This report provides the findings of a study into whether the care clusters which form the basis for mental health Payments by Results currencies within the Care Pathways and Packages Project provide a fit for purpose classification system.
Given the importance of the currencies to financing services, it was felt that despite their high face validity it was essential that the properties of the clusters be demonstrated in order to constitute a fit for purpose classification system.
This study is restricted to investigating the properties of the care clusters and does not include either the assessment tool (SARN) or the development of PbR currencies. Both of these are addressed in parallel workstreams.
The methodology was dependent on the development of archetypal cluster profiles (SARN scores) for each cluster. These archetypes are a ssumed to be the perfect versions of the clusters. These archetypes can then be used to against which to match routinely collected SARN scores to determine cluster membership. This depends upon trained clinical experts collecting data and providing clinical judgement. Whilst a great deal has been learnt though the process and the outcome generally supportive of the model, the results do not fully meet the ambitious aims of the project.