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Mental Health Service Commissioning

The means by which local authorities and health care planners research, develop and buy mental health services, commonly known as ‘Mental Health Commissioning’ is changing.  The new Government's approach is substantially different to the last, with a significant focus on local decision making and General Practitioner commissioned services. 

Collaborative and evidenced based solutions, which work with individuals and networks of individuals as co-producers of their care are likely to thrive. General Practice commissioning is predicted to boom. This is due to the development of strategic consortia of commissioner practitioners and parallel delivery of traditional provider focused practices.

Quality, cost effectiveness and outcome orientation in the design and delivery of new services will be paramount in an increasingly austere commissioning environment.

Whilst significant changes to the commissioning environment are likely to impact on Primary Care Trusts and Strategic Health Authorities roles significantly, World Class Commissioning concepts are likely to remain an important feature of the Mental Health commissioning environment for Voluntary and Community Sector (VCS) providers.

In mental health, the new government’s prioritisation of support for the National Dementia Strategy and the development of veteran care, offer new service development opportunities to VCS providers.

What are the implications?

  • A likely ongoing requirement on commissioners to work collaboratively with community partners in order to procure services, represents an opportunity to VCS service providers.  To established, traditional service providers, it also represents a threat as new community partners are identified.
  • A need for the development of improved channels for engagement with the public and with patients, (which may or may not include existing VCS organisations) offers mental health organisations with experience in ‘continuous and meaningful engagement’ an opportunity to support new commissioning approaches.
  • Clinicians are going to develop substantially more influence in service design. VCS providers perceived by local clinicians as poor, misaligned with strategic service provision need or dated in service design may not be re-commissioned.
  • VCS providers must be able to offer evidence based service provision in order to maintain and develop funded service provision. 
  • VCS organisations that seek to understand support and contribute to, a strategic view of the whole population’s health - and measures to challenge whole population health inequalities - are likely to thrive. 
  • As new approaches to commissioning stimulate local health care markets new entrants will appear. A dilution of funding for existing providers is likely.  New providers may discount service delivery costs to enter local markets.
  • Organisations promoting continuous improvement, quality and innovation, with robust local reputations are likely to thrive.
  • Contract compliance and a demonstrable commitment to continuous improvement will increasingly be seen as pre-requisites for ongoing (and new) commissioning relationships
  • Value for money considerations will have an enhanced role in purchasing decisions. VCS organisations, which are unable to offer competitive service provision (relative to quality), are unlikely likely to be funded by new commissioners at a local and strategic level.

Moving forward

  • How will your organisation demonstrate it is the ‘best’ community partner to work with in a larger and more diverse market of mental health service provision? Can you demonstrate that quality is embedded in your work?
  • What are your relationships like with local General Practitioners? How well do you understand their patient needs and priorities?
  • The extent to which new (General Practice) commissioners are required to make sustainable commissioning decisions - that represent value for money - could impact on commissioning opportunity, flexibility and growth.  Getting in at the beginning of service delivery design, (whilst plans are being developed) makes sense moving forwards.
  • Do you need to review how you engage with services users as well as the general public? Can you demonstrate how this engagement is consistent and used to your shape services?
  • What are your relationships like with local clinicians and General Practitioners especially? Do you need to have more influence with these key stakeholders?

Working effectively

  • Is the evidence you gather to demonstrate the effectiveness of your services clear, consistent and robust? Are you communicating this evidence in a way that commissioners understand?
  • Does your organisation have a systematic approach to continuous improvement and innovation?
  • Are you able to demonstrate a good track record of contract compliance to both new and existing commissioners?
  • How are you ensuring that your service offers value for money?  How can you highlight that your ‘added value’ offers a competitive service, particularly in an environment where new provides may choose to offer ‘cheaper’ services?

New approaches to service design and delivery

  • Are you considering consortia options when bidding for new contracts?  Might your organisation stand a better chance working collaboratively - rather than going it alone?
  • Are your mental health services aligned with the National Dementia Strategy or new Government commitments to improved veteran care?
  • Are you responding to the personalisation agenda?
Last updated at 13:42 Wed 14/Jul/10.

Discuss

How will this affect your organisation? Have you considered it during your strategic planning? Can you share any interesting relevant links?

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