RCPsych Editor
Earlier this month I was very pleased to be
asked to edit the College e-newsletter. The e-newsletter is
part of the College’s developing communications plan which has seen
the President’s e-letters to members and the relaunched website,
all aiming to keep the College in touch with its members.
Over the year I shall be listening to the
College officers and staff to work out what is important news for
us all. I want to keep the newsletter short and topical to
complement the more considered reviews and papers in the College
journals.
Please send me any comments on the newsletter
or suggestions you have for issues you think we should cover.
I will try to keep a balance of articles covering different
specialties and different countries in the UK and overseas
(I’ve only worked in London but am proud of my second generation
Dublin roots). Please tell me if this balance is not
right.
The College will send the newsletter to all
College members who have supplied an email address.
Rosalind Ramsay
Consultant Adult Psychiatrist
To contact me, please email: dhart@rcpsych.ac.uk
Payment by Results – grasping the
nettle
Martin Elphick, Payment by Results working
group chair
We hear that there is more money going into
the NHS now – at the top end – than ever before. So why are
mental health budgets being cut? One reason may be because we
have no information-based funding mechanism to compete with primary
care and the acute sector.
The Payment by Results (PbR) programme is the
latest Department of Health funding model, the successor to the
Casemix programme which began in the early 1990s. The Casemix
model had a mental health strand but this was not as well developed
as in acute specialties. The model aimed to reward clinical
and managerial effectiveness rather than provide incentives to
manipulate returns by exploiting loose diagnoses or data
definitions. Over time understanding the benefits and
undoubted risks became more sophisticated.
Payment for activity carried out under PbR is
guaranteed and we have already seen mental health trusts face cuts
to cover the overspend in acute trusts; with PbR accounting for 70%
of the NHS budget, not yet being a part of it makes us an exposed
minority group.
The College has formed a Payment by Results
working party, reporting to the English Policy Committee, to keep
track of developments and to bring together expert opinion.
We are setting up a website for College Members, with monthly
updates. Look at the College PbR website for information from
the Department of Health on its latest pilot project and plans.
For more information see
Elphick, M (2007) Information—based management of mental health
services: a two-stage model for improving funding mechanisms and
clinical governance. Psychiatric
Bulletin (31, 44-48).
Fairbairn, A (2007) Payment by Results in
mental health: the current state of play in England.
Advances in
Psychiatric Treatment 13: 3-6.
Update on implementing the NSF for
Mental Health and NICE guidance
Delivering
the Government's mental health policies: Services, staffing and
costs
The Sainsbury Centre for Mental Health published this report by
Jed Boardman and Michael Parsonage in January 2007. The report,
organized around the seven standards of the NSF for adult mental
health in England, assesses the service, workforce and financial
implications of delivering the key objectives of the governments
mental health policy by 2010/11. Substantial resources have
gone into mental health in recent years, but total spending needs
to rise by a further 53% in real terms and staff numbers by nearly
40% between now and 2010/11 if the objectives are to be met.
“The National Service Framework for mental
health was an ambitious ten-year plan, which is unlikely to be
achieved in full by 2010/11. Improving mental health services
remains a serious challenge for the NHS and social services and
significant gaps remain. Given the importance of continuing
to improve services and to promote social inclusion, citizenship
and rights vision of services, plans now need to be made to develop
a successor to the NSF which set out the future direction,
standards, structure and delivery of mental health services after
2010.”
Key statistics include:
Financial requirements (all figures in 2005/06
prices):
Public spending on adult mental health in
England, 1999/2000: £3.3bn.
Public spending on adult mental health in
England, 2005/06: £4.9bn.
Projected public spending on adult mental
health in England, 2010/11: £6.0bn.
Required public spending on adult mental
health in England, 2010/11: £7.5bn.
Staffing requirements:
| |
Current staff,
2005/06 |
Required staff, 2010 |
| Consultant psychiatrists |
2,689 |
4,075 |
| Other medical staff |
4,446 |
6,844 |
| Qualified nurses |
51,298 |
70,790 |
| Social workers |
6,124 |
10,211 |
| Clinical psychologists, psychotherapists and counsellors |
13,623 |
16,320 |
| All above groups |
78,180 |
108,240 |
Update on the mental health
bill
The Mental Health Bill has completed the
committee stage in the Lords and will enter the report stage on
19.2.07.
www.rcpsych.ac.uk/pressparliament/aboutourparliamentarywork/westminster.aspx
New communications
strategy
The passage of the Mental Health Bill through
Parliament gives the College a good opportunity to ensure that its
position on issues surrounding mental health and the role of the
psychiatric profession is understood more widely by the media and
the public. The College has therefore appointed Bell Pottinger
Group to advise on a range of topical mental health issues over the
next six months.
Bell Pottinger Group, a specialist
communications company, will concentrate on helping the College to
develop a comprehensive communications package, both nationally and
regionally. The College Divisions, working with Bell
Pottinger Group, will play a key role in developing their own
regional media strategies. Bell Pottinger Group will also
advise on improving relations with more specialist media, for
example, with the ethnic media to address this key objective in the
College's race equality action plan.