PAYMENT BY RESULT STATUS REPORT

Heleno Ferraz

Senior Project Specialist

Mental Health PbR & Outcome

Background

• PbR Steering Group established in July 2011.

• Main purpose to provide leadership , coordination and oversight for the Region.

• There was a need to understand London position & risks impacting on PbR implementation.

• London Health Programmes agreed to put together a PbR Status Report on behalf of the Steering Group.

Method

• Data collection - self reporting survey + group discussion• The survey consisted of 16 questions grouped in three

categories:• Clustering information,• IT Systems, • Care packages and others

• The survey was sent to all PbR project Leads in each of the 10 MH London Trust .

• Group discussion – 30th September 2011

Clustering Information

• Q2 The sample: • All 10 London Trusts have completed the survey

• Q2 Policy and Procedure:• 7 Trusts have an implementation policy for PbR• 3 Trusts said they did not have a policy and one Trust included

PbR Policy as one of their top three priorities.

Percentage of total patient clustered

• 2 trusts scored between 25% to 50%, • The remaining 8 trusts scored 50% and above.• It would appear that Trusts are on track for 31st deadline.

Groups of patients being clustered

• 9 Trusts - clustering all their patients including those on CPA.

• 1Trust - clustering ‘only new patients’. The same Trust have clustered 70% and over.

Clustering scores being collected at agreed intervals

• 7 Trusts responded ‘YES’, 2 Trusts responded ‘NO’ and 1 Trust did not answer this question.

• This is one of the areas we will explore further in our focus group at the end of the month.

Cluster ‘0’

• 8 Trusts allocate patient to cluster ‘0’. • 5 of these Trusts also record reasons for allocating

patients to cluster ‘0’

• This may suggests that the majority of the London Trusts are using MHC tool as directed.

UNDERSTANDING INFORMATION ISSUES

• 8 Trusts have an IT system that is able to record scores and care clusters.

• 5 Trusts have ‘some’ form of local processes and system for checking clustering accuracy.

• 9 Trusts had a system for collecting internal reports to show clustering completion rates .

Core components of care packages

Discussions with Mental Health Commissioners?

Survey Summary of key issues

• London Trusts appears to be on track to meet 31st December target for clustering all their patients.

• Most appear to be using the MHC tool & PbR Guidance as directed

• Most are working on some form of ‘clustering validation ‘ is taking place at local level

• The majority of Trusts IT systems is capable of recording scores and clusters and reports this.

• Areas for development• Care packages are the least developed aspect of this

work.• Engagement with commissioners on costing

• Summary of priorities as indentified by Project Leads.

• Ensure clustering accuracy • Cluster costing • Data support • Developing care packages  

Next steps

1. Meeting with Project Leads to explore some of the questions in more detail.

I. Use of cluster ‘0’II. IT system – issues with RiO and others III. December deadlineIV. What would be helpful?

2. Final report to be presented October Steering Group.

3. Some areas identify in this report will be followed up by the new PbR Clinical Lead

4. Trust Project managers group to share learning.