Quality standard for service user experience in adult mental health

1. People using mental health services, and their families or carers, feel optimistic that care will be effective.

2. People using mental health services, and their families or carers, feel they are treated with empathy, dignity and respect.

3. People using mental health services are actively involved in shared decision-making and supported in self-management.

4. People using community mental health services are normally supported by staff from a single, multidisciplinary community team, familiar to them and with whom they have a continuous relationship.

5. People using mental health services feel confident that the views of service users are used to monitor and improve the performance of services.

6. People can access mental health services when they need them.

7. People using mental health services understand the assessment process, their diagnosis and treatment options, and receive emotional support for any sensitive issues.

8. People using mental health services jointly develop a care plan with mental health and social care professionals, and are given a copy with an agreed date to review it.

9. People using mental health services who may be at risk of crisis are offered a crisis plan.

10. People accessing crisis support have a comprehensive assessment, undertaken by a professional competent in crisis working.

11. People in hospital for mental health care, including service users formally detained under the Mental Health Act, are routinely involved in shared decision-making.

12. People in hospital for mental health care have daily one-to-one contact with mental healthcare professionals known to the service user and regularly see other members of the multidisciplinary mental healthcare team.

13. People in hospital for mental health care can access meaningful and culturally appropriate activities 7 days a week, not restricted to 9am to 5pm.

14. People in hospital for mental health care are confident that control and restraint, and compulsory treatment including rapid tranquillisation, will be used competently, safely and only as a last resort with minimum force.

15. People using mental health services feel less stigmatised in the community and NHS, including within mental health services.

• Full quality standard for service user experience in adult mental health (PDF format)

This NICE quality standard defines best practice within this topic area. It provides specific, concise quality statements, measures and audience descriptors to provide the public, mental health and social care professionals, commissioners and service providers with definitions of high-quality care.

Scope of the quality standard

This quality standard outlines the level of service that people using NHS mental health services should expect to receive. It covers improving the experience of people using adult NHS mental health services. It does not cover mental health service users using NHS services for physical health problems, or the experiences of families or carers of people using NHS services specifically.

Quality statements for service user experience in adult mental health

The quality standard for service user experience in adult mental health requires that services should be commissioned from and coordinated across all relevant agencies encompassing the whole care pathway. An integrated approach to provision of services is fundamental to the delivery of high quality care to service users.

NICE has produced a support document to help commissioners and others consider the commissioning implications and potential resource impact of this quality standard, available from www.nice.org.uk.

NICE quality standards are for use by the NHS in England and do not have formal status in the social care sector. However, the NHS will not be able to provide a comprehensive service for all without working with social care communities. In this quality standard care has been taken to make sure that any quality statements that refer to the social care sector are relevant and evidence-based. Social care commissioners and providers may therefore wish to use them, both to improve the quality of their services and support their colleagues in the NHS.

Subject to legislation currently before Parliament, NICE will be given a brief to produce quality standards for social care. These standards will link with corresponding topics published for the NHS. They will be developed in full consultation with the social care sector and will be presented and disseminated in ways that meet the needs of the social care community. As we develop this library of social care standards, we will review and adapt any published NICE quality standards for the NHS that make reference to social care.

Rationale for developing this quality standard

Over the past few years several documents and initiatives have highlighted the importance of the service user's experience and the need to focus on improving these experiences where possible.

• Lord Darzi's report ‘High quality care for all' (2008) highlighted the importance of the entire service user experience within the NHS, ensuring people are treated with compassion, dignity and respect within a clean, safe and well-managed environment.
• The development of the NHS Constitution (2009-2010) was one of several recommendations from Lord Darzi's report. The Constitution describes the purpose, principles and values of the NHS and illustrates what staff, service users and the public can expect from the service. Since the Health Act came into force in January 2010, service providers and commissioners of NHS care have had a legal obligation to take the Constitution into account in all their decisions and actions.
• The King's Fund charitable foundation has developed a comprehensive policy resource - 'Seeing the person in the patient: the point of care review paper' (2008). Some of the topics explored in the paper are used in the development of this guidance and quality standard.

National initiatives aimed at improving service users' experience of healthcare include NHS Choices, a comprehensive information service that helps people to manage their healthcare and provides service users and carers with information and choice about their care. Initiatives, such as patient advice and liaison services (PALS), have also been introduced.

Despite these initiatives, there is evidence to suggest that further work is needed to deliver the best possible experience for users of NHS services. The Government signalled in its White Paper, ‘Equity and excellence: liberating the NHS' (July 2010) that more emphasis needs to be placed on improving service users' experience of NHS care.

High-quality care should be clinically effective, safe and be provided in a way that ensures the service user has the best possible experience of care. This quality standard on service user experience aims to ensure that users of mental health services have the best possible experience of care from the NHS.

Policy context

• Department of Health (2011) Equity and excellence: Liberating the NHS.
• Department of Health (2011) No health without mental health: a cross-government mental health outcomes strategy for people of all ages.
• Department of Health (2010) The NHS Constitution for England.
• HMSO (2009) The Health Act 2009.
• Goodrich J, Cornwell J (2008) Seeing the person in the patient. The Point of Care review paper. London: Kings Fund, p6-17.
• Darzi A (2008) High Quality Care for all: NHS Next Stage Review Final Report.
• Department of Health (2005) Delivering race equality in mental health care: an action plan for reform inside and outside services and the government's response to the independent inquiry into the death of David Bennett.

Key development sources

• NICE clinical guidance 136 (CG136) Service user experience in adult mental health (2011).
• National Collaborating Centre for Mental Health Service user experience in adult mental health: improving the experience of care for people using adult NHS mental health services. (2011)

Definitions and data sources

• Commissioning dataset definitions available from www.datadictionary.nhs.uk
• Mental health minimum dataset definitions available from www.datadictionary.nhs.uk
• Hospital episode statistics. Available from www.hesonline.nhs.uk
• NHS mental health inpatient survey. Available from www.cqc.org.uk
• NHS mental health community survey. Available from www.cqc.org.uk
• NHS staff survey. Available from www.cqc.org.uk

Development team

Director	Fergus Macbeth
Associate Director	Lorraine Taylor
Lead Analyst	Craig Grime

• Guidance Development Group: Service user experience in adult mental health

Guidance

Guidance on service user experience in adult mental health was developed alongside this quality standard and is available here:

• CG136 Service user experience in adult mental health

Consultation feedback

Consultation on the service user experience in adult mental health quality standard took place from 21 June 2011 to 19 July 2011. All eligible comments were reviewed by the Guidance Development Group and the standard was updated accordingly.

• Service user experience in adult mental health guidance and quality standard consultation comment and response table

Implementation support materials

• Information for people who use NHS mental health services
• NICE support for commissioners and others using the quality standard
• Slide set

Endorsing organisations

Many organisations share NICE's commitment to improve quality by making it clear what quality care is for service users and the public, health and social care professionals, commissioners and service providers.

So that these standards reach the widest possible audience, some of the organisations who have been involved in the development process, and who endorse the quality standard on service user experience in adult mental health, have become partners in its publication.

These organisations are:

Anxiety UK
British Association for Counselling and Psychotherapy
Mind
Royal College of Nursing