Last set of NHS star ratings show progress still to be made in mental healthcare

Posted Wednesday 27 July 2005

Only 25 per cent of mental health trusts achieved top three star rating

Mental health charity Mind today responded as the Healthcare Commission published the last set of annual star ratings of performance for NHS trusts in England before the new system of assessment is introduced. 

While noting that the number of mental health trusts achieving two or three star status has increased, Mind is concerned that only a quarter of mental health trusts received the top rating. The charity also wants to ensure that the five mental health trusts achieving no stars, indicating the poorest levels of measured performance or little progress in implementing clinical governance, are given appropriate support and resources to improve quickly.

The star ratings system has long been criticised both within the NHS and by organisations such as Mind. The ratings have been described as simplistic, and Mind is concerned that standards are changed year on year making accurate comparison or assessment of progress impossible.  One such area for concern is the implementation of 24-hour access to crisis resolution teams across England. 

Despite overwhelming evidence that support from such teams is of huge benefit to those in crisis, standards for implementation have shifted to accommodate the slow development of these services in some areas. This allows mental health trusts to claim that they are providing crisis resolution teams - however, these may not be available 24 hours a day, seven days a week. It is clear that targets were set too high with inadequate resources, and shifting the goalposts has enabled boxes to be ticked even in cases where a full service is not being provided (1).

Mind is looking to the new assessment system, called 'The Annual Healthcheck', to address issues of consistency in the standards by which NHS performance is rated. Mind is also very keen to see a greater input for all those using NHS services in assessing the quality of their healthcare. 

Richard Brook, Chief Executive of Mind, said:
"That only a quarter of mental health trusts have today achieved the top star rating is surely a matter of grave concern. But we have long been aware of problems with the rating system - from talking to our service users we know that the treatment experienced by an individual can vary greatly from supposed achieved standards. The NHS needs a robust and transparent assessment programme, and I hope that 'The Annual Healthcheck' will provide this."

Notes to editors:

(1) See Healthcare Commission document 'Performance indicators for the performance ratings 2004/2005: Key targets and performance indicators for mental health trusts and providers of mental health services', page 4 (Crisis Resolution Team Implementation, updated December 2004).

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