Position statement on mental health payment systems

This position statement, published by the Royal College of Psychiatrists, outlines the College’s views on the mental health payment systems formerly known as Payment by Results.

Download Royal College of Psychiatrists’ Statement on Mental Health Payment Systems

Mental health payment systems aim to provide a transparent, rules-based system for paying mental health service providers. It is intended to reward efficiency, support patient choice and diversity. Payment is intended to be linked to activity and adjusted for casemix to ensure a fair and consistent basis for provider funding rather than relying on historic budgets and the negotiating skills of individual managers.

In 2012/13 the NHS mandated national currencies for much of adult mental health services in England. The currencies consist of 20 Clusters, each of which are a global description of a group of people with similar characteristics as identified from a holistic assessment and rated using the mental health clustering tool (MHCT). Each Cluster is linked to a set of
interventions (Care Packages) which have a total cost, and for which a tariff would be paid once the system is ‘live’. Care Packages are a summary of the types of care to be delivered (often divided into ‘core’ and ‘supplementary’), the time allocated to interventions and the personnel (of appropriate profession and skill level) to deliver them.

The College’s strong recommendation is that the tariff system should be designed to support and incentivise the commissioning and delivery of evidence-based integrated care pathways. The mental health tariff system should be fully aligned with the pathways recommended by NICE guidelines and quality standards and should incentivise service models that are known to deliver high-quality care, good outcomes and value for money across the health and social care system.