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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.
The money and time would be better spent on improving collaboration between NHS staff and County Council staff (Social workers) and training their employees on a regular basis so they are competent to cordinate care for their clients who are under Mental Health Services. How can a Social Worker with no Mental Health experience or training carry out the conditions of the Care Plan Approach for a client/service user who has a diagnosis of a severe and enduring mental illness. How will “payments by results” influence their practice?
By illegally discharging their clients(proceadure not followed,no other care in place,no service user involvment) and accepting service users who have complex needs which is alcohol and/or substance misuse as well as mental health issues. Their outcomes are more positive than just a service user with only mental health issues and also recovery is a lot quicker. This is probably due to funding already made available and the large number of charities and agencies that support alcohol and substance misuse and have done for many years. Everyone knows that the Recovery process for service users with a severe and enduring Mental illness is a long process and this is partly due to a lack of or no provision of services in place and the “opinion” that certain mental illnesses cannot be treated or recovery is unlikely.It is completely biased and unfair. If you are “deamed to be untreatable” then why should my Social Worker waste their time on the likes of me when she could be paid more to treat someone with complex needs and help achieve their monthly targets for which im sure will be paid extra.Once again the Mentally Ill has been convienently forgotten about! And why has this payment by results not been piloted across the UK to see if it does actually work and if it doesnt then that will be highlighted and improved. And shouldnt the confederation mental health network include service users views a swell as all the others??? Afterall it is us that will be affected and without us they wouldnt get paid atall.