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The mental healthcare sector in England is under huge financial pressure and providers are undertaking large-scale cost reduction programmes. Service reconfigurations are impacting negatively on quality of care for patients and there is little understanding of how providers can reallocate resources to improve performance and increase efficiency.

Against this background, Professor Russell Mannion is co-applicant/co-investigator on a four-year Health Foundation funded study led by Professor Rowena at the University of York, which also involving colleagues from the University of Sheffield. The study will explore the efficiency, cost and quality of current provision across all mental health trusts in England and investigate how organisational changes can be made to drive efficiency improvements.

Using a number of research methods – including analysing large linked national datasets, surveys, focus groups and interviews – the team will assess which quality indicators are valued by service users and clinicians, for example improvements in outcomes, better and more equitable access to care, and distance to provider. They will then derive QALY (quality-adjusted life year) weightings for these different aspects in order to assess efficiency, using a QALY framework. This will enable the derivation of a cost-effectiveness plane for mental health trusts to identify high-quality, low-cost providers and further examine factors that are associated with cost-effectiveness.

In depth case study methods will be used to explore the organisational strategies, structures, incentives and cultures which drive (or attenuate) improvements in cost and quality of mental healthcare. The study starts in May 2017 and will fund a full-time research fellow based in the Health Services Management Centre at the University of Birmingham.