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Abstract
Background: Private and voluntary organizations are significant providers of mental health and social care in England. Limited strategic information is available on the range of people placed into independent sector care.
Aim: To describe independent sector usage by NHS and local authority commissioners through examining secondary mental health care placements for adults of working age, types of service provision, linkage between agencies and associated costs.
Method: A census day study was undertaken across all agencies commissioning mental health services within seven Strategic Health Authority areas (n = 127). A 100% response rate was obtained from data providers consisting of 82 Primary Care Trusts, 42 Local Authority Social Services Departments and three specialist commissioning agencies. Data was obtained for 3,510 cases.
Results: A weekly expenditure of over £2.98 M was identified with considerable variation in costs across and within client groups. All illness groups were being supported across the full range of service models. Many people were placed at distance and links with CPA care co-ordinators and commissioners were frequently not robust.
Conclusions: Private providers dominate the independent sector and require strategic engagement. Improved co-ordination between the independent sector, NHS provider trusts, CPA care co-ordinators and service commissioners would more effectively utilize this significant resource.
Declaration of interest: This work was part of a wider programme of work that was funded through grants from Care Services Improvement Partnership National Institute for Mental Health in England Development Centres in the North West and West Midlands and the County Durham and Tees Valley Strategic Heath Authority.