the noble Lord, Lord Darzi, that having so many targets was not delivering the results that we want. We have had to think boldly and innovatively. Since July 2023, NHS England has included waiting time metrics for referrals to urgent and community-based mental health services. I am looking at how we can drive improvements in quality and in the data to help services, particularly those with the most lengthy waits. I will also review the 2021-22 clinical review of standards to consider what else can be done to put mental health on a more equal footing, which it absolutely deserves.

My Lords, what are the Government doing to improve access to perinatal mental health services? The Minister will appreciate the urgency, given that suicide remains a leading cause of maternal death.

It is particularly appropriate that the noble Baroness raises this issue, as it is Maternal Mental Health Awareness Week. Yesterday I was very glad to attend an event organised by the Maternal Mental Health Alliance, where I spoke to women about their experience and what has made—or not made—a difference to them. I know we are looking forward to a debate on this later in the year, but 41 maternal mental health services have already been set up to provide care for women with moderate, severe or complex mental health difficulties, and more than 62,000 women are reported to have accessed a specialist community perinatal mental health service or a maternal mental health service. Additionally, 165 beds have now been commissioned across England in 20 mother and baby units, providing in-patient care to women. But yes, we need to do more.

My Lords, in some NHS trusts, autistic patients with learning needs and poor mental health are automatically opted into video and phone appointments, despite their communication needs. It feels as if the needs of the NHS and doctors working from home are prioritised over patient care. I know this from experience, because my son was repeatedly given video and phone appointments, even though I kept saying I wanted him to be seen in person. What can the Government do to ensure that there is a uniform approach across trusts, that patient care is prioritised and that guidelines are adhered to?

I thank the noble Baroness for raising her experience with her family. It is clear that patients are individual people and they need to be cared for and communicated with in the way that is appropriate to them. So I am sorry to hear what she reports; that is not what we expect. If she has not already provided the details, I will be pleased to look into the matter she raises, because it has repercussions across the whole system, as she rightly says.

My Lords, the overwhelming majority of mental health conditions start in childhood and adolescence, and we need to do everything to give those children and young people the very best start in life. Yet, regrettably, we know that there are 35,000 children in this country who have been on a waiting list for two years or more. I listened closely to my noble friend on the excellent work that this Government are doing with the support teams in schools, but for those children and young people who have met the threshold for services, what more can be done to alleviate these unacceptable waits?

I pay tribute to my noble friend for her contribution in supporting awareness and improved mental health, not just for young people but in maternity settings and across all mental health services. This morning I was at Alexandra Park School, where I saw what I regard as the exemplar for what my noble friend is talking about, because we need to prevent mental ill-health in young people. That is why we are extending the mental health support teams to ensure that every school has that available. While that is being developed, funding is available for mental health leads in schools. We are also working with local areas to ensure that they meet their obligations to the local community, which of course includes young people. I also feel that our Young Futures hubs will make a big difference. I agree with her: we have inherited a difficult position, but I assure your Lordships’ House that we are working to make progress, particularly for young people.

My Lords, what assessment has the department made of the benefits and risks of the growing trend that is being reported of those who are unable to access affordable mental health care therefore turning to AI platforms such as Grok and ChatGPT, which are of course unverified for this use?

As the noble Baroness says, it is very important that people use the right support. Otherwise, there is immense danger in going for what is perhaps less suitable. To my knowledge, we have not made a particular assessment, but I will pick up the noble Baroness’s point, because it is very right. On a more positive note, we are—and I am particularly—looking at what support we can develop in a digital and online sense to support people, not just on waiting lists but to prevent ill health and assist in their recovery.

My Lords, given that there is a waiting list for mental health care, including community-based services, and given the many competing demands on public finances, what can the Minister tell the House about conversations that her department and local ICBs may well be having with local community non-state civil society organisations, including those that offer music, art, talking drama, dance and other therapies, to help those on the waiting list?

As the noble Lord is aware, I regard the contribution of the community sector—the third sector—as absolutely crucial here. I personally work very closely, like the department more generally, both to improve our practice and to recognise the difference that the creative arts, for example, can add to people’s mental well-being, as the noble Lord says.

My Lords, in my own city of Leicester, some excellent work is being done with minority-ethnic communities in particular to help with access to mental health services. Nevertheless, significant inequalities remain. What more is being done to address those inequalities, particularly as they relate to people whose first language is not English?

What the right reverend Prelate raises is absolutely key: tackling inequalities in mental ill-health is so important. We know that some groups are more excluded than others, and this is taken into account in the preparation of the 10-year plan, which will be published over the next few months. I hope the right reverend Prelate will, like me, find that the 10-year plan addresses how we will tackle inequalities over the coming years—it will do so—because that is a key point.