In July, Cygnet proudly sponsored a roundtable discussion at the House of Lords which brought together parliamentarians, clinicians, local government leaders, and independent providers to explore how policy ambition can finally be translated into delivery.
The discussion highlighted how Britain’s mental health system is breaking. With more than five million referrals in 2023 and a 25% reduction in inpatient beds since 2010, the demand for services is growing faster than the system’s capacity to respond.
As a trusted partner to the NHS, Cygnet continues to invest in new hospitals and social care settings, ensuring people receive the right care at the right time. But as we helped to highlight at the recent parliamentary roundtable, lasting change requires coordinated action across the whole system.
“Mental health doesn’t happen in silos,” said Professor Lord Patel of Bradford, Senior Independent Board Director at Cygnet and Chair of the meeting. “We need both high-quality hospital provision and effective community care. It should never be a case of one or the other.”
Collaboration: The Path Forward
Speakers agreed that no single organisation can meet current levels of need alone. Local authorities, housing providers, independent sector partners and community organisations must work together as equal partners in designing and delivering care pathways.
Cygnet’s continued investment in new hospitals, workforce development, and social care services was highlighted as a model of how independent providers can help stabilise the system through offering capacity, capital investment and specialist expertise when NHS services are under pressure.
“We don’t think we can develop mental health services without developing partnerships,” said Lord Patel.
Cygnet are proud that against a national backdrop of a reduction in NHS mental health beds over the past decade, we have opened seven brand new hospitals since 2024, providing 230 beds, helping 1,500 patients each year, and bringing 1,000 new jobs to the economy.
We also continue to expand and invest in our step-down and supported living services, helping reduce delayed discharges and enabling individuals to transition safely back into the community.
The Implementation Gap: From Policy to Practice
Attendees at the roundtable discussion expressed frustration that mental health policy remains “rich in vision but poor in execution.” Despite numerous reviews and policy commitments, services continue to face fragmentation and underfunding.
“We already know what works, but policy keeps chasing novelty,” said Lord Patel.
Speakers including Professor Sir Simon Wessely and Dr Lade Smith CBE called for an end to repeated pilots and consultations, urging Parliament to fund proven models at scale with clear accountability.
“Mental health accounts for 20% of the disease burden but receives less than 10% of funding – this structural underinvestment is why services can’t keep pace with demand.” – Dr Lade Smith CBE, President of the Royal College of Psychiatrists.
Workforce: The Critical Infrastructure
A skilled and supported workforce was identified as the foundation for sustainable reform. High-risk services are often staffed by the least experienced professionals due to attrition and vacancy pressures.
As Baroness Watkins (mental health nurse and former NHSE Non-Exec Director) warned, “without urgent attention to staffing, any reform will collapse under the weight of unstaffed services.”
“Often the most challenging environments have been run by staff with the least experience,” warned Sojan Joseph MP, Chair of the All Party Parliamentary Group on Mental Health.
The workforce crisis was identified as the single greatest determinant of success or failure. Cygnet continues to prioritise training, wellbeing programmes and career development, ensuring staff are equipped and supported to deliver outstanding care. In 2024, our agency reduced from 12.1% to 7.8% and turnover reduced from 27.4% to 21.2%, figures we are proud of.
Our latest staff survey demonstrated that what we do is successful, with 88% of staff saying they enjoy working for the company and 85% of employees said they would be happy for a friend or relative to be cared for by Cygnet, a powerful endorsement of the quality of our services.
Bottlenecks in Discharge and Housing
A major concern highlighted was the growing number of patients clinically ready for discharge but unable to leave hospital due to a lack of community placements or housing. This not only delays recovery but ties up inpatient beds and fuels crisis escalation.
Cygnet’s investment in social care placements, step-down facilities and supported living directly helps relieve these pressures, ensuring patients can continue their recovery in the right environment.
In 2024, 17% of all of our discharges were to a pathway within Cygnet, showing effective care pathway management and continuity of care. Additionally, across all our service lines, more than three-quarters of those in our care were successfully discharged back towards the community.
Equity and Detention Reform
A sobering part of the discussion centred on racial disparities in detention under the Mental Health Act.
“If you’re black, you’re around ten times more likely to be detained,” Professor Sir Simon Wessely
Digital health platform Thalamos highlighted how poor data quality, and a lack of interoperability make it impossible to track repeat detentions or identify systemic bias.
Cygnet shares the sector’s concern about persistent racial inequalities in detention under the Mental Health Act. Attendees at the event rightly called for mandatory, real-time data on detentions and stronger accountability.
Cygnet continues to embed equity, diversity, and inclusion in its practice, from workforce training, our six staff support networks to patient and carer advocacy initiatives.
Cultural Change and Neurodiversity
The roundtable also explored the rapid growth in self-identification with ADHD, autism, and other conditions. While this trend reflects progress in stigma reduction, concerns were raised about diagnostic inflation and the strain it places on already stretched services.
“Among school-age children, nearly 50 per cent now identify with ADHD or autism – a massive cultural shift,” said Professor Wessely.
Attendees agreed that policymakers must balance respect for lived experience with clinical rigour, supporting accurate assessment and appropriate intervention. Public mental health education and workforce training in neurodiversity and trauma are essential next steps.
What MPs Can Do Now
The report offers a clear roadmap for Parliament:
- Implement a National Delivery Programme – Roll out proven evidence-based models like the Community Mental Health Framework, step-down services, and early intervention pathways nationwide, with delivery milestones and local accountability.
- Rebuild Capacity – Restore inpatient beds where clinically necessary and invest in community provision, prioritising early intervention for children and young people.
- Put Equity at the Core – Embed equity impact assessments and measurable targets for reducing racial disparities in detention and outcomes.
- Mandate Joint Commissioning – Require ICBs, councils, and housing providers to share budgets and outcome frameworks, ensuring joined-up recovery pathways.
- Deliver a Workforce Strategy – Go beyond recruitment targets to invest in retention, supervision, wellbeing, and trauma-informed care training.
From Rhetoric to Reality
The roundtable’s conclusion was both hopeful and urgent. Baroness Bottomley summed up the evening: “The reforms are known. The data are clear. The lived experiences have been shared. It is now a question of political will, implementation capability, and genuine cross-sector collaboration.”
If MPs act on these recommendations, they can help transform mental health services from a system managing crisis to one enabling recovery and thriving – a shift that would benefit not only patients, but the whole of society.
Through ongoing investment, partnership, and service expansion, Cygnet continues to play a leading role in transforming mental health and social care across the UK, moving from rhetoric to reality in delivering high-quality, person-centred support for those who need it most.