Community Mental Health Services

Layla Moran Excerpts

Thursday 19th March 2026 Commons Chamber

[Layla Moran (Oxford West and Abingdon) (LD)]

On behalf of the Health and Social Care Committee, it is a pleasure to present to the House our report on the subject of community mental health services. I thank the Backbench Business Committee for allocating time for this statement.

Mental health services are failing too many people. As MPs, we hear heartbreaking stories from our constituents every day: individuals who struggle to navigate a complex, poorly resourced system; clinicians frustrated that they cannot provide the level of care they would like to; or, worst of all, families who have tragically lost loved ones, knowing that they could have been saved if care had been more responsive. This area is also personal to me, as my partner, Rosy, lives with bipolar, and I have seen at first hand the good, the bad and the downright absent of the mental healthcare system.

The inquiry looked under the bonnet of community care, especially for those with severe mental illness. We received a wealth of evidence but the most compelling came from those who we call “experts by experience”, such as Chris Frederick, who said:

“Despite some of the referrals, recommendations and lots of content on social media—‘You should try these different techniques’—you really are on your own. There is nobody there to support you.”

Powerful stories like this drove our 22 recommendations to improve community mental health provision, but today I only have time to highlight just a few.

First, we need proper, integrated mental health care in the community. There is an NHS England pilot programme for six 24/7 neighbourhood mental health centres, and we saw at first hand in Barnsley Street how patients were able to walk in and receive the treatment and care that they needed. There were no complicated referrals and no “pathway says no”; they were able to take the brave step of asking for help and getting it. And it is not just about help with clinical needs, because in the same building there are people who help with housing, benefits and more. One staff member said,

“this place helps people feel like a skilled person, not just an ill person”.

That makes perfect sense, because a person is not just their diagnosis and we get better results by taking a more deliberate, holistic approach.

The outcomes of the pilots are emerging, but clinicians told me that they are seeing fewer patients in the local A&E in crisis and fewer needing expensive in-patient care. The approach works for patients but also for staff and families. In an unusually bleak landscape, it felt like an oasis in the desert. The Committee is therefore disappointed that the Government rejected our recommendation to extend the pilots by another 12 months beyond April 2026. However, they do agree that the learning should be rolled out nationwide, so I welcome the £473 million of funding to be made available to integrated care boards to invest in models like the pilots. I am, however, hearing from existing centres that they are deeply concerned about the future, with funding ending and their ICBs already reprioritising. What a waste.

The Committee is also clear on the link between physical and mental health. Someone living with severe mental illness is far more likely to have physical illnesses too, and there is extensive evidence of co-morbidities and preventable deaths. The NHS should reinstate the annual physical health check target for people with severe mental illness. The Government, in their response to our report, recognise the importance and positive impact of the check, but have not committed to reinstating it. They argue that it will appear in the promised modern service framework. I do not really care how they reinstate it and I reserve judgment.

Indeed, much of the Government response signposts to the yet unpublished MSF, which is undoubtedly going to play a major role in bringing consistency across the country—a problem we heard about time and again. The Government want to drive

“rapid and significant improvements in quality of care”,

but a year on from their announcement, we have heard nothing more about it, so we recommended setting a deadline for the publication of the MSF in 2026, which the Government have accepted. The mental health sector is in crisis and it deserves these new standards urgently.

To achieve the best outcomes, we must include voluntary, community, faith and social enterprise organisations, but they need certainty to plan. That is why we have recommended a move to multi-year contracts. We are glad that the Government have accepted this recommendation, but we must be clear on the details of the “practical support and accountability” they say will also be provided. The charity Turning Point says:

“There is a sense of looking down on VCFSE people as the gofers who run about—‘We do all the important work, and they just look after people when we aren’t there.’”

That culture needs to shift. The Committee also recommended that such organisations are embedded in the design of services from the off, and we are further concerned by the lack of data sharing and interoperability, which is stifling innovation. Far too often, these organisations have the answers we need, and we need to value them more.

But with that, we also need stronger accountability. The Committee is baffled by the fact that there are no mental health waiting list standards—which, in common parlance, is a target. In plain speak, mental health patients deserve to be seen and treated in a timely manner, just as any other patient might in the NHS. For example, if someone’s doctor refers them to a consultant to treat a bunion, they know that the NHS says that they should have to wait a maximum of 18 weeks. However, if someone is referred to a consultant for bipolar, the NHS has nothing to say about how long they can expect to wait—and indeed, as a result, many people wait for years.

The Committee has found that the lack of national standards is contributing to inconsistent access. This is a long-standing issue. Waiting time standards have been consulted on and we understand that they have been drafted. In fact, the Government recognise their importance in their response to the report, but they have no plan to implement them—the House can understand why we are a bit baffled. We have seen how effective a target can be in driving national change, especially in an area of crisis in the NHS. Gareth Harry of NHS England said,

“in general when the mental health sector has been set a target historically, it has done very well against it.”

The Committee will not rest until there is a waiting time standard for mental health, in just the same way that there is for elective procedures.

On the subject of parity of esteem, let us turn to the mental health investment standard, which was championed by Liberal Democrat Minister Norman Lamb and introduced in 2016. It required the share of ICB spend on mental health to be at least as large, proportionately speaking, as overall increases in local budgets. In practice, that meant that over nine consecutive years, the proportion of the NHS budget spent on mental health increased, but this year the Government changed the planning guidance to water down the MHIS and require spending not in accordance with the overall proportion, but only in line with inflation.

