Practical mental health commissioning explains the changing commissioning environment and how commissioners can make the most of available resources to improve the quality and outcomes of mental health and social care services in their area.
This framework is intended to guide commissioners as they traverse this complex and changing terrain.
The framework’s main focus is on the mental health system, across all tiers, but it also addresses population mental health and health improvement, and the links between mental and physical health, especially for people with common and severe mental illnesses.
It takes an all-age approach, covering the whole of the life course from the very early years to old age. It does not delve in significant detail into children and young people’s mental health and mental health in older age, but it will be supported by further, companion documents describing the key commissioning issues in these areas.
It explores the key policy imperatives driving commissioning for mental health into the future:
- improving population mental health and wellbeing and shifting the locus of power and responsibility to individuals, communities and local government
- increasing people’s choice and control over services through personalisation of assessment processes and service provision
- system reform to support innovation and free up resources to follow people’s choices through personalisation, Payment by Results (PbR) and related developments.
It describes the key commissioning enablers for achieving these three objectives. It seeks to knit into a coherent whole the multiple strands of improving quality, ensuring efficiency and productivity and supporting people to become more engaged in their own health care, while also managing increasing need and demand for services.
It recognises the multiplicity of factors involved in achieving quality and effectiveness in mental health and social care. Services need to be person-centred, cost-effective, clinically effective and safe. They have to work upstream, at the preventive and promotion end of the spectrum, as well as downstream with people experiencing severe mental illness. This requires commissioners to work in partnership across the public, independent, voluntary and community sectors, beyond the conventional boundaries of mental health provision.
The framework is in three parts:
- The changing commissioning landscape
This section outlines the policy background, the shift to GP-led commissioning, the expanded role of local authorities, the new mental health strategy, and the other key points such as quality standards and outcomes frameworks that inform the commissioning process.
- What mental health commissioning looks like now
This section outlines the nuts and bolts of the commissioning cycle, the joint strategic needs assessment and other key features of the commissioning process.
- Going forward: what mental health commissioners need to know
This section describes, with examples from the field, the imperatives that will drive commissioning forward and the priorities that will continue through the period of transition and into the new health and social care system.
This framework does not attempt to provide a definitive and detailed guide to commissioning across the spectrum of mental health need. Rather, it aims to contribute to and inform ongoing policy and practice development nationally and across local government.
It has been written and produced with input from a broad range of professionals, individuals and organisations. In particular, it has been informed by and will be of particular relevance to the memberships of ADASS, the NHS Confederation and the Royal Colleges of Psychiatrists and General Practitioners.