News / Monitor sets 2017/18 target for MH payment

Monitor and NHS England consulted on the two options – paying either on the basis of episodes of treatment/year-of-care or using a capitated payment approach – in October. The consultation was held on the basis of the new approaches starting in 2016/17.

However, a pricing update presented to the Monitor and NHS Trust Development Authority board in January said that the change would now go ahead in 2017/18.

A spokesman for Monitor said this was in response to feedback from the service. While commissioners and providers had supported the payment options, they asked for more time to prepare.

A new survey by the HFMA’s Mental Health Finance Faculty underlines that 2016/17 would have been overly ambitious. This found that just over a quarter of a sample of 26 mental healthcare providers were proposing to adopt one of the new approaches in 2016/17, although organisations were clear that this was the likely direction of travel.

In the meantime, the survey confirmed that block contracts would remain in place in many health economies. Some trusts said they planned to shadow year-of-care tariffs in the coming year as a step towards implementing the new currencies. Others suggested episodes of care would be used as a stepping stone to introducing capitated models.

Reinforcing the national decision, one trust was clear that a ‘year-of-care approach is not possible in 2016/17 due to timescales and information quality’.

Other trusts highlighted the importance of linking future payment to outcomes and of ensuring the costs of care are covered – supported by cost and performance data collected by mental health clusters and produced using patient-level cost models.

The HFMA survey follows earlier work by the faculty in 2015 that fed into the Monitor/NHS England consultation on payment models. That also highlighted a lack of confidence in meeting the earlier introduction of the new approaches.