What are the seven standards?
The seven standards tackle five areas: health promotion and stigma, primary care and access to specialist services, needs of those with severe and enduring mental illness; carers' needs and suicide reduction.
Standard one addresses mental health promotion and strategies to combat discrimination.
Standards two and three set out how primary care should work, including onward referrals, access to round-the-clock care and NHS Direct.
Standards four and five describe effective services for those with severe and enduring mental illness, including crisis plans, round-the-clock care access, in-patient treatment and rehabilitation care.
Standard six establishes annual checks for carers of those with severe and enduring mental illness, and a written and implemented care plan.
Standard seven looks at suicide prevention. It's really a composite of standards one to six, with additional guidelines to ensure staff can assess suicide risk, learn lessons from local suicide audits and be supported in preventing prisoner suicide.
What do they mean for staff?
Delivering the standards requires close cooperation between NHS staff and those working in social care. Lead roles are taken in standards one and seven by health authorities, in standards two and three by primary care groups, in standards four and five by NHS trusts and in standard six by local authorities.
There are big workforce issues. Meeting the standards will mean improving education and training, as well as recruiting new staff and retaining them. A workforce action team is up and running, and it recently highlighted some areas which are ripe for change. Personnel planning and development need to be better managed, integrated with broader service and financial planning, and less rigid, to make best use of staff skills. Education and training need to be developed, with a special look at flexibility and career shifts. It's unclear how quickly changes will affect staff. Final recommendations from the workforce action team, which are due in spring 2001, should clarify matters.
What do they mean for users and carers?
Partnerships between providers, users and carers are vital to ensure services meet needs. It will be interesting to see how this happens, but the NSF pledges strong user and carer involvement as the seven standards are rolled out, especially in:
• planning, providing and evaluating education and training
• influencing the research agenda, including developing research tools with users to assess their views on how services can best meet needs
• developing and evaluating occupational activities
• clinical audit, such as satisfaction with the care programme approach (CPA). The CPA is a system for people being discharged from psychiatric hospital, which specifies that a key worker must be allocated and package of multi-disciplinary care must be set up.
