Driving quality implementation in the context of the Francis report

| | Principle five: value the
importance of outcomes
and accurate data
‘The measurement of quality is clearly expected to move beyond ensuring that structures and
processes are in place, to measure the outcomes of care in a way that is of value to both clinicians
and patients […] The Royal College of Psychiatrists is well placed to provide guidance
on the use of outcome measures in mental health based on what is of clinical value to patients
and clinicians and what is feasible in practice. The College strongly supports the implementation
of patient-reported outcome measures in mental health as a way of improving the quality
of care provided’ (Royal College of Psychiatrists, 2011: p. 5).
To improve patient care, we need outcome measures
from well-designed studies that provide
accurate and valid data which relate to the outcomes
we are trying to measure. Both individual
clinicians and providers of services must submit
accurate data to the NHS on patient care. Having
accurate data means services/quality can be monitored
effectively and outcome metrics produced.
The College encourages the use of Community
Mental Health Profiles (www.nepho.org.uk/cmhp/),
which present a range of mental health information
for local authorities in England. These are designed
to give an overview of mental health risks, prevalence
and services at a local, regional and national
level using an iteractive mapping tool. The data
should be used to inform commissioners of health
and social care services in their decision-making,
leading to the improvement of mental health and
mental health services.
The College is involved with the Department of
Health Mental Health Payment by Results (MHPbR)
Quality and Outcomes Group. Its purpose is to
embed quality and outcome measures into payment
by results, to oversee the piloting of a range
of measures, to evaluate them and to inform commissioners
of appropriate quality and outcomes
measures. The key findings from the report of the
group (Department of Health, 2013d) are:
• z seven quality indicators are recommended for
use from a set of indicators analysed
• z the clinician-rated outcome measure (CROM)
based on Health of the Nation Outcome
Scales/Mental Health Clustering Tool
(HoNOS/MHCT) is now recommended for use
• z good progress has been made on the
development of a patient-rated outcome
measure (PROM), with testing of the
Warwick–Edinburgh Mental Well-Being Scale
(WEMWBS) receiving positive feedback from
patients
• z further progress on the development of
patient-rated experience measures (PREMs)
and the recommendation to collect the
‘friends and family’ question
z • completion of the Industry and Mental
Health Service Collaborative (IMHSeC)
website which will provide guidance on the
content of care package for each of the clusters
(www.cppconsortium.nhs.uk/admin/
files/1300792324IMHSeC%20Project%20
Outline.pdf).
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Occasional Paper OP92