Mental health network

New guidance published on developing an outcomes-based payment approach for IAPT services

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New Guidance published by NHS England and NHS Improvement - January 2017

NHS Improvement and NHS England have published detailed guidance on the new outcomes based payment approach for IAPT services. This follows NHS Improvement’s publication of the 2017/19 National Tariff Payment System (2017/19 NTPS). Within this, rule 8 mandates the use of an outcomes-based payment model for IAPT services from 1 April 2018. 

An outcomes based payment approach consists of:

  • A basic service price component reflecting activity: includes an amount for assessment and an amount for the mental health cluster-based package of care or episode of care.
  • An outcomes payment component: based on the performance of the service against the 10 national quality and outcome measures.
The belief is that by moving to an outcomes based payment approach, commissioners and providers can better understand the care they need to provide and the resources necessary to deliver that care. It is also hoped that it will help better meet the Five Year Forward View (5YFV) mental health objectives. 
Commissioners and providers will need to work through six key elements when developing and implementing this approach:
  • Understanding service user severity and complexity and quality of provision
  • Agreeing quality and outcome measures and establishing relative outcome weightings
  • Agreeing local process and how to link quality and outcome measures to payment
  • Agreeing financial gain/loss-sharing arrangements
  • Agreeing an approach to monitoring and feedback
  • Considering the service in the context of local system factors
The IAPT outcomes-based payment approach balances the need to pay for activity, taking into account case complexity and severity as a driver of cost, with the need to incentivise good outcomes. It builds on the IAPT model and the data that all providers of IAPT services are required to collect and submit to the national IAPT minimum dataset. 

The full detailed guidance can be found online here

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