The state of care in mental health services 2014 to 2017

Published: 20 July 2017 Page last updated: 12 May 2022

The state of care in mental health services 2014 to 2017 presents findings from our programme of comprehensive inspections of specialist mental health services.

The state of care in mental health services 2014 to 2017 cover image

The report combines evidence from our inspections and findings from our role monitoring use of the the Mental Health Act, as well as analysis of data from other sources. This rich resource of information means we now know more about the quality of mental health care than ever before.

What we did

We have completed comprehensive inspections of all specialist mental health services in England.

As at 31 May 2017, we had rated 54 NHS trusts and 218 independent NHS services.

What we found

68% of core services provided by NHS trusts were found to be good, with 6% rated as outstanding. Among independent services, 76% were rated as good or outstanding (72% good and 4% outstanding).

Some services performed particularly well, especially community services for people with a learning disability or autism and community services for older people.

In addition, services that needed to improve have made real progress when they have taken on board our findings and committed to tackle problems proactively and learn from others.

However, there are a substantial minority of NHS trust and independent services that need to improve the quality of care they provide. Thirty-nine per cent of NHS trusts were rated as requires improvement as at 31 May 2017, as did 23% of independent services. And a very small number were rated as inadequate: one NHS trust and three independent services.

The report identifies several areas of concern:

  • Concerns about ‘locked rehabilitation wards’
  • Great variation between wards in how frequently staff use restrictive practices and physical restraint to deescalate challenging behaviour
  • The impact of staffing shortages
  • Poor quality clinical information systems
  • Commissioning of crisis care services