Total purchasing and extended fundholding of mental health services : final report

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This report describes the evaluation of total purchasing and extended purchasing sites with an interest in mental health services. A consistent objective of these sites was the improvement of communication and information flows between primary and secondary care. The priority was the development of services for people with common mental health problems in the community. The most commonly cited outcomes of the pilots were improved relationships with key local stakeholders such as provider trusts and health authorities. Many of the pilots were successful in developing mental health service provision at a community and primary care level through the attachment of professionals such as community psychiatric nurses (CPNs) to practices and the establishment of practice based mental health teams. In line with the findings of the main total purchasing study, success was linked to the presence of key individuals leading change, interagency cooperation and budget holding. Problems and barriers included the level and quality of financial and activity information available from local mental health providers, purchasing in-patient services, neglect of needs assessment and relationships with social services and service users. The report concludes by looking at the implications of these findings for primary care groups.

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