News / MH costs welcomed as basis for talks

The first set of reference costs for mental health clusters has, as expected, highlighted data issues, but finance professionals have welcomed their publication as the first step in addressing data quality.

The cluster reference costs were published alongside the costs for acute and community services for 2011/12. In a guide to the cost publication, NHS deputy chief executive David Flory said the mental health costs would be used to inform the development of benchmark costs for 2013/14.

The 21 care clusters cover working adults and older people only and the reference cost for each has been split between admitted and non-admitted care. The quoted cost represents the average daily cost of a patient in each cluster. There are a further two clusters, 00 and 99, which reflect patients to which a cluster code could not be assigned and those who were not assessed or clustered, respectively.

In admitted patient care there was little difference in the national average unit cost of the clusters. Excluding clusters 00 and 99, the average unit cost ranged from £319 to £366. HFMA Mental Health Faculty chair Paul Stefanoski said this was probably because the figures largely reflects the inpatient bed day cost, which remains constant irrespective of the cluster assigned to the service user.

He said there was a wider spread in non-admitted care, ranging from £5 (cluster 18: cognitive impairment – low need) to £30 (14: psychotic crisis). Community team costs are more easily attributable to particular clusters and as more specialist teams tend to serve the psychotic clusters, the cost is higher.

‘There are still huge data quality issues – at best the data is now eight months old, at worst 20 months. But this is to be expected and things are undoubtedly improving,’ said Mr Stefanoski, adding that high costs and activity in clusters 00 and 99 were symptomatic of this.

While it has backed the use of benchmark costs in 2013/14, the faculty has insisted the move should be cost neutral. ‘I am happy the information is out there so we can have constructive dialogue with commissioners about the extent of the development still required,’ he said. ‘It will be a test of the maturity of local commissioning relationships.