NHS Recovery Plan: annual progress update

Mental Health, Learning Disabilities, Neurodiversity, and Dementia

As we emerge from a pandemic and confront a Cost Crisis, we are keenly aware of the challenges facing mental health services. We will work to ensure that anyone who needs it can access mental health support when they need it.

Steps we have taken

We have allocated nearly £40m to NHS Boards to improve Child and Adolescent Mental Health Services (CAMHS) in 2021/22, with £4.25m of that allocation directly focussed on offering treatment to those already on their CAMHS waiting lists. We also provided an additional £9m to NHS Boards in 2021/22 to address waiting lists for Psychological Therapies (PT).

Since we made that investment, we have seen improvements in the activity and performance of NHS Board CAMHS services, and improvements in capacity which can be measured by growth in workforce.

For example, community CAMHS staff have grown by 173.4 WTE which is a 19.3% growth in workforce since March 2021. We are creating new posts to continue our expansion of the workforce, posts being advertised in CAMHS have grown from 17.1 in March 2021, to 147.4 – an increase of 762% as we continue to create posts in this area.

The latest statistics also show that for CAMHS the waiting list has dropped from 10,346 at the end of March to 9,729 at the end of June, a 6.0% decrease overall and the number of people waiting over eighteen weeks dropped from 4,536 to 4,147 an 8.6% decrease.

For PT, total waits have dropped from 23,394 at the end of March to 22,472 (a 3.9% decrease) at the end of June, and waits over eighteen weeks from 9,879 to 8,932 (a 9.6% decrease).

So far in 2022, we have seen record levels of activity in CAMHS and Psychological Therapies, with more patients being seen than ever before.

As waiting list backlogs are tackled, we expect this activity to be reflected in improved performance, with all Health Boards working towards meeting the 90% waiting times standard, resulting in shorter waiting times, and a better experience for individuals and families supported by our NHS.

Action fifteen of the Mental Health Strategy 2017-27 outlines our commitment to funding 800 additional mental health workers in key settings, including A&Es, GP practices, police station custody suite and prisons – ensuring local provision and support is at the heart of our plans. We have exceeded this commitment and an additional 958.9 whole time equivalent (WTE) mental health roles have been filled. Since 2018/19 we have allocated almost £84m to enable recruitment to these posts and will continue to provide the necessary funding to ensure that these posts are protected in 2022/23 and beyond.

Steps we are taking

We continue to invest in digital service capacity, with access to cognitive Computerised Behavioural Therapy (CBT) programmes and Near Me, the video-conferencing platform, being made available nationally. We have also launched the Digital Mental Health Innovation Cluster, and the Mind to Mind website, a resource with short videos of people with experience of facing mental health challenges. There have been around 63,000 digital therapies referrals in the last year, and user satisfaction with computerised CBT is 91%.

We are developing quality standards in mental health to ensure that individuals, their families and carers know what they can expect from services, and we have ensured a person-centred approach is at the heart of the work.

We have provided funding to the National Autism Implementation Team (NAIT) to support Health Boards to develop action plans to introduce adult neurodevelopmental pathways.

We are now piloting Adult Neurodevelopmental Pathways in four Health Boards, to support the implementation of a single diagnostic pathways for ADHD and Autism. The pilot started in January of this year and will conclude in 12 months. The results of this work, including a final report, will be available next year.

Box 6: Integrating Mental Health Services and Unscheduled Care

We continue to work with partners through the Redesign of Urgent Care Programme and Unscheduled Care Collaborative, to ensure that people with urgent mental health care needs get the right help, in the right place, at the right time. This will be facilitated by ensuring that each Health Board provides access to a mental health clinician 24 hours a day, seven days a week for those who require urgent specialist mental health assessment or urgent referral to local mental health services. This is creating national and local routes to ensure people in emotional crisis or distress and those in need of urgent care are assessed and supported, regardless of how they access services. National Guidance has been developed to support Health Boards to implement this approach and significant progress has been made. For example, referral routes from NHS 24 to local services for urgent care during the out of hours period and increased availability of mental health clinicians providing professional support to Police Scotland and the Scottish Ambulance Service. We will continue this work to improve the unscheduled care mental health response.

Steps we will take

We have committed additional investment in dementia post-diagnostic support services to ensure more people are able to access support that works for them following a diagnosis. This includes additional investment going to local areas via Integrated Joint Boards (IJBs) and new funding for community led offers of support that is being administered via Age Scotland’s About Dementia team.

As the Plan progresses, we will continue to expand our Digital Mental Health Programme by improving the quality of service and levels of accessibility, while expanding capacity, improving equality of access and support services to meet increasing demand across all territorial Health Boards.

We will also be developing a new dementia strategy for Scotland which embeds the voice of lived experience, reflects the lessons of the pandemic and seeks to maximise the opportunities across the wider policy landscape to improve the experience of people living with dementia and their carers; and will publish a new Mental Health and Wellbeing Strategy in the year ahead, in addition to a new long-term Suicide Prevention Strategy and delivery plan with CoSLA.