• NHS England confirms second wave of sites to take on devolved tertiary mental health commissioning powers
  • The 11 new sites will be given devolved commissioning responsibility for low and medium secure adult or tier four child and adolescent mental health services
  • The 17 sites will all be live by next April and will account for £600m of the specialised commissioning mental health budget

A second wave of providers has been chosen to take on new commissioning powers for tertiary mental health services, HSJ can reveal.

NHS England has selected a futher 11 sites to be given devolved commissioning responsibility for low and medium secure adult, tier four child and adolescent mental health services or adult eating disorder services.

Claire Murdoch

Claire Murdoch 2

Source: Neil O’Connor

Claire Murdoch said the sector will need more than 10,000 extra staff

This is the second wave of providers to be given such powers, after the first six areas were announced in July last year.

NHS England’s national mental health director Claire Murdoch told HSJ the two waves will transfer £640m of the specialised commissioning mental health funding directly into the hands of providers – nearly 40 per cent of the total budget.

But Ms Murdoch said that any more devolution of the specialised commissioning budget will have to wait until the success of the new pilots is evaluated.

In a wide ranging interview, Ms Murdoch also claimed the mental health sector would need more than the 10,000 extra staff promised by the PM and said the sector must be protected from the capped expenditure savings drive.

Sites piloting new mental health care models

Beginning in October

CAMHS

  • Surrey and Borders Partnership FT – with Sussex Partnership FT, Cygnet Health Care, Elysium Healthcare, Huntercombe Group, Priory Healthcare and Partnerships in Care
  • Northumberland, Tyne and Wear FT
  • Leeds Community Healthcare Trust – with Bradford District Care FT, Leeds and York Partnership FT and South West Yorkshire partnership FT
  • Hertfordshire Partnership FT
  • South London Mental Health and Community Partnership, a collaboration between South London and Maudsley FT, Oxleas FT and South West London and St Georges Mental Health Trust

Adult secure

  • Mersey Care FT – with Cheshire and Wirral Partnership FT, North West Boroughs Partnership FT, Elysium Healthcare and Cygnet Health Care
  • Sussex Partnership FT – with Kent and Medway Partnership Trust and Surrey and Borders Partnership FT
  • Tees, Esk and Wear Valleys FT – with Northumberland, Tyne and Wear FT

Adult eating disorder

  • Leeds and York Partnership FT – with Bradford District Care FT and South West Yorkshire Partnership FT

Going live by April 2018

Adult secure

  • Barnet, Enfield and Haringey Mental Health Trust – with Central and North West London FT, North East London FT, East London FT and West London Mental Health Trust

Adult eating disorder

  • Oxford Health FT – with Avon and Wiltshire Mental Health Partnership FT, Berkshire Healthcare FT, Southern Health FT, 2gether FT, Priory Healthcare and Partnerships in Care

The first six pilots – which have a combined budget of £350m – went live this April, with the next nine expected to begin in October and the final two by April next year.

N HS ENgland said these pliots plan to use 283 fewer beds through admission avoidance, shorter lengths of stay, and bring back hundreds of patients from out of area placements. This is expected to save more than £50m over the next two years.

The areas will act as pilots to develop new care models for low- and medium-secure adult mental health care and tier four children and adolescent mental health services.

The aim is to tackle a disconnect between locally commissioned services and national commissioned secure and specialist mental health services, which has contributed to patients being sent out of their local area for a bed, sometimes hundreds of miles away.

NHS England received 29 applications to be part of wave two, with more than 100 bidders including mental health trusts, as well as organ isations from the private, housing and charity sectors.

Ms Murdoch said the new models were being driven forward at pace.

She added that clinicians and managers where: “energised by the possibilities of reframing care more locally, innovating the different models, many of which are very reliant upon intensive home treatment support to avoid the need of escalation up to specialist beds, many of which have been outside the patch or far away from home.

“All of them are predicting savings, all of them are predicting reducing bed days and all of them are predicting better outcomes for patients.”

Ms Murdoch said the pilots fitted in with the new care models and STPs plans to localise care as much as possible.

But she stressed the centre cannot just let go of the specialised commissioning budget until hard data comes back showing if the pilots are successful.

She added: “What we have to be careful of, so as not to throw the baby out with the bathwater, is to just make sure we keep a level of expertise and common standards in terms of treatment outcomes for patients that we could recognise nationally, that we can give reassurance to patients and tax payer these are evidence-based treatments and good value.

“We cannot just let it [the speciliased commissioning budget] go. These two first waves are a brilliant opportunity to look at and evaluate the what next. But clearly this takes us a big step on the way there.

“These new waves in MH care are part of a quiet revolution. These are [accountable care systems], they are taking a segment of the population, they are taking on accountability and responsibility, they are saying we can reframe your care for you.”