Fears that mental health services will be badly affected by
government plans to devolve service commissioning from primary care
trusts to GP practices have been raised by a leading mental health
charity, writes Sally Gillen.
Research by the Sainsbury Centre for Mental Health has
highlighted concerns over the introduction of practice-based
commissioning next April, which will mean surgeries are able to
commission most specialist services.
Under the new system, national tariffs will be set for
specialist services. But mental health provision will be excluded
from Payment By Results because of the difficulty in dividing
services and applying distinct prices.
The charity says there are dangers that practices will choose
the cheapest options rather than the most appropriate services, and
it is also concerned that the IT needed to help doctors make
choices about treatment is not available.
Author and director of primary care at the SCMH Dr Alan Cohen
said: “Practice-based commissioning is the logical conclusion
of the government’s NHS reforms. But it will not work for
patients unless we can be sure that all services are of sufficient
quality, that choices are supported by good information and that
cost considerations do not distort decision making. None of these
conditions yet apply to mental health services in
Unlike for PCTs, guidance on the new system does not include a
requirement on individual practices to consult service users about
services or give notification of plans to change those they
“To avoid de-stabilising mental health services we need to
see clear rules for practices to give plenty of advance warning of
changes to what they buy for their patient,” added