Psychiatrist (The), 36(12), December 2012, pp.454-458.
Publisher:
Royal College of Psychiatrists
Payment by results is being extended to mental health services in the UK. To support its implementation in secondary mental health services, the DofH has developed the Mental Health Clustering Tool (MHCT) to assign patients to groups based on need and anticipated service use, rather than diagnosis. The authors examined 92% (117/127) of the patients in their community mental health learning disability team using the MHCT to discover whether it could capture their needs sufficiently well for assignment to a payment by results care cluster. A large proportion, 48%, of the sample was assigned to the variance cluster, Cluster 0, which is used when the needs of patients do not match any of the current 21 care clusters but a service will be provided. Clinicians’ ability to assign patients to clusters was primarily related to the absence of pervasive development disorder. Severity of intellectual disability alone did not appear to be associated with Custer 0 but aggression and agitation was more common in this cluster. It is concluded that the MHCT in its current form does not adequately capture the needs of people with more severe intellectual disability. An integrated mental health and learning disability clustering tool is in development and the authors suggest that until it is available it will not be possible to implement payment by results in mental health within learning disability services.
Payment by results is being extended to mental health services in the UK. To support its implementation in secondary mental health services, the DofH has developed the Mental Health Clustering Tool (MHCT) to assign patients to groups based on need and anticipated service use, rather than diagnosis. The authors examined 92% (117/127) of the patients in their community mental health learning disability team using the MHCT to discover whether it could capture their needs sufficiently well for assignment to a payment by results care cluster. A large proportion, 48%, of the sample was assigned to the variance cluster, Cluster 0, which is used when the needs of patients do not match any of the current 21 care clusters but a service will be provided. Clinicians’ ability to assign patients to clusters was primarily related to the absence of pervasive development disorder. Severity of intellectual disability alone did not appear to be associated with Custer 0 but aggression and agitation was more common in this cluster. It is concluded that the MHCT in its current form does not adequately capture the needs of people with more severe intellectual disability. An integrated mental health and learning disability clustering tool is in development and the authors suggest that until it is available it will not be possible to implement payment by results in mental health within learning disability services.
Subject terms:
instruments, learning disabilities, mental health problems, mental health services, needs assessment, severe mental health problems, financing;
Two surveys have shown community care services for people with learning difficulties are heavily under funded. Describes how campaigning groups are worried that unless something is done soon they are heading for disaster.
Two surveys have shown community care services for people with learning difficulties are heavily under funded. Describes how campaigning groups are worried that unless something is done soon they are heading for disaster.
Subject terms:
learning disabilities, mental health services, social care provision, vulnerable adults, community care, financing;
Great Britain. Department of Health and Social Care
Publication year:
2022
Pagination:
129
Place of publication:
London
An independent report that analyses funding flows associated with 'Building the Right Support' for people with a learning disability and autistic people. Building the Right Support seeks to support an overall reduction in the number of people with a learning disability and autistic people who are in specialist inpatient mental health care by improving their access to community support. The report seeks to examine the funding flows, and any related financial incentives and disincentives, that a) enable people to move out of hospital into homes with care and support, and b) develop the infrastructure of community services that prevent unnecessary hospital admissions and enable people to live ordinary lives in the community. This research highlights the problems arising from the inability to access national comparative data to provide comprehensive financial information, which would enable financial performance monitoring and the ability to identify trends and initiate corrective actions relating to BtRS. The study concludes that the moral case for change remains overwhelming - people need to move out of inpatient settings and have the right to live an ordinary life. Savings generated by inpatient bed reductions are unlikely to be sufficient to meet the costs of many people still to be discharged from inpatient care. Careful consideration needs to be given to how Integrated Care Boards (ICBs) can be supported and incentivised to enable as many people as possible to be discharged to live ordinary lives in the community. Similarly, continued high admission rates (particularly of autistic people) need to be addressed, and greater focus placed on investing in support that is available at an early stage with greater control for people and their families to find solutions that do not rely on inpatient stays, especially through transition.
(Edited publisher abstract)
An independent report that analyses funding flows associated with 'Building the Right Support' for people with a learning disability and autistic people. Building the Right Support seeks to support an overall reduction in the number of people with a learning disability and autistic people who are in specialist inpatient mental health care by improving their access to community support. The report seeks to examine the funding flows, and any related financial incentives and disincentives, that a) enable people to move out of hospital into homes with care and support, and b) develop the infrastructure of community services that prevent unnecessary hospital admissions and enable people to live ordinary lives in the community. This research highlights the problems arising from the inability to access national comparative data to provide comprehensive financial information, which would enable financial performance monitoring and the ability to identify trends and initiate corrective actions relating to BtRS. The study concludes that the moral case for change remains overwhelming - people need to move out of inpatient settings and have the right to live an ordinary life. Savings generated by inpatient bed reductions are unlikely to be sufficient to meet the costs of many people still to be discharged from inpatient care. Careful consideration needs to be given to how Integrated Care Boards (ICBs) can be supported and incentivised to enable as many people as possible to be discharged to live ordinary lives in the community. Similarly, continued high admission rates (particularly of autistic people) need to be addressed, and greater focus placed on investing in support that is available at an early stage with greater control for people and their families to find solutions that do not rely on inpatient stays, especially through transition.
(Edited publisher abstract)
Subject terms:
learning disabilities, autism, mental health services, hospital discharge, community care, financing, economic evaluation, savings, cost effectiveness;
British Journal of Psychiatry, 166, January 1995, pp.9-18.
Publisher:
Cambridge University Press
Assesses the economic burden of psychiatric disorders and learning disability in order to aid decisions on priorities for research. A wide variety of data sources both on prevalence and on the usage and costs of relevant services were used to measure the economic burden of each condition.
Assesses the economic burden of psychiatric disorders and learning disability in order to aid decisions on priorities for research. A wide variety of data sources both on prevalence and on the usage and costs of relevant services were used to measure the economic burden of each condition.
Subject terms:
learning disabilities, mental health problems, mental health services, NHS, needs, schizophrenia, severe mental health problems, social services, social care provision, costs, dementia, depression, financing;
Offers a comprehensive introduction to the theory, techniques and practice of occupational therapy in the fields of mental health and learning disability. The first part looks at the theory and framework of occupational therapy. The second focuses on the skills used by the occupational therapist in mental health practice, the needs of the client groups with which they work and the organisation and management of services. Contents include: philosophy and theory base; the occupational therapy process; the context of occupational therapy; media and methods; client groups; organisation and management.
Offers a comprehensive introduction to the theory, techniques and practice of occupational therapy in the fields of mental health and learning disability. The first part looks at the theory and framework of occupational therapy. The second focuses on the skills used by the occupational therapist in mental health practice, the needs of the client groups with which they work and the organisation and management of services. Contents include: philosophy and theory base; the occupational therapy process; the context of occupational therapy; media and methods; client groups; organisation and management.
Subject terms:
learning disabilities, mental health problems, mental health services, management, occupational therapists, occupational therapy, older people, physical disabilities, play therapy, primary care, rehabilitation, research ethics, social skills training, substance misuse, adolescence, assessment, bereavement counselling, children, ethics, field work, financing, group therapy, groupwork, health needs;