Commissioning out of area Treatments

Project Description

Out of area services make up a considerable proportion of mental health and social care provision and expenditure; around £690 million was spent on mental health out of area placements in 2009/10 (CQC, 2010), with this figure thought to  have increased since the re-structure of commissioning bodies and a lack of clarity for ‘who does what, where’.

It is assumed that nearly half of all out of area placements in the independent and voluntary sector are made by local authorities (48.6%), with one quarter by NHS commissioners (24.3%) and roughly one quarter jointly funded (25.7%).  Nearly two thirds of the funding for these placements (62.6%) comes from NHS commissioners (Ryan et al, 2007).  Management of placements by care coordinators, practitioners and commissioners at a distance can create many difficulties. All out of area service use can impact on people’s contact with family and friends and limit opportunities for social inclusion, employment, education and independence (Rethink, 2007).

This is the case whether or not the reason for an out of area placement is lack of local capacity, suitable skills or practical issues such as legal restrictions. This social dislocation can be especially problematic for people from minority ethnic groups.

From a commissioning and financial perspective, use of out of area services also means that monies and specialist skills are being lost from the local system that could be used to improve local capacity and capability. The use of out of area services represents a hidden cost that links to a lack of development of local services (DoH, 2007).  This in turn can reduce choice for people, control over services and efficiency, and lead to public criticism.

In view of this, out of area commissioning can be a large proportion of overall mental health budgets, and subsequently ‘big business’ for CSU’s, however the question is, how are your current commissioners are assessing ‘value’ for money not only from a commissioning perspective, but also where the value attributed is aligned with the values and needs of service users?  In other words, are they affecting systems and commissioning cycles, or merely managing a caseload and facilitating demand?

Unlike other commissioning bodies, this is our core function, with highly specialised skills and expertise in this area.  Not only can we create a bespoke and credible model for your CCG, but as we are not associated with finance departments and other corporate functions, what you see is what you get; Mental Health Commissioning defined.

We have provided an example of a recent project undertaken to illustrate the kind of work we have completed and highlight the effectiveness of the model.

JMB Health Consultancy has been successfully managing OATs for several CCG’s and CSU’s within the North West with outcomes such as:

• Strategic alignment of providers and local needs analysis
• Effective commissioning strategies
• Effective service mapping
• Individual goal setting

Example of savings achieved

Putting it into context…. If you are a CCG, do you know what you are paying – and more importantly what you are getting for the money?

CAN YOUR EXISTING COMMISSIONERS PROVIDE YOU WITH VALUE FOR MONEY SOLUTIONS FOR OUT OF AREA TREATMENT REVIEWS, FUTURE EXPENDITURE AND POTENTIAL SAVINGS?

We Can – Our 6 point savings challenge and promise to you will address this.

If you would like to know more, contact JMB health Consultancy for more information and a no obligation conversation about how we can help!