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The introduction of access and waiting time standards for mental health services

Sarah Khan Deputy Head of Mental Health NHS England spoke at today’s Measuring and Monitoring Quality in Mental conference on:

• introduction of access and waiting time standards
• planning for a step change in the national data-sets
• challenges and opportunities

In her presentation Sarah commented;

"Mental Health conditions are becoming longer term conditions where they need not be"

"the 15-20 year gap in life expectancy of individuals with serious mental illness compared with the rest of the population is 'shocking and wrong'"

"Norman Lamb's statement of the need for the 'same quality of data and transparency' as in physical health is absolutely critical"

"the outlook for psychosis where treatment is within 8 weeks is significantly better. This is the cardiac arrest equivilant in mental health"

"the routine clinical measurement, our way of working needs to change"

"we have a real opportunity to radically improve here"

"we really want to get the EIP standard right"

Presentation abstract:
Measuring and monitoring quality in mental health: preparing to implement the new access & waiting time standards

Presentation outline:
1.    Context for the introduction of access and waiting time standards for mental health services
2.    The standards to be introduced from 15/16
3.    The data challenge:
•    What data do we want?
•    What data do we have?
•    What are we doing about it? 
4.    Measurement challenges, opportunities and hopes for the future

The announcement last October that access and waiting time standards were to be introduced in mental health services in 2015/16 represented a landmark.  The new standard for people experiencing a first episode of psychosis – from 1st April 2016, more than 50% of people should start a NICE concordant package of care within a maximum of 2 weeks – offers huge opportunities to improve care whilst posing significant challenges to the mental health system.  One of the key challenges will be data collection and measurement.  

Ensuring effective measurement of this ‘two-pronged’ standard will be critical to realising the aims of the new policy.  The standard requires both that the referral to treatment waiting time is < 2 weeks and that the care accessed following the ‘clock stop’ is in accordance with NICE standards.  There are currently significant gaps in some areas in access to some of the key interventions recommended by NICE, such as CBT for psychosis and family therapy. 

The current version of the Mental Health and Learning Disability Dataset (MHLDDS) does not contain the data fields required either to measure the referral to treatment waiting time or to assess whether the care accessed was NICE concordant.  Significant development work is underway which has been led jointly by NHS England and the Health and Social Care Information Centre, driven very much by the input of clinical and other field experts.  

In the presentation, Sarah will outline the strategic context for the introduction of access and waiting time standards and the aims of the new policy.  Focusing on the early intervention in psychosis (EIP) standard, she will share the data / measurement challenges associated with its implementation and the work that is underway and planned to address them.  Finally she will reflect on the opportunities the access and waiting times programme offers to improve radically the availability and transparency of intelligence on the quality and effectiveness of mental health care in England. 

Sarah’s PowerPoint presentation is available for download at the end of this page

Useful references:

Guidance to support the introduction of access and waiting time standards for mental health services in 2015/16, NHS England, February 2015
http://www.england.nhs.uk/wp-content/uploads/2015/02/mh-access-wait-time-guid.pdf 

The forward view into action: planning for 2015/16, NHS England, December 2014
http://www.england.nhs.uk/wp-content/uploads/2014/12/forward-view-plning.pdf 

The Mandate: a mandate from the Government to NHS England: April 2015 to March 2016, Department of Health, December 2014
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/386221/NHS_England_Mandate.pdf

Achieving better access to mental health services by 2020, Department of Health and NHS England, October 2014 https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/361648/mental-health-access.pdf 

Closing the Gap: priorities for essential change in mental health, Department of Health, January 2014
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/281250/Closing_the_gap_V2_-_17_Feb_2014.pdf 

No health without mental health: a cross-government mental health outcomes strategy for people of all ages, Department of Health, February 2011
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/213761/dh_124058.pdf

Sarah is the Deputy Head of Mental Health in the Mental Health Clinical Policy & Strategy Team within the Medical Directorate at NHS England.  She is leading the work to introduce access and waiting time standards.  Previously, Sarah held senior roles at Central and North West London and Oxleas NHS Foundation Trusts leading strategy, planning, performance and information functions.

Conferences of interest:

Implementing the national objective to end Prone/Face Down Restraint: Examining Restraint Positions in Practice
Tuesday 21 April 2015 
ICO Conference Centre, London

Improving Mental Health Crisis Care
Thursday 30 April 2015 
Hallam Conference Centre, London

Smoking Cessation in Mental Health
Monday 11 May 2015 
Hallam Conference Centre, London

Information Governance in Mental Health: Implementing Caldicott2 & the New Code of Practice on Confidential Information
Monday 11 May 2015 
Hallam Conference Centre, London

Masterclass: Mental Health Pathways
Monday 11 May 2015 
Hallam Conference Centre, London

Stronger Code: Better Care Implementing the Changes to the Mental Health Act Code of Practice
Tuesday 12 May 2015 
Hallam Conference Centre, London

Masterclass: The Mental Capacity Act and Advance Decisions
Wednesday 13 May 2015 
Cavendish Conference Centre, London

Improving the Quality of Perinatal Mental Health Services
Tuesday 19 May 2015 
Hallam Conference Centre, London

Improving Physical Health for People with Mental Health Conditions
Wednesday 20 May 2015 
Colmore Gate Conference Centre, Birmingham

Psychosis & Schizophrenia in Adults
Monday 8 June 2015 
Hallam Conference Centre, London

Foundation Certificate in Dementia: 2 Day Interactive Training Course
Monday 15 June 2015 — Tuesday 16 June 
Hallam Conference Centre, London

Psychological Therapies for Severe Mental Illness
Wednesday 1 July 2015 
ICO Conference Centre, London

Improving Physical Health for People with Mental Health Conditions
Monday 14 September 2015 
Hallam Conference Centre, London

 


Download: Sarah Khan full presentation

23 March 2015

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