Mental Health Information: NHS Trust Forum

26th April 2010, Birmingham Botanical Gardens

Proposed changes to MHMDS v4.0

Consultation Exercise Reponses

Paul Croft

Consultation Exercise Reponses

300+ individual comments received 20+ organisations including:

- Trusts

- Department of Health

- Care Quality Commission (CQC)

- National Mental Health Development Unit

- NHS Data Model and Dictionary Service (NHS Connecting for Health)

Responses to be published on The NHS Information Centre website by Friday 7th May

We will consider ALL comments and incorporate suggestions/address issues identified wherever possible

Scope Changes

Independent/Third Sector Mental Health Services Primary Care Mental Health Services (not GP’s and excluding

Improving Access to Psychological Therapies IAPT) Early Intervention Services (where not provided by Adult Mental Heath

Providers or currently included within MHMDS) High Secure Services Learning Disability Services (TBC)

1. Expansion of scope of MHMDS is NOT part of these proposed changes.

2. These will require testing/piloting to ensure that MHMDS could beimplemented for these areas/services prior to seeking formal approval.

3. Testing will also identify existing data items/definitions/value lists that may need changing to reflect this activity.

4. Timescales will be dependent upon results of testing.

Diagnosis

Changes to move existing items from IPEP and Reviews Tables

Split between Primary/Secondary Diagnosis – might need to be reconsidered

Not requiring formal diagnosis to be captured from all settings – only where it is currently captured as part of clinical process.

Interventions/Procedures

1. Only intended to be ‘moved’ from ‘CPA Reviews’ table to new ‘Interventions’ table

2. This should reflect ‘planned’ interventions/ procedures NOT those that have occurred.

3. Most Trusts don’t have capability of reporting Read Codes – poor data quality currently

4. Improvement of recording and reporting of interventions key strategic aim – will undertake review of mental health interventions with view to include in future changes to MHMDS

Outcome Measures

HoNOS (Working Age Adult) HoNOS 65+ (Older Persons) HoNOS-CA (Child and Adolescent) HoNOS-Secure (Secure Services) HoNOS-LD (Learning Disability) HoNOS-ABI (Acquired Brain Injury) PHQ-9 EQ-5D

1. Variants of HoNOS/PHQ-9 NOT required – only need to include where used by clinicians

2. EQ-5D – removed due to potential licensing issues3. CAMHS remains out of scope of MHMDS – only include as may be

most clinically appropriate outcome measure e.g. for patients under 18 in adult mental health services

4. MHCT Assessment – HoNOS items can ALSO be included as a HoNOS where deemed clinically appropriate (Only Standard Working Age HoNOS)

Episodes

Still investigating whether Team Episodes would be more useful as a replacement for existing episodes for:

- Community Episode (of Community Psychiatric Nursing (CPN))

- Acute Home Based Care Episode

- Mental Health NHS Community Care Episode

- Consultant Outpatient Episode- Professional Staff Group Episode-Still investigating whether Team Episodes would be more useful as a replacement for existing episodes for Any thoughts?

Any thoughts?

Seclusion/Assaults/Self-Harm/Restraint

1. Required for monitoring of incidents for equality purposes following ending of Count Me In Census

2. These should only be captured for inpatients

3. Assaults – include reported assaults on patient by another patient only

4. Self-Harm – include suicide attempts

5. Investigating whether self-harm needed or if already included within incident reporting to NPSA

Equality Items

1. Required for equality monitoring purposes following ending of Count Me In Census

2. Should be captured for ALL patients not only Inpatients

3. Disability indicators – includes both perceived or registered disability. They do not necessarily have to be formally diagnosed.

4. Planning to adopt existing guidance from Count Me In Census for these Items – including extensive guidance for Sexual Orientation

5. Recording and reporting of ALL equality monitoring items being reviewed across NHS – will align MHMDS where required

Various

CPA – Only need periods for patient on CPA (new CPA)

Reviews – new reviews table should include ALL reviews. Formal CPA Reviews should also include items in CPA Review Table

Staff – Staff Name is being removed

Proposed New Data Items

Some additional data items have been suggested:

Length of Seclusion (in minutes) Reason for Delayed Discharge Responsible Clinician/Care Coordinator Start and

End Dates HoNOS-Secure (Secure Services) – include in its

entirety HoNOS-LD (Learning Disabilities) HoNOS-ABI (Acquired Brain Injury)

Timescales

MHCT/Care Clusters ISN Published April 2010

MHMDS v4.0 ISN Published July 2010

Capture MHCT and Care Clusters in local systems April 2011

Submission of MHMDS 4.0 – new table structures Q1 2011-12

Submission of proposed new data items in MHMDSQ1 2011-12

(where already captured within local systems)

Conformance by all Trusts (local capture and reporting) TBC

Exercise – Definitional Testing of Value Lists

Source of Referral Outcome of Referral Review Type Location Type Mental Health Team Type

1. Review values lists

2. Identify any values in lists that should be removed i.e. those that cannot

occur

3. Identify any potential missing values