4th Report - Community Mental Health Services

The government accepts, committing to embedding the voice of people with lived experience in person-centred care delivery. They highlight community-based mental health centres as an example where experts by experience co-produce models to ensure high-quality, timely care, not just at crisis points.

The government rejected the recommendation for specific actions to ensure continuity of care, stating they are already implementing the community mental health framework through early implementor sites and monitoring service performance, with further assessment planned for the MSF on SMI.

The government partially accepts, launching 6 national pilots of community-based mental health centres with £473 million capital funding. These pilots aim to provide integrated, person-centred care, with an evaluation due in 2026 to inform future models.

The government partially accepts, stating that future expansion of community mental health centres will be informed by pilot learning and tailored to local needs. However, there are no current plans to extend the pilot phase beyond 12 months, pending an independent evaluation.

The government partially accepts the recommendation but then discusses a plan for scaling up community-based mental health centres following evaluation of pilots, which is unrelated to the committee's conclusion on the value of co-production and peer support.

The government accepts the recommendation but defers concrete action, stating that development of the Mental Service Specification for SMI is underway. Timelines will be confirmed in due course, incorporating findings from a review and community mental health centre evaluation due in summer 2026.

The government accepts the recommendation, committing to develop the Modern Service Framework (MSF) for SMI through genuine co-production with lived experience experts and engaging relevant sectors. However, it shifts focus from the Community Mental Health Framework's implementation gaps and the need for evaluation, to the development of the MSF.

The government states it accepts the recommendation, but its response describes NHS England publishing new guidance on a 'personalised care framework' and the role of a 'named worker' within multidisciplinary teams. It does not address the specific recommendation to commission an independent and comprehensive evaluation of the Community Mental Health Framework's implementation and impact.

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.

The government states it partially accepts, but its response discusses improving access and waiting time standards for mental health services generally, and eliminating long waits for children and young people's community services by 2026-27. It does not address the specific recommendation for a 24/7 Neighbourhood Mental Health Centre in every community.

The government partially accepts the recommendation but then responds by discussing physical health outcomes for people with SMI and annual physical health checks, completely failing to address the call for extending the 24/7 Neighbourhood Mental Health Centre pilot programme or finalising its evaluation metrics.

The government accepts the recommendation but then details its commitment to reforming the Better Care Fund, including changes for the 2026-27 financial year, without addressing the specific request for a roadmap and timeframe for the national scale-up of the pilot programme.

The government explicitly states it does not accept the recommendation. However, its reasoning discusses the voluntary nature and governance of Section 75 arrangements, which is entirely unrelated to the committee's request for a deadline for the Modern Service Framework's publication.

The government states it accepts the recommendation, but its response focuses on supporting Integrated Care Boards with multi-year commissioning arrangements and a strategic commissioning development programme in 2026-27 to strengthen partnerships with VCFSE organisations. It does not address how people with lived experience will be involved in MSF development, how the MSF will integrate with wider systems, or how it will incorporate learnings from Neighbourhood Mental Health Centre pilots.

The government partially accepts the recommendation, acknowledging the value of alliance models and promoting the inclusion of VCFSE organisations in integrated care systems to strengthen collaboration and co-production. It does not, however, commit to specific actions regarding sustained investment or directly addressing the broader fragmentation of Community Mental Health Services.

The government accepts the recommendation and states that NHS England is working with pilot sites, and insights from these pilots will be collated to inform future guidance on neighbourhood-based models of care.

The government partially accepts, committing service development funding for 2026-2029 to support growth in specific services like IPS, NHS Talking Therapies, and MHSTs. It requires ICBs to meet the Mental Health Investment Standard but does not provide a clear, actionable plan for a comprehensive 0-25 year old offer or addressing the transition 'cliff edge'.

The government partially accepts, committing to requiring ICBs to meet the Mental Health Investment Standard and publishing a new Mental Service Specification for SMI to ensure clinical consistency. However, they will not make further legislative changes regarding mental health spending and do not commit to publishing national access and waiting time standards.

The government partially accepts the recommendation but then responds by discussing staff retention, workforce pressures, and the 10 Year Workforce Plan, which are unrelated to the recommendation to reinstate physical health check targets for people with SMI or include physical health outcomes in the Modern Service Framework.

The government partially accepts the recommendation but then responds by outlining its commitment to publishing a 10 Year Workforce Plan, which is completely irrelevant to the committee's call for reviewing and reforming the Better Care Fund and its funding cycles.

The government partially accepts the recommendation but then responds by discussing the vital role of mental health social workers and how the 10 Year Workforce Plan and upcoming MSF will address workforce planning and clinical standards, completely ignoring the recommendation to expand Section 75 arrangements for budget pooling and integrated service delivery.

The government states it accepts the recommendation but then discusses general accountability, new operating models, and patient feedback mechanisms for mental health services, without addressing the specific call for VCFSE organisations to be treated as equal partners with equitable funding and co-production from the outset.

The government accepts the recommendation, acknowledging the importance of multi-year contracts for VCFSE organisations and noting the NHS medium-term planning framework facilitates this. A strategic commissioning development programme will provide practical support to ICBs during 2026-2027 to strengthen commissioning skills.

The government partially accepts the recommendation, acknowledging the value of alliance models and stating NHS England is promoting partnership working for VCFSE inclusion. Future guidance will continue to emphasize co-production and the role of community assets in delivering mental health services.

The government accepts the recommendation, stating NHS England is working with pilot sites to identify digital interoperability barriers and share learning. Insights from these pilots will be collated to inform future guidance and support the implementation of neighbourhood-based models of care if scaled up.

The government partially accepts, committing to require ICBs to protect mental health spending in real terms for financial years 2026-2029 via the Mental Health Investment Standard. However, it declines to make further legislative changes regarding mental health spending at this time, citing existing provisions for annual statements.

The government partially accepts the recommendation, stating NHS England already monitors relevant impacts through published data and ICBs meet the Mental Health Investment Standard. Additionally, service development funding has been secured for 2026-2029 to support growth in key mental health services.

The government partially accepts the recommendation, committing to retain the Mental Health Investment Standard by requiring ICBs to protect mental health spending in real terms for financial years 2026-2029. However, it explicitly states it will not legislate to make the Standard a statutory requirement at this time.

The government partially accepts this recommendation, acknowledging challenges like burnout and limited progression and stating the forthcoming 10 Year Workforce Plan will address these issues by improving staff treatment, training, and roles. However, it does not set out specific measures as requested.

The government partially accepts, stating it is committed to publishing a 10 Year Workforce Plan to ensure the NHS has the right people and skills for transformed services. The plan will address workforce sustainability and articulate changes for different professional groups but does not detail how it will ensure specific alignment, integration, or inclusion of all partners.

The government partially accepts, acknowledging the vital role of mental health social workers and stating they will be recognised in the 10 Year Workforce Plan. However, it does not commit to specific projections for workforce increases or ensuring every person with SMI has a named mental health social worker.

The government accepts the recommendation, outlining that its new approach to mental health will strengthen accountability with clearer standards and transparency. It confirms the Patient and Carer Race Equality Framework is now a contractual requirement, with NHS England supporting its full implementation, and promises further proposals for system-wide accountability.