GP mental health training can cut NHS costs

Plans to extend GP mental health training are key to tackling the 'escalating' economic burden of comorbid depression and anxiety in people with long-term conditions, England's mental health czar has said.

Mental health: improved GP training part of 25-point plan
Mental health: improved GP training part of 25-point plan

Dr Geraldine Strathdee, national clinical director for mental health at NHS England, said too few GPs and practice nurses received basic core mental health training.

She also called for QOF targets in mental health care to be better aligned with secondary care work.

It comes as the government announced new plans to bring mental health ‘out of the shadows’, setting out 25 areas on which the NHS must improve over the next two years. The plans back RCGP proposals to enhance GP training on mental health.

Speaking at a Westminster Health Forum event on NICE in London last week, before the government’s announcement on mental health, Dr Strathdee said England already spends ‘literally hundreds of billions of pounds every year treating the consequences of not treating mental health conditions’.

Around 40% of people with diabetes, cancer or stroke also experience depression or anxiety, and the costs of treating this comorbid depression are ‘escalating’, she said.

‘If that’s not identified, and it’s not picked up and treated, you will definitely die significantly earlier, and if you do live, you’ll have significantly more disability.'

Around 80% of all mental health treatment takes place in primary care and yet, she said, ‘less than a third of GPs get given the access they need… to core basic training, let alone postgraduate training’.

‘I think we can do a huge amount in saving society a lot of money, and an enormous amount of human distress, if we just got our workforce a little more skilled up.’

Dr Strathdee added that more must be done to align primary and secondary care incentives in mental health. ‘To expect busy GPs to know all the guidelines and implement them, and then give secondary care a completely different incentive system, is just plain silly.'

Hospital targets should be lined up with the QOF, she said. She accepted that QOF mental health indicators had not given ‘the breadth of what people needed’ in mental health care, and called for more mental health directed enhanced services (DES) and local enhanced services (LES) for a ‘more sustainable commissioning system for people with complex co-morbidities’.

Also speaking at the event, Wiltshire GP Dr Gavin Jamie said that the ‘tick-box’ drive to ‘quantify’ mental health was unhelpful for primary care.

Describing the current indicators as ‘vague’, Dr Jamie also called for an approach focused on professional development, rather than QOF targets, to improve mental health care. He said that NICE should put its trust in the professionalism of healthcare professionals, saying it should ‘look at trying to educate and communicate its guidelines more effectively’.

The RCGP recently said GPs should receive more training in child and mental health.

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