Analysis of the Payment by Results Policy for Mental Health in England

Abstract

Purpose: To analyse the Mental Health Payment by Results policy with an emphasis placed on exploring the perceptions of Providers involved in implementation, to identify any barriers to implementing the policy and provide recommendations to improve implementation. Methods: This report follows the structure of the Walt and Gilson policy analysis framework addressing each area of context, content and processes with a focus on actors who are involved in the implementation process to inform how this policy is being implemented in practice. Results from the primary interview data were triangulated with the literature. The data collected was subsequently analysed and barriers to implementation were identified. Results: The following barriers to implementation were identified: 1) Inadequate time frame 2) Inaccurate data arising from (i) staff not being trained adequately (ii) the Mental Health Clustering Tool (reliability and variability, issues of clarity, difference in thresholds) clustering at the correct times (iii) clustering at the correct times (iii) defining care packages (iv) costing clusters 3) Lack of guidance from central government 4) Insufficient IT systems which do not support the policy 5) Lack of preparation of providers and commissioners 6) Changes in commissioning structure. Conclusion: On the basis of the barriers identified and the literature review, recommendations to policy makers were made to assist them with improving the implementation of Mental Health Payment by Results.