9 Accepted in Part

Fragmented mental health system requires sustained investment and cultural shift for transformative community care.

Recommendation
Delivering real change and achieving parity of esteem in mental health care requires dismantling the current fragmented system and reimagining service design and delivery. The 24/7 Neighbourhood Mental Health Centre 75 pilots seem to be genuinely transformative. The experience from Trieste, and early evidence from Barnsley Street, show that radically different, individualised, community-based care gets results. We also heard that the model shows possible cost savings for the wider system. Realising large- scale reform will depend on sustained and ringfenced investment to enable stretched Integrated Care Boards to take the action needed. This must be matched by a profound cultural shift across the system from clinicians to commissioners to government. (Conclusion, Paragraph 91)
Government Response Summary
The government partially accepts, focusing its response on improving the transition from children and young people’s mental health services to adult services for 0-25 year olds. It commits to strengthening continuity of care and eliminating rigid age-based thresholds with a new developmental service specification, but does not explicitly address sustained, ringfenced investment or a broader cultural shift for large-scale reform.
Government Response
Accepted in Part
HM Government Accepted in Part
The government partially accepts this recommendation. We acknowledge that the transition from children and young people’s mental health services to adult mental health services is often complex and can be challenging for some young people. More young people are being supported to access NHS mental health services - in the first 12 months of this government, nearly 40,000 more children and young people received support compared to the previous 12 months. This is helped by over 7,000 extra mental health workers being recruited since July 2024, against our target of 8,500 by the end of this Parliament. The government is committed to: • strengthening continuity of care • eliminating rigid age-based thresholds • enhancing support during transitional stages • ensuring seamless, person-centred pathways for young people Work is underway to improve integration of mental health and wider support for children and young people across the age range (0 to 25) and the range of needs. As part of this, the government has provided £8 million of top up funding to 24 early support hubs the 2025 to 2026 financial year so that they can expand their current offer and pilot innovative models of holistic support for children and young people aged between 11 to 25. An ongoing evaluation of the projects has found that children and young people value hubs' non-clinical, informal, personalised approach to care, but some felt it was less suited to those with more complex needs. The full evaluation is due to report in summer 2026. Learning from the early support hubs is informing the approach to the flagship young futures hubs which will provide education, wellbeing and mental health support in the community. NHS England are also leading the roll out and development of neighbourhood MDTs for children and young people. The MDTs will provide integrated care that provides timely access to specialist advice, including paediatric and mental health expertise, through primary care-led team working. This will deliver care closer to home and improve the outcomes and experience for children and young people, as well as their families and carers. We are accelerating the rollout of MHSTs in schools and colleges to reach full national coverage by 2029. We will boost the capability and capacity of staff so that they can offer more effective support to young people with complex needs, such as trauma, neurodivergence and disordered eating. This investment in children’s mental health will improve outcomes and experiences for young people, including those transitioning between child and adult services. In addition, we expect to develop bespoke guidance in the revised Mental Health Act Code of Practice on the care and treatment of patients who are under 18. This will account for the specific needs and vulnerabilities of this cohort and will cover the critical issue of transition to adult services. The new developmental service specification for children and young people’s intensive mental health services will no longer require the provider to routinely transfer or discharge a young person at their 18th birthday. This decision will be based upon the view of the clinical team, and if they believe that the young person is receiving appropriate therapeutic care which would be disrupted by a transition to other services, then until that period of care is completed and the appropriate arrangements are in place they can remain in children and young people’s services. The developmental service specification is currently being tested using existing resources, with the aim of learning from this phase before full publication and onward implementation.
Addressee Bodies
Department of Health and Social Care
Timeline
Recommendation age 0.7 yr
Report published 02 Dec 2025