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It is a real privilege to be awarded an Adjournment debate to discuss the profile of social care in decompressing the strain on mental health services in Hornsey and Friern Barnet. I begin the debate by emphasising how many improvements we have seen in society over the past 20 years when it comes to the position of people who suffer from poor mental health. I do not want this debate to be a counsel of despair. Rather, I want it to be an opportunity to push forward the work that Baroness Casey from the other House is doing, and to be positive about what can be achieved with the opportunity we have—with people seeing mental health services as part of a normal health condition—and how we can support people to have long and happy lives and live with a condition, and to support families and so on.
I know that Members across the House will have constituents who get in contact time and again because they have fallen through the cracks of our porous health and care system. Navigating the endlessly complicated care pathways, from primary NHS care to social care, community support and housing, is not easy. The exponential growth in mental health referrals, coupled with the enormous pressures on local authorities to provide social care and social housing against increasingly constrained budgets, has created a perfect storm. That is being felt across the country, but most acutely in my community, where people are too often failed in their time of greatest need. Too many people are being left without the care, support and stability they desperately need to recover.
A previous Labour Prime Minister emphasised that his priorities were “education, education, education,” but when it comes to mental health and social care, we need to talk about “early intervention, early intervention, early intervention”. The North London foundation trust, which covers Barnet, Camden, Enfield, Haringey and Islington, says that the financial challenges facing local authorities are really straining their ability to work together, as they are forced to consider more radical reductions in adult social care services. In particular, the reduction in investment in preventive and early intervention services is having a catastrophic effect, but local trusts are finding it hard enough to fund their basic statutory responsibilities. The lack of suitable housing and step-down care is also having a direct impact on in-patient services and contributing to much longer hospital stays. That is the system I will be focusing on today.
The trust says that of the five local authorities it covers, Haringey is the most affected by the lack of suitable and affordable housing, and therefore has the largest number of delayed discharges. From January to July 2026, a total of 846 occupied bed days were unavailable to other patients desperate for care due to Haringey residents being unable to be discharged from mental health in-patient wards despite being clinically ready for discharge. In July alone, the trust had an average of 10 in-patients on their wards who were clinically ready to leave but could not be discharged due to lack of suitable housing provision or social care support, and 8% to 12% of the total adult in-patient bed base was unavailable to other patients who needed one.
Healthwatch Haringey has highlighted the recurring barriers to gaining access to timely, co-ordinated and person-centred mental health support, such as lack of continuity between services, fragmented care pathways and inconsistent communication between providers. When services do not work together effectively, people experience poorer outcomes and are more likely to reach crisis point. This is precisely the cycle that we need to break. We need to protect organisations like Healthwatch and others that amplify voices so that we can understand the data behind monitoring service quality and amplifying patients’ voices.
Someone who is clinically well enough to leave hospital can become trapped at the most expensive stage of the care pathway, unable to continue their recovery in the community. At the same time, someone desperate, experiencing an acute mental health crisis, may be unable to gain access to a hospital bed. This is not an effective use of public money; that public money could be spent on quality of care, which is desperately important for the families who are suffering due to issues around the particular care that their loved-ones have received.
In March 2024, mental health trusts in England recorded 49,677 delayed discharge days—the highest level since national reporting began. Analysis of NHS data identified Barnet, Enfield and Haringey mental health NHS trust among the trusts with the highest levels of delayed discharge nationally. These figures demonstrate exactly the point I am making today: mental health cannot be treated in isolation from housing and social care. In order to fix one, we must fix all three.
Disability Action Haringey, which does excellent work supporting disabled people to maintain their independence and freedom, has highlighted the combination of difficulties in accessing suitable housing, delays in obtaining social care, the financial hardship that so many suffer, social isolation and the challenges of navigating multiple services simultaneously. People experience poor housing or insufficient care, their mental health deteriorates, and they reach crisis point, requiring hospital treatment. We must break that cycle.
In my constituency, the Safe Haven crisis hub provides a vital service, helping people to de-escalate during a mental health crisis and providing an alternative to accident and emergency. I know that this is the kind of example that Baroness Casey will be looking at. She is very welcome to come and visit Mind in Haringey, which hosts this particular crisis hub, because it shows the best practice. Staff there have seen people reaching out to their services with increasingly complex needs, often requiring co-ordinated support across health, housing, social care and the voluntary and community sector. That is why collaborative care and cross-body communication are so critical.
We also have a rapidly ageing population across Haringey and Barnet, which will inevitably place additional pressure on social care. Haringey council’s older people’s needs assessment reported that Haringey had around 27,700 residents aged 65 and over in 2022, and that figure is projected to rise by approximately 40%. The pressure on our social care system is therefore going to grow, as we all know, and we need to ensure that the system is ready for it.
The evidence is clear: mental health services cannot be considered in isolation from social care. Investment in social care is not separate from investment in mental health services—it is investment in mental health. Investment in supported housing is not separate from relieving pressure on the NHS, but part of relieving that pressure. Investment in community-based support is not simply about providing an alternative hospital, but about helping people to recover, maintain their independence and avoid reaching crisis point in the first place.
