Advanced Search
Background NHS mental health services are under pressure due to chronic underfunding and constrained resources. The Health & Social Care Act implemented an extensive restructure of the NHS and introduced three new legal duties: duty to arrange, promote competition, and integrate services.
Aim To establish how the Health and Social Care Act 2012 affected commissioning of mental health services in England and how the duties are being fulfilled.
Method Freedom of Information (FOI) requests were sent to all 211 clinical commissioning groups in England. The number, value, and length of all contracts for mental health services were requested from 2013 to 2016 by type and name of provider; as well as a range of quality and performance data.
Results The FOI received a 93% response rate. CCGs commissioned between 1–127 contracts each: 65.3% of all contracts were awarded to the third sector (private for profit, not for profit, and voluntary organisations), amounting to 6% of the total value of contracts commissioned. NHS foundation trusts were awarded 25% of contracts, worth 70% of the total value of contracts. 71% of contracts had no evidence of quality monitoring.
Conclusion The high volume and low value of contracts commissioned to third sector organisations fulfils the new duty to arrange but not to integrate; showing considerable fragmentation of mental health provision. The emerging external market is a result of the Health & Social Care Act promoting diversification of the provider market. Finally, the lack of quality and performance data raises concerns over the transparency and accountability of an NHS that is increasingly being provided by companies.
Thank you for recommending British Journal of General Practice.
NOTE: We only request your email address so that the person to whom you are recommending the page knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.
Tweets by @BJGPjournal
British Journal of General Practice
