Mental health commissioners and providers are not ready for payment by results, says new NHS review


The NHS Confederation Mental Health Network have a published a review that discusses the readiness of mental health commissioners and providers to start working under the new Payment By Results system from April 2012.

The review involved speaking to more than 100 people from mental health trusts, commissioners, the independent sector, local authorities and national stakeholders in September 2011.

The review found that:

  • Commissioners and providers will not be ready to use the care clusters as the contract currency for 2012/13 with local prices
  • Most people were enthusiastic about the clustering process, and could see real benefits in implementing Payment By Results
  • Poor data quality means that trusts will not have a robust currency by April 2012
  • Trusts have not made sufficient progress in costing clusters to have local tariffs for April 2012
  • Tariffs are not yet fit for purpose, due to a lack of national guidance on how to calculate them and limited understanding of the variation in care packages by cluster
  • The changing commissioner landscape has reduced commissioners’ ability and capacity to focus on mental health

The review goes on to make 19 recommendations, including the following:

  • Mental health contracts should contain risk sharing agreements until the market is confident that local tariffs are fit for purpose
  • Reviews should be undertaken to gain a greater understanding of consistency issues in clustering users, and the variation in care packages provided to users within one cluster
  • Communication mechanisms should be strengthened to ensure momentum is maintained in implementing Payment By Results and consistency of approach
  • There is a particular need to educate new commissioners about Payment By Results
  • The establishment of a national website for the sharing of learning, tools and techniques would support local implementation

Mental Health Payment by Results Readiness Review (PDF). NHS Confederation Mental Health Network, Nov 2011.

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