Public Health England

Introduction

Welcome to the Severe Mental Illness Profiling tool. It has been developed to support an intelligence driven approach to understanding and meeting need. It collates and analyses a wide range of publically available data on prevalence, risk, prevention, early intervention, assessment, treatment, outcomes and service costs. It provides commissioners, service providers, clinicians, services users and their families with the means to benchmark their area against similar populations and gain intelligence about what works.

Tool structure - data are presented under the headings Risk and Related Factors, Prevalence, Services, Quality and Outcomes, and Finance. Within this they are grouped by geography (Clinical Commissioning Group or local authority) and then ordered by topic (e.g. primary care followed by secondary care).

Tool content - data are drawn from many sources and vary by time period, population and presentation of values. Care should be taken with interpretation. Detailed meta data and any caveats are set out in the Definitions section.

Data quality - indicators are included if viewed as robust, of sufficient quality, or they offer an important element that could not be otherwise gained. Each indicator has been assessed and labelled with its quality rank.

 

Psychosis Care Pathway

The Psychosis Care Pathway provides a high level summary using 16 key indicators to help users assess and benchmark how they manage this important condition. This pathway is consistent with and linked to the Commissioning for Value Psychosis packs to be published by NHS England.

 

Supporting Documents

Recent updates

August 2016

- Three indicators in the Services domain at CCG level have been updated for Q4 2015/16, using data from the new Mental Health Services Monthly Statistics provided by the HSCIC.

- Two indicators at CCG level using prescribing data provided by the HSCIC have been updated for Q3 and Q4 2015/16, one in the Services domain and one in the Finance domain.

- Please note that the definition of the Mortality from suicide and injury undetermined, age standardised rate indicator, in the Quality and Outcomes domain, has been changed so that it is in line with the National Statistics definition, as such the values have changed slightly. Historic data has been changed, so all time periods use the same National Statistics definition.

 

July 2016

3 indicators based on NHS England Mental Health Community Teams Activity data have been updated to include Q3 and Q4 2015/16:

  • 1 Services indicator at CCG level
  • 2 Quality and outcomes indicators at CCG level

 

May 2016

* CHANGES to PHOF, DEPRIVATION & PRESCRIBING INDICATORS:

- In the Risk and Related Factors domain the Socioeconomic deprivation indicator has been updated for 2015.

- Indicators that correspond to PHOF indicators and have been updated in the PHOF profile have been updated.

 

April 2016

In the Risk and Related Factors domain the Socioeconomic deprivation: overall IMD score indicator has been updated to 2015.

In the Quality and Outcomes domain for County/LAs, the Excess under 75 mortality rate in adults with SMI indicator has been amended and updated to be the same indicator as reported in the PHOF. Note that a different but similar indicator in the Psychosis Pathway domain for CCGs has not been updated.

 

March 2016

22 INDICATORS UPDATED

- 15 indicators based on Mental Health and Learning Disabilities Statistics filtered data provided by the HSCIC:

  • 7 Services indicators, 5 at CCG level and 2 at both CCG and Mental Health Trust levels, for Q2 2015/16
  • 8 Quality and outcomes indicators at both CCG and Mental Health Trust levels for Q2 2015/16

- 1 Quality and outcomes indicator at both CCG and Mental Health Trust levels for Q2 2015/16, based on HSCIC Currencies and Payment reports

- 1 Services indicator at CCG level for 2013/14 and 2014/15, % of people in contact with mental health services who are in black and minority ethnic groups, based on an HSCIC indicator derived from the Mental Health and Learning Disabilities Dataset

- 3 indicators based on NHS England Mental Health Community Teams Activity data, for Q2 2015/16:

  • 1 Services indicator at CCG level
  • 2 Quality and outcomes indicators at CCG level.  In addition, minor updates have been made to these two indicators for Q3 2014/15 and Q1 2015/16 following revised data being issued by NHS England

- 2 indicators based on HSCIC CCG Prescribing data, for Q2 2015/16:

  • 1 Services indicator at CCG level
  • 1 Finance indicator at CCG level

 

 

February 2016

21 BENCHMARKING NETWORK INDICATORS INCLUDED 

21 Mental Health Trust based indicators from the national Benchmarking Network are included. The indicators are based on annual data for 2013/14, with 11 indicators in the Services domain and 10 indicators in the Quality & Outcomes domain.

