HSJ Live: Mental health trusts with the biggest income cuts revealed

5.10pm The Guardian reports that dozens of people have lost some of their sight after undergoing operations provided by a private healthcare firm at an NHS hospital.

Musgrove Park Hospital, part of Taunton and Somerset Foundation Trust, is facing a string of claims for compensation after half the 60 patients who underwent the procedure suffered complications.

The hospital’s contract with Vanguard Healthcare was terminated only four days into the programme after 30 patients, most elderly and some frail, reported a range of complications, including blurred vision, pain and swelling.

3.00pm The Royal College of Nursing has commented on our mental health investigation. Chief executive and general secretary Peter Carter said:

“The history of mental health care is that it has always been the poor relation of physical health care. These figures suggest that matters have taken an abrupt turn for the worse, at the very time when demand is increasing. After years of difficult economic circumstances, many people are feeling the strain and all parts of the mental health system have to deal with that, from GP services to community and inpatient services.

“We know that nursing staff are working flat out under sometimes intolerable pressure. They have done so for some time. Our concern is that they may now be so stretched that they are unable to meet the most essential needs of vulnerable people. With a number of employers saying that they have cut staffing levels by more than ten per cent, there is a large and widening gulf between the services needed and what is available on the ground. We will be publishing the results of our own investigation into this over the coming months.

“A lot of good work has been done in recent years to understand mental health better and to encourage people to seek help when it is needed. If the NHS does not accept that it needs skilled mental health nurses to deliver that help, then we could squander every advance that has been made. Of course, there are many demands in the NHS and public services more widely, but as a society the cost could be very high if we fail to invest in mental health.”

2.46pm A trust’s success or failure is about more than just its leadership, Richard Bourne of the Socialist Health Association argues in an opinion piece.

He says there are many factors that play into a trust’s performance, including leadership, finance, staff engagement and strategy, and the wider care system has just as much to do with it as the organisation’s leadership does.

2.27pm The chief executive of a trust recommended for special measures is to retire at the end of the year due to ill health.

Stuart Bain, who has held the top job at East Kent Hospitals University Foundation Trust since August 2007, was diagnosed with lymphoma last year, the trust said in a statement.

The trust’s finance and performance director, Jeff Buggle, is also leaving to become the new finance director of Barking, Havering and Redbridge University Hospitals Trust.

1.11pm GP practices that persistently provide inadequate services will face closure if they fail to improve within a year, the Care Quality Commission has announced.

The CQC today unveiled its special measures regime for general practice, which will be introduced in October, at the same time as its new style inspection process and ratings of individual practices will begin.

You can learn more about the CQC’s plans here.

12.01pm NHS England have also commented on our mental health story.

Director for long term conditions, Martin McShane, said: “Delivering parity of esteem for mental health patients was never a one-year plan and is a five year ambition that is about much more than just the NHS.

“In eighteen months we have taken action to deliver parity including creating choice, better physical health care for people with serious mental illness, better crisis care, better information and, with Monitor are consulting on new payment systems. We are also delivering improvements in psychological care that are gathering international attention because we are measuring outcomes systematically – a world first.”

11.49am Labour have released a statement in relation to HSJ’s mental health research. Shadow minister for public health Luciana Berger said:

“This appalling picture shows just how badly the government is failing on mental health.

“On David Cameron’s watch, mental health services have been squeezed with the number of specialist mental health doctors and nurses falling while more vulnerable patients are having to travel hundreds of miles to get a bed.

“It is the government’s responsibility to ensure the right services are in place for some of the most vulnerable people in our communities, but the system is failing people with mental illness. Rather than watching from the sidelines, ministers must urgently get to grips with this crisis in our mental health services.”

11.18am The Department of Health has commented on our mental health investigation. A spokesperson for the DH said:

“We have gone further than ever before to put mental health on a par with physical health and have instructed the NHS to make sure every community does the same. The recent tariff shows encouraging progress towards a payment system for mental health that rewards great results for patients and we will continue to hold the NHS to account on this issue. The CQC is now inspecting mental health services against new, tougher care standards to ensure patients are being given the level of care we expect and that they deserve.”

10.45am The mental health charity Mind have commented on our research. Policy and campaigns manager Geoff Heyes said:

“Mental health services are facing a crisis. Although the Government has committed to ensuring that mental health services are given equal priority to physical health services, we are still nowhere near seeing this on the ground. At a time when we need to see funding for mental health trusts increase, a cut of 2.3 per cent in real terms is unacceptable. There is absolutely no room for belt-tightening in mental health services, not least because they have always been chronically underfunded and seen as an easy target for cuts. But right now demand is rising right across the system, from talking therapies to crisis care, and services are creaking under the pressure.

“Clinical commissioning groups need immediately to review the state of their local mental health services and do everything in their power to ensure the resources are there to help people at their most unwell. They must prioritise mental health services, both to ensure parity of esteem with services for physical health problems and to safeguard existing services. Mind are calling on the next government to commit to increasing the overall NHS mental health budget by a minimum of 10 per cent in real terms over five years.”

10.34am Mark Winstanley, chief executive of the charity Rethink Mental Illness, has also commented on our findings:

“This data is yet more evidence that our mental health system is at breaking point. How many more warning signs does the Government need before they take real action?

“Mental health accounts for 23 per cent of the disease burden but gets just 11 per cent of the NHS budget and until we address this fundamental inequality, people with mental illness will continue to suffer. If the political will was there, the money could be found.

“We agree with NHS England that parity of esteem is about more than just the NHS, but it would be a good place to start. The actions they point to as evidence for delivering parity are basic things that should have been sorted out years ago. They help to bring mental health care up to a basic level, but in no way do they bring mental health in line with the rest of the NHS.

“We know what the problems are and we also know what works. This is not complicated and could be rectified if the government and the NHS made it a priority.”

10.25am Stephen Dalton, chief executive of the Mental Health Network has commented on our mental health exclusive. Mr Dalton said:

“We welcome this in-depth analysis of mental health funding from the HSJ. It confirms what our members, and people using services, already sadly know too well - that despite the rhetoric, mental health services have been subject to real terms cuts for the past three years. This is a worrying picture which highlights the urgent need for political leaders and NHS England to stop talking about parity of esteem and get on with addressing the funding deficit resulting from year on year cuts. Service users don’t need more initiatives and plans from government, they need properly funded services that they can get access to when they need it. No one who works in or uses mental health services will be surprised by these findings. In some parts of the country we are at a tipping point.”

9.52am: Responding to the mental health findings, Foundation Trust Network head of policy Miriam Deakin said: “This comprehensive analysis is another reminder that parity between services for mental health and physical health is critical. As the FTN has been advocating for some time, this means moving at pace beyond the rhetoric to delivering parity of esteem in funding, payment systems and profile.

“As the research highlights, the stark reality is that NHS spending on mental health has been reduced in real terms in recent years and services are coming under increasing pressure.

“Our members tell us that early intervention is vital to support people with mental health issues and improve outcomes. The disparity in services is at a tipping point and we look forward to working with the national bodies to address mental health funding, commissioning and training with the same urgency as physical health.”

9.45am: The findings of our mental health investigation have been covered by the Independent under the headline Cuts leave NHS mental health services ‘dangerously close to collapse’. The work has also be covered in other media.

9.37am: Good morning. Today on hsj.co.uk exclusive analysis reveals the extent of funding cuts to mental health trusts between 2011-12 and 2013-14.

Our data shows more than half of the providers saw a real terms funding decrease and wide variation between trusts – with some seeing double digit reductions – due to a combination of commissioners cutting investment, and services being transferred to alternative providers.