This meeting of the Health and Adult Social Care Scrutiny Panel was scheduled to receive a report on the proportion of NHS spending on mental health, and to note future work items for the Panel.

NHS South East London Integrated Care Board (ICB) Financial Decisions on Mental Health

This item was scheduled to provide an update to the Panel about the proportion of NHS spending on mental health. The report included as background information a response to a question asked at the meeting of the Panel on 7 November 2024 and the Integrated Care Board’s (ICB) response. The question related to a perceived decline in the proportion of NHS spending in South East London on mental health, as reported in the NHS South East London Integrated Care Board Annual Report and Accounts 2023-24:

On page 85 of the SEL ICB annual report (NHS-SEL-ICB-Annual-report-and-accounts-23_24.pdf (selondonics.org)) it says that the proportion of money spent on mental health has declined (screenshot below). My suggestion is that the scrutiny panel should have an opportunity to ask the NHS why they decided to reduce the proportion of funding going to mental health, and what process they followed in doing this. What process does NHS budgeting follow and is there an opportunity for the public to comment? It appears that everyone says mental health is a priority, but spending as a proportion of the whole NHS budget is falling, as it has in previous years. The response from the ICB explained that although the proportion of spending on mental health had fallen, this was because of a new transfer of responsibilities for dental, ophthalmology and pharmacy from NHS England to the ICB: The annual report also explains the following in terms of the requirement for SEL ICB to deliver the Mental Health Investment Standard: The Mental Health Investment Standard (MHIS) for 2022/23 was achieved by SEL ICB and this has been confirmed by independent review. For 2023/24 the ICB is demonstrating achievement of the MHIS with an increase in spend over 2022/23 of 9.43% compared to the target increase of 9.22%. The proportion of mental health spend has shown a slight decrease as a percentage of the overall programme allocation because this has increased by 11.89% since 2022/23. However, this is distorted by a new transfer of responsibilities unrelated to mental health. The table below sets out the increase in the programme allocation between 2022/23 and 2023/24, where £202,200k of the increase is for the delegation of budgets for dental, ophthalmology and pharmacy from NHSE to the SEL ICB. Without this significant transfer of responsibility, the year-on-year budgetary increase would have been 6.38%. This transfer is unconnected to SEL ICB’s requirement to increase spend in mental health by at least the rate of allocation growth under the MHIS. Mental health for both adults and children are strategic priorities for SEL ICS and we continue to invest in these services in line with both national and local expectations. The report explained how the ICB allocates its funding, and in particular how it makes decisions about the proportion of the mental health budget. The report noted that the ICB was in the process of refreshing its Medium Term Financial Strategy (MTFS).¹

Commissioning of Future Reports

This item on the agenda was scheduled to ask the Panel to note that the next meeting, scheduled for 20 March 2025, would receive reports on the following topics:

• Addiction Strategy
• Approach to Prevention include cancer screening
• Maternal Mortality The meeting was also scheduled to consider the scope of these reports to make sure that councillors' questions are answered fully.