Through the Harkness / Health Foundation Fellowships in Healthcare Policy, I was given a brilliant opportunity to spend a year in the United States.
What did the Harkness / Health Foundation Fellowship entail?
Through the Harkness / Health Foundation Fellowships in Healthcare Policy, I was given a brilliant opportunity to spend a year in the United States. I went there to analyse mental health performance assessment systems and compare them with practice here in the UK. There are many different ways of assessing quality in mental health services and I wanted to see exactly what people in the US were measuring and how they were using this to improve the quality of services. I was also interested in what was being done to involve service users in these developments.
What did you find out?
The main discovery was that the US is probably about five years ahead of the UK in this work. In the US, they are much better at measuring routine outcome measures - so you can see the effect services are having on individuals’ care, in terms of their quality of life, well-being and reductions in symptom distress. This is very interesting because it can show us the way forward. The UK is really struggling with routine outcome measurements but these are critical as there’s evidence that clinicians who routinely track outcomes for their service users produce better care.
Can lessons from the US be translated into practice in the UK?
Absolutely. The techniques are transferable. Commissioning of mental health services is very weak in the UK but we can drive up the quality of services if we can ensure service commissioners have better performance data.
Have you put what you’ve learned on the Fellowship to good use?
I went to talk to a child and adolescent mental health services outcomes consortium, made up of about 30 mental health providers, about the work being done in the US on outcomes measurement. The consortium then got in touch with my US contacts and invited them for talks over here. That’s wonderful, because one of the things I wanted to do with the Fellowship is to make links between the people I’ve met in the US and the people who are doing similar work in the UK. I’ve also given presentations at the national outcomes measurement programmed, run by the Department of Health, who again were very interested in the US experience.
How would you describe the experience?
It’s a unique and privileged opportunity. I loved every minute. We had a really bonded group of fellows, from the UK, New Zealand and Australia. I think they would all say the same: that you come away with so much context for understanding your own healthcare system. I can appreciate the NHS all the more for having been exposed to the inequities of provision in the US. Although America is certainly more advanced at quality measurement and outcomes measurement, that’s not to say that services there are more advanced than here in the UK. There are vast discrepancies in both the quality of mental health services and access to mental health services investment across different mental health systems, and it’s probably fair to say that measurement does demonstrate that.
It’s too early for me to say how this will benefit my career, but I certainly think it will pay off in the long term.
15 March 2006