Mental Health Services Monthly Statistics Performance April, Provisional May 2021

A number of changes to CCGs were made operationally effective from 1 April 2021. These changes included 38 former CCGs merging to form 9 new CCGs.

The Organisation Data Service (ODS) is responsible for publishing organisation and practitioner codes, along with related national policies and standards.

72 hour follow-up measures (MHS78, MHS79 and MHS80) have now been released for Performance October 2020 onwards.  Data for these measures for previous reporting periods will be published as soon as they are available.

NHS Digital apologises for the inconvenience caused.

The move to MHSDS version 4.1 from April 2020 has brought with it changes to the dataset; the construction of a number of measures have been changed as a result.

From Performance August 2020 onwards, the methodology for calculating restrictive interventions (MHS76 and MHS77) in the reporting month has been updated to include all restraints that span several months. Previously the measure only includes restraints that started or ended in the month and did not include those spanning more than 2 months. This change predominately impacts segregation.

From Performance September 2020 onwards, the methodology for MHS26 (Delayed transfer of care) has been updated. Previously only the first midnight of a delayed transfer of care within a hospital provider spell was excluded. The updated methodology now excludes the first midnight for delay start date where there is a gap of more than one day within the same hospital provider spell. This is to take into account valid gaps between delay reasons.

Full details of these changes are available in the associated Metadata file.

From Performance September 2020 onwards, a presentational change has been introduced to restrictive interventions csv files to exclude providers with no inpatients.

From Performance January 2021 onwards, several EIP measures have had ethnicity added as a secondary breakdown. This was initially available at England level only. Provider and CCG level ethnicity breakdowns are included from Performance February 2021 onwards.

• EIP01 - Open referrals on EIP pathway in treatment
• EIP23a - Referrals on EIP pathway entering treatment
• EIP23b - Referrals on EIP pathway entering treatment within two weeks
• EIP23c - Referrals on EIP pathway entering treatment more than two weeks
• EIP23d - Open referrals on EIP pathway waiting for treatment
• EIP23e - Open referrals on EIP pathway waiting for treatment within two weeks
• EIP23f - Open referrals on EIP pathway waiting for treatment more than two weeks
• EIP23i - Proportion entering treatment waiting two weeks or less
• EIP23j - Proportion waiting more than two weeks (still waiting)
• EIP63 - Open referrals not on EIP pathway
• EIP64 - Referrals not on EIP pathway, receiving a first contact and assigned a care co-ordinator with any team
• EIP65 - Referrals not on EIP pathway, receiving a first contact and assigned a care co-ordinator with any team more than two weeks after referral
• EIP66 - Referrals not on EIP pathway, receiving a first contact and assigned a care co-ordinator with any team two weeks or less after referral
• EIP67 - Proportion of referrals not on EIP pathway receiving a first contact and assigned a care co-ordinator with any team two weeks or less after referral

From Performance January 2021 onwards, a range of children and young people with eating disorders measures were added to the monthly release. The data released for Performance January 2021 and February 2021 was subsequently removed for investigation, although data is available from Final March 2021 onwards. The Performance January 2021 and February 2021 data will be re-issued as soon as possible. NHS Digital apologises for the inconvenience caused.

These measures are experimental and are published to drive improvement; the official source of statistics on Children and young people with eating disorders is NHS England.   All measures cover a rolling 3-month reporting period. Measures cover referrals still waiting for treatment, referrals entering treatments, both split by routine/urgent and various waiting periods. Entering treatment is defined as having a care contact and a NICE concordant treatment recorded in SNOMED in the reporting period. The metadata file provides more information on the construction, there is also guidance for providers available.
These measures include:

• ED85 - Referrals with eating disorder issues entering treatment in RP, aged 0-18
• ED86 - Referrals with eating disorder issues categorised as urgent entering treatment in RP, aged 0-18
• ED87 - Referrals eating disorder issues categorised as routine entering treatment in RP, aged 0-18
• ED88 - Referrals with eating disorder issues waiting for treatment at end of RP, aged 0-18
• ED89 - Referrals with eating disorder issues categorised as urgent waiting for treatment end RP, aged 0-18
• ED90 - Referrals with eating disorder issues categorised as routine waiting for treatment end RP, aged 0-18

ED86, ED87, ED89 and ED90 are broken down further by waiting time.  Full details of these are available in the associated Metadata file.

