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Clustering in mental health payment by results: a critical summary for the clinician

  • David Yeomans
Summary

Mental health payment by results (PbR) is a disruptive new prospective payment system intended to replace National Health Service block contracts in England and provide a mechanism for opening up the mental health economy. Patients are allocated to one of 21 treatment clusters, each with a different price or tariff. Clinicians perform cluster allocation using the Mental Health Clustering Tool. The clustering process makes demands on clinicians' time even with support from information systems. Clustering is novel and it is unclear how it will work in practice. The process is likely to be susceptible to gaming.

LEARNING OBJECTIVES

  1. Understand that the clinical process of diagnostic classification is different from the financial process of clustering categorisation.
  2. Understand the importance of learning the clustering tool ratings definitions in order to make accurate cluster allocations.
  3. Recognise that mental health payment by results is driving the widespread adoption of outcomes measurement.

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Copyright
Corresponding author
Dr David Yeomans, Hawthorn House, St Mary's Hospital, Green Hill Road, Leeds LS12 3QE, UK. Email: david.yeomans@nhs.net
Footnotes
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For a commentary on this article, see pp. 235–236, this issue.

For a discussion of the use of outcome measures see Lewis G, Killaspy H (2014) Getting the measure of outcomes in clinical practice. Advances in Psychiatric Treatment, 20: 165–171. Ed.

Declaration of Interest

None.

Footnotes
References
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Department of Health (2013a) Mental Health Clustering Booklet (Version 3.0) (2013/14). Department of Health (https://www.gov.uk/government/publications/mental-health-payment-by-results-arrangements-for-2013-14).
Department of Health (2013b) MHCT Algorithm Spreadsheet. Department of Health (https://www.gov.uk/government/publications/mental-health-payment-by-results-arrangements-for-2013-14).
Department of Health (2013c) Mental Health Payment by Results Guidance for 2013–14. Department of Health (https://www.gov.uk/government/publications/mental-health-payment-by-results-arrangements-for-2013-14).
Department of Health (2013d) Key Steps for Successful Implementation of Mental Health Payment by Results. Department of Health (https://www.gov.uk/government/publications/mental-health-payment-by-results-arrangements-for-2013-14).
Jacobs, R (2014) Payment by results for mental health services: economic considerations of case-mix funding. Advances in Psychiatric Treatment, 20: 155–64.
Lee, S, Forsyth, K, Morely, M et al (2013) Mental health payment-by-results clusters and the Model of Human Occupation Screening Tool. OTJR: Occupation, Participation and Health, 33: 40–9.
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Royal College of Psychiatrists (2014) Royal College of Psychiatrists' Statement on Mental Health Payment Systems (formerly Payment by Results) (Position Statement PS01/2014). Royal College of Psychiatrists (http://www.rcpsych.ac.uk/pdf/PS01_2014x.pdf).
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BJPsych Advances
  • ISSN: 1355-5146
  • EISSN: 1472-1481
  • URL: /core/journals/bjpsych-advances
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Clustering in mental health payment by results: a critical summary for the clinician

  • David Yeomans
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