Source · Select Committees · Public Accounts Committee
Recommendation 12
12
Accepted
NHSE unable to explain cost-effectiveness criteria for mental health service investment decisions
Conclusion
When we asked what criteria it used to decide on investment in one area against another, NHSE explained the consultative approach it took to prioritise services but could 13 NHS Long Term Workforce Plan, Overview, Chapter 1, paragraph 26, and Table 5 14 Qq 147–148 15 Qq 31,102, 105, 108, 111 16 House of Commons Committee of Public Accounts report, Improving access to mental health services, Sixteenth report of session 2016–17 17 Q 17; C&AG’s Report, paras 7, 15 18 Q 102 19 Qq 101, 109–110; C&AG’s Report, paras 7, 3.12. 20 Qq 34, 61, 98–105, 117; C&AG’s Report, paras 15, 2.25 Progress in improving NHS mental health services 11 not explain to us the cost effectiveness of its chosen interventions. It agreed with us that it is important to understand the impact of its initiatives, highlighting the opportunity that its current evaluation of mental health support teams in schools provides to understand the impact of earlier interventions on preventing later problems.21
Government Response Summary
The government commits to implementing MHSDS v6 by April 2024 and v7 by April 2025 for better data recording and patient-level cost tracking. NHS England will also aim for 50% of relevant patients to record paired outcome scores by year-end and has commissioned an independent evaluation of Mental Health Support Teams, including cost-effectiveness.
Government Response
Accepted
HM Government
Accepted
2.1 The government agrees with the Committee’s recommendation Target implementation date: January 2024 2.2. NHS England is working to improve the recording of information on patient need, as well as other areas, through the implementation of the Mental Health Services Dataset (MHSDS) version 6 in April 2024. The version 7 update, which is currently scheduled for April 2025, is likely to include the introduction of the International Classification of Diseases (ICD) - 11 diagnostic standard, and support for the new mental health currencies in development, which will better track patient-level costs. Integrated care systems can access data from the MHSDS for commissioning services, service planning, monitoring performance and reporting on performance. 2.3 As part of improving data on patient outcomes, NHS England is aiming to have 50% of patients in Children and Young People (CYP), perinatal and adult community mental health services recording a paired outcome score (where the patients have the same outcome measure recorded at least twice so progress can be measured) by the end of the year where the outcomes data quality key performance applies, and will look to extend that target in future strategies. Furthermore, an independent impact evaluation of Mental Health Support Teams (MHSTs) has also been commissioned via the National Institute of Health Research, which will include a cost effectiveness analysis of MHSTs. These improvements collectively will put the department and NHS England in a better position to jointly assess the effectiveness of different interventions that have been implemented and will be used to inform the creation of future strategies. 2.4 DHSC will provide an update in January 2024 as part of its joint letter with NHS England to the Committee.