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Commission GPs to provide extra mental health services, urges NHS England director

CCGs have been urged to commission GP practices locally to provide additional mental health services, as QOF is ‘no longer the only game in town’.

NHS England’s national director for mental health Dr Geraldine Strathdee said commissioning leaders should copy programmes developed by ‘pioneers’ who have commissioned enhanced services from practices to meet the needs of patients with mental health problems in primary care.

She said that especially given the impending withdrawal of certain mental health indicators from next year’s QOF the imperative was on CCG leaders to commission new services to respond to local issues.

Dr Strathdee said: ‘QOF is no longer the only game in town – we have to find a new way forward to support primary care with its huge mental health demand and enhanced schemes seem a very interesting way of addressing that.’

She added: ‘If I was in an area with high levels of psychosis, for those localities an enhanced service for psychosis/serious mental illness is “absolutely essential” and I know some of the 32 CCG leads in London are putting drafts together.

‘In parts of the country where there are not high rates of psychosis, I know GPs say they would like an enhanced service for people with anxiety and depression, medically unexplained symptoms.’

She added that the Government’s pledge to offer patients a choice of provider for treatment of mental illness was a key step towards better standards of mental health care.

Speaking at a King’s Fund event on improving mental health, Dr Strathdee said: ‘Choice in mental health will come in soon, and what we’re asking every mental health team in the country, whether you’re in primary or specialist care to [post on their website] the name of the team, who the service is for, what assessments are offered, what effective treatments and what patients say about your service, what evaluation you have done, whether you have the [Provider of Mental Health] kitemark.’

Dr Strathdee added: ‘One of the things that will drive change most is transparency. I believe that if we give people this choice it will drive standards right up.’

Dr Strathdee also said she supported moves to introduce extended GP training, to provide a better grounding in mental health: ‘I would like to see the fourth year of GP training, dedicated to mental health – in the sense of what is encountered in primary care depression, anxiety medically unexplained symptoms, alcohol misuse, eating disorders, perinatal symptoms – all the things that actually come in the GP’s door.’

Readers' comments (7)

  • Vinci Ho

    We need more psychiatrists , CPNs and talking therapists to actually base in community in the neighbourhoods of GPs as well as more GPs with special interest or special skills.
    We need genuine investment and this is for the future. No rocket science. Questions goes back to those up in the hierarchy ....

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  • Actually we need psychiatrists to have access to weighing scales, phlebotomist and blood test results and cpn, social workers to help pts to attend appts and blood test .

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  • Bob Hodges

    Not enough GPs to do this AND General Practice.

    Otherwise it's a sound principle.

    Fix the leaky GP bucket!

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  • We have a mental health nurse consultant working alongside GPs employed by the practice and doing the MH work of a GP. He helps meet unmet need and reduces demand on GPs. You can see more here:

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  • The problem is and probably always will be, that GP's reach for the prescription pad to quickly ,the lack of CBT services means they have no where to turn or 6 months waiting times ,hopefully with new providers offering NICE recommended therapies within 3 days this will change .

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  • Sadly, all mental health patients get from a psychiatrist is a script for yet another load of drugs and many patients feel they get better time / care via the GP.

    Mental health care needs a revolution and a new approach to treatment, for that reason, GP's do provide better care abut appreciate it is real drain on GP's time.

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  • I agree with Simon Bradley's comment above. If mental health patients had access to a specialist mental health nurse at their local surgery, crisis situations could be avoided, thus effectively helping the patient and reducing the referral rate to the community mental health team.

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