The mental health system is full of acronyms and jargon that can make it difficult to understand, whether you want to raise awareness, take part in a consultation or contact your local politician. It’s hard to know who to contact and how to contact them when the language in front of you feels confusing.
Below is a list of key terms that you might come across and what they mean. You can use the search box to help locate specific words. If there are any other terms you’d like us to include here, please email us on email@example.com
When patients are sent out of their local area for inpatient treatment because no bed is available for them locally.
These are targets set by the Government and NHS England. The Access and Waiting Time Standard for Children and Young People with an Eating Disorder states that under-18s should start treatment that complies with the National Institute for Health and Care Excellence (NICE) guideline within one week from referral for urgent cases, and within a maximum of four weeks for all other cases. Also see ‘Understanding the healthcare system’ (England).
Services designed to provide treatment for children and young people with a mental health problem
Different ways in which people access treatment for their condition. It could also be thought of as different routes through the healthcare system. The care pathway a person goes through will often depend on a number of factors: the patient's age, their diagnosis, how severe their eating disorder is deemed to be, whether or not they are medically stable, what services are available locally and the healthcare commissioners’ rules about what they will pay for. For example: In area A all adults with an eating disorder can be referred directly from their GP to a specialist eating disorders service. However, in area B adults with an eating disorder are first referred to a non-specialised mental health service to try treatment there before the commissioners will consider funding treatment for them at the eating disorder service.
A plan for a patient’s care. It should be written down and the patient should have a copy. The patient and families/carers (if appropriate) should be involved in writing it and ensuring that it is put into practice. All professionals involved in the patient’s care should contribute to writing and reviewing the plan and ensure that what they do is in line with it.
Integrated Care Boards (ICBs, previously called CCGs) commission services in England. responsible for the planning and commissioning of most healthcare services at a local level. They usually include a range of different health and social care professionals, as well as local Government officials. You can find more information about your local ICB here.
Clinical Networks can help ensure that health services are planned and operate in a more coordinated way, by bringing together commissioners, service providers, clinical experts, charities, patients and families/carers.
Committees that provide clinical expertise and patient and carer perspectives (through ‘Patient and Public Voice’ members) to advise NHS England on how it should commission specialised services (including inpatient eating disorder services).
Collaboration between people who commission and/or provide services and those who use them.
The 'purchasing' of health and social care services for a population. Commissioners are expected to identify the needs of local populations and put in place plans to ensure that there are appropriate services available to meet these needs.
Asking patients, families/carers, the public and professionals for feedback, typically on specific proposals or a draft policy, often within a set time frame. In a healthcare setting, a consultation can refer to an appointment.
Services designed to provide treatment for children and young people with a mental health problem.
The transfer of power and funding.
A group of experts (this should include people with lived experience) who are assembled to draft new standards such as a standardised care pathway and/or Access and Waiting Time Standard.
The five-year (2016-2021) strategy for improving mental health care in England.
The Freedom of Information Act 2000 and the Freedom of Information (Scotland) Act 2002 provide the public with access to information held by public organisations such as NHS Trusts or university medical schools. They do this in two ways: public organisations must publish certain information about their activities, and members of the public are entitled to request information from these public authorities.
Forums established by local authorities in England where key leaders from the local health and care system can work together to improve the health and wellbeing of their local population and reduce health inequalities. Health and wellbeing board members are expected to collaborate to understand their local community's needs, agree priorities and encourage commissioners to work in a more joined-up way.
NHS organisations in Scotland and Wales that are responsible for planning, ‘purchasing’ and providing care. Also see ‘Understanding the healthcare system’ (Scotland; Wales).
A way of organising services to deliver mental health treatment. This involves a central base and a network of smaller teams (mini-teams) of clinicians working in different locations, such as within local Child and Adolescent Mental Health Services. This approach is often taken in more rural/remote areas, where it is sometimes thought to enable more accessible services.
A programme that aims to improve access for adults to talking therapies in the NHS by providing more local services and psychological therapists. IAPT services usually only provide treatment for anxiety or depression; however, in some areas they do provide treatment for some patients with eating disorders (particularly bulimia nervosa).
The number or proportion of a population that develops a mental illness over a specified period.
Care that is person-centred and coordinated within healthcare settings, across mental and physical health, and across health and social care. For care to be integrated, organisations and professionals must coordinate all the different elements of care that a person needs.
In some areas, STPs have evolved to become Integrated Care Systems (ICSs), a new form of closer collaboration where NHS organisations and local councils aim to reach all key decisions by consensus. Under the NHS Long Term Plan strategy, every area is expected to become part of an ICS by 2021. For more information see 'What are Sustainability and Transformation Partnerships (STPs) and Integrated Care Systems (ICSs)?' Also see ‘Understanding the healthcare system’ (England).
A process by which the NHS, local authorities and others assess the current and future health and social care needs of a population to inform local decision making.
