News / New mental health currency unveiled

NHS England has released details of a new mental health currency to replace clusters and is looking for NHS providers to improve data quality ahead of more formal adoption in 2025/26.

The national body has been working on a new currency for mental health for a number of years, first consulting on a new way to count mental health activity in early 2021. The new model replaces the former currency for adult mental health pathways, which assigned service users to one of 21 clusters. Clustering was first mandated in 2012, but was criticised for a lack of clinical meaningfulness and for the administrative burden it placed on clinicians undertaking the clustering assessment.

The new currency groups mental health activity into units known as mental health and neurodevelopmental resource groups (MHNRGs) that consume similar levels of resources and provides a basis for understanding the activity undertaken to meet population needs. 

The currency is being ‘soft launched’ this year, with guidance first published in the middle of May via the NHS Futures platform. 

The currency would see people initially assigned to one of six population groups:

• psychosis and bipolar disorders
• personality disorders
• neurocognitive disorders
• mood and anxiety disorders
• eating and feeding disorders
• children and young people

Two further groups – neurodevelopmental disorders and addiction, alcohol and substance misuse – are also under development.

Patients are then further grouped into one of three settings: community, inpatient or crisis. Future development will see more granular currency units created to reflect severity or acuity of patients and potentially to add further settings.

The soft launch effectively means using 2024/25 to get the sector familiar with the new model and to encourage providers to get data flows in place to support the currency. Unlike clusters, which depended on a separate Honos assessment for each patient, the new currency should be able to be allocated using data from the Mental Health Services Data Set (MHSDS). This will massively reduce the burden on clinicians in terms of currency assignment, but is reliant on improving the recording of data within the data set.

The plan is to formalise requirements in 2025/26 and to start getting systems and providers to use the currency in discussions about service developments, planning and funding. The annual NHS payment scheme consultation, later this year will consult on more detailed proposals for introducing MHNRGs.
However, NHS costing practitioners will get an early taste of the currency this summer. Providers are being asked to submit costs for mental health service currencies as part of this summer’s National Cost Collection for the 2023/24 financial year, albeit with the costings initially being kept at a high level until the granularity of the currency is developed.

The NHS England guidance on the new currency models was published in May, before the announcement of next month’s general election.