Here in Wales we have the Mental Health Measure. This is a piece of legislation passed in 2010 and implemented in phases in 2012, and which is intended to improve the quality and timeliness of mental health services. Specifically, it provides for:
- primary mental health care;
- care and treatment planning and care coordination;
- the right for an automatic reassessment of needs in secondary mental health services for people discharged within the previous three years;
- advocacy in hospital.
This month the National Assembly for Wales Health and Social Care Committee has reported on its post-legislative scrutiny of the Measure. The Welsh Government has already committed to conduct a formal evaluation of the legislation through a duty to review, built in as the Measure passed into law. In pursuit of this an inception and an interim report have already appeared, with a final document due in 2016. With the Health and Social Care Committee’s report appearing this month it is clear that the Mental Health Measure is becoming seriously scrutinised.
When the Committee published its call for evidence last year the COCAPP research team submitted a response alerting Assembly Members to our ongoing study. It would have been ideal had we been able to report key findings, given that COCAPP is an examination of care planning and care coordination and is, therefore, of interest to anyone wanting to know how part 2 of the Measure (dealing with care and treatment planning) is being experienced. But the Health and Social Care Committee’s timescales and those of COCAPP were not aligned, meaning the best we could do was to draw attention to our project.
This month the Committee praises many aspects of the Measure but also makes ten recommendations. They address:
- meeting demands for primary mental health care, particularly in the case of children and young people;
- improving the collection of data to better support the evaluation of primary mental health services;
- taking action to improve the form, content and quality of care and treatment plans, with a view to increasing service user involvement and spreading best practice through training;
- making sure that rights to self-refer for reassessment are properly understood and communicated to all;
- improving staff awareness of service users’ eligibility for independent mental health advocacy in hospital;
- setting timescales for new task and finish groups reviewing the Measure, and setting out plans to respond to their recommendations;
- during evaluations of the legislation, consulting with as wide a range of people as possible using traditional and novel approaches;
- ensuring that information is available in a variety of formats, so that all groups of people are able to access this and to understand;
- following the publishing of new plans for the improvement of child and adolescent mental health services, making clear how these will be realised;
- carrying out a cost benefit analysis of the Measure.
Clearly, Assembly Members have detected evidence of an uneven pace in the development of primary mental health care across Wales, and are particularly concerned to make sure that the mental health needs of children and young people are properly identified and met in timely fashion. As a COCAPP-er, I am interested to read that the Committee thinks care and treatment planning for everyone can be improved, informed by examples of best practice and through investment in staff training. I also pick out the recommendations on improving service user collaboration, and estimating the costs and benefits of the Measure. These resonate, to me, with current concerns in Wales with prudent health care and co-production.
And as for COCAPP’s findings? Suffice to say our draft final report is now under review with the National Institute for Health Research (NIHR) Health Services and Delivery Research (HS&DR) Programme. More to follow in due course…Follow @benhannigan