Determining local service levels for antenatal and postnatal mental health services
Benchmarks for a standard population
Available data suggest that the standard benchmark rate for referral for psychological therapies is estimated to be 80 per 1000 deliveries.
Available data also suggest that the benchmark rate for referral to a specialist perinatal mental health service is estimated to be 40 per 1000 deliveries. This includes 4 per 1000 deliveries who are likely to require admission to a mother and baby unit.
For an average primary care trust population of 300,000, assuming the same annual delivery rate as the national average (50 per 1000 women aged 15-49 years), the number of women requiring referral for psychological therapies is around 300 per year (80 per 1000 deliveries). Around 140 per year (40 per 1000 deliveries) will require referral to a specialist perinatal mental health service, and of these around 15 per year will require admission to a mother and baby unit.
For an average general practice size of 10,000, assuming the same annual delivery rate as the national average (50 per 1000 women aged 15-49 years) the number of women requiring referral for psychological therapies is around 10 per year (80 per 1000 deliveries). Around 5 women per year will require referral to a specialist perinatal mental health service.
Figure 1 illustrates the likely severity of mental disorders experienced by women during pregnancy and the postnatal period and the likely service demand based on the opinion of the topic-specific advisory group on antenatal and postnatal mental health services.
For the purpose of this benchmark, the base population is the number of deliveries in England in 2005-06. This base population is also used in the associated commissioning tool. It has been chosen for the following reasons:
- prevalence estimates of postnatal mental disorders are expressed in rates per 1000 deliveries
- delivery data are readily available to commissioners to support service planning.
This benchmark could also be applied to the number of live births, which some commissioners may choose to use to plan demand for services. The number of live births (rounded to the nearest 100) by primary care organisation can be obtained here.
The delivery data presented in the tool have been aggregated so that women who deliver outside their PCT area are counted against the primary care organisation of the referring GP. This is to ensure that, as far as possible, delivery data and live birth data are comparable.
Examine the assumptions used in estimating these figures.
These services are likely to fall under the programme budgeting category 205X (other mental disorders).
Use the antenatal postnatal mental health services commissioning and benchmarking tool to determine the level of service that might be needed locally and to calculate the cost of commissioning the service using the indicative benchmark and/or your own local data.
Sources of further information to help you in assessing local health needs and reducing health inequalities include:
- The Improving Access to Psychological Therapies programme workforce capacity tool, which has been developed to help commissioners estimate the number of new workers required to manage demand for psychological treatment in their area.
- Annex A of the Commissioning framework for health and well-being, which outlines the process and data needed to undertake a joint strategic needs assessment.
- Department of Health Delivering quality and value - focus on benchmarking.
- NICE Health equity audit - learning from practice briefing.
- PRIMIS+, which provides support to general practices on information management and the recording and analysis of data, and a comparative analysis service focused on key clinical topics.
This page was last updated: 02 March 2012
- Commissioning antenatal and postnatal mental health services
- Specifying antenatal and postnatal mental health services
- Determining local service levels for antenatal and postnatal mental health services
- Assumptions used in estimating a population benchmark
- The commissioning and benchmarking tool
- Ensuring corporate and quality assurance