NHS England chair leads major system-wide review
Dr Penny Dash is leading a new national review into mental health services, with a dual focus on improving care quality and boosting productivity across the NHS. The review, commissioned as part of wider health system reforms, reflects growing concern about rising demand, inconsistent outcomes and inefficiencies in service delivery.
The initiative builds on Dash’s earlier work examining healthcare quality and regulation, and is expected to feed into the government’s 10-year health plan. Early indications suggest the review will explore how resources are used across mental health services and whether current models of care are delivering sufficient value for patients.
Mental health has become a central priority for NHS leaders, with demand continuing to increase across both adult and child services. At the same time, policymakers are under pressure to demonstrate improvements in productivity following the pandemic-related decline in NHS performance.
Evidence of productivity gains – but challenges remain
Initial data suggests that mental health trusts have shown some of the strongest productivity improvements within the NHS in recent years. Activity levels increased during 2025 despite real-terms funding pressures, indicating that services are delivering more care with constrained resources.
However, this headline progress masks deeper structural issues. Across the NHS, productivity fell sharply during the pandemic by around 25% in 2020/2021, and has yet to fully recover. National targets now require annual productivity growth of around 2% to restore performance and meet rising demand. In mental health specifically, variation between regions and services remains significant. Some areas have expanded access and improved outcomes, while others continue to face long waiting times and limited capacity. The review is expected to examine these disparities in detail, identifying where productivity gains have been achieved and where inefficiencies persist.
Rising demand and funding pressures
The review comes at a time of sustained growth in demand for mental health services. NHS figures show that spending on mental health is continuing to rise, with planned investment reaching more than £20.6 billion in 2025/26 across services including learning disability and autism care. Access has also expanded significantly. Nearly 850,000 children and young people are now receiving support annually, representing a substantial increase since the launch of the NHS Long Term Plan.
Despite this progress, services remain under strain. Waiting time targets are still not consistently met, and demand for specialised services, such as ADHD and autism assessments has surged, exposing gaps in provision and oversight. The combination of rising demand and limited workforce capacity has intensified the need for more efficient service models, making productivity a central focus of the review.
Focus on digital innovation and system reform
A key theme expected to emerge from the review is the role of digital technology in improving productivity and care quality. NHS England has already identified digital transformation, including data analytics, AI and remote care as critical to achieving productivity gains. Dash has previously highlighted the importance of using data more effectively to identify care gaps and drive improvement. Earlier findings from her work on healthcare quality pointed to a fragmented system with duplication, inefficiency and limited coordination between organisations.
The mental health review is likely to build on these insights, examining how better use of data and technology could support earlier intervention, reduce duplication and improve patient outcomes. There is also expected to be a strong focus on shifting care away from acute settings and into community-based services, aligning with broader NHS strategy to deliver more preventative and localised care.
Implications for policy and frontline services
The outcome of the review could have significant implications for how mental health services are structured and funded in England. Recommendations may include changes to commissioning models, workforce deployment and the balance between NHS and independent sector provision. For frontline services, the review represents both an opportunity and a challenge. While productivity improvements could unlock additional capacity and improve access, there are concerns about the risk of placing further pressure on already stretched teams.
Ultimately, the review highlights a critical moment for mental health services within the NHS. With demand continuing to rise and resources constrained, improving productivity is no longer optional but essential. As Dr Penny Dash’s work progresses, its findings are expected to shape the next phase of NHS reform, determining how mental health care can be delivered more efficiently while maintaining quality, safety and patient trust in an increasingly complex healthcare landscape.
