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Carter review spells out ambitions for mental health and community health services

What is Lord Carter looking for in mental health and community health services?


A review of mental health and community providers has concluded that eliminating unwarranted variation in these areas could achieve savings of nearly £1bn by 2020/21.


The review, by a team led by Lord Carter and published by NHS Improvement, follows a similar review of value for money in acute non-specialist trusts published in 2016.


Several of the recommended actions are either similar to recommendations included in the original Carter review, or make reference to them.


Steps recommended by the latest Carter review include:

  • trusts should reduce variation in the cost of corporate service functions, and look at opportunities to collaborate and share corporate services
  • trusts should develop plans to ensure their pharmacists and other pharmacy staff spend more time with patients and on medicines optimisation
  • NHS Improvement should implement measures for analysing cost of inpatient care and care hours per patient day, and it should develop the model hospital for use by all trusts
  • NHS England should help strengthen commissioning and contracting for mental health and community health services to ensure more consistency, including by using model frameworks for service specification
  • NHS Improvement should work with mental health and community trusts to improve engagement and retention, and trusts should strengthen oversight of workforce productivity in services delivered in the community, and introduce improved and modernised delivery models
  • the getting it right first time (GIRFT) programme should ensure community health services are properly considered in relevant clinical specialities, and that inappropriate out-of-area placements for adult mental healthcare are eliminated by 2021.


Further information

NHS Improvement: Lord Carter’s 2016 review into the operational productivity of acute non-specialists trusts