Review of community mental health and social care for adults in the North West

This review was jointly commissioned by the Clinical Commissioning Group, Local Authority and NHS Foundation Trust in this northern county. It took place between February and June of 2014, using interviews, discussions and focus groups to inform a report for the commissioners which identified aspects of the clinical culture and care pathways which could be improved. A team of four Centre for Mental Health staff and associates spoke to a range of staff, service users and stakeholders in the area, and met throughout the process with a steering group representing the commissioners.


Child and Adolescent Mental Health Services

The Centre was commissioned by a local authority's Public Health with the Clinical Commissioning Group and Mental Health Foundation Trust to oversee and steer the review of the county's Child and Adolescent Mental Health Services, in partnership with the Good Governance Institute who carried out the interviews with local stakeholders. The Centre chaired a Clinical Reference Group and provided monthly updates on the progress of the review for a multi-agency steering group.


Economic evaluation of a liaison psychiatry service

Psychiatric liaison services provide mental health care to people being treated for physical health conditions in general hospitals. The co-occurrence of mental and physical health problems is very common among these patients, often leading to poorer health outcomes and increased health care costs.

The Centre’s work provided an independent economic evaluation of the Rapid Assessment Interface and Discharge (RAID) psychiatric liaison service operating in City Hospital, Birmingham. It was based mainly on critical scrutiny and re-analysis of data collected as part of a wider internal review. The analysis of cost savings in the internal review of RAID focused on the ability of the service to promote quicker discharge from hospital and fewer re-admissions, resulting in reduced numbers of in-patient bed-days. We estimated on conservative assumptions that RAID generates incremental benefits in terms of reduced bed use at a benefit:cost ratio of more than 4:1.

The service also offers some potential savings in addition to reductions in bed use, such as fewer discharges of elderly patients to institutional care rather than their own homes. We conclude that the RAID service is good value for money, particularly as the benefits included in the assessment are over and above any improvements in health and quality of life which are the fundamental justification for health spending. Unlike most health care interventions, RAID actually saves money as well as improving the health and wellbeing of its patients.