Commissioning stepped care for people with common mental health disorders

This is an extract from the commissioning guide. The complete commissioning guide is available at www.nice.org.uk/guidance/cmg41

8 Further information

Table 19 summarises national drivers relevant to commissioning services for people with common mental health disorders. Local service redesign may address only one or two of them.

Table 19 National policy on common mental health disorders

Document	Author	Year	Significance
No health without mental health: a cross-Government mental health outcomes strategy for people of all ages	Department of Health	2011	Details shared objectives to improve mental health outcomes for the population, including improving recovery and service-user experience.
Talking therapies: a four year plan of action	Department of Health	2011	Details plan to complete roll-out of Improving Access to Psychological Therapies programme for adults of all ages who have depression or anxiety disorders.
NHS Outcomes Framework 2011/12	Department of Health	2011	Includes measures to enhance the quality of life and employment of people with mental illness and to improve service-user experience of community mental health services.
Transparency in outcomes: a framework for adult social care	Department of Health	2011	Includes measures to enhance the quality of life and employment of people with mental illness.
NHS operating framework for 2011/12	Department of Health	2011	Sets out focus on early intervention and prevention to reduce the likelihood of mental illness developing and increasing access to psychological interventions through Improving Access to Psychological Therapies.
Healthy lives, healthy people: our strategy for public health in England	Department of Health	2010	Focuses on economic benefits and health outcomes of improving mental health and wellbeing at a population level.
Using the Commissioning for Quality and Innovation (CQUIN) payment framework – a summary guide	Department of Health	2010	Makes a proportion of providers' income conditional on quality and innovation.

Other useful sources of information for developing common mental health disorder services may include:

The standard NHS contracts for acute hospital, mental health, community and ambulance services.
NHS Evidence: provides free access to clinical and non-clinical information – local, regional, national and international; includes a QIPP library with case studies and commissioning zone.
The NICE shared learning database offers examples of how commissioners and service providers have used NICE guidance to create innovative and effective local implementation programmes for service improvements.
NICE pathway for depression in adults
NICE public health guidance 22 on promoting mental wellbeing at work
NICE public health guidance 12 on social and emotional wellbeing in primary education and 20 on social and emotional wellbeing in secondary education
Skills for Health Digest of National Occupational Standards for psychological therapies.
The Quality and outcomes framework (QOF) is a voluntary quality incentive scheme that rewards general practices for implementing systematic improvements in the quality of service-user care; the QOF includes indicators on depression.

Sources of further information to help you assess local health needs and reduce health inequalities include:

NHS Evidence provides free access to clinical and non-clinical information – local, regional, national and international. Information includes evidence, guidance and government policy.
Department of Health Delivering quality and value – focus on benchmarking.
NICE Health equity audit – learning from practice briefing.
NHS Comparators provides comparator data for NHS commissioning and provider organisations to enable users to investigate aspects of local activity, costs and outcomes.
The Disease management information toolkit (DMIT) is a good-practice tool for decision-makers, commissioners and deliverers of care for people with long-term conditions.
Disease prevalence models produced by the Association of Public Health Observatories provides primary care trust-level prevalence estimates.
PRIMIS+ provides support to general practices on information management, recording for, and analysis of, data quality, plus a comparative analysis service focused on key clinical topics.
SHAPE (Strategic health asset planning and evaluation) application provides support to strategic health authorities and primary care trusts on strategic planning across a whole health economy.
The Joint Strategic Needs Assessment Information centre resource looks at the wider determinants of health, working with PCTs, Local Authorities and third sector providers.