This is HSJ’s fortnightly briefing covering quality, performance and finances in the mental health sector.
Feedback and comments are welcome, so please feel free to email me in confidence.
Not as much investment as we should have
It must have been refreshing for everyone working in the mental health sector (or at least those who tuned in to NHS England’s board meeting last month) to hear national leaders talk about the lack of investment in mental health data.
NHSE director for experience, participation and equalities Neil Churchill told the board there were ongoing discussions with the Care Quality Commission about the possibility of expanding its community mental health survey.
He added that given mental health was a national priority, there had not been as much investment as there should be in understanding patients’ experiences of the service.
This is an understatement – and regular readers of this briefing will be familiar with the theme that data quality is a huge problem in the sector.
So, it is nice to hear national leaders admitting this and making noises about addressing it.
The cancer comparison
Mental health is definitely playing catch up to the acute sector, where there are mountains of good quality, comparable and transparent data.
NHSE national mental director Claire Murdoch has often made the “cancer comparison” when talking about access to mental health services.
This goes that while the Five Year Forward View for Mental Health will increase access to services from a quarter of children who need it to a third, there are still thousands of children with mental health problems who need support but are not able to access it. But if two-thirds of cancer patients were not getting access to treatment it would rightly be a national scandal.
Now it seems we have the same comparison with data.
Dr Churchill pointed out that while 66 per cent of patients with a cancer diagnosis respond to the national cancer survey, we know little about the experiences of mental health patients.
Looking at the nearest equivalent for mental health – conducted by the CQC – reveals a stark contrast.
The cancer survey in 2016 had a sample size of 109,700 of which 72,800 responded. The CQC survey was based on feedback from 12,000 people and had a response rate of 26 per cent.
A drive to improve patient experience data in mental health is very welcome. The more we know, the better chance of improving care.
But it remains to be seen what an expansion to the survey will entail and how much money will back it up.
Better data is needed right across the board and not just in relation to patient experience.
The mental health dashboard from NHSE is still a work in progress, though it gets more consistent with every quarterly reincarnation. NHS Digital is still trying to bring a level of consistency to its out of area placement dataset, and no one is currently publishing accurate information of the number of patients in locked rehab.
The jigsaw has more gaps than pieces at the moment, which is why it was welcome to hear NHSE chief Simon Stevens say there were “delicate discussions” with NHS Digital providing more data in relation to mental health and inequalities. Hopefully these conversations translate into new and improved data collections – the sooner the better.