Abstract
ObjectiveIn April 2015, the English National Health Service started implementing the first waiting time targets in mental health care. This study aims to investigate the effect of the 14-day waiting time target for early intervention in psychosis (EIP) services after the first six months of its implementation.Study designWe analyse a cohort of first-episode psychosis patients from the English administrative Mental Health and Learning Disabilities Dataset 2011 to 2015. We compare patients being treated by EIP services (treatment) with those receiving care from standard community mental health services (control). We combine non-parametric matching with a difference-in-difference approach to account for observed and unobserved group differences. We analyse the probability of waiting below target and look at different percentiles of the waiting time distribution.ResultsEIP patients had an 11.6–18.4 percentage point higher chance of waiting below target post-policy compared to standard care patients. However, post-policy trends at different percentiles of the waiting time distribution were not different between groups.ConclusionsMental health providers seem to respond to waiting time targets in a similar way as physical health providers. The increased proportion waiting below target did not, however, result in an overall improvement across the waiting time distribution.
Highlights
Providing access to services for people in need of care is a key perspective for health systems around the world [1]
early intervention in psychosis (EIP) patients had more severe problems with hallucinations and delusions (HoNOS six score) and were more likely to be diagnosed with schizophrenia or allocated to the first-episode psychosis care cluster
EIP services are internationally recognised as supporting the timely provision of evidence-based care to patients with psychosis
Summary
Providing access to services for people in need of care is a key perspective for health systems around the world [1]. A number of countries operate waiting time targets to guarantee patients access to care within a maximum window of time, even though the definition of this window varies widely across countries and areas of health care [1]. Since the National Health Service (NHS) Plan in 2000, the English NHS has had a sustained focus on continually setting shorter waiting time targets combined with aggressive performance management of providers.
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