With the publication of the Community Mental Health Framework, CPA has now been superseded nationally.  As such, measures relating to CPA have been removed from all MHSDS outputs from April 2021 data onwards.  These measures include:

• MHS02 - People on CPA at the end of the reporting period
• AMH02 - People in contact with adult mental health services on CPA at the end of the reporting period
• AMH03 - People on CPA aged 18-69 at the end of the reporting period (adult mental health services only)
• AMH04 - People in contact with adult mental health services CPA at the end of the reporting period with HoNOS recorded
• AMH05 - People on CPA for 12 months at the end of the reporting period (adult mental health services only)
• AMH06 - People on CPA for 12 months with review at the end of the reporting period (adult mental health services only)
• AMH15 - Proportion of people aged 18 to 69 on CPA at the end of the reporting period in settled accommodation (adult mental health services)
• AMH18 - Proportion of people aged 18 to 69 on CPA (adult mental health services) at the end of the reporting period in employment
• ACC02 - The number of people on Care Programme Approach (CPA) at the end of the reporting period with an associated Care Cluster open at the end of the reporting period with a valid Adult Mental Health Care Cluster Code (Final) recorded
• ACC53 - The proportion of people on Care Programme Approach (CPA) at the end of the reporting period with an associated Care Cluster open at the end of the reporting period with a valid Adult Mental Health Care Cluster Code (Final) recorded
• CYP02 - People in contact with children and young people's mental health services on CPA at the end of the reporting period

As part of an improvement initiative, the two existing Restrictive Interventions measures:

• MHS76 - Number of people subject to restrictive intervention
• MHS77 - Number of restrictive interventions

have now been supplemented by four new measures:

• MHS96 - Restraints per 1,000 occupied bed days in Reporting Period
• MHS97 - Percentage of people in hospital subject to restrictive intervention in Reporting Period
• MHS98 - Average Minutes of restraint in Reporting Period
• MHS99 - Maximum Minutes of restraint in Reporting Period

These are available in a new standalone csv file from Performance April 2021 onwards.  This file also contains many new breakdowns for the two longstanding measures, MHS76 and MHS77.  These are listed in the Mental Health Services publications list.

In addition, a new interactive report based on these new measures has been made available on the Mental Heath data hub.  This allows users to further explore this data.

Unlike the longstanding Restrictive Interventions measures for which both Performance and Provisional files exist, these new measures are currently available for Performance only.  

The legacy csv files and legacy interactive report will continue to be made available alongside the new csv file and new interactive report until further notice.  It is however envisaged that the new interactive report will replace the legacy one in due course.

There are five new MHSDS monthly statistics that have been introduced from the June 2021 publication. These statistics have been produced by both NHS Digital and NHS England and as such are dual-badged.  NHS Digital has worked with NHS England in assuring the statistics before they are published. These five new statistics are:

• MHS91 Number of people in contact with Specialist Perinatal Mental Health Community Services (12 month rolling)

• MHS92 Closed referrals for children and young people aged between 0 and 17 with 2 contacts where the length of referral was over 14 days and a paired score

• MHS93 Closed referrals for children and young people aged between 0 and 17 with 2 contacts where the length of referral was over 14 days

• MHS94 Percentage of closed referrals for children and young people aged between 0 and 17 with 2 contacts where the length of referral was over 14 days and a paired score

• MHS95 Number of children and young people aged under 18 supported through NHS funded mental health with at least one contact (12 month rolling)

The methodologies for the construction of each measure is available in the associated Metadata Tab. The key difference to consider when using the statistics listed above is the methodology for assigning Clinical Commissioning Group (CCG) to activity; a brief explanation of the different methodologies is presented below and any CCG level statistics should be used with consideration of these differences. For the above statistics, the NHS England methodology for assigning CCGs has been adopted.

• NHS Digital – the CCG is assigned to activity based on the most recent information about an individual and, as such, activity measured will be attributed to a single CCG. The CCG methodology also assigns a CCG based on the CCG of GP Practice or Residence.

• NHS England – the CCG is assigned to activity based on the information available at the time of activity and, as such, activity measured may be attributed to multiple CCGs. The CCG methodology is based on CCG of Residence only.

• The statistics listed above includes data for residents in England only.