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57 CCGs underspend mental health budgets despite overall increase

57 CCGs underspend mental health budgets despite overall increase

More than a quarter of CCGs have underspent their mental health budget for 2016/17, amounting to a total of £48.6m not reaching mental health services.
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More than a quarter of CCGs have underspent their mental health budget for 2016/17, amounting to a total of £48.6m not reaching mental health services.

A comparison by Healthcare Leader of every CCGs’ projected and actual spend on mental health, as it’s laid out in NHS England’s ‘mental health dashboard’, revealed that 57 CCGs had underspent on their mental health budget to a total of £48.6m.

Despite the underspend at a CCG level, NHS England overall exceeded its mental health budget, spending £9.72bn on a budget of £9.49bn.

This is largely due to CCGs like Nottingham City and South Devon and Torbay, which spent an extra £14.6m and £16m on their budget respectively.

NHS England stressed to Healthcare Leader that it had overspent on its mental health budget overall. However, its comment did not address that 57 CCGs had underspent on their 2016/17 mental health budgets.

An NHS England spokesperson said: “It’s ridiculous and entirely incorrect to suggest mental health spending is under budget when we have quite clearly spent more on mental health as a percentage, and in absolute terms, and overspent by £230m on what has been budgeted by for the whole of the country.

'We are proud once again to have met our commitment to increase mental health funding, with 85% of all CCGs meeting or exceeding the publicly recognised and respected Mental Health Investment Standard.”

CCG reduction in spending

But, elsewhere, NHS Great Yarmouth and Waveney CCG underspent its mental health budget by £3.9m with a planned spend of £51.5m but an actual spend of £47.6m.

Rebecca Hulme, chief nurse at NHS Great Yarmouth and Waveney CCG, told Healthcare Leader the underspend occured because of a reduction in the amount that the CCG spent on the NHS's continuing healthcare scheme.

The NHS Continuing Healthcare (CHC) scheme provides eligible patients with free care in their home after they leave hospital.

Other funding may 'meet needs more effectively'

Ms Hume said some patients left the CHC scheme to access other pots of funding 'which meet their needs more effectively, such as personal health budgets or social care funding'.

She said: 'We regularly review all patients who receive CHC in line with national guidance. It is not possible to know in advance who will still be eligible and who will not, which is why the amount we estimate we will spend at the start of each year when we put together our budget can sometimes change.'

NHS Isle of Wight CCG’s underspend amounted to £3.7m but a breakdown of the money provided to Healthcare Leader by the CCG said their was an error in the CCG’s 2016/17 financial plan, ‘where £2.8m of expenditure was added twice’.

A statement from the CCG said: ‘NHS England were made aware of this at the Month 3 (June ’16) reporting period.

The underspend comes as it was previously revealed that CCGs in South Sefton, Scarborough, Isle of Wight, St Helens and Walsall are collectively spending £4.5m less in 2017/18 than they spent on services in 2016/17.

Mental health dashboard

The ‘mental health dashboard’ released every quarter by NHS England, details how much commissioners are spending on various aspects of mental health, including young people’s mental health and suicide prevention.

The latest fourth-quarter dashboard includes the final amount CCGs spent on mental health in 2016/17.

Healthcare Leader compared these figures with the CCGs’ projected mental health spend found in the third-quarter dashboard released at the end of May and found the underspend.

Despite the underspend at a CCG level, NHS England overall exceeded its mental health budget, spending £9.72bn on a budget of £9.49bn.

This is largely due to CCGs like Nottingham City and South Devon and Torbay, which spent an extra £14.6m and £16m on their budget respectively.

NHS England was forced to retract the mental health dashboard that was released in July after they said they ‘spotted an error within the financial outturn data’.

'Disappointing'

However, the dashboard re-released yesterday (12 August) by chief executive Simon Stevens at NHS England’s Health and Care Innovation Expo includes the same figures.

Dr Richard Vautrey, chair of the BMA’s GP committee, said the spending data was ‘disappointing’.

He told Healthcare Leader: ‘This is yet another sign of CCGs not really using the resources that they’ve got and prioritising community based services when we need every single penny spent and invested in general practice and community services.

‘It’s really disappointing that CCGs are not doing that and still preferentially investing in hospitals, rather than investing in the community.’

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