The issue

At the time of appointment, Barnet, Enfield and Haringey Mental Health NHS (BEHMHT) were facing long term sustainability issues. The Trust’s five-year planning assumptions would not have translated into sustainable service provision without substantial revision. The problems within the organisation were not well understood by either the provider or commissioners and a critical point had been reached where inaction was no longer an option.

The work

The clients wanted Carnall Farrar to conduct a diagnostic project which would allow key stakeholders to understand the sustainability issues being faced by the BEHMHT and across the system more broadly, and agree on a future plan for delivering sustainable mental health services across NCL.

The output

  • An in depth analysis of patient mix and spend on mental health care
  • Analysis of the quality of care, patient outcomes and access at BEHMHT and Camden and Islington NHS FT
  • An understanding of provider costs and resources to deliver services and a full financial review of providers
  • A shared understanding of the key drivers of the deficit and clinical sustainability challenges facing the system
  • A tangible and credible plan for stakeholders which related directly to the issues illuminated by the analysis
  • A set of recommendations for stakeholders to take forward

The outcomes

  • The work created a shared understanding by commissioners and providers of current performance and the clinical and financial challenges.
  • There was large variation in spend per head of population across the 5 NCL CCGs.
  • BEHMHT was performing well for the level of funding it received at the time.
  • Differences in patient mix drove the differences in the resources needed.

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