CCGs must be guided to ensure quality of mental health services

Clinical commissioning groups (CCGs) took over commissioning of local health services at the beginning of the month, but more needs to be done to ensure that they give mental health services the prominence they deserve.

April 1 saw widespread changes come into force in the NHS, the biggest and most controversial for many years, which will affect people with mental health problems just as much as everyone else.

Briefly, here are a couple of the main changes, according to the Web MD site [www.webmd.boots.com/nhs/10101/nhs-reforms-explained]. From April 1, several hundred CCGs, run by GPs and other clinicians, have replaced primary care trusts and strategic health authorities, and take over their responsibility for about £60 billion of state funding.

CCGs make commissioning decisions and determine care budgets, although their work is overseen by NHS Commissioning Boards.

The reforms also allow NHS services to be offered by "any willing provider", which means that private sector providers can compete against the NHS and its partners to provide services. Critics have said that there is a risk of a ‘rush to the bottom’, as providers cut costs to win contracts, thus driving down quality of treatment for patients.

For me, other worries have not been adequately addressed, such as whether CCGs will effectively commission specialist mental health services. My main worry is that if the CCG does not have someone in it with an interest in, or in-depth knowledge of, mental health issues, which can be seen as niche and (seemingly) expensive, then services may be marginalised in favour of more mainstream ones.

While there is the commitment to ensure that mental and physical health services have ‘parity of esteem’, whether that happens quickly on the ground remains to be seen. It is worth remembering that spending on mental health still lags way behind that spent on physical conditions: about 11% of the NHS’ total spend is on mental health, despite it accounting for 23% of the UK health burden.

So, to try and ensure that mental health is given the prominence it deserves, now is the time to influence CCGs. For example, people with mental health problems, along with family members, friends and carers can get involved with organisations such as Healthwatch England and Local Healthwatch, which are there to represent the views of service users, carers and the public.

In addition, CCGs and GP practices are being encouraged to develop Patient Participation Groups, which will be able to monitor developments and influence decision-making at a local level.

While the changes to the NHS may be controversial for some, we have to work with them and, the mechanisms set up to give patients a say have to be used to do just that – make sure that people with mental health problems get their voices heard and that the services they need are put, or remain, in place.