Local Commissioning of Adult Mental Health Services
REPORT OF A SERVICE DEVELOPMENT PROJECT ON THE LOCALITY COMMISSIONING OF MENTAL HEALTH SERVICES FOR ADULTS OF WORKING AGE FUNDED BY A SECTION 64 GRANT FROM THE DEPARTMENT OF HEALTH
APRIL 2003 TO MARCH 2006
1. Purpose of Paper
The purpose of this paper is to share the outcome of the work that HASCAS, the Health and Social Care Advisory Service, undertook on the local commissioning of mental health services for adults of working age by Primary Care Trusts and their health and social care partners. This work was funded by the Department of Health and took place during the three years from April 2003 to March 2006.
2. Introduction and Background
HASCAS applied for funding to develop evidenced based standards for the commissioning of adult mental health services and to review selected pilot sites against those standards. The standards therefore were used as a service development tool helping to focus and prioritise what actions needed to be addressed. The Standard Headings are listed below.
Early on HASCAS, together with the first nine PCTs, established a working definition of mental health commissioning as:
the assessment of health needs, the development of strategies to meet those needs, the purchasing of services for users and the monitoring of the quality of the services provided for a given population
3. The Project
The project was launched at a meeting of the first nine locality commissioners in May 2003. Each locality was invited to bring a team of three comprising a mental health commissioner together with colleagues from the local provider trust, local GPs, colleagues from social services or the voluntary and independent sectors. The purpose of this meeting was to hear from the sites those issues that were challenging them (they were asked to list their five major concerns), and what they hoped to get out of involvement with the project and to initiate a discussion about the standards for commissioning.
4. The Review Process
The reviews were constructed around the HASCAS Commissioning Standards Framework which each group of PCTs and their partner agencies agreed and added to at an initial meeting at the start of each year.
The HASCAS Regional Director co-ordinating the review worked with the site co-ordinator identified by the PCT for the review, to draw up a schedule of meetings between key individuals and teams and the reviewers, and also wrote the site specific reports. For each two-day review it was usually possible to accommodate about 25 to 30 meetings. Written information was also obtained, including policy documents, clinical guidance, practice protocols, and statutory documents and routine returns. The interviews and document collection were informed by the HASCAS standards prepared for the project. Each review team comprised a minimum of five people, which always included the HASCAS Service Development Adviser (SDA), and an experienced mental health commissioner and in most cases both a service user and a carer. One reviewer always had a nursing background, with the other reviewers being drawn from GPs, social services senior managers, clinical psychologists, and general adult psychiatrists. Two commissioners from the participating PCTs were involved in three of the reviews.
5. The Outcomes
All the 19 Locality Commissioners received an individual report on the review visit providing a bench mark of where they were considered to be against the standards, and making recommendations on how the commissioning process could be improved. The aim was not to compare each PCT with the others, but to provide an honest external assessment of how they compared with the standards. The report included a set of the Standards completed to illustrate where the review team felt the commissioning met, partially met or failed to meet each standard and criterion.
6. Conclusions
The Project was extremely successful and the 19 Locality Commissioners found the process helpful, and took steps to implement the HASCAS recommendations included in their individual reports. Where requested HASCAS re-visited about half the Locality Commissioners to review their progress in implementing their recommendations, and to offer advice on a particular aspect of the commissioning process where they wanted additional input.
HASCAS COULD HELP YOU REVIEW YOUR COMMISSIONING ARRANGEMENTS AND VIA A GP SKILLED IN PRACTICE BASED COMMISSIONING (PbR) HELP YOU DEVELOP AN INTEGRATED COMMISSIONING STRATEGY FOR ADULT MENTAL HEALTH GAINING THE BENEFITS OF PCT COMISSIONING ALLIED TO STRONG PbR COMMISSIONING.
For more information contact:
Ian Allured
Tel:
0207 307 2892
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