The MHSDS and CYP Outcomes Reporting July 2018 1
What is the problem? Poor Data Quality and Availability is one of the key areas that needs to be addressed in improving CYPMH services: Significant gaps in the availability of data mean it is difficult to get a clear picture of what services are available to children and young people across the country. (CQC report October 2017) Is one of the key areas attributed by services as the cause of current underperformance Addressing this supports the key area of Accountability and Transparency in Future In Mind CCGs have recently submitted recovery plans to improve data quality in MHSDS It is not known nationally or regionally who is performing well and where improvement is needed The one off collection from CCGs in December and local intelligence from regions indicated issues with data quality and under reporting, but also genuine performance issues 2 Presentation title
Mental Health Services Dataset The Mental Health Services Dataset (MHSDS) is a personlevel, output based, secondary uses data set It delivers robust, comprehensive, nationally consistent and comparable person-based information for children, young people and adults who are in contact with Mental Health Services. 3
4 https://www.england.nhs.uk/publication/joint-technical-definitions-for-performance-and-activity-20171-8-201819/
Access Definition CYP attending their second contact in the current financial year CCG Prevalence The measure counts new CYP attending their second contact this financial year and CYP who have remained in the system since the previous year and attended a further two contacts This means that there is a large spike in reported numbers in the first quarter of each financial year NHS England measure an estimated year-end position which accounts for this spike Minimum standard for FY18/19 is 32% cumulatively by the end of the year The standard will increase to 35% by FY2010/21 5
Prevalence Estimated prevalence of diagnosable mental health problems in CYP aged 5-16 at 9.6% (2004 survey) The percentage prevalence varies between CCGs according to age, sex and socio-economic classification (social class) This is applied to CCG populations as at April 2014 (NHS Digital data) Updated prevalence information will be available late 2018 But The commitment remains 70,000 more CYP per year CCGs have already developed trajectories and submitted plans The revised prevalence might inform planning for 19/20 and 20/21 in some CCGs but will not affect the overall national commitment 7
What is being counted? The total number of CYP in treatment: 1 Age is <18 at first contact. The second contact can be after the 18th birthday. 2 Although treatment may include indirect contacts it does not include email or SMS. 3 An individual can be counted only once in a financial year. 4 Treatment is defined as 2 contacts. The date of the second contact determines the reporting month. 5 Individuals can be counted in multiple financial years if they have 2 contacts in each. 9
How can I get more details? The metadata the technical definition of how NHS Digital data is derived is available at https://digital.nhs.uk/data-and-information/data-collections-and-data-sets/data-sets/mental-healthservices-data-set/mental-health-services-monthly-statistics CYP access data is calculated across months and financial years in a complicated way As a result, an SQL script is included instead of the edited snippets used for other KPIs You cannot just copy and paste the SQL into a database but it does help you along the way 20
How can I access the data? From October 2017 activity, new CYP starting treatment is published monthly as indicator MHS69* MHSDS reports are available from https://digital.nhs.uk/data-and-information/publications/statistical/mentalhealth-services-monthly-statistics From the February report onwards, provisional data is also available in the same file The file is called MHSDS Monthly: Final mmm-yy Provisional mmm-yy Children and Young People Receiving Second Contact With Services CSV As well as CCG and provider data, it is possible to see which providers are contributing to which CCGs 21 * This is also called MHS69a in some publications
Which file? Definitely not these ones Contains access and waiting times information about Eating Disorders and EIP services but not the number of CYP starting treatment This one Not this one Contains a great deal of interesting information about CYP services, including DNA rates, self-referral rates and the use of scores at assessment but not the number of CYP starting treatment 22
Other Data is Available 100 90 80 70 60 50 40 30 20 10 0 % DNA Rates 23 Presentation title
Other Data is Available 60 % Self Referrals 50 40 30 20 10 0 24 Presentation title
Outcomes The national CYP outcomes measure was confirmed by NHS England in a recent message to CCGs It is consistent with existing CYP IAPT outcomes measurement Reliable improvement (and reliable change) is the basis for measurement Full guidance will be published with initial data on 28 th July all information given here is provisional until that point Data quality information will be published by NHS England for the first time on 28 th July and each month thereafter Information will be published by provider only during the data quality phase Performance Information will be published by NHS England from April 2019 25 Presentation title
Outcomes Webinar More information and the ability to ask questions will be available at the NHS England data surgery: Introduction to the Outcomes Metric Children and Young People Mental Health Outcomes Webinar Web link to join the meeting: CLICK HERE Friday 20 July 2018 14:00-14:30pm *This webinar can only accommodate 120 attendees so please dial in promptly if you want a place! (Please note you need to click the blue link above to view the presentation materials this webinar is not dial in only) Dial in 0800 9171950 Attendee access code: 204 510 72 26 Presentation title
What Will be Available As with the current access standard, measurement will be per referral Data quality items will include the number of referrals With two contacts With at least one score about the clinical cut-off (i.e. the denominator for measurement) With at least one paired assessment score That reliably improved That reliably deteriorated That made no reliable change 27 Presentation title
Some Data is Available Now 45 40 35 30 25 20 15 10 5 0 % Assessment Scores Recorded at First Attendance 28 Presentation title
How can I improve my MHSDS submissions? 1. Check the data there are multiple opportunities to check what you are uploading 2. Sign off the data data should not be submitted until operational and clinical leaders have given a meaningful sign-off 3. Use the data ensure that MHSDS-produced figures are visible within your organisation Before Upload Input data Window Opens MDS Extract Create database Upload to Open Exeter Initial row count check Validation reports Pre-deadline extract Optional reupload Window closes Post-Upload Post- Deadline Extract Data Quality Notices Published reports 29
30 https://digital.nhs.uk/binaries/content/assets/legacy/pdf/q/9/mhsds_submission_windows_1718_1819_v2.pdf
Contact Follow us on Twitter @MH_ISTNetwork Michael Watson Intensive Support Manager Intensive Support Team (Mental Health) M 07879 113 249 E M.Watson@nhs.net W improvement.nhs.uk Follow NHS Improvement on: Twitter LinkedIn 31