More than two-thirds of NHS trusts providing mental health care in England are planning to reduce or close services this year, according to an unpublished survey seen by the Guardian, raising the prospect of longer waits for millions of adults and children.
The poll of 37 mental health providers, carried out by the NHS Alliance in March before the start of the financial year, found that 68% expected to cut back or shut some services in 2026-27. More than half, 57%, said they were likely to reduce the number of clinical staff they employ, while 59% expected to freeze vacancies.
The findings, revealed by the Guardian on Friday, land less than 48 hours after the government announced the opening of up to 159 new NHS mental health centres across England, backed by £343m and billed as the biggest redesign of mental health services in a generation. The first sites are due to open this autumn.
That gap between national expansion and local contraction is at the heart of the concerns raised by charities and sector leaders. The government money is capital funding, for buildings and estate, while the cuts identified in the survey fall on revenue budgets that pay for staff and day-to-day running costs.
Alex Stewart, assistant director of the NHS Alliance's mental health network, said services were "coming under extraordinary pressure as a result of rapidly rising demand for care and very tough financial conditions". He said the trade-offs and difficult decisions over jobs and services the network had warned about "are making their mark", noting that mental health leaders are especially exposed when finances tighten because a higher share of their spending goes on staff.
Stewart, who welcomed the recent capital announcement and confirmation of access targets, warned that mental health's share of overall NHS spending is expected to fall for a third consecutive year, adding that it was "essential that mental health investment is not allowed to fall behind".
A written statement from the Department of Health and Social Care in March forecast that mental health would account for 8.4% of NHS spending in 2026-27, down 0.28 percentage points on the previous year, with total spending rising from £15.7bn to £16.1bn. The share has fallen from 9.0% in 2023-24.
Tom Pollard, head of policy, public affairs and campaigns at Mind, said the survey results showed "the huge uphill battle we face" to save mental health services in England and to ensure everyone could access high-quality care. Charities have broadly welcomed ministers' ambitions but say meaningful improvements will be impossible if funding for staff and services is simultaneously reduced.
"To see cuts to any mental health service is unfathomable and unacceptable."
That was the verdict of Richard Munn, Unite's national officer for health, on plans by East London NHS foundation trust to close a £25m gap in its finances. The trust, which serves Hackney, Tower Hamlets and Newham as well as Luton and Bedford, intends to shed 330 of its 6,000 staff — about 5% — and has said it is seeking the savings because NHS England has obliged all 205 trusts to balance their books. Fothergill ward, a 20-bed intermediate care unit at its East Ham care centre, has stopped taking referrals and is due to close on 21 September.
The trust said the proposals were indicative and at an early stage, that no cuts would be implemented without passing a quality impact assessment, and that it was working closely with trade unions and partners to protect the quality and safety of care.
Demand, meanwhile, continues to climb. More than one million children had an active referral to child and adolescent mental health services in 2024-25, almost double the figure in 2018-19, with more than 60,000 waiting over two years for treatment.
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