Increasing the value that services deliver
Trust leaders are committed to doing all they can to deliver effective and productive services for patients and achieve the best value for money for taxpayers. They recognise there is more trusts can do to ensure the consistency of services and reduce unwarranted variation between services, for example, in contact rates and length of stay.
However, measuring and improving the productivity of services in the NHS tends to be approached through metrics focused on measuring the total number of 'inputs' (such as NHS funding and the number of staff) and the total number of 'outputs' (such as the amount of activity delivered). This may work for physical health conditions, but a different approach is needed for mental health services, and arguably other health services more broadly. A much wider lens of improvement and the concept of 'delivering value' is needed, with a focus on striving to improve outcomes for patients, especially for those who experience the greatest inequalities in access, experience and outcomes. This would be a far more meaningful indicator of productivity in mental health services, as well as other health services more broadly.
Accurately measuring and improving value in mental health services requires local and national action to address. The lack of investment in core mental health services, alongside insufficient attention to the wider public services individuals with severe mental illness rely on more broadly, has hindered what services can deliver and their impact in particular. Investment for mental health services needs to be targeted on the modernisation and development of mental health trusts’ estates, both inpatient and community based, and ways of working.
Mental health trust leaders and stakeholders alike told us that focusing on patient outcomes is also a key element in improving the quality of services. Another key enabler of productivity that requires sufficient long-term investment is supporting the NHS to develop an inclusive, open culture which enables innovation and empowers staff to drive forward initiatives that deliver higher quality and more cost-efficient care.
To increase the value delivered by all mental health services, we need to:
-
Use metrics focused on timely and equitable patient access, experience and outcomes from mental health services, and which account for system and partnership working.
-
Provide adequate long-term investment in core mental health and wider public services to enable sustainable improvement, with a particular focus on increasing the mental health sector’s access to capital investment.
Case study
East London NHS Foundation Trust's work to deliver value in healthcare. They focus on supporting teams across the organisation to reduce waste and providing higher value care to the benefit of patients and providers. The trust has developed an '8 waste tool' to help services understand the different opportunities that might exist to improve the value they provide.