Supporting prioritisation and evaluation of mental health funding related to urgent and emergency care

Confused businessman with direction arrows on whiteboard, photo by ronstik/Adobe Stock

ronstik/Adobe Stock

Researchers produced a guide to help local NHS systems and partnerships determine spending and planning priorities and then evaluate selected projects for mental health urgent and emergency care.

What is the issue?

The current literature on the prioritisation of resource use in health and social care is dominated by suggested approaches that are time-consuming, costly and data hungry, making them better suited to large-scale resource commitments.

There is less guidance suitable for local and smaller-scale prioritisation of resources, such as by NHS Integrated Care Systems (ICSs) and Sustainability and Transformation Partnerships (STPs), and particularly for where funding prioritisation has to be achieved in a relatively short time frame (weeks rather than months).

How did we help?

RAND Europe was commissioned by Eastern Academic Health Science Network and NHS England and Improvement (1) to help ICSs and STPs determine spending and planning priorities for mental health urgent and emergency care in the East of England, and (2) to evaluate the selected projects.

Our researchers produced a guide highlighting the key points to consider when approaching the prioritisation process and the evaluation of what is prioritised. The focus for the work leading to this document was specifically on mental health winter pressures funding in the East of England; looking at how options for funding were identified and prioritised in 2019/20.

What did we find?

Prioritising the use of resources between alternative options has four main steps

  • Preparatory work
    clarify context/scope, identify stakeholders, develop inclusion criteria
  • Gather information
    scan for options, engage stakeholders, deduplicate
  • Filter to produce shortlist
    apply criteria, seek consensus across stakeholders
  • Ranking and portfolio analysis
    gather evidence on benefits, costs, risks, apply criteria, balance portfolio

Logic models are a practical way to support prioritisation and subsequent evaluation

  • Logic models are a visual way of outlining a project’s journey from the resources put in to set the project up (e.g. money, staff) to the desired outcomes (e.g. improved mental health).
  • The five key parts of a logic model are:
    • Inputs: The resources used to develop, set up and run a project
    • Activities: The project set up using the input resources
    • Outputs: The direct product of the project
    • Outcomes: The overall aim of the project
    • Context: External factors that may influence the project but are largely out of the decision-maker’ control.
  • Relatively simple and high-level logic models can be used to a) help filter a longlist of options to a shortlist and b) rank the options that remain on the shortlist. More developed and detailed logic models can be the basis for evaluating how well projects turn out.
  • It is also important to consider how to monitor the outputs and outcomes of projects that are resourced. Logic models make it easier to do this.

The guide contains a checklist for approaching the prioritisation process, as well as for developing a logic model to evidence and evaluate a project. In addition, the guide lists resources to help with prioritising spending and/or monitoring and evaluating projects.