Summary
The NHS is facing a significant financial challenge and needs to make substantial improvements in productivity if it is to provide high-quality services without additional funding. Spending on mental health accounts for around 10 per cent of the overall health budget and so the mental health sector has a key role in responding to this challenge.
The King’s Fund and Centre for Mental Health, with the support of the Royal College of Psychiatrists and the NHS Confederation’s Mental Health Network, have worked together to explore how mental health services could be delivered in a different and more cost-effective way. The consensus from their work, including an expert seminar and a review of evidence, is that there is scope for mental health services not only to improve their own productivity but also to support productivity improvements in other parts of the NHS.
Mental health and the productivity challenge: Improving quality and value for money focuses on four main areas:
- immediate priorities for improving productivity in existing mental health services
- what mental health services can offer to improve productivity in the NHS as a whole
- the economic benefits beyond the NHS of improved mental health care
- the longer-term challenge of building a preventive and empowering mental health system.
The report suggests that there are real opportunities to change the way mental health services are delivered in order to achieve more within existing budgets.
Of the improvement areas highlighted in the report, we consider that the following are the most promising targets for immediate attention:
- reducing unnecessary bed use in acute and secure psychiatric wards
- establishing systems to review the use of highly expensive out-of-area treatments
- improving workforce productivity
- strengthening the interface between mental and physical health care, particularly for older people and people with long-term conditions.
Many case studies and practical examples are included to illustrate these conclusions, and there are recommendations for action that involve everyone in the health service.
To download the report http://www.kingsfund.org.uk/publications/mental_health_and.html
PDF version Radical changes need to be made to mental health services to cut costs and improve patient care, including not putting patients with mental health problems into hospital beds, according to a report from The King's Fund and the Centre for Mental Health.
The report – which said that current spending cuts presented a "significant opportunity" to make efficiency savings and improve care for patients by re-designing services – recommended a reduction in "unnecessary bed use" in hospitals and psychiatric units by providing better community-based services, a move that could save up to £200m a year. And it said there should be fewer patients placed in facilities outside their local area, quoting evidence that suggested a reduction of up to 50 per cent could be achieved and this would save £65m a year.
The report also called for improvements in services for older people and those with long term conditions who also have mental health problems because reducing delays in hospital discharges for patients with dementia could save more than £300m a year.
And better care could be provided by reducing "unnecessary" admissions to secure services and improving discharge arrangements, by increasing the productivity of the workforce (including improving the management of nursing rosters and reducing sickness absence), and by providing effective employment support to help people with mental health problems remain in or return to the workplace
The report's lead author Chris Naylor, senior researcher at The King's Fund, said: "Mental health services must not be overlooked in the drive to improve productivity and increase quality in the NHS. This report shows that, by re-designing services, there are significant opportunities to reduce costs and reinvest the proceeds to improve the quality of patient care. The government's forthcoming mental health strategy provides an opportunity to make this happen."
More than £500m could be saved if mental health services in England were run more efficiently, a report says.
Better community support, cutting unnecessary hospital stays and reducing sickness absence can all help cut costs, say policy experts.
The NHS has been asked to find £20bn of efficiency savings by 2014.
The Kings Fund and Centre for Mental Health say changes might improve productivity but mental health services should not be singled out for cuts.
One pound in every £10 spent on the NHS goes into mental health services.
Report author Chris Naylor, of The King's Fund, said: "This report shows that, by redesigning services, there are significant opportunities to reduce costs and reinvest the proceeds to improve the quality of patient care."
The report recommends:
Report co-author Andy Bell, of the Centre for Mental Health, said improving support for people with mental health problems represented good value for taxpayers' money.
He added: "Mental health services can do their bit to make the NHS more productive but should not be singled out for cuts to valued and valuable activities."
The study is published ahead of a cross-government mental health strategy to be launched soon.
Commenting on the work, Prof Nick Craddock, Professor of Psychiatry at Cardiff University said more research was crucial.
"We need services informed by evidence, rather than the political ideology that has driven many of the wholesale changes over recent years.
"It is good to avoid unnecessary hospital admissions. However, it is important to realise that for many patients admission is life saving, and is a vital part of high quality care."
The Care Services Minister Paul Burstow said the report recognised the approach the upcoming mental health strategy will promote.
He added: "The NHS has to get better at seeing the whole person. Treating someone's physical symptoms and not understanding their mental health just isn't good enough."
He said he would set out plans on Thursday to extend psychological therapies to older people and those with long term conditions as part of the new strategy.
Marjorie Wallace, chief executive of the mental health charity SANE, said: "We do not want cuts to hurt mental health services, however our experience of a series of tragedies highlights our view that closing beds and hospital wards and relying on crisis teams is not the answer.
"We know of many patients who need more intensive help than many hard-pressed community teams can offer. Without the backstop of in-patient care, they and their families can find themselves neglected when they are most in need."
http://www.bbc.co.uk/news/health-11885481