The cost, quality and value of mental healthcare provision in the English NHS

Mental illness has a significant impact on individuals, society and the economy. There is as yet limited understanding of how mental healthcare providers can use their limited resources to achieve best outcomes for patients and taxpayers. We looked at the efficiency, cost and quality of mental healthcare provision, and how changes can be made to deliver better care within available budgets. Using analysis of large national datasets, discrete choice experiments, focus groups and interviews, we assessed which aspects of quality are valued by service users, clinicians and the general public. These included improvements in outcomes, person-centred care and a coordinated approach. Quality adjusted life year weightings were developed for each quality indicator to assess efficiency. We identified high-quality, low-cost providers and examined which organisational factors were associated with performance. We found that better performing providers have high staff engagement, higher investment in technology, and good relationships with local partner organisations.