Managing Implementation: Mental Health Commissioning Clare Mahoney Head of Integrated Mental Health Commissioning, Liverpool PCT 7th July 2009

Commissioning……..what is it? Best fit between resources and needs Strategic and population level World class Shifting focus of care from diagnosis and treatment to prevention and well-being Reducing health inequalities Focus on outcomes Commissioning cycle Described as the eyes, ears, brain to reflect the core functions: Governance Data gathering and intelligence & analysis Procurement World Class Commissioning, (Dec 2007), aims to deliver a more strategic and long term approach to commissioning services, with a focus on delivering improved health outcomes, and ultimately delivering better health and well-being for all. The aim is that world class commissioning will be “pivotal in shifting the focus of care from diagnosis and treatment to prevention and well-being” (DH 2008). It is seen as one of the most important mechanisms for achieving the NHS vision of delivering a health and care system that is fair, personalised, effective and safe; having a direct impact on population health and significantly reducing inequalities between the areas with the worst health and the population as a whole. The recent Darzi report (DH 2008) identified the need for PCTs to commission comprehensive well-being and prevention services, in partnership with Local Authorities, to improve mental health. The expanded mental health and social care commissioning task comprises three sets of functions that have been described as being the ‘conscience’, ‘eyes and ears’, and ‘brain’ reflecting core functions of governance, data gathering and analysis, and procurement. PCTs are responsible for deciding where to locate these functions for mental health becoming the overall guardian of local mental health commissioning activities. They need to develop stronger and more sophisticated governance of the ‘web’ of accountability relationships both within the local mental health system, and across wider civic society. Specifically, PCTs will need to give consideration to how they will govern partnerships, markets, their relationship with patients and the public, the securing of clinical advice and leadership and reduce mental health inequalities.

Supporting children and parents via commissioning processes Increase visibility Challenge stigma Data collection and analysis Safeguarding children Care plans Equality issue Keep it high Support the champions

Cont’d… Address gaps and deficits Partnerships: joint-funding, joint-protocols Make good use of helpful policy Development of outcomes measures Public mental health evidence base