Developing a person based resource allocation formula for setting practice-level mental health budgets
Using the ‘casemix-based modelling approach, the research team led by Professor Asthana looked at several factors in distributing the then £8 billion mental health budget. Factors including age, sex, ethnicity, tenure, employment status were used to predict the likelihood that different ‘person-types’ would fall into each of the casemix categories.
They then combined these likelihood estimates with NHS administrative and census data to predict the number of people in each practice falling into each casemix category. Using treatment costs attached to all patients included in the original casemix study, they then applied casemix cost distributions to patient counts to generate an overall estimate of the resource needed to meet the mental healthcare needs of each practice population.
The evidence pointed to a complex relationship between mental health needs, age and deprivation. Needs were generally higher in northern England, especially major cities but there was a notable coastal fringe of ‘high-need’ practices which reflected the high proportion of elderly people in retirement hot-spots.
The research informed practice-level indicative budgets from 2009-11 following the restructuring of Primary Care Trusts. Professor Asthana continues to advise the Government on fairer distribution of NHS funding.
- Asthana S, Bailey T, Gibson AJS, Hewson P & Dibben C 2009 Developing a Person Based Resource Allocation Formula for Setting Practice-Level Mental Health Budgets: 2009/10 and 2010/11. Department of Health, Policy Research Programme
- Asthana S, Gibson A, Bailey T, Moon G, Hewson P & Dibben C 2016 'Equity of utilisation of cardiovascular care and mental health services in England: a cohort-based cross-sectional study using small-area estimation' Health Services and Delivery Research 4, (14) 1-712 , DOI Open access
- Asthana S, Gibson A, Hewson P, Bailey T & Dibben C 2011 'Devolved commissioning, population size and budgetary risk: evidence from the modelling of ‘fair share’ practice budgets for mental health' Journal of Health Services Research and Policy
- Asthana S, Gibson A, Hewson P, Bailey T & Dibben C 2011 'General practitioner commissioning consortia and budgetary risk: evidence from the modelling of 'fair share' practice budgets for mental health' J Health Serv Res Policy 16, (2) 95-101 Author Site , DOI