Oxfordshire CCG (OCCG) wanted to move away from traditional contracts with providers to contracts based on outcomes for patients. As part of the process, OCCG wanted to engage with patients and carers to ensure the outcomes reflected what they felt was important. One of the areas was mental health.
SCW were asked to take forward engagement to
- Determine a high level outcome for mental health that tells us that someone is moving towards recovery and well-being
- Understand why these were important to people in Oxfordshire and how they linked to national priorities
- Gather suggestions about how these broad outcomes may be measured
- Face to face workshops for service users, carers, GPs/clinicians and the voluntary sector
- A survey that we developed and promoted – including through digital channels and partner websites
- Partner working with providers, service user groups and the third sector to increase engagement
- Feedback analysis and reporting
From all the feedback received during this consultation, it was clear that one of the proposed outcomes was the least favoured both by service users, carers and providers. This was for a variety of reasons - for example availability of jobs, suitability of employment and stigma. There was an expressed wish that ‘meaningful activity’ should replace ‘paid’ in this outcome. It was felt that local voluntary work, education and training should be reflected with equal importance in this outcome.
The remaining five outcomes received positive feedback from all respondents. There was general concern that some of the outcomes would be affected by influencers outside the control of the NHS, such as benefit welfare reform, housing provision and the economy, and as such consideration should be given to how these areas will impact on the success of the outcome.
Whilst people were positive about the outcomes there was an underlying concern that the measures needed to be specific, measureable, appropriate, realistic and timely (SMART). People felt that the outcomes and measures should be set up to ensure that financial reward for the provider is not at the detriment of the patient, and that sufficient quality controls are put in place.
OCCG now operates in a partial outcomes based contract with their mental health provider.