26 November, 2019

News > Quality of NHS mental health services has declined over last five years, survey shows

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People accessing NHS mental services are increasingly likely to experience problems in accessing and receiving care, according to results from a survey of more than 12,000 service users published today. Declines in quality over the last five years mean that service users are less likely than ever to report getting as much help as they need and receiving personalised care.

The survey, coordinated by Picker on behalf of the Care Quality Commission, looks at people’s experiences of using community mental health services for a wide range of common conditions and has been running annually since 2014. Covering experiences from accessing care to getting support with other services, it provides the most comprehensive view available of mental health service quality from the perspective of users.

People using mental health services value timely support and clear communication – but access to mental health professionals has declined over the last five years. In 2019, only two in five (42%) of users said that they were “definitely” seen often enough for their needs in the last 12 months: this is a 6% point decline from a figure of 47% in 2014. Many also wanted more time to discuss their needs and treatment: only 57% said they “definitely” got enough time for this in 2019, an 8% point decrease from 65% in 2014.

It is a principle of person centred care that people should have the opportunity to be involved in decisions about their treatment and should have their preferences and circumstances respected. Again, standards in these areas have declined. Only half (52%) of respondents said they were “definitely” as involved as they wanted to be in agreeing their care, a 4% point decline from 56% in 2014. A similar proportion (55%) said that their personal circumstances were “definitely” taken into account in this agreement, down 6% points from 61% in 2014. More than a quarter of service users (29%) said that they were not “always” treated with respect and dignity by NHS mental health services, a 3% increase from 26% in 2014.

Commenting on the findings, Chris Graham, CEO of Picker, said:

These results are very worrying. They show that community mental health services are struggling to meet users’ needs, despite recent policies emphasising the importance of these services. Declines in performance over the last five years are a particular concern and it is vital that the service is supported to arrest and reverse this pattern.

Improving community mental health services cannot be viewed as a ‘nice-to-have’ in a cash-strapped health system. As recent policies have recognised, increasing capacity and quality in community-based services should have benefits for the acute sector and should create savings that outweigh the required investments. Because service users are experiencing declining quality and access, it appears that recent funding increases have not enabled services to keep pace with demand – and further investment is needed to ensure the mental health of our population.


Full survey results can be seen on the CQC’s website.

View the Community Mental Health Survey 2019 infographic.

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