Mental health trust 'implementing value based healthcare'

The redesign is likely to result in significant changes to its clinical workforce, including the creation of new job roles.

Trust chief executive Rachel Newson told HSJ the programme had been inspired by the “value based healthcare” approach espoused by Harvard Business School professor Michael Porter.

Ms Newson said she was introduced to the approach at a session held by Professor Porter in 2011.

She and other Coventry and Warwickshire staff have since learned more about the approach.

Professor Porter’s philosophy centres on the idea that health care services should prioritise the aim of increasing value – defined as improvement in outcomes relative to cost. He has written extensively on ways to bring this about.

The trust proposes to put them into practice with a number of service changes, including the introduction of “integrated practice units”, a name for service provision models advocated by Professor Porter. Health services would be organised into dedicated teams for treating specific health conditions.

Ms Newson told HSJ the approach “made good clinical sense” and would also help the trust deal with “an ever decreasing income”.

She said the programme may be the first time the value based model had been applied in a mental health setting in the UK, but that other trusts in the sector were showing an interest in the approach.

Unite the union has attacked the plans, claiming they could result in 20 fewer staff in the community mental health team, and other posts in the team being changed to less senior grades.

Ms Newson said the trust was considering whether clinical interventions were being delivered by “the people with the right skills” as part of its focus on value.

“You wouldn’t have a very expensive highly skilled member of staff doing something that lots of other people could do as well,” she said.

However she disputed Unite’s figures and said new staffing arrangements had not been finalised.

“Until we are clear what the final roles will be, it’s hard to tell whether anybody will actually not be able to slot into a job at their current grade,” she said.

Ms Newson said the trust had no plans to make people redundant, but added: “I can’t second guess whether there’s going to be someone who believes their skills are so different to the roles available that they might find themselves in a position of not finding a role that’s suitable to them.”

The trust is expected to finalise its plans later this month.