Read Jack Serle's latest HSJi Review, which discusses resisting mounting mental health pressures.

Mental health services are at a critical juncture. Around 90,000 people in England have been waiting at least three years for a first appointment with a mental health professional, out of a total waiting list of 1 million.

Meanwhile, both adult and Child and Adolescent Mental Health Services units are struggling to admit patients promptly, exacerbating crises in emergency departments and community settings. Read the full article here.

Latest investigations

NHS Scotland in the election year

As the Scottish Parliament election approaches, health boards have been instructed to reduce long elective waits. Insourcing to reduce orthopaedic, imaging and cataract waiting lists given extra funding. The role of community pharmacies is being expanded, while the Hospital at Home programme is set to quadruple its capacity within two years. A new health and care app is also on track for a limited launch. In line with a tougher stance on financial management, government loans will no longer be available to health boards. A new national business services IT platform is currently being procured. There is a significant increase in use of advice and guidance services and patient-initiated follow-up pathways planned. Additionally, efforts are underway to reduce variation in care by standardising clinical practices and centralising specialist services in fewer centres.

South London and Maudsley Foundation Trust

South London and Maudsley Foundation Trust is considering changing both its pathology and soft facilities management suppliers. Contractual disputes are delaying service reconfiguration efforts. It is also expanding its presence in the Middle East, while also partnering with a venture capital fund to back startups which offer mental health services. A mental health urgent care centre is planned for 2026–27. The trust is trialling a social intervention model designed to reduce hospital admissions. It is planning a block purchase of private beds. An increase in observations of more acute inpatients has contributed to a rise in bank costs.

Northamptonshire Healthcare Foundation Trust

Northamptonshire Healthcare Foundation Trust is facing long waits in musculoskeletal (MSK) and dietetics services. Children are waiting two to three years for access to mental health care. Widespread staffing shortages continue to pose a significant challenge. To help manage demand and waiting times, various apps are being used. Community services have successfully reduced the need for CYP mental health beds; however, adult mental health wards have extremely high occupancy. The intermediate care team has proven effective in reducing demand on acute hospital services. A group has been formed with Leicestershire Partnership Trust. There are plans to break even by 2025–26 but the organisation faces a steep efficiency target. NHFT aims to persuade bank staff to move into vacant substantive posts by offering enhanced training opportunities and streamlined onboarding. It has also paused all recruitment of administrative staff.

Data points

Last week the following data points were updated:

• E-COLI HOSPITAL-ONSET CASES (12-MONTH ENGLAND AVERAGE), E-COLI HOSPITAL-ONSET CASES (12-MONTH REGIONAL AVERAGE), E-COLI HOSPITAL-ONSET CASES (12-MONTH ROLLING COUNT), MRSA hospital-onset cases (12-month rolling count) and C-Diff hospital-onset cases (12-month rolling count) of Acute for April
• A&E waiting target, Beds occupied by delayed discharges and Length of delayed discharges of Scotland for May
• Staff absent (%), Number of medical staff, Nursing, midwifery and health visiting staff, Health care assistants and other support staff, Scientific, therapeutic and technical staff and Admin and estates staff of Wales for Q3 2024-25