I strongly welcome the Government’s commitment to address these enormous challenges, and was particularly excited to hear the Prime Minister talking about tackling social care in advance of 2028, which was when Baroness Casey was going to report back. I also welcome the Government’s wider action to improve mental health care through the NHS 10-year plan, and would like to ask for a meeting to discuss standards of care in the mental health service. I also invite Baroness Casey or the Minister to Mind in Haringey to see an excellent way in which the statutory and voluntary sectors work together.
The Government’s actions meant that, earlier this year, we successfully reached the target of recruiting 8,500 mental health workers. That is a crucial step towards providing better and earlier care, closer to people’s homes. I welcome the £343 million to open 159 NHS mental health centres across England, which will give people access to specialist support away from A&E. These problems are not just about cash, but about the system being proactive and improving workforce morale so that we can improve outcomes for patients.
Investment in housing is crucial, but the £39 billion earmarked for social and affordable housing has the potential to be transformative. Yesterday, we heard the Secretary of State for Housing, Communities and Local Government lay out her vision for tackling rough sleeping, which is an element in the mental health jigsaw puzzle.
If we want people to maintain their independence, they need appropriate homes and community support. If we want to prevent people from reaching crisis point, we need to address the circumstances that contribute to stress, worry and deteriorating mental health. Social care reform has been pushed down the road too many times, but now is the moment for it to come forward. We must invest further upstream to improve people’s lives, free up NHS capacity, reduce unnecessary hospital stays, support recovery and create a health and care system that is preventive rather than reactive. People living in Hornsey and Friern Barnet and communities across the country should be able to live safely, recover with dignity and get the right support.
In pulling together my words, I thank the wonderful mental health staff at the North London NHS foundation trust, which sadly lost members during covid, because they were so close to patients—I feel that it has still perhaps not got back to where it was pre-covid. We need to support that workforce. I also thank Mind in Haringey, Safe Haven, Disability Action Haringey, Healthwatch Haringey, Haringey council, Barnet council and all the elected Members who care deeply about the future of social care in the UK.
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I congratulate my hon. Friend the Member for Hornsey and Friern Barnet (Catherine West) on securing this important debate. I have spoken to the Minister for Social Care, who is happy to meet my hon. Friend to discuss her concerns, including her concerns around standards of care in particular. We can arrange for that to happen.
This debate is important because when we talk about social care and mental health services, it can be easy to talk in terms of systems, services, assessments and waiting lists, but behind every one of those words is a real person—someone who may be struggling to get through the day without the right support. It could be a family member who has reached breaking point in trying to care for someone that they love. Those are the people we must keep at the heart of the changes that we are making to our NHS and social care system.
My hon. Friend has taken a sustained interest in these issues in Hornsey and Friern Barnet, particularly the pressures facing adult social care and mental health services, the importance of community provision and the importance of ensuring that people can access the right support at the right time. Let me be clear: it is unacceptable that anyone is left without the mental health care that they need, particularly when they are in crisis.
Let me turn to the local picture in my hon. Friend’s constituency. There is clearly a variation in mental health need across north London. The prevalence of severe mental health illness is particularly high in Haringey, where an estimated 1.44% of residents are living with a severe mental illness—compared with 1.16% nationally—making it among the highest rates in England. Residents of Hornsey and Friern Barnet draw on mental health and social care services at some of the most difficult points in their lives. As my hon. Friend knows, the constituency is served by both Barnet and Haringey councils. There is a different picture in each area.
Barnet was assessed by the Care Quality Commission as “good” in January ’25. Haringey was rated as “requires improvement” in February ’25, with the CQC highlighting concerns surrounding mental health discharge processes, communication and timeliness around hospital discharge, partnership working, and a shortage of move-on accommodation for people with mental health needs.
I appreciate how important these issues are for people who are already facing considerable challenges, and how frustrating it is when services do not work together effectively. The Department has therefore supported Haringey through its improvement offer, and I am pleased that the council has engaged constructively with that process. In May, Haringey requested to be de-escalated from the Department’s formal reporting process, which was accepted. The council provided a voluntary update on its progress in August, and expressed confidence in its improvement trajectory.
While that is encouraging, I want to be clear that de-escalation does not change the CQC rating, which remains at “requires improvement” until the CQC completes a further assessment. The CQC issued a notice of assessment on 3 August and we will now await the outcome. I hope that will provide a clear picture of the progress being made and, most importantly, help to ensure that people receive the safe, timely and joined-up support that they deserve.
I want to say a few words about the national picture for mental health. I think we all acknowledge that the challenge is significant, but our ambition is significant too. The 10-year health plan sets out our ambition to reform the NHS, and we are already taking important steps to improve mental health services, including reforming the Mental Health Act 1983 to support better and more personalised care, and recruiting thousands more mental health staff.
