Priorities for mental health: economic report for the NHS England Mental Health Taskforce
This report provides an economic analysis of possible priorities for service improvement in mental health. It was commissioned by NHS England as an input to the five-year strategy recently produced by the independent Mental Health Taskforce.
After 10 years of substantial expenditure growth, the NHS is now halfway through a decade of austerity and is required to find productivity improvements of around £22 billion a year by 2020/21. Essentially this means finding more ways of generating improved health outcomes at lower cost.
Past experience suggests that productivity increases in the NHS come mainly from the development and dissemination of improvements in clinical interventions, rather than from large-scale reorganisations or system changes.
There is a strong evidence base for a range of interventions in mental health which produce better outcomes at lower cost. However, these are not always widely available or their effectiveness is reduced by poor implementation.
A key ingredient of any mental health strategy should therefore be to promote the wider adoption of best practice, as represented by the delivery of specific evidence-based interventions in line with national guidelines. In some cases this may be accelerated by supporting systems-related changes such as new payment mechanisms, particularly for integrated services operating at the mental/ physical health interface, but these should always be seen as means to an end rather than ends in themselves.
The fundamental need is to define what best practice looks like in terms of evidence-based interventions and service models, and then to deliver these throughout the NHS.
This report examines nine possible areas for service improvement where there is good evidence of cost-effective interventions, with specific costed proposals.