A diagnostic framework for CCGs commissioning community mental health services

This work, developed by accountancy firm Mazars LLP, has been commissioned by NHS Confederation and Strategic Health Authority Mental Health Leads. It is a diagnostic tool aimed at mental health commissioners working for clinical commissioning groups (CCGs), helping them to identify where the gaps are in their local service provision and what they need to do to make effective changes, where necessary.

The framework

A summary of the framework, and the four areas it covers, is presented as a flow chart

A summary of the framework is presented as a flow chart, signposting to the relevant sections where the authors go into greater detail about the four areas of the framework:

Assessment
Access to services
Treatment
Management

At the top of the chart it tells you where you can find more information about the overriding principles, namely securing common values and reducing inequalities in primary care.

Commissioning

Note saying 'Value for money' pinned to a noticeboard

This report and framework briefly summaries why effective commissioning is necessary

Mazar LLP, although the main business is accounting, has specialist teams for education, health, and local government. Within these teams, they provide expertise in audit, governance and risk, due diligence, business process improvement, healthcare commissioning, mental health services, efficiency, and financially modelling, all of which are important to CCGs. So this framework has been written by people who have experience of both the clinical and business processes that the NHS needs to ensure are operating efficiently and effectively. This report and framework briefly summaries why effective commissioning is necessary, particularly in mental health where the burden of illness is rising. It provides a list of questions for CCGs to consider together with their partners and stakeholders, and illustrates solutions to these questions using case studies from around England.

Commentary

Mind the gap sign at underground station

Teams can ask themselves to identify gaps hindering service improvement

Although commissioned by an NHS organisation, it is a commercial one that has produced this framework. However, there is much to be learned from the private sector. In the illustrated version of the framework, the authors have provided questions that teams can ask themselves to identify gaps hindering service improvement, which need to be filled so that patients receive a better quality mental health service.

Questions include:

Is there significant unmet need?
What is the patient experience of access?
Do services have the right kind and numbers of staff?
Do local services work effectively with each other?

These are all simple, common sense questions, but important, because if one identifies a gap, then that gap may well put a burden on existing resources. If there are insufficient members of staff, then the staff that are on duty will be overstretched, stressed, more at risk of sickness, and mistakes are more likely to happen.

This framework needs to be used by all groups involved in the delivery of community mental health services, including the patients themselves. Staff in CCGs may feel that they are offering the best access, but service users may have an entirely different point of view and this should be considered as you work through the framework with your teams. Hopefully the case studies will inspire you to develop new, improved ways of working, where necessary.