Local branches of Government, which are responsible for providing a wide range of services. In England in many areas there are two tiers of local authority: county or shire councils as the top tier, and district, borough or city councils as the lower tier. In other areas, there is a single 'unitary authority'. In England, upper tier (i.e. county councils) or unitary authorities are responsible for providing social care and public health. They are run by councillors who are elected by local people. Local authorities have a role in monitoring the performance of NHS services in their area and can raise concerns on behalf of their residents. As part of their duty to represent local people, local councillors can investigate and seek to resolve issues local residents face.
Responsible for commissioning (planning and ‘purchasing’) services to meet the needs of their local populations. Also see ‘Understanding the healthcare system’ (Northern Ireland).
There are four Local Education and Training Boards (LETBs) in England that are responsible for the training and education of NHS staff, both clinical and non-clinical, within their area. LETBs are committees of Health Education England. They are made up of representatives from local providers of NHS services and cover the whole of England.
This is a rule set by NHS England for CCGs that means they must increase their spending on mental health services in line with the increase in their total spend, plus a percentage increment to account for the additional mental health funding they have been given. Every CCG has been judged to have met this target in 2018/2019, although an audit is in progress to check on the reliability of this data. CCGs will now also be expected to demonstrate that their total spending on mental health services for children and young people is increasing at a faster rate than their overall spending on mental health.
New approaches to commissioning and providing NHS services, which are aimed at breaking down the barriers between services to promote early intervention and provide more integrated care.
A document that states the rights and responsibilities of patients, families, other carers and NHS staff in England.
A document that sets out the Government’s objectives for NHS England, as well as its overall budget.
A set of indicators that the Government uses to measure the performance of the NHS in England.
Evidence-based recommendations for health and social care services and professionals.
A concise set of statements that highlight key elements of quality care (based on relevant NICE Clinical Guidelines) and how progress in these areas should be measured.
Treatment that complies with relevant guidance published by the National Institute of Health and Care Excellence (NICE). This phrase is used within the NHS in England as part of the language of the 'access and waiting times standards' to explain that the treatment received should be based on research evidence. An alternative to this wording would be ‘NICE-approved’ treatment.
An independent authority that can investigate complaints and make recommendations to improve services for patients and those that support them.
The amount of something produced or the amount of money spent.
In the context of mental health: Treating mental health and wellbeing with the same level of importance as physical health.
The total number or proportion of people who have a mental health illness.
Groups of GP surgeries that can share staff and work together more while maintaining the independence of the individual practices. PCNs are expected to cover populations of between 30,000 and 50,000 people in most cases.
An organisation that delivers a service (such as an eating disorder service).
Groups of service providers (each led by an NHS Trust as ‘lead provider’) that from April 2020 began to assume responsibility for managing the budgets of inpatient mental health services previously commissioned nationally by NHS England, as well as providing the care. This will include inpatient eating disorder services. Also see ‘Understanding the healthcare system’ (England).
An attempt to guarantee that money allocated for a particular purpose will not be spent on anything else.
A document that defines the standards of care expected from organisations that provide NHS care.
The Scottish Intercollegiate Guidelines Network (SIGN) for Scotland, provide evidence based guidelines about how to treat different illnesses, including eating disorders.
Personal care and other practical assistance for vulnerable people, including people with additional needs, which may stem from their age, physical or mental health conditions and children who need care and protection.
The ratio of observed to expected deaths in a study population (ideally after accounting for age and sex).
STPs bring together local NHS organisations (including CCGs and NHS Trusts), local authorities, voluntary sector organisations and others to plan how to improve the health and social care of residents in their area. For more information see ‘What are Sustainability and Transformation Partnerships (STPs) and Integrated Care Systems (ICSs)?’ Also see ‘Understanding the healthcare system’ (England).
An NHS plan for improving access to quality mental health treatment and support in the community across England.
The ten-year strategy for the NHS in England. This covers the period from 2019/20 to 2028/29.
In some areas NHS services are described as providing care at either Tier 1, 2, 3 or 4. This is a result of attempts to define and arrange services based on the form of treatment a patient needs. For example, a patient would receive treatment at Tier 1 when they had a GP appointment and treatment at Tier 4 if they were then admitted to an inpatient eating disorders service. This approach is becoming old-fashioned as efforts are underway to blur the boundaries between services to help deliver integrated care for patients.
The percentage of patients who will be expected to receive treatment within the waiting time specified. If a tolerance level is set at 95%, this means that if less than 95% of patients are seen within a waiting time target, then the target will be judged to have been missed.
A target that specifies the maximum time that patients should have to wait following referral. Usually this applies to the period between referral and the start of treatment, although some targets may only cover the gap between referral and an assessment.
People employed by an organisation or set of organisations such as the NHS.
A way to measure staffing levels. One WTE = one full time member of staff. FTE (Full time equivalent) can also be used instead.