The must-read stories and debate in health policy and leadership.

Only a small number of integrated care systems have managed to implement a key – and resource heavy – expansion of mental health crisis support, according to NHS England documents seen by HSJ.

In the long-term plan the NHS detailed ambitious proposals to roll out an enhanced crisis care model via 111 in all systems by 2023-24.

However, the first service launched in 2016 in Cambridgeshire and Peterborough and only six of 42 ICSs have followed so far, the latest adopting in April 2022. Systems must be able to facilitate urgent, face-to-face treatment 24/7 and ensure telephone triage is supervised by experienced registered mental health staff, among other criteria.

It is a significant task and works towards an ambition to become one of the first countries in the world to offer such a service.

News on progress of this key expansion comes as existing 24/7 crisis helplines, run by individual trusts and scaled up during covid ahead of schedule, are experiencing national problems.

Healthwatch England told HSJ services are having to “pick and choose” who they help because of high demand, which in effect led to “service rationing”. HSJ understands that when fully rolled out, 111 could help address existing unmet need.

Jenrick’s cutting words on capital

Given that health and social care secretary Therese Coffey will split her time between health and the role of deputy prime minister, it is expected that new health minister Robert Jenrick will play a significant role in government – and so his declarations at the Conservative Party conference were of particular interest yesterday.

At a fringe session organised by think-tank Policy Exchange, he said that cutting the NHS’s capital budgets would be ‘deeply short-term’ and undermine the government’s ability to put the service on “a sustainable footing for the future”.

His comments followed speculation that capital spending plans in particular may be cut. 

He said: “It would be deeply short-termist were we to meet our day to day pressures by cannibalising funding [set aside for capital projects]. I would certainly make that case as strongly as I possibly can.”

Also on hsj.co.uk today

With soaring inflation, the pound dropping like a stone, tax cuts and increased borrowing, what does the latest economic turmoil mean for the NHS – and how is the media interpreting it, asks this week’s news round-up The Primer. And in his expert briefing West Country Chronicle, Nick Carding asks what progress has been made on a peninsula-wide electronic patient record.