Effective commissioning

NICE clinical guideline CG45 on antenatal and postnatal mental health makes recommendations on how the components of services may be adapted to meet local needs and deliver integrated care. This can be achieved by developing managed clinical perinatal networks. Specialist mental health commissioners and providers should ensure that there are properly developed links between specialist perinatal mental health services, social services and primary care services, with commissioning agreements in place to support service reconfiguration and redevelopment.

Benefits of effective commissioning

  • improving the mother-child relationship and subsequently the developmental and emotional state of the child
  • reducing inequalities and improving timely access to services in primary care, mental health and maternity services
  • reducing the risk of relapse and/or recurrence of a mental disorder
  • reducing the risk of stopping medication in an unplanned way
  • reducing the number of inappropriate referrals and readmissions
  • reducing the length of inpatient stays, and increasing the provision and take-up of alternatives to inpatient admission
  • reducing the risk of self-harm and suicide
  • reducing costly out of area placements 
  • better value for money, through helping commissioners to manage their commissioning budgets more effectively
  • increasing pateinet centred and needs led care by providing opportunities for clinicians to undertake local service redesign to meet local requirements in novel ways.

Key clinical issues to consider

  • identifying women with common mental disorders and/or who are at risk of developing a serious mental disorder
  • enabling patient choice by providing up-to-date information about the risks and benefits of treatment before conception, when pregnant and during the postnatal period
  • providing timely and appropriate care and treatment for women with common mental disorders
  • providing support, advice, information and training to maternity, psychiatric and primary care services through managed perinatal networks
  • providing a quality assured service.