Liaison psychiatry teams in general hospitals can cut costs to the NHS by reducing how many people need beds and how long they stay, according to a report published yesterday by Centre for Mental Health with the NHS Confederation’s Mental Health Network and the London School of Economics and Political Science (LSE), and funded by the Strategic Health Authority Mental Health Leads.
Liaison psychiatry services provide mental health care to people being treated for physical health conditions in general hospitals.
The Economic Evaluation of a Liaison Psychiatry Service examines the costs and benefits of an award-winning service based at Birmingham City Hospital. The service, known as RAID, offers comprehensive, round-the-clock mental health support to all adult patients in the hospital.
The report finds that the financial savings RAID generates within the hospital significantly outweigh the costs of running the service. Since expanding from a small liaison psychiatry team to its current form in 2009, RAID is estimated to have cut the costs of bed use within the hospital by some £3.5 million a year.
Most of the savings the service generates come from shorter lengths of stay and reduced readmissions to the hospital among elderly patients. But further savings are also likely to be generated by an increase in the number of patients being discharged to their own homes rather than residential care.
The report concludes that liaison psychiatry can represent good value for public money. It both cuts costs in the NHS and improves people’s quality of life. By even the most conservative analysis, the RAID service creates savings that are four times bigger than the extra cost of expanding the service it replaced.
The report is published alongside an NHS Confederation briefing, With money in mind: the benefits of liaison psychiatry.
Mental Health Network director Steve Shrubb said:
The results of this evaluation are extremely encouraging. Patients get better care when mental health needs are assessed and treated at the same time as physical health. Patients are taken to the right place, problems can be identified earlier and follow-up is more effective. These services will almost certainly save money too. Integrated care such as this could help the NHS go a long way towards meeting its current unprecedented savings challenge.
Chair of the SHA Mental Health leads group Lawrence Moulin said:
SHA leads across the country welcome the building evidence base that not only does mental health support for people in acute hospitals improve quality, but it also leads to real savings. We look forward to supporting its universal implementation.
Centre for Mental Health chief executive Sean Duggan said:
Separating out physical and mental health needs is no longer sustainable in a health service facing rising cost pressures. It doesn’t make sense to patients and it doesn’t make business sense, either. Liaison psychiatry is an important way of bringing physical and mental health care closer together and when it is done well it provides excellent value for public money.
George Tadros, Consultant in Old Age Liaison Psychiatry and RAID lead clinician, said:
RAID is an innovative service which has brought psychiatry back to the front doors of an acute hospital and managed to integrated mental health services within physical health provision. As a clinician, I hope similar schemes will develop across the country.
Parsonage, M. and Fossey, M. Economic Evaluation of a Liaison Psychiatry Service (PDF). The Centre for Mental Health, 17 Nov 2011.
With money in mind: the benefits of liaison psychiatry (PDF). NHS Confederation, 16 Nov 2011.