Initiative will enable like-for-like comparisons across boards

MENTAL health services in Scotland are to be compared by using new benchmarking standards in the first scheme of its kind in Europe.

The initiative is aiming to develop measures to allow comparison of key aspects such as quality and efficiency of services provided by health boards on a like-for-like basis for the first time.

It is hoped this will identify areas for improvement, such as reducing the number of hospital re-admissions, and help provide a more equitable service.

An initial report on the project, which collated existing data and was published last week by the Scottish government, has revealed the variations across health boards in Scotland. Total expenditure for general psychiatry services was highest in NHS Lothian, at £164,080 per 1000 population, compared to NHS Shetland, which had the lowest spend at £36,015 per £1000.

But Dr Sarah Taylor, director of public health at NHS Shetland, pointed out that one of the issues highlighted in the report was how difficult it was to compare services provided using existing data. "We link into services on the mainland in Grampian, so if somebody needs a hospital stay with a mental service they go into the Grampian service," she said. "We have local community services on the island, but our inpatient service is with Aberdeen. There is a whole set of work now from this project that is trying to establish counting in a way that reflects the true figures."

Other statistics in the report reveal that Glasgow has the highest number of incapacity benefit claimants with a mental health diagnosis, at 35 per 1000 population. Overall in Scotland, there are just over two nurses per 1000 population within mental health, ranging from 0.22 in Orkney to 2.61 in Tayside.

The total bed numbers for mental health specialties are highest in Argyll and Clyde, at 1.64 per 1000 population, and lowest in NHS Highland, at 0.92.

A spokeswoman for NHS Highland said services were delivered in a different way due to the remoteness and rurality of the area. "We treat mental health in a number of ways and we try to look after patients safely as close to home as possible," she said. "We use our community hospitals and mental health teams as fully as we can."

The report of the mental health project makes a number of recommendations, including that NHS boards, local authorities and voluntary organisations work together to classify services using certain definitions and that specific "scorecards" for specialist services are developed.

Richard Colwill, spokesman for the mental health charity Sane, said: "Sane welcomes benchmarking as a means of improving mental health services in Scotland, providing the focus on benchmarks does not distort the need to provide basic, adequate care when it is needed."

Public health minister Shona Robison said the work was a first for Scotland and Europe. "The need to benchmark services in Scotland has never been so important, both in supporting the delivery of services and in helping the NHS to attain its performance targets," she said.

"Through doing this work, we should be able to measure like for like and start to measure the progress that is being made in delivering better quality healthcare which also improves patient care and satisfaction."