The Secretary of State recently admitted that instead of the overall share of the NHS spend going up, it will drop for the third year running. We believe that is wrong. The Government have underestimated how damaging a signal this deprioritisation has sent to the sector. Although we agree that there is a conversation to be had about inputs and outputs—like all parts of the NHS, this area needs to roll up its sleeves and make change—the Darzi review was clear that mental health accounts for 20% of the disease burden but only about 8% of the spend, and that disparity is getting worse, not better, under this Government.

Rapid change and transformation must happen, but to do it quickly and effectively some double-running will likely be necessary. We therefore recommend writing the original mental health investment standard definition into legislation so that no Government can again change it by the back door. That, alongside implementing those long-wanted waiting time standards, would be a significant step towards making reality a stated aim of the NHS constitution itself: that there should be parity of esteem between mental and physical health.

We believe that this Government have the right intentions, but we remain concerned that at the moment, they are all talk and not enough action. Much will depend on the efficacy of the modern service framework, which we look forward to seeing and scrutinising when it is finally here. We all know that delivering meaningful transformation requires a fundamental reimagining of mental healthcare as trauma-informed, person-centred and rooted in a social model. This will take bravery, leadership and unwavering political will, and we ask all Members of this House to join us in pushing for it.

[Jen Craft (Thurrock) (Lab)]

I thank the hon. Member for her chairship of the Health and Social Care Committee during this inquiry. As someone who has bipolar disorder, it was a really difficult experience to sit through at times, as I watched witness after witness after witness speak to what is very much my own experience. I have called myself lucky in this House previously—lucky to have a support network around me, and to have the wherewithal and the ability to build up what I need as a support package, because, sadly, I have never really received it from the NHS. By sitting through the Committee, I realised that I am not in fact lucky; I am quite unlucky, in that the burden that my illness places on those who care about and love me is quite extraordinary.

Does the hon. Member agree that in order to really put action behind our words on parity of esteem, the Government must take action on the recommendations of the Committee, particularly around neighbourhood mental health centres? Something like that in my area would be transformational for me and my family. It would mean that I would no longer have to rely on my loved ones to provide care for me. It would mean that I would no longer have to build a package of support. It would mean that I would be more effective at this job, a more effective mother and a more effective wife, and I would know that I had the support available whenever I needed it and however often I needed it.

I have a plea to the Government—I know the Minister is in the room—and a question for the Chair. Will she join me in pleading with the Government to personally take action on that one specific recommendation and roll out neighbourhood mental health centres nationwide?

[Layla Moran]

I pay tribute to the hon. Lady, my fellow Health and Social Care Committee member, for how movingly she shared her personal story. That was pivotal in the shaping of this report. She has just demonstrated to this House the power of having experts by experience lie at the heart of design and these recommendations—indeed, that was our very first recommendation in this report.

I could not agree more with the hon. Member’s point about the 24/7 neighbourhood centres. I am a carer—I hate that word, by the way; I am talking about my partner—and as someone who is often picking up the pieces, I know very well how transformational the centres might be in my own area. While some funding is available to ICBs, I am concerned that without the detail behind this issue, we risk it not being transformed quickly enough. I think that double-running is important—we have already seen that from the example of Barnsley Street. The six pilots that are up and running are already looking at possibly shutting down. As I said, what a waste! I urge the Minister to do more and faster, because this could change the game.

[Wera Hobhouse (Bath) (LD)]

So many mental health problems could be cared for much better in the community. As the chair of the eating disorders all-party parliamentary group, I know that some years ago we had an inquiry called “There’s No Place Like Home”. That was supported by Beat, which put out a report about the critical gap in provision, as there are no daycare centres for eating disorder services. Does my hon. Friend’s report also cover eating disorders? Will she make the plea to the Government, which we have made again and again, that we need much more critical daycare centre support and provision in the community?

[Layla Moran]

My hon. Friend has been a doughty campaigner on eating disorders for many, many years. We did not look specifically at eating disorders, but I know that some of the centres have that embedded. We know very well that if we are going to take a holistic approach to someone with severe mental illness, it is not just about the physical side or the housing; many of them suffer from other disorders or substance abuse. The key thing here is actually a simple principle: if we treat someone like a person, rather than a number that needs to go through a pathway like a pinball, we get better results. It is faster and cheaper, and we would have a workforce who feel that they are doing good, rather than feeling demoralised. It is win-win-win.

[Claire Young (Thornbury and Yate) (LD)]

On a similar note, does the Committee Chair agree that the long delays in assessing people for neurodivergence is contributing to greater mental ill health? While people are waiting, they are not being properly supported and do not feel that they have the necessary understanding of themselves to be able to move forward. Was that touched on in her work? If not, would she consider that for future investigation?

[Layla Moran]

We did a one-off report on that issue, in fact. It was not in this report, but we have looked at it. One of the key things here is good, local working with the wider community, which echoes some of what we have seen in this report. I know that many Members will have an interest in child and adolescent mental health services in this area. A forthcoming joint inquiry by the Health and Social Care Committee and the Education Committee will look at CAMHS, and no doubt some of the questions around neurodiversity will come into that as well. My hon. Friend is entirely right to point out this issue; it is a huge problem. I have one constituent who was told that they would have to wait 16 to 18 years for an assessment—I think that says it all.