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The Mental Health Clustering Tool for people with severe intellectual disability

  • Vishwa Radhakrishnan (a1), Kevin Smith (a2) and Jean O'Hara (a2) (a3)
Abstract
Aims and method

We assessed 92% (117/127) of the patients in our community mental health learning disability team using the Mental Health Clustering Tool (MHCT) to establish whether their needs could be captured sufficiently well to enable assignment to a care cluster for payment by results in mental health. We explored the characteristics of those assigned to Cluster 0 to identify how they differed from those who could be assigned to Clusters 1-21.

Results

As expected, nearly half of the case-load (48%) could not be assigned to any cluster except Cluster 0, the variance cluster, which is used when the needs of patients cannot be captured by the current 21 care clusters but a service is, or will be, provided.

Clinical implications

The MHCT in its current form does not adequately capture the needs of people with more severe intellectual disability. An integrated mental health and learning disability clustering tool is in development. This is expected to include new rating scales and new clusters, however until the development is completed and validated it will not be possible to implement payment by results in mental health in learning disability services.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
Vishwa Radhakrishnan (vishwa.radhakrishnan@gmail.com)
Footnotes
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Declaration of interest

None.

Footnotes
References
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1 Jacques, J. Payment by results and mental health services. Psychiatr Bull 2008; 32: 361–3.
2 Department of Health. Guidance on the NHS Contract for Acute Hospital Services for 2007/8. Department of Health, 2006.
3 Department of Health. Mental Health Clustering Booklet (v2.03) (2012/ 13). Department of Health, 2012.
4 Wing, JK, Curtis, RH, Beevor, AS. Health of the Nation Outcome Scales (HoNOS). Glossary for HoNOS score sheet. Br J Psychiatry 1999; 174: 432–4.
5 Self, R, Rigby, A, Leggett, C, Paxton, R. Clinical Decision Support Tool: a rational needs-based approach to making clinical decisions. J Ment Health 2008; 17: 3348.
6 Fairbairn, A. Payment by results in mental health: the current state of play in England. Adv Psychiatr Treat 2007; 13: 36.
7 Alexander, B. Update on the latest developments on PbR for mental health, and clarification of implementation timescales. Department of Health, 2010.
8 HM Government. Valuing People Now: A New Three-year Strategy for People with Learning Disabilities. Department of Health, 2009.
9 Roy, A, Matthews, H, Clifford, P, Fowler, V, Martin, DM. Health of the Nation Outcome Scales for People with Learning Disabilities (HoNOS-LD). Br J Psychiatry 2002; 180: 61–6.
10 World Health Organization. The ICD-10 Classification of Mental and Behavioural Disorders. WHO, 1992.
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BJPsych Bulletin
  • ISSN: 1758-3209
  • EISSN: 1758-3217
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The Mental Health Clustering Tool for people with severe intellectual disability

  • Vishwa Radhakrishnan (a1), Kevin Smith (a2) and Jean O'Hara (a2) (a3)
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