Poor data stops mental health tariff

The government has delayed plans to implement a national Payment by Results tariff for adult mental health services.

The Department of Health had aimed to introduce the tariff in 2013-14, but it has been delayed by concerns about the accuracy of the data being supplied by providers for the Minimum Health Dataset.

The dataset, which contains patient record level data for adults living with mental health conditions, is managed by the Health and Social Care Information Centre.

As reported by eHealth Insider on Monday, the HSCIC has uncovered significant error rates in the data, along with other datasets kept by the NHS.

The PbR system was set to cluster patients into 21 groups, with funding attached to their care and treatment.

However, the dataset and clustering system are not reliable enough to make sure providers receive the correct payment.

The DH has confirmed that the national roll-out of the system will no longer take place next year, following concerns regarding “data quality.”

In a statement to EHI, a DH spokesperson said: “We started our rollout of Payment by Results for mental health in 2012-13 and this will continue into 2013-14 and beyond.

“However, data quality will need to improve before we can start to introduce mandatory national tariffs for mental health services.

“While we have said that 2013-14 is the earliest year when a mandatory mental health tariff could be introduced, this was never a ‘deadline’ date. We are working with NHS mental health service providers to improve data quality.

“It will be a decision for Monitor and the NHS Commissioning Board to agree when a national tariff should be implemented.”

The announcement came on the day that the government published the implementation framework for its mental health strategy.

This maintains that one of its key priorities will be “to align NHS providers’ financial incentives with providing high quality care and delivering good outcomes for patients.”

However, Dr Joe McDonald, chairman of the British Computer Society Mental Health Group, told EHI that he was “not surprised” at the decision to delay the implementation of the tariff.

“Over a year ago we said that over half of the mental health trusts wouldn’t be ready to go with this,” he said.

“We conducted a survey that showed that one of the key issues was that the North, Midlands and East trusts were not ready as they were still waiting for Lorenzo.

"Many trusts don’t have adequate systems and that is likely to be the problem.”

Lorenzo is the ‘strategic’ IT system that was due to be delivered to the NME by local service provider CSC as part of the National Programme for IT in the NHS.

It has been severely delayed, and is in use in just one mental health trust – Humber NHS Foundation Trust, which went live with it earlier this year.

Mental health trusts in London and the South were more likely to receive systems through the programme, with a significant number adopting CSE Healthcare’s RiO.

The implementation framework says mental health will work towards a payment system in which currencies are “based on the needs of people accessing services.”

The DH will also develop indicators that will connect payment to recovery and to the patient’s experience.

Work has already begun on developing a PbR system for children and young people’s mental health services.