Introduction to Payment by Results PbR for Mental Health

1. This presentation provides a resource to explain to colleagues the background, approach and future development of Mental Health Payment by Results (PbR)This presentation provides a resource to explain to colleagues the background, approach and future development of Mental Health Payment by Results (PbR)

2. 2 Mental Health Currency Published � 22 Feb

3. 3 Timetable Clarified - 1 April A Dear Colleague letter from Bruce Calderwood (Director, Mental Health Policy) and Bob Alexander (Director, NHS Finance) has clarified the timetable. 2010/11 � The clusters are available for use. Reference costs are returned on a cluster basis. 2011/12 � All service users accessing mental health care (post GP or other referral) that have traditionally been labelled working age (including early intervention services from age 14) and older people�s services, should be allocated to a cluster by 31 December 2011. Local prices should be agreed for use in 2012/13 and this will require understanding of local costs per cluster 2012/13 � The clusters (with local prices) become mandatory for contracting and payment purposes. 2013/2014 � The earliest possible date for a national tariff for mental health (if evidence from the use of a national currency presents a compelling case for a national price). We expect to finalise future timetables later in 2010.We expect to finalise future timetables later in 2010.

4. 4 Currencies or Prices? Our focus is on currency at the moment � a common way of describing and contracting for mental health services. Think of a currency as a shopping basket � a group of products that are paid for as a whole. Will be possible to compare the contents and prices of each shopping basket.Our focus is on currency at the moment � a common way of describing and contracting for mental health services. Think of a currency as a shopping basket � a group of products that are paid for as a whole. Will be possible to compare the contents and prices of each shopping basket.

5. 5 The Currency Methodology This is an ongoing process and we want the local NHS to be involved in development and improvement..This is an ongoing process and we want the local NHS to be involved in development and improvement..

6. 6 Care Pathways & Packages Approach The evidence base for the clusters is explored in the Journal of Mental Health article.The evidence base for the clusters is explored in the Journal of Mental Health article.

7. 7 What is the Scope of the National Project and the clusters? IAPT and secure services will be a focus for 2010 development work.IAPT and secure services will be a focus for 2010 development work.

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9. 9 Mental Health Clustering Tool (MHCT) Nationally agreed and utilised tool for allocation to Care Clusters in 2010/11 Tool incorporates HoNOS with additional items Item 1 (Overactive, Aggressive, Disruptive or Agitated Behaviour) not used for Clustering purposes Items marked (H) are historical. Other items are current (within the last two weeks) Historical items to be identified alphabetically rather than numerically for distinguishing purposes This tool was agreed by piloting organisations following an extensive evaluation.This tool was agreed by piloting organisations following an extensive evaluation.

10. 10 Data items within the Mental Health Clustering Tool ..

11. 11 Importance of Information For this to work, we need MHCT ratings and a care cluster for each service user. This is a significant leap in the quality of individual information available for mental health service users. It is happening at the same time as many providers are moving systems. There are considerable challenges e.g. linking social care held information with NHS held information. We need to consider whether information will have to become more timely i.e. more like the acute trust situation.

12. 12 Development and Implementation � Entering a New Phase

13. 13 The project is a genuine partnership between DH and the NHS. Local projects are being run often under the auspices of the SHA. These local projects are represented on the Product Review Group which makes recommendations on issues that require national consistency e.g. the version of the care clusters to use. Professional bodies are also heavily involved through membership of the Expert Reference Panel and, in the case of the Royal College of Psychiatrists, membership of the Product Review Group. The project is a genuine partnership between DH and the NHS. Local projects are being run often under the auspices of the SHA. These local projects are represented on the Product Review Group which makes recommendations on issues that require national consistency e.g. the version of the care clusters to use. Professional bodies are also heavily involved through membership of the Expert Reference Panel and, in the case of the Royal College of Psychiatrists, membership of the Product Review Group.

14. 14 Product Review Group and Sub-Groups

15. 15 Other issues to address in 2010 Future-proofing the cluster numbering. Link between IAPT Minimum Data Set information and clusters. Personalisation agenda and social care. Training to support mental health professionals in using the approach. Technical issues around elements included within cluster such as first assessment.

16. 16 Mental Health PbR sits at the centre of improved mental health services

17. 17 Any Questions