Mental Health: Performance Management ‐ Myth Or Reality? A Personal View
| DOI | https://doi.org/10.1108/13619322199700022 |
| Pages | 5-7 |
| Published date | 01 September 1998 |
| Date | 01 September 1998 |
| Author | Hilary Hodge,Carole Jobbins |
| Subject Matter | Health & social care |
The Mental Health Review 2:3 ©Pavilion Publishing (Brighton) 1997 5
HilaryHodge, Director of Priority Care
NORTH WEST NHS EXECUTIVE
Carole Jobbins, Mental Health Co-ordinator
NORTH WEST NHS EXECUTIVE
H
ow do we know what is going on in mental
health? What performance measures should
we be using to gauge progress being made
against the Department of Health objectives? What
makes a good purchaser of mental health? What
should we be looking at to assess provider perfor-
mance? Why do we consider some clinicians are
better than others? Against which criteria do we
judge whether clinicians possess relevant skills to
deliver good outcomes? Anyway, have we defined
and do we agree what good outcomes for various
aspects of mental health might be?
How do we know whether or not inter-agency
relationships are working or not? Do we know what
mental health needs in any particular community are
and how well they are being met? Do we understand
the interrelationships of different elements of mental
health care and how the presence or absence of one
part affects the delivery of care provided in others?
What do we know about mental health experiences
of people who are within the criminal justice system
and how these arebeing dealt with? Do we under-
stand how to measure the contribution primary care
is making to addressing mental health needs and
what support systems are needed to improve the
interfaces between primary and secondary care?
Lastly,but surely it should be firstly,how do we
assess what people who have mental health problems
think about the treatment, careand supportthat
they do, or maybe do not, receive? Then thereare
the carers who actually provide most of the care.
Should we know how well they aredoing it, or more
probably, understand what their needs are to continue
the support that they give?
These questions all point to the complexity
of defining what we mean when we ask how, as
providers and commissioners, we ensure that
mental health services are monitored and delivered
effectively against organisational goals and objectives.
It has only recently become acceptable to even
suggest the veryidea of being explicit about goals
of any kind. Anybody who thinks that all of this
can be put into some simple framework under the
heading of ‘performance management’, using a few
key numerical indicators, exhibits an ignorance of
the subject which is profound.
That is not to say, however, that mental health
services cannot be monitored, even using some of
the existing information currently being collected,
however imperfect and crude this might be. As long
as these measures are not taken as possessing some
absolute meaning, then using them as indictors to
ask questions can be of value. Some of the activity
data can be interrogated to highlight differential use
of services, such as lengths of stay, readmission rates,
occupied-bed days and waiting list, both for admis-
sion and for discharge. When compared across wider
areas than a single health authority, activity data can
help to pinpoint issues for further investigation. An
example of this is wide variances in the numbers
per head of population who aresubject to CPA.
The contracting process can provide mechanisms
for assessing services, but only if is carried out
between consenting partners, in a collaborative
atmosphere and with commissioners and providers
who areall knowledgeable about mental health.
Drawing up contract specifications by informed
dialogue can help to generate mutual understanding
Mental Health: Performance
Management – Myth Or Reality?
APersonal View
PERSONAL PERSPECTIVE
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