Sainsbury Centre for Mental Health urges caution on new GP commissioning scheme

10 November 2004

Individual GP practices will struggle to commission mental health services for their patients, says a paper published today by the Sainsbury Centre for Mental Health (SCMH).

The paper, 'Practice-Based Commissioning in the NHS: The implications for mental health', by Dr Alan Cohen, argues that the Government's new Practice-Based Commissioning scheme could lead to cost considerations taking precedence over quality or patient choice. Mental health services, it says, are not ready for the scheme.

It warns that the omission from April 2005 of mental health services from the new system of Payment by Results means that practices will be able to seek the cheapest, not the most appropriate, options. The information technology needed to help GPs and patients make informed choices about treatment is also not available, with mental health services lagging badly behind the rest of the NHS.

The paper calls on the Government to leave primary care trusts (PCTs) to commission the majority of mental health services for the time being. But it recommends that a more limited range of 'talking therapies' for common mental health problems, like depression, could be better commissioned by practices.

Dr Alan Cohen, SCMH director of primary care, said: "Practice-based commissioning is the logical conclusion of the Government's NHS reforms. But it will not work for patients unless we can be sure that all services are of sufficient quality, that choices are supported by good information and that cost considerations do not distort decision-making. None of these conditions yet apply to mental health services in England."

"In the future, practice-based commissioning can offer real benefits to patients. To achieve them, we need to see service users and carers being involved in making commissioning decisions. And to avoid destabilising mental health services we need to see clear rules for practices to give plenty of advance warning of changes to what they buy for their patients."

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