Mental health trusts have expressed dismay that a national tariff will not be in place until 2013 at the earliest.
The timescale was revealed in a letter to managers on Monday. It follows a pledge in the next stage review that mental health “currencies” would be available by 2010. Service providers had originally anticipated that the national tariff would be developed quickly afterwards.
The letter, from Department of Health director of mental health policy Kathryn Tyson and NHS finance director Bob Alexander, says the proposed currencies will be published in 2010-11 for use “if there is local agreement and capacity to do so”.
By 2011-12, all health economies should be using the currencies “in some form” and be establishing local prices.
But 2013-14 will be “the earliest possible date” for a national payment by results tariff for mental health, and only if there is seen to be a “compelling case for a national price”.
The timetable has fuelled concerns that mental health services will be more “exposed” to commissioners’ cost cutting measures if they do not have a tariff at a time of tightened public spending.
NHS Confederation Mental Health Network director Steve Shrubb said: “This will disappoint a number of people.
“We’re in a recession. Commissioners have a tariff with their acute customers and not with mental health providers, so that exposes mental health.
“When we consider what a large proportion of the NHS spend is on mental health, it seems not unreasonable to expect it should receive a higher priority.”
The tariff involves grouping patients into clusters based on their symptoms and needs, with commissioners paying for the number of people in each cluster.
Cumbria Partnership foundation trust chief executive Stephen Dalton said he welcomed the phased approach.
But he warned treatment costs varied widely across the country. The economic climate meant there would be no “safety net” for trusts that lost out under the tariff, he said.