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Mental Health Information NHS Trust Forum Thursday 28th January 2010
Introduction • Latest release and use of MHMDS • MHMDS Approvals – where we are • New datasets • IAPT • Community, Maternity, Child Health, CAMHS • ICs new role
Plan (Hope) • Approvals – soon • Only issue – what goes to commissioners • ISN – February / March • Q4P / Q3R submission as normal • Annual submission as normal • No Q4R submission • Q1P submission – v4 IDB • Fall back – no Q1P (but not agreed with DH or anyone else) and mapping
Payment by Results • V3.5 – any time • HoNOS65+ any time (if you’re on the list) • Guidance
Summary of changes • Clusters: • Can flow - now • Should flow – from April 2011 • Must flow – by December 2011 • New data items • Can flow – Q1, 2011/12 • Should flow – as soon as possible • Must flow – April 2012/13
Tables removed • Community episode of Community Psychiatric Nursing • Inpatient Episode (IPEP replaced by INPATEP and PROVSPELL) • Professional Staff Episode • Care Co-ordinator • Responsible Clinician • CPN Contact • Consultant Outpatient Attendance • Professional Staff Group Contact • Contact with Care Co-ordinator • Spell Suspensions
Unchanged tables • Master Patient Index • Day Care Episode • Consultant Outpatient Episode • Acute Home-Based Care Episode • Mental Health Care Home Stay Episode • Day Care Facility Attendance • Mental Health Clustering Tool • Payment by Results Care Cluster • Social Service Statutory Assessment • SCT Recalls • ECT • Leave of Absence • AWOL
Reconfigured tables • Disaggregated from Review table • Employment • Accommodation • Primary and secondary diagnoses • HoNOS • Intervention (not mandated) • CPA Episode • Staff table • Replaces KWS and RC • Team Episode • Replaces CEP and PGEP • Hospital Provider Spell and Inpatient Episode • Replace IPEP • Healthcare Professional Contact • Replaces OPATT, KWCONT, CCONT and PGCONT
New to MHMDS • Psychosis details (previously recorded on FERN) • Referral details • Delayed Discharges (Unify2) • Crisis Plan • HoNOS variants and PHQ9 • Home Leave • Self Harm (Count Me In) • Restraint (Count Me In) • Seclusion (Count Me In)
Amended tables • Ward stays • Added Security Level, Ward Gender, Ward Age, extra Care Intensity • Clinical Team • Now for national use and better team list added • KWASS renamed to CCASS • Staff ID added to link to Staff table • RCASS • Assignment dates and Staff ID added • Review table • Just about reviews; abuse question indicator and data linkage items added • Mental Health Act event • Extra data items added to enable move to replace KP90 • SCT • Expiry date added
Mental Health Bureau ServiceV4 Gary Sargent – Bureau Services Manager
Why the change ? • V3 v V4 : • Standardisation • Development and support • Security • Storage • Access - Authentication • Ease • No installation
Contact Details Exeter Helpdesk, firstname.lastname@example.org, tel. 01392 251289 Gary Sargent, Bureau Services Manager, email@example.com, tel. 01392 206916
Implementation and Submission Schedule Jo SimpsonGary Sargent
Implementation Plan for v4 and Submission Schedule • Implementation timetable for v4 processing • Subject to ISN • Mitigation actions in reserve • Way in which 2011/12 and 2012/13 submission timetable is structured
Draft Submission Schedule Last v3/3.5 submission Annual file 2010/11 – July 2010 No Q4R submission for 2010/11 – agreed with DH
Improving Access to Psychological Therapies (IAPT) Nick BridgesSenior Business Analyst
Areas to be considered • Why is the data set needed ? • Structure of the data set • Submission process • Status of the approval process • Key dates • Further planned developments • Note: Applies to all providers of NHS Services, including independent providers
Why is the data set needed ? Support the NHS in delivering: • NICE approved, evidenced-based psychological therapies for people with depression and anxiety disorders • Access to services and treatments for people experiencing depression and anxiety disorders from all communities within the local population, irrespective of age, gender, ethnicity, diagnosis, socio-economic status, sexuality, faith or disability • Increased health and wellbeing, measuring recovery and meaningful improvements
Why is the data set needed ?Continued Support the NHS in delivering: • Patient choice and satisfaction • Timely access to services • Improved employment, benefit, and social inclusion status including help for people to retain employment, return to work, improve their vocational situation and participate in the activities of daily living.
Structure of the data set • 50 item data set • A relational database containing four tables: • Person • Referral • Appointment • Disability • Called the ‘IAPT Intermediate Database (IDB)’
Submission process Data flow: • Provider data extract from local system • Format into required IDB format • Upload via Open Exeter web portal (using N3 connection) • Central data processing – includes various derivations and calculations • Data made available for download to providers, commissioners and the NHS IC The is essentially the same as new MHMDS process, which will be discussed in detail this afternoon. But, are some differences from MHMDS processing: • IAPT system will be in place from ‘summer 2011. MHMDS system is being developed first • No “assembly” process, only derivations and calculations. • Commissioner data is pseudonymised • Monthly submission
Status of the approval process • Considered at ISB board yesterday ! • Outcome…..
Further planned developments • Detailed data set documentation will be issued, including: • Data set specification and guidance • Information Standards Notice • Specification of outputs of the processing, including extracts and rules for derivations / calculations undertaken • Bureau Service processes • KPI’s will initially run in parallel with data set and then cease in 2013/14
Further planned developments • Outcome based currency and tariff • Investigation to be undertaken to determine relationship between the IAPT data set and the mental health clusters: • What the requirements are for deriving an IAPT currency and tariff • Whether any requirement exists to change existing MH clusters / clustering tool to incorporate IAPT. • Additional items are likely to be added to the IAPT data set, such as patient experience, duration of problem and previous treatments. • Planned date for ISN is still to be finalised, but expectation is that development closely maps to PbR agenda • More details will be issued as the development progresses
Update on MHMDS Indicators and Validations Maria ShortSenior Information Analyst
Performance Indicators from MHMDS… Results from IC http://www.ic.nhs.uk/services/mhmds/quarterly Results from Department of Health http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_109146 Measures from CQC e.g. ‘Completeness’ of MHMDS (09/10) http://www.cqc.org.uk/periodicreview/nationalcommitmentsandpriorities2009/10/mentalhealthtrusts.cfm
Performance Indicators from MHMDS… • Data produced from MHMDS for DH Performance Indicators and published on IC website • DH take data from here and publish with the rest of their performance framework • DH changed some of their definitions In Sept / Oct 2010 • MHMDS analysis NOT changed to reflect these changes • IC and DH working together to align these!
Performance Indicators from MHMDS… Main differences… • DH state ‘reference period’ • HoNOS has age restriction on DH definitions • AWOL definition counts ‘episodes’ rather than care spells in DH documentation We have been working with DH to change the definitions to align with the current analysis so that the indicators remain comparable for 2010/11. IC will change analysis for 2011/12.
CQC measures… • Quality and Risk Profiles: • http://www.cqc.org.uk/_db/_documents/QRP_data_sources_-_MH_v1.6b.pdf • Q4 2009/10 • Measure ‘reversed’ compared to previous indicators i.e. Numerator counts invalid / missing / default records depending on data item • Have a read!
Performance Indicators from MHMDS… http://www.ic.nhs.uk/services/mhmds/quarterly
Performance Indicators from MHMDS… http://www.ic.nhs.uk/services/mhmds/quarterly **Detailed constructions on ‘Constructions tab’**