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A n Introduction to Mental Health Clustering and Mental Health Payment by Results

A n Introduction to Mental Health Clustering and Mental Health Payment by Results. Care Pathways and Packages Project SHSC = Mental Health Clustering Project. Needs Assessment Health and Social Care. Cluster Allocation Care Clusters 1 - 21. Resource Allocation .

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A n Introduction to Mental Health Clustering and Mental Health Payment by Results

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  1. An Introduction to Mental Health Clustering and Mental Health Payment by Results

  2. Care Pathways and Packages ProjectSHSC = Mental Health Clustering Project Needs Assessment Health and Social Care Cluster Allocation Care Clusters 1 - 21 Resource Allocation. Health and Social Care Intervention/ Skill Mix/ Outcomes Cost = local Tariff = ‘PbR’ Service User Provider Commissioner

  3. 2010 /11 Clusters available Reference costs by Cluster 2011/12 Allocated to a Care Cluster by 31st Dec 2011 2012/13 Clusters (local Tariff) Mandatory for Contracting and payment 2013/14 Earliest possible date for a National Tariff ?? National Timescales

  4. Project Infrastructure City-wide Strategic Group to be established and key principles agreed (e.g. integration of health and social care) Assessment using M.H.C.T. Cluster Allocation Data Quality S H S C2010/11 Priorities

  5. What are the benefits? Service Provider / Practitioner driven A clearer shared language Benchmarking Better resource planning Provides data to inform service redesign Help Care and Support Planning (potential for integration with SDS and personalisation)

  6. SHSC Timeline Staff training on MH Clustering Tool All Staff assessing using Clustering tool Developing costings for Care Clusters Sep 10 Dec 10 Mar 11 Jun 11 Sep 11 Dec 11 Mar 12 Begin Reporting clustering Data as part of MHMDS All Service Users allocated to a Cluster Begin using clustering as Basis of contracting IT and data management Solutions in place

  7. National PbR Governance Arrangements MH System Reform Board PbR Expert Advisory Group PbR Programme Board KEY MH PbR Expert Reference Panel MH PbR Project Board Formal reporting arrangements For advice and Information MH PbR Product Review Group Forensic Clustering Tool, Care Transition and Algorithm Costing and Currencies Quality and Outcomes Others Services LD CAMHS Liaison Others

  8. Regional Arrangements • Care Pathways and Packages Programme – Yorkshire and Humber and North East of England • West Midlands Group • London Development Programme

  9. Yorkshire, Humber and North East (CPPP) Governance Arrangements CPPP Programme Board CPPP Core Project Team CPPP Central Project Team Workstreams MH Clustering Tool Development Data Management Group Costing Methodologies Group Quality and Outcomes Group

  10. SHSC Governance Arrangements SHSC Trust Board Sheffield Strategic Mental Health Clustering Board EDG Mental Health Clustering Project Board Chair = Project Executive Lead Members = Key Stakeholders / Senior Level Managers Mental Health Clustering Project Team Chair = Project Manager Members = Workstream Leads

  11. In: Post GP care for mental health services that have traditionally been labelled working age (including early intervention services from age of 14) and older peoples services Out (for now): IAPT Child and adolescent mental health services (CAMHS) Secure Services (low, medium and high) Learning disability services Specialist services What is included / excluded?

  12. Clustering Outcomes MENTAL HEALTH CLUSTERING TOOL OUTCOMES IPAT Outcomes Care Clusters 1 - 3 Care Clusters 4 & 5 Care Clusters 6 - 8 Care Cluster 10 Care Clusters 11 - 13 Care Clusters 14 &15 Care Clusters 16 &17 Care Clusters 18 - 21 Mild / Moderate Common Mental Problem Health 8 wks – 6 mths. Severe / Very Severe Common Mental Health Problems 6 mths – 3 yrs Overvalued Ideas; Enduring; Chaotic & Challenging (Personality) Disorders 3 yrs + First Episode Psychosis Up to 3 yrs Recurrent Psychosis Low /High/ High Symptom & Disability 3 yrs + Psychotic Crisis & Severe PsychoticDepression 8 – 12 wks Dual Diagnosis & Difficult to Engage 3 yrs + Low / Moderate / High; High Physical or Engagement Cognitive Impairment or Dementia 3 yrs +

  13. When to cluster? • At the point of referral or initial assessment • At planned Care Programme Approach (CPA) or other formal reviews • At any other point where a change in planned care is deemed necessary (e.g. unplanned reviews / urgent admissions)

  14. The Clustering Tool In order to allocate someone to a cluster a mental health professional must : • Rate a person’s needs based on the18 data scales. Each scale is rated from 0 (no problem) to 4 (severe or very severe problem) • Based on the ratings, indentify a profile that matches that of the service user they are assessing • Make a final decision on which cluster to allocate the service user to. This is the decision of the professional

  15. The 18 assessment scales

  16. An example of a cluster profile Care Cluster 10 First Episode Psychosis

  17. Common Mental Health Problems (low severity) Common Mental Health Problems Non-psychotic (moderate severity) Non-psychotic (severe) Non-psychotic (very severe) Non-psychotic disorders of overvalued ideas Enduring Non-psychotic disorders (high disability) Non-psychotic chaotic and challenging disorders Blank Cluster First episode in psychosis Ongoing recurrent psychosis (low symptoms) Ongoing or recurrent psychosis (high disability) Ongoing or recurrent psychosis (high symptom and disability) Psychotic crisis Severe psychotic depression Dual diagnosis (substance abuse and mental illness) Psychosis and affective disorder difficult to engage Cognitive Impairment (low need) Cognitive Impairment or dementia (moderate need) Cognitive Impairment or dementia (high need) Cognitive Impairment or dementia (high physical or engagement) The Clusters

  18. What happens next? • Establish a Sheffield citywide strategy group and agree key principles (including, that clustering should not have a negative impact upon the integration of health and social care services). • Maintain links with CPPP, Dementia SMT and the Acute, Scheduled Care and FMI Pathway development work in SHSC • Begin process of training local clinicians to use the clustering tool and start to cluster. • Begin locally costing each cluster in preparation for use in contracting 2012/2013.

  19. Where can I find out more? Mental Health Clustering Booklet: http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/documents/digitalasset/dh_112282.pdf Department of Health – Payment by Results http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/Publ cationsPolicyAndGuidance/DH_112284 Care Pathways and Packages Programme http://www.cppconsortium.nhs.uk/index.php Or Contact the Project Manager at Sheffield Health and Social Care Kathryn Robertshaw (kathryn.robertshaw@shsc.nhs.uk)

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