Total purchasing and extended fundholding of mental health services

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This study describes the aims, methods and interim findings of a study to evaluate the impact of total purchasing and extended fundholding on the provision of mental health services. All baseline telephone interviewing has now been completed and the authors report on findings from the analysis of semi-structured telephone interviews with representatives from 27 total purchasing pilot (TPP) and 13 extended fundholding (EFH) sites. Their evaluation has sought to outline some common themes or dimensions of total purchasing or extended fundholding and mental health. The progress of sites has been charted along each of these dimensions which are: needs assessment; communication between secondary and primary care; locus of service provision; primary care role in severe mental health problems; user involvement and overall approach to total purchasing. The most striking thing about the sites are their differences rather than their similarities. Each is developing along the identified dimensions at a different pace, depending on local circumstances, resources, personalities and their interests. Having delineated what the sites hope to achieve, the authors intend to investigate if they succeed in their aims.

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