Commissioning GPs to provide extra mental health services

Commissioning GPs to provide extra mental health servicesThis post is adapted from an orginal article posted on Pulse

Speaking at a King’s Fund conference on improving mental health, Dr Geraldine Strathdee, National Clinical Director for Mental Health, NHS England, urged Clinical Commissioning Groups to commission GP practices locally to provide additional mental health services.

The conference, ‘Improving mental health: How community and primary care services can support better mental health outcomes‘, explored how multi-disciplinary approaches, better engagement with GPs, and thinking about how mental health services are commissioned, can reduce unnecessary emergency admissions and ensure that the right care and support is provided in community settings. .

Dr Strathdee said that commissioning leaders should learn from programmes developed by ‘pioneers’ who have commissioned enhanced services from practices to meet the needs of patients with mental health problems in primary care.

Examples of enhanced mental health services in primary care include:

The 2014/15 QOF settlement for England will remove three key cardiometabolic indicators from the severe mental illness (SMI) domain (Read more). In the light of this, Dr Strathdee said that it is vitally important for commissioning leaders to commission new services to respond to local issues.

Dr Strathdee said:

“QOF is no longer the only game in town – we have to find a new way forward to support primary care with its huge mental health demand and enhanced schemes seem a very interesting way of addressing that.

If I was in an area with high levels of psychosis, for those localities an enhanced service for psychosis/serious mental illness is absolutely essential and I know some of the 32 CCG leads in London are putting drafts together.

In parts of the country where there are not high rates of psychosis, I know GPs say they would like an enhanced service for people with anxiety and depression, medically unexplained symptoms.

Choice in mental health will come in soon, and what we’re asking every mental health team in the country, whether you’re in primary or specialist care to [post on their website] the name of the team, who the service is for, what assessments are offered, what effective treatments and what patients say about your service, what evaluation you have done, whether you have the [Provider of Mental Health] kitemark.

One of the things that will drive change most is transparency. I believe that if we give people this choice it will drive standards right up.”

Dr Strathdee also said she supported moves to introduce extended GP training, to provide a better grounding in mental health. She said:

“I would like to see the fourth year of GP training, dedicated to mental health – in the sense of what is encountered in primary care depression, anxiety medically unexplained symptoms, alcohol misuse, eating disorders, perinatal symptoms – all the things that actually come in the GP’s door.”