Parity of Esteem
a Chief Officers Perspective
Nigel Gray
Chief Officer
we’re better
What do I see?
• Health and Social Care Integration, Better Care Funds
and the big ticket items do not automatically
included Mental Health… but we are getting there.
• A default position to Urgent Care services when
Planned Care could be .. Well more planned!
• There is some really good stuff going on but we don’t
always share it!
• We are not there yet!
Commissioning Services and
Parity of Esteem
• Treating mental health equally to physical health
– Equal Access to the most effective and safest care and treatment embedding parity of esteem requirement in all major contracts
– Equal efforts to improve the quality of care - integrated improvement
programmes (urgent care in mental health, quality premiums)
– Equal high aspirations for service users - shared city wide vision
describing aspirations, as described by people who access services
– Equal status in the measurement of health outcomes - quality
• City wide approach (3 CCG, unit of planning) on
parity of esteem
• Reflected in JHWS and Lead CCG objectives
Leeds Mental Health Framework
• 5 year Framework developed by a citywide MH
Partnership Board - representation from Leeds City
Council, Service providers, people who access
services, Public Health and CCGs.
• The Framework Vision - Leeds is a city that values
people’s mental wellbeing equally to their physical
• 5 Outcomes – one of which is Mental health and
physical health services will be better integrated
• Commitment to PoE and Framework Vision in all
contracts across acute, community and MH.
CCGs Strategic Actions 14/15
Agreement to use key cross cutting issues in RCPsych
Report 2013 “Whole-person care: from rhetoric to
reality..” to guide our local priorities:
• Assess local position / what’s our baseline?
• Agree local action plan and progress measures.
• Promote issue of parity in service developments and
assess proposals against parity principles
• Develop clinical champion role across CCGs to raise
awareness and training opportunities
Parity of Esteem Programme
Leeds CCGs 2014/15 and Beyond
• Develop city wide high profile mental health
information for public and professionals to improve
patient pathways.
• Improve mental health awareness in primary care -
identify training needs for primary care clinicians, improve
and extend psychiatric liaison role to primary care.
• Improve physical health of people with mental health
issues – 2 x CQUIN with MH provider LYPFT on smoking
cessation and nutritional advice, improved follow up
support for people on anti psychotic medication supported
in primary care.
Parity of Esteem Programme
Leeds CCGs 2014/15 and Beyond
• Investment in Mental Health – maintain levels
of investment with statutory provider, increased investment in
third sector provision, re-invested MH contract tariff deflator
0.3% to achieve parity with Acute contract (targeted to quality
improvement), exploring integration of MH budget with Local
Authority to maximise benefit of personal budgets.
• Improve Integration of MH in long term
conditions pathways – agree MH training for
clinicians working with LTC , KPI for LYPFT on discharge
information (incl physical health data) back to primary care.
• Working Collaboratively – Integrating MH support with PC and
Chronic Disease Management, MH Partnership Board building
relationships between CCGs and LA and those who access
• Personal health budgets and pooled budgets
• Leeds Pioneer Status for integration…including Mental
• Sharing Expertