Commissioning neuropsychiatry services: barriers and lessons

Area of Science:

• Neuroscience
• Psychiatry
• Health Services Research

Background:

• Previous studies indicate significant variability in the commissioning of neuropsychiatric services.
• This inconsistency results in unequal access to essential care, often described as a 'post-code lottery'.

Purpose of the Study:

• To map current funding and commissioning arrangements for neuropsychiatric services in London.
• To identify perceived barriers to effective neuropsychiatric service commissioning among relevant stakeholders.

Main Methods:

• A survey was conducted targeting all mental health and neuropsychiatric service commissioners in London.
• Response rate achieved was 83%, providing a robust dataset for analysis.

Main Results:

• Significant variability was observed in the commissioning of neuropsychiatric services through the mental health stream.
• Commissioning and contracting arrangements were found to be highly variable.
• Key barriers identified include lack of earmarked funding, disjointed funding streams, and insufficient critical mass of neuropsychiatric cases.

Conclusions:

• The development of neuropsychiatric services is impeded by unclear commissioning processes and funding inconsistencies.
• A strategic approach is required to ensure more equitable provision of these specialized services.
• National or regional commissioning models covering larger populations are proposed as a superior framework for equitable service delivery.