Mental Health Information NHS Trust Forum 26 th

Mental Health Information: NHS Trust Forum 26 th April 2010, Birmingham Botanical Gardens

Welcome and Introductions General Mental Health Information Update Netta Hollings

Welcome • General Election 2010 • House keeping

Agenda for Today

Updates • Pb. R – ISN (DSCN) – for Classification and Currency – MHMDS changes – ISB – June; July ISN – Accurate clinical and activity information to support development of MH tariffs …MHMDS version 4. 00 – Coverage, accurate team and staff info, diagnosis and HONOS • Reducing the Burden – KP 90 collection – Mental Health Act related info – comprehensive and detailed – DRE Dashboard – team caseload – Community Activity – team caseload – Other elements of Performance Framework – CDS

Update continued • More use of MHMDS – – – DH ACRA (PCT allocations) Clinical Prioritisation – Bruce Keogh QIPP – NHS Board dashboard Supplied to SHAs, PCTs, Audit Commission routinely DH Service Performance Indicators for MH Trusts • Delayed Transfers of Care Indicators for Quality Improvement CQC Periodic Review NI 149 and N 1 150 WCC Datapacks Clinical Indicators … NHS Comparators …

Update continued • Mental Health Informatics Board – Established – chaired by DH; members – DH (Mental Health policy, CIO office and National Clinical Director), IC, Cf. H clinical leads, Chief Exec rep. – Then “task force” layer and Intelligence Network – will be discussed at Pan Programme group in May

Update continued • IAPT – ISB this week (28 th April) • Mental Capacity Act – Do. LS publication – 23 rd March • Assembly investigation – Verbal update • Independent Sector – Representatives today – “Beginner’s Guide to MHMDS”

Update • Advance warning – Next annual bulletin • Diagnosis • Person based cost analysis • More about patients on SCT – Service mapping • Some elements may return (but NB reducing the burden item earlier) • Use of ESR – Mentally Disordered Offenders – CAMHS – Referral to Treatment data – Dementia – Autism / LD

Update on Uses of MHMDS and Related Data Quality Issues Jo Simpson Steven Burrows

New uses of MHMDS • Growing interest in activity data: MHMDS extracts now regularly supplied to SHAs, PCTs, Audit Commission, as well as CQC • Growing interest in linking this to reference costs: – Advisory Committee on Resource Allocation (ACRA) – Clinical Prioritisation – NHS Board – to support QIPP agenda • Price proxies developed for units of activity from DH Reference costs

Matching MHMDS and Reference Cost Activity • Community Mental Health Teams - Face to Face • Mental Health Consultant Services (Community Setting) - First Contact / Follow-up Contact Face to Face • Mental Health Consultant Services (Outpatient Setting) - First Attendance / Follow-up Attendance Face to Face • Mental Health Inpatients • Eating Disorder Services • Mother & Baby Units

Other activity • • Mental Health Specialist Teams Mental Health Day Care Facilities Non Face to Face Children’s Services Drug & Alcohol Services Maximum Secure Units High Dependency Secure Provision Autistic Spectrum Disorder Teams

Other activity • • Mental Health Specialist Teams Mental Health Day Care Facilities Non Face to Face Children’s Services Drug & Alcohol Services Maximum Secure Units High Dependency Secure Provision Autistic Spectrum Disorder Teams

National Unit Costs sum (Provider unit cost x Provider activity) = total activity

National MHMDS price proxies 08 -09

Notes • Age Bands include ages from 15 to 111 • Total Bed Days removes wrongly recorded bed days totals which significantly skew costs amongst Medium and Standard bed days • When the total of bed days is greater than 365 days (apparent in c. 1, 100 records of the 1 million plus total) then the type of bed day is ranked in the order of highest to lowest, and where counts are equal in order of Intensive Medium Standard bed days

Sample total volume and costs in the 2008/9 MHMDS extract Volume Costs (£'000 s) Unit cost (£) % total costs Inpatients 7, 802, 671 2, 690, 995 344. 9 70. 3% Outpatients 1, 527, 911 261, 889 171. 4 6. 8% CPN 5, 559, 079 591, 549 106. 4 15. 5% 734, 776 102, 077 138. 9 2. 7% 1, 250, 342 129, 791 103. 8 3. 4% Physiothera pist 148, 772 17, 267 116. 1 0. 5% Psychothera pist 266, 430 33, 936 127. 4 0. 9% - 3, 827, 504 - 100. 0% Psychologist OT Total

Price proxy for Mental Health Activity: all English Providers

Related issues / areas for improvement • Incorrect Start and End dates of Ward Stays – either overlapping – or not synchronised to Hospital Provider Spell, – or not present • Derived bed days that are plainly invalid are excluded from cost calculations

Related issues / areas for improvement • Incorrect Start and End dates of Ward Stays – either overlapping Invalid Bed Days that can’t be used, eg > 366 in year or 92 in quarter – or not synchronised to Hospital Provider Spell Admissions and discharges but not correctly related to Bed Days – or not present No Bed Days • Bed Days are most expensive unit of activity – potential impact on resourcing and payment.

Related issues / areas for improvement • Coverage – all services and teams so that comprehensive records of contacts and appointments • Improvements to recording of NHS day care facilities, acute home based care and stays in NHS residential homes – not considered reliable enough to include at present

Basic Data Quality Checks Total Record Counts Any change in services? Can huge changes in data volumes be explained?

New uses of MHMDS 2. Growing range of indicators • • • DH Service Performance Indicators for MH Trusts Indicators for Quality Improvement CQC Periodic Review NI 149 and N 1 150 WCC Datapacks

Related DQ issues • DH Service Performance Indicators for MH Trusts – HONOS, Diagnosis, Under 16 s, AWOL • Indicators for Quality Improvement – CPA • CQC Periodic Review – Diagnosis, HONOS • WCC Datapacks

New uses of MHMDS 3. Reducing the burden • KP 90 collection, Mental Health Act related information – comprehensive and detailed • DRE Dashboard – team caseload • Community Activity – team caseload • Other elements of Performance Framework

Present comparison, trust level figures about uses of the Mental Health Act * subject to confidentiality risk assessment

Basic Data Quality Checks Team Type (at the end of the reporting period) Are your CLINTEAM and REV tables aligned? Are you using the same team identifier in both tables allowing the data to be linked?

New uses of MHMDS 4. Making published statistics more useful – wider range of analysis in MH Bulletin to include • • • Diagnosis Person based cost analysis More about patients on SCT