Cambridge and Peterborough CCG have been working collaboratively with Cambridge and Peterborough NHS Foundation Trust (CPFT) to develop an outcome framework for use in the newly established Perinatal Mental Health Service. The starting point for the development of our framework was to agree the desired outcomes for service users and then establish what questions needed to be answered to determine if those outcomes are being achieved.
The framework will be live from April 2019 and will consist of the following:
|Prevention of deterioration of MH during perinatal period & improved MH of target group experiencing severe MH difficulties||
|Reduction in relapses||Number and percentage of women who have completed treatment who are referred back to the service within 30 days||Monthly|
|Improved mother-child relationship||Postpartum bonding questionnaire||Monthly|
|Women have a positive experience of care||POEM||Monthly|
|Women are appropriately involved in decisions about their care||Number and percentage of women reporting they felt appropriately involved in their care, as reported in the Patient Experience Questionnaire (PEQ)||Monthly|
The first fundamental principle we had in developing this framework was that it should be done collaboratively between commissioner and service: this way the tools would be meaningful at the practice level and hopefully diminish any sense of top down, enforced measurement. However, the timescales did impact on the number of individuals who could be involved in the process because we wanted to have it set up as early in the inception of the service as possible; it is easier to start off with such a framework in place than to retrofit it to embedded practice. The second principle is that we are taking a test and learn approach to this framework. The reporting dashboard is in development and we are keeping dialogue open around how the data should be presented and what benchmarks and KPIs are appropriate. The three tools recommended by NHS England (HoNOS, CORE-10 / CORE-OM, POEM) are part of the framework and so we recognised that these are fixed, but as there are six measures, we are open to testing the number of times they are each completed and if there is the right fit with the questions to be answered. The most important thing is to ensure that the outcomes measures are clinically useful and the monitoring framework gives us timely and valuable information about the performance and quality of the service.
The Child Outcomes Research Consortium (CORC) in partnership with experts in the field of perinatal mental health from the Anna Freud National Centre for Children and Families (AFNCCF) have been commissioned to provide guidance on best practice and how to overcome common barriers to implementation by producing an Outcome Measurement Implementation Manual and by disseminating the manual, case studies and learning via 12 regional training workshops in collaboration with Perinatal SCNs.