10 December 2004
The new NHS payment-by-results hospital funding system should be used in mental health care but its introduction must be gradual, the Sainsbury Centre for Mental Health said this week.
Mental health, and a few other specialist services, have been excluded from the first implementation of payment by results in NHS England, which is due to take place between April 2005 and 2009. The Department of Health intends to bring these services under PBR after 2008.
PBR relies on a series of standard tariffs, which have proved difficult to identify in mental health care as treatment is complex and the cost often varies from patient to patient. Implementation is also hampered by poor data collection and inadequate IT systems.
The Sainsbury Centre's support for extending to mental health care is significant, as countries with well-established PBR-style systems, such as Australia and the United States, have not done so.
The centre's policy paper, Payment by results: what does it mean for mental health?, calls for a gradual introduction while robust classification methods are found and IT is improved.
Chief executive Angela Greatley said: 'Payment by results was not designed for mental health care. It is untried and untested for these services anywhere in the world. But that does not mean it should be rejected, rather that we need to proceed with caution.
'Payment by results could help improve the quality of mental health care, offer greater choice to service users and improve efficiency and value for money. To simply reject it because it is too difficult would be to make mental health services yet again a Cinderella within the NHS,' she added.
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