We are also making £473 million of capital funding available over the next four years, including community-based mental health centres and mental health emergency departments. That includes £343 million to establish 100 community-based mental health centres and 59 mental health emergency departments across England, building on the six centres already operating in Birmingham, York, Copeland, Tower Hamlets, Lewisham and Sheffield.
One community-based mental health centre will be established in most places in England. That typically coincides with a borough in London. Mental health emergency departments will cover approximately 50% of type-1 A&E departments by ’29-30, and I am pleased to report that there is already a unit at Highgate mental health centre on Dartmouth Park Hill, which has been operational since 2024, but of course we recognise that we must go further. That is why we are developing a new mental health strategy for England, which will set out how we can transform mental health care so that people receive support earlier, face shorter waits, and are helped to stay active and participate in education, work, family and community life.
On delayed discharge and in-patient capacity, my hon. Friend described how discharge delays can leave people with no choice but to remain in mental health in-patient settings for longer than is appropriate. The Government recognise the importance of ensuring that people can leave hospital as soon as they are ready, with the appropriate support in place, such as rehabilitation services. That provision requires effective joint working across health and social care services, which is why the better care fund has committed over £9 billion in ’26-27 to integrated care boards and local authorities. That pooled funding is intended to support services that help people to retain or recover their independence, and to prevent avoidable admissions. Funding recipients are expected to agree local goals for preventing avoidable admissions and reducing delayed discharge, and to work together to develop effective services.
Let me address the point about social care, housing and community support at discharge that my hon. Friend made so eloquently. For some people, particularly those with more complex needs, being clinically fit to leave hospital is not the only condition required for a safe and successful discharge; the right social care, housing and community support must also be available to enable them to live well in the place they call home. In particular, autistic people and people with a learning disability can lack suitable supported housing options in their community, which can contribute to people remaining in mental health hospitals past the point of need. The Government are taking action to increase the availability of appropriate housing and support, including through the £39 billion social and affordable homes programme that my hon. Friend referred to, through which we want new supported housing supply across a diverse range of housing types, including for people with learning disabilities and autistic people.
NHS England is also investing £13 million in 2026-27 through its housing capital programme, to support areas to develop housing for autistic people and people with learning disabilities outside mental health hospital settings, alongside additional funding to support the development of crisis accommodation. Supporting timely discharge incudes ensuring that suitable arrangements are in place. It is essential that people leave mental health in-patient settings safely, with appropriate support in the community and with their needs properly considered.
Revised statutory guidance on discharge from mental health in-patient settings was published in 2024 under the National Health Service Act 2006. The guidance sets out how health and care systems can work effectively together to support discharge from hospital and ensure that the right support is in place in the community. It also includes best practice on involving patients and carers in discharge planning, as well as providing clarity on how health and care partners should work together effectively, including in relation to shared responsibilities and arrangements for funding section 117 aftercare.
Section 117 of the Mental Health Act 1983 places a duty on the NHS and local authorities to provide aftercare once they have left hospital to certain patients who have been detained under the Act. That aftercare should provide people with the support they need to live successfully and safely in the community, while reducing the risk of deterioration in their mental health and the need for further hospital admissions. Depending on an individual’s needs, aftercare can include accommodation, day services and other health and social care support.
We know, however, that there can be a lack of clarity over which organisation is responsible for providing and funding aftercare and in which locality, which can lead to further delays in providing support to vulnerable people. The Government’s recent reforms to the Mental Health Act clarify which local authority is responsible for arranging an individual’s aftercare, by applying the existing social care rules on ordinary residents to people receiving aftercare under the Act. That should provide greater clarity and consistency for local authorities and ICBs, supporting more effective joint planning and better aligned aftercare services.
I now turn to longer term adult social care reform and the Casey commission, which my hon. Friend referred to. We need to think ambitiously about the future of social care. At its best, social care is transformational. It can give people the support they need to live independently, maintain relationships, contribute to their communities and live the lives that they want. That is at the heart of the Government’s vision for a national care service: a system that is more person-centred, integrated with health services and preventive. The Prime Minister has been clear that he wants rapid progress towards that vision, working in partnership with the adult care sector.
The Independent Commission on Adult Social Care, led by Baroness Casey, remains central to the Government’s ambitions to reform the sector. Baroness Casey’s Big Conversation on Care, launched on 29 July, gives people across England the opportunity to tell us what they want and expect from a future care service. This conversation will feed into the commission’s recommendations for the funding of adult social care, which will now be made in the summer of ’27. In the meantime, we will continue to put in place the building blocks of the national care service through improving support for the workforce and unpaid carers, and providing more than £4.6 billion of additional funding for adult social care in 2028-29, compared with 2025-26.
I thank my hon. Friend again for raising these important issues and for shining a light on the experience of people who rely on mental health and social care services in her constituency. They are encouraging signs of progress locally, particularly Haringey’s engagement with the improvement process, but clearly there is more to do. The Government are determined to support local partners to make these improvements, while addressing the long-term challenges facing social care. Ultimately, this is about making sure that no one is left waiting unnecessarily for care and giving every person confidence that the services around them will work together when they need them most.
Question put and agreed to.