Policy context
Mental health services:
Mental health services provide support, assistance and treatment for those with a mental illness and their informal carers. The services may be provided by NHS primary or secondary care, local authority social services, voluntary organisations and the independent sector. It is therefore essential that these individual services co-ordinate their work to meet the individual service user's needs, and this work can be shown to be fit-for-purpose. This is beginning to happen in different places with jointly managed services.
NHS QIS strategic work programme:
In 2004, NHS QIS published a national overview of schizophrenia services in Scotland . The key findings identified that mental health services sometimes lack co-ordination, do not deliver evidence-based interventions, do not record outcomes and often do not meet service user-assessed needs. To address these findings, NHS QIS published its three year strategic work programme in 2005, Improving the Quality of Mental Health Services, 2005-2008. To ensure that mental health services continue to improve, three key areas were identified: care, often provided by different organisations, should be co-ordinated by means of integrated care pathways (ICPs); the success of a service should be measured by the extent to which the needs of service users are actually met; and information systems should be developed to enable assessment of the first two key areas.
Delivering for Mental Health:
In 2006, the Scottish Executive Health Department (SEHD, now the Scottish Government) published Delivering for Mental Health (DfMH). DfMH addresses the need to set targets and commitments for the development of mental health services in Scotland. It takes forward the Millan Principles, which underpin Scotland's mental health legislation (Mental Health (Care and Treatment) (Scotland) Act 2003), and marks a national commitment to a new style of working for mental health services . NHS QIS is taking this work forward in conjunction with NHSScotland and partner organisations by developing standards for ICPs, as set out in Commitment 6 of DfMH:
‘NHS QIS will develop the standards for ICPs for schizophrenia, bipolar disorder, depression, dementia and personality disorder by the end of 2007. NHS board areas will develop and implement ICPs and these will be accredited from 2008 onwards.’
Commitment 6 is linked to achieving the Health Improvement, Efficiency and Governance, Access and Treatment (HEAT) targets for mental health:
- Target 1: Reduce the annual rate of increase of defined daily dose per capita of antidepressants to zero by 2009/10.
- Target 2: Reduce suicides in Scotland by 20% by 2013.
- Target 3: Reduce the number of readmissions (within 1 year) for those that have had a hospital admission of over 7 days, by 10% by the end of December 2009.