OTHER INDICATOR UPDATES

- 3 Risk and Related Factors domain indicators related to socioeconomic deprivation, statutory homelessness and children in poverty have been updated at both County & UA level and District & UA level

- 1 Quality and Outcomes domain indicator on emergency hospital admissions for intentional self-harm has been updated at County & UA level.

 

January 2016

26 INDICATORS UPDATED

23 indicators have been affected by the transition from the Mental Health Minimum Dataset (MHMDS) to the Mental Health and Learning Disabilities Dataset (MHLDDS) from September 2014.  15 of these indicators, those based on end of quarter snapshots of activity, have been updated using additional data provided by the HSCIC.  Please refer to the metadata of these indicators.  8 indicators, those based on sums of quarterly activity, have not been updated because it is not possible to clearly distinguish mental health services activity from learning disabilities services activity for these indicators. It is planned that these 8 indicators will be able to be updated from the Mental Health Services Data Set (MHSDS), which will replace the MHLDDS for activity from January 2016.

The 15 updated indicators are:

- 7 Services indicators, 5 at CCG level and 2 at both CCG and Mental Health Trust levels, for Q1 2015/16

- 8 Quality and outcomes indicators at both CCG and Mental Health Trust levels for Q1 2015/16

All of these are based on Mental Health and Learning Disabilities Statistics filtered data provided by the HSCIC.

Additionally updated:

- 1 Quality and outcomes indicator at both CCG and Mental Health Trust levels for Q1 2015/16, based on HSCIC Currencies and Payment reports

- 3 indicators based on the 2014/15 Quality and Outcomes Framework reports:

•1 Risk and related factors indicator at CCG level

•1 Prevalence indicator at CCG level

•1 Quality and outcomes indicator at CCG level

- 2 Risk and related factors indicators at County & UA level, based on 2014/15 Department for Education data

- 3 indicators based on NHS England Mental Health Community Teams Activity data, for Q1 2015/16:

•1 Services indicator at CCG level

•2 Quality and outcomes indicators at CCG level

- 2 indicators based on HSCIC CCG Prescribing data, for Q1 2015/16:

•1 Services indicator at CCG level

•1 Finance indicator at CCG level

 

December 2015

24 INDICATORS UPDATED

23 indicators have been affected by the transition from the Mental Health Minimum Dataset (MHMDS) to the Mental Health and Learning Disabilities Dataset (MHLDDS) from September 2014.  15 of these indicators, those based on end of quarter snapshots of activity, have been updated using additional data provided by the HSCIC.  Please refer to the metadata of these indicators.  8 indicators, those based on sums of quarterly activity, have not been updated because it is not possible to clearly distinguish mental health services activity from learning disabilities services activity for these indicators. It is planned that these 8 indicators will be able to be updated from the Mental Health Services Data Set (MHSDS), which will replace the MHLDDS for activity from January 2016.

The 15 updated indicators are:

- 7 Services indicators, 5 at CCG level and 2 at both CCG and Mental Health Trust levels, for Q3 and Q4 2014/15

- 8 Quality and outcomes indicators at both CCG and Mental Health Trust levels for Q3 and Q4 2014/15

All of these are based on Mental Health and Learning Disabilities Statistics filtered data provided by the HSCIC.

Additionally updated:

- 1 Quality and outcomes indicator at both CCG and Mental Health Trust levels for Q3 and Q4 2014/15, based on Currencies and Payment reports

- 8 indicators based on the 2014/15 Quality and Outcomes Framework reports:

  • 1 Prevalence indicator at CCG level
  • 7 Quality and outcomes indicators at CCG level

 

November 2015

2 INDICATORS UPDATED

- 1 Risk and related factors indicator at County & UA level and District & UA level related to violent crime: rate per 1,000 population.

- 1 Quality and outcomes indicator at County & UA level related to mortality from suicide and undetermined injury.

PROGRAMME BUDGETING DATA

New programme budgeting data for 2013/14 for CCGs is now included in the Finance domain. Due to changes in the way the data is reported, new indicators are now included:

  • Mental Health spend per head of population
  • Mental Health prescribing spend per head of population
  • Proportion of CCG spend that is on specialist Mental Health services

 

October 2015

11 INDICATORS UPDATED

- 2 Services indicators at CCG level, GP prescribing of drugs for psychoses and related disorders and New cases of psychosis served by Early Intervention teams, updated with Q3 and Q4 2014/15 data; revised Q2 2014/15 data for the latter uploaded also.

- 2 Quality and outcomes indicators at CCG level, Gate kept admissions and Follow up after discharge, updated with Q3 and Q4 2014/15 data and revised Q2 2014/15 data.

- 1 Finance indicator at CCG level, Cost of GP prescribing for psychoses and related disorders, updated with Q3 and Q4 2014/15 data.

- 2 Quality and outcomes indicators at Mental Health Trust level, Delayed transfers of care due to NHS and Delayed transfers of care due to social care, updated with Q4 2014/15 data.

- 4 Quality and outcomes indicators at Mental Health Trust level updated with data from the 2014 NHS Staff Survey.

In addition 7 Risk and related factors indicators are now included at District & UA level as well as at County & UA level.

 

September 2015

4 INDICATORS UPDATED

- 2 additional Risk Factor indicators now included at District & UA level as well as at County & UA level

- 1 Quality & Outcomes indicator related to emergency hospital admissions for intentional self-harm updated at County & UA level

- 1 Prevalence indicator related to the comparison of QoF and estimated prevalence updated at CCG level. This now uses QOF data for 2013/14, which is already in this tool.

PROGRAMME BUDGETING DATA PROPOSALS

Programme budgeting data for CCGs is now available from NHS England for 2013/14. Due to changes in the way the data is reported, indicators in the Finance domain cannot be updated. Three new indicators are proposed:

  • Mental Health spend per head of population
  • Mental Health prescribing spend per head of population
  • Proportion of CCG spend that is on specialist Mental Health services

These new indicators will be included in the October update. At the same time the previous indicators based on programme budgeting data will be archived, unless there is a demand for these indicators to remain in the tool. If you have any feedback on this please send to mhdnin@phe.gov.uk

 

July 2015

15 INDICATORS UPDATED

- 3 Mental Health Trust level Service indicators updated

- 12 Mental Health Trust level Quality and Outcome indicators updated

March 2015

30 INDICATORS UPDATED

- 14 CCG level Service indicators updated

- 14 CCG level Quality and Outcome indicators updated

- 1 LA level Risk indicator updated

- 1 CCG level Finance indicator updated

February 2015

11 INDICATORS UPDATED 

-9 County and Unitary Authority level social care indicators in Services and Quality & Outcomes domains updated

-Psychosis Pathway indicator on social care mental health clients in residential care or receiving home care updated

-Psychosis Pathway indicator on GP prescribing of drugs for psychoses and related disorders updated

 

 

 

December 2014

42 INDICATORS UPDATED

+ NEW TRUST LEVEL INDICATORS

-CCG level MHMDS indicators updated

-New Trust level MHMDS indicators added

-New indicators on emergency admissions

-QOF indicators updated

-Updates to some risk indicators and outcomes (including excess mortality and suicide)

-4 Staff Survey Trust indicators updated

October 2014

26 INDICATORS UPDATED 

Psychosis pathway revised and finalised

+ NEW indicators added

- 4 indicators on MHA detentions and orders

- Duration of untreated psychosis

- Recording of HoNOS change

- Access to psychological therapy

- 3 indicators added to psychosis pathway (mapped LA to CCG)

August 2014

Updated indicator: New cases of psychosis: Estimated incidence per 100,000 aged 16-64 (District, County and UA)

June 2014

First version released