the reforms set out above section affects organisation of the whole of the nhs including mental health the key impacts on mental health service provision are as yet not fully clear there are diverse opinions both about the reforms and about their effect on mental health with some arguments for example suggesting that gps have considerable experience treating patients with common mental health disorders and others pointing to widespread concern that gps are not adequately skilled to commission for people with severe mental health problems lawtonsmith the health and social care act included the involvement of other health professionals in ccgs including hospital doctors and nurses with scope for the involvement of nhs managers there has been renewed focus on outcomes under the health and social care act and the white paper equity and excellence liberating the nhs specifically upon the nhs outcome framework which will be a tool for management at each level in the nhs the experience of mental health care in the nhs is included in these outcome measures which are intended to provide a national level indication of how well the nhs is performing