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BABCP is the lead body supporting cognitive behavioural therapy (CBT) approaches in the UK and Ireland.
The government released its 10-year plan for the NHS on 7th January 2019, setting out strategic priorities for the next decade.
BABCP welcome several of the ambitions and priorities laid out, whilst cautioning about the impact of setting unachievable targets for an already stretched workforce without a clearer explanation of how recruitment and retention will be better encouraged. BABCP also note how far we are from parity of funding for mental and physical healthcare.
BABCP particularly welcome the focus on both adult and child and adolescent mental health, provision of psychological therapies and better crisis care, focus on prevention and intervention and the emphasis on improving workforce wellbeing and equality and diversity in patient and staff populations.
BABCP note that concrete plans for funding and provision of social care have been delayed. BABCP recognises that adequate funding for social care is vital to enable health, social care and education to work together effectively to improve mental health. BABCP await the green paper on social care with interest.
One of the challenges to the aims of the 10-year plan is the ongoing tension between the goal of better national integration and the local commissioning of services. This leads to local decision-making on how limited budgets are spent and variations in service nationwide.
BABCP notes the specific priorities within the plan and makes the following comments;
BABCP is clear that parity of esteem between mental and physical health requires parity of funding. BABCP welcomes the pledge to spend at least £2.3bn more a year on mental health care and also to grow the mental health budget faster than the overall NHS budget for each of the next 5 years. However, we note that the overall increase over the next five years is said to be £20.5 billion “in real terms”, suggesting that there is still a long way to go in terms of parity of funding. We also consider that this may be insufficient because of the cumulative effects of chronic spending cuts to mental health and social care.
BABCP welcome the celebration of IAPT services in England as “world leading” and the pledge to expand provision to help 380,000 more people receive therapy for depression and anxiety by 2023/24. BABCP supports continued funding of IAPT training places to meet the increased demand for psychological therapists. BABCP hopes that financial support for psychological therapies will also be forthcoming across the UK. We assert that this must be done in the context of keeping to the standards set in the IAPT manual https://www.england.nhs.uk/wp-content/uploads/2018/06/the-iapt-manual.pdf in England and with corresponding quality assurance measures in the devolved nations.
BABCP agrees that child and adolescent mental health is crucial and welcomes the emphasis on prevention and early intervention, and the pledge that ring-fenced CYP MH funding will grow faster than both overall NHS spending and total mental health spending. BABCP also welcomes the extension of services for young people up to 25. Whilst BABCP welcomes early intervention in education settings, BABCP calls for this to be evidence-based and carefully evaluated.
Whilst BABCP welcomes a focus on staff wellbeing, it calls for further access to confidential support for wider groups of healthcare professionals and for more compassionate leadership of the NHS. Workforce shortages may be related to previous unachievable targets, salary freezes and cuts to training budgets. There is a lack of clear or detailed planning for how short-staffing in the NHS will be overcome, particularly in the current climate of uncertainty.
BABCP welcome the emphasis on equality and diversity in both patient and staff populations and recognition of specific needs of certain populations including looked after children, LGBTQ+ and BAME populations. BABCP will watch with interest to see how these aims translate into practice.