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Mental Health: delivering the three shifts

Mental Health: delivering the three shifts

5 June 2025 Long read

Key Points

  • The three shifts in health and care will not be delivered without mental health services. Yet there is a waning political will and focus on addressing the systemic challenges facing the mental health sector and delivering the well-established principle of parity of esteem between mental and physical health care, despite good mental health being critical to our society and our economy. To fulfil the government’s vision and implement the 10-year health plan, this needs to change. 

  • The NHS has worked hard to respond to demand for mental health care growing and patient needs changing, by increasing access and transforming models of care within the resources available. However, there is still significant unmet need. The mental health sector is also facing challenges in consistently delivering high quality, safe care. 

  • Failing to adequately address the challenges facing the mental health sector risks further entrenching the sector's historical, structural disadvantage to the detriment of the wider health and care sector. Meeting mental health need supports the whole health and care sector to deliver high quality, effective care individuals need in the right place, at the right time and supports the government's drive to get people back to work. 

  • This briefing sets out our analysis and the key actions that the mental health sector, government and national bodies should collectively prioritise in the short to medium term in order to deliver values-driven, patient-centred, and staff-enabled mental health care. This will support the delivery of the three shifts the government wants to make in health and care, and better meet the mental health needs of individuals, society and the economy over the next decade. These key actions include: 

    • Design national priorities and policies in a way that recognises the distinctions between different mental health and neurodiverse conditions and the services that are needed to meet individuals’ needs. 

    • Develop and implement evidence-based standards, models of care and pathways for key areas – such as neurodiversity and mental health urgent and emergency care – to deliver the right care, in the right place at the right time, and improve the health and care system’s use of resources. 

    • Roll out broader mental health waiting time and access standards, with local areas funded and empowered to work out together how to tackle mental health and neurodiversity care backlogs.  

    • Hold the mental health sector to the same standards and expectations as other sectors on key areas such as improving patient flow and managing waiting lists.  

    • Address the variation in the availability and consistency of community-based mental health care and support, including the support provided by mental health social care services.
       

  • This briefing also shines a spotlight on the breadth and depth of good practice being delivered by NHS mental health trusts and their partners across the country. This work offers valuable insights and lessons for providers, commissioners and policymakers on how to improve in line with the three shifts. This good practice includes delivering specialist care and long-term support more sustainably and closer to home, and co-producing and delivering services with people with lived experience and partners to deliver higher quality, more effective, person-centred, integrated and inclusive care. 

  • Our April 2025 briefing, Mental health: shifting the focus, set out in more detail the key challenges currently facing the mental health sector and how trusts are responding and innovating. The challenges the sector is responding to include: the growing and changing nature of demand and delivering high quality, safe care consistently; accurately measuring and improving the value delivered by services; and the current level of prioritisation and funding for services to meet the full spectrum of mental health need that exists. 

  • To deliver NHS mental health care over the next decade that is values driven, patient centred and staff enabled, we must focus in the short to medium term on the following actions: 

    • Values driven: a number of fundamental principles should underpin the national vision for mental health and leadership of the sector, acting as ‘north stars’ for decision making. These fundamental principles include: establishing parity of esteem within national policy; delivering consistently high-quality care; and ensuring adequate funding for the sector, in particular capital investment, to improve the productivity, quality and value delivered by services. 

    • Patient centred: we need to recognise and take the opportunities to better focus services around patients, from better measuring productivity and improving pathways and models of care, to working in partnership and harnessing data to better meet local needs. 

    • Staff enabled: with trust leaders knowing that caring for the workforce enables them to deliver better quality, higher value care, we need to cultivate a well-looked after and empowered, multi-disciplinary workforce. This is central to maximising capacity and sustaining improvement and innovation in the design and delivery of mental health services. 

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