Delivering consistently high quality and safe care

Quality of care and patient safety across the NHS have been at increasing risk due to a growing mismatch between demand for services and the overall funding, capital investment and workforce available. In our latest survey of trust leaders, almost half of respondents (47%) said they would have to scale back services in the coming year to deliver their financial plans, and a further 43% said this was under consideration. When asked which aspects of patient care were most at risk, respondents' main concerns were access to timely care and patient experience.

As trusts across the sector respond to these pressures, there is an opportunity to learn from the work of mental health trusts in recent years. Many have been collaborating with service users, families and carers to deliver higher-quality, more person-centred and holistic care that better meets people's needs. This way of working needs to continue to be supported locally and nationally, and the learning shared for other parts of the NHS to benefit from. There is more that the mental health trust sector needs to do to ensure that all patients are properly involved in decisions about their care, that their care is robustly and regularly reviewed, and they always feel treated with dignity and respect. Consistently listening to service users, their families and carers and wider communities and embedding this into the design and delivery of services is vital to the sector making further improvements.

By seeking to learn from others and adopting good practice, as well as reducing variation between services and areas of the country, we can deliver significant benefits. Doing so would contribute to improving safety, especially in high-risk services. National bodies have a key role to play in ensuring that good practice is identified and shared in a systematic and coordinated way to help mental health providers with implementation or approaches to improvement.

However, as well as supporting peers within the sector to learn from each other, there is a more fundamental need for the government to recognise that mental and physical health are not operational silos that can be addressed in turn. For mental health services to consistently deliver high-quality, safe services in all parts of the country, mental health needs to be a clear priority across government and backed by long-term sustainable levels of investment in core services. Those services play a crucial role in providing the right care and support for individuals, particularly those with severe mental illness, and they need to be able to deliver care as early as possible. Earlier intervention delivers better patient outcomes and is more cost effective.

Beyond this, we know there are efforts underway to rationalise the recommendations coming into the system from an array of quality and safety reviews, inquiries and investigations. We welcome and have been working to support this. National-level vision and direction are needed to move beyond the specific reviews or reactions to individual cases and ensure national quality and safety recommendations have the intended, and necessary, impact.

To deliver consistently high quality and safe care within mental health services, we need to:

Case study 

There are examples of high-quality recovery care being delivered by mental health trusts and local partners to support people to live independently. For example, Northamptonshire Healthcare NHS Foundation Trust's Meadowbank ward, which has been recognised nationally for providing high quality recovery care. The ward takes a proactive approach and has developed strong links with outside agencies to help reintegrate individuals back into the community, regain a meaningful life and prevent relapses.