Location of care for people with serious mental illness:
implications for service use and costs
Briefing No.1. May 2014
This update includes a summary of the research project Location of care for people with serious mental illness: implications for service use and costs and a briefing about what has been happening over the last few weeks.
It is for all partners in the project including mental health service users and carers and for general practices and mental health services in Lambeth.
We will produce briefings throughout the project. For any questions please see contact details at the end of the briefing.
A. Introduction
This is a health economics study which is using data from primary care and mental health services to find out how use of services by people with severe mental illness changes over time and how much this costs.
B. The study:
· also has a qualitative element; A sample of people with severe mental illness being discharged from SLaM into the new Living Well Hub in Lambeth will be interviewed within 6 months of their discharge and again 3 – 6 months later. Many of the interviews will be conducted by people with mental health experience who have been trained as peer researchers.
· is being done in Lambeth because of the changes the Living Well Collaborative are implementing in mental health services and to test the theory that people being discharged through the new arrangements are less likely to return to secondary care, leading to reduced expenditure.
· is being done in partnership with the Lambeth Living Well Collaborative, Lambeth & Southwark Public Health Department, and the NHS Lambeth Clinical Commissioning Group (LCCG)
· is led by Paul McCrone, Professor of Health Economics at the Centre for the Economics of Mental & Physical Health, Health Service and Population Research Department of the Institute of Psychiatry (King’s College London)
The other people leading the study are
· Steven Wright, Senior Researcher, Centre for the Economics of Mental and Physical Health, Institute of Psychiatry
· Sarah Corlett, Consultant in Public Health, Lambeth & Southwark Public Health Dept
· Is due to finish in mid 2015
· funded by a grant from the National Institute of Health Research Service Development and Organisation Programme (NIHR Ref No. 11/1023)
C. What’s been happening?
The data
The study will link data collected by GPs in their practices with data collected by South London & Maudsley NHS Trust (SLaM) so that people’s use of primary and mental health services can be analysed. Linking datasets is legally restricted to protect patient confidentiality. Anyone wishing to link clinical datasets has to make a detailed application to the Health Research Authority (http://www.hra.nhs.uk/) known as section 251 approval. Approval has now been granted for this study.
This means that both datasets can be linked using an algorithm (which enables data belonging to individuals to be linked without using personal identifiers).
A letter is shortly to go to all practices in Lambeth requesting their participation in the study. This will entail running a data query to extract consultation data on people known to have severe mental illness in their practice and using existing extracted data on people with SMI for this study. Practices will receive data facilitation support to run the query and extract the data.
The interviews
The aspect of the study is led by Steve Wright. Steve has been working with the Living Well Hub team members at their Stockwell base to design recruitment to the study. They have been given contact packs for prospective participants including an invitation letter, Participant Information Sheet, contact details form, and S.A.E (for return of the contact details form if a person would like to participate).
Informed consent will be required and prospective interviewees will have plenty of time to think about their participation and ask any questions before signing up. Most interviews will be held at the Living Well Hub or the Living Well Partnership (Mosaic Clubhouse, Effra Centre) but people can be interviewed in their homes if they prefer.
Steve has contacted a number of peer researchers who received training in qualitative research techniques (interviewing) in 2013 to ask if they would like to help run this study. A meeting will be held with this group on the 29th of April to discuss and plan the study, review the draft interview topic guide and to revise their interview skills.
Recruitment will begin as soon as possible after this. Most people will be recruited through the Living Well Hub but anyone living in Lambeth who has been discharged from SLaM within the previous 6 months and is interested in participating is welcome to express an interest. Interviews will be taped, transcribed and analysed according to key themes in a way that preserves anonymity of interviewees.
A number of staff from the Living Well Hub will also be interviewed.
More information
You are welcome to ask any question about the study. Please contact
Steve Wright: Tel: 0207 848 0503
Sarah Corlett: Tel: 0207 525 7401
In partnership with