Mental health care clusters and payment by results: considerations for social inclusion and recovery
| Date | 23 May 2011 |
| Pages | 71-77 |
| DOI | https://doi.org/10.1108/20428301111140912 |
| Published date | 23 May 2011 |
| Author | Michael Clark |
| Subject Matter | Health & social care |
Policy
Mental health care clusters and payment
by results: considerations for social
inclusion and recovery
Michael Clark
Abstract
Purpose – This paper aims to critically examine the emerging policy agenda of payment by results
(PbR) and care clusters in order to identify how to engage with it to ensure it is supportive of social
inclusion and recovery.
Design/methodology/approach – Care clusters and PbR for mental health care are critically
examined.
Findings – There is scope in the ongoing development of care clusters and associated pathways to
continue the progressive developments towards recovery and social inclusion in the commissioning and
delivery of mental health care, but they need to be nurtured and actively pursued.
Practical implications – The care clusters and developments building on them provide scope for
supporting social inclusion and recovery practice, but also some risks; hence, those with an interest in
furthering such practice need to engage now locally and nationally with care clusters developments.
Originality/value – PbR is being pursued as a policy for commissioning mental health care in England,
based on a model of care clusters. This paper discusses the move to PbR and its possible implications
for the recovery and social inclusion agenda.
Keywords Mental health, Care clusters, Pathways, Payment by results, Social inclusion, Recovery
Paper type General review
Introduction
After ten years of the National Service Framework for Mental Health (Department of Health,
1999) and subsequent policy developments, those connected with mental health care in
England have become acclimatised to progressive developments for social inclusion and
recovery for people who have experienced mental health problems. We should be mindful of
how these ideas were evolved, took root and informed service and practice development in
mental health care in England, and of how this had to be actively developed. These
improvements were not a natural phenomenon and we should not expect them to remain
static – they may develop forwards or backwards.
With the change in government following the May 2010 election, we are in a state of flux and
uncertain policy direction. This includes the White Paper Liberating the NHS (Department of
Health, 2010a) with its proposals for profound restructuring of the National Health Service
(NHS). A new cross-government mental health policy has just been launched (No Health
Without Mental Health). It offers many encouragements, but lands in the middle of this
massive structural reform of the NHS, as well as a period of financial retrenchment.
DOI 10.1108/20428301111140912 VOL. 15 NO. 2 2011, pp. 71-77, QEmerald Group Publishing Limited, ISSN 2042-8308
j
MENTAL HEALTHAND SOCIAL INCLUSION
j
PAGE 71
Michael Clark is a Research
Manager with the NIHR
School for Social Care
Research, based at the
London School of
Economics and Political
Science, London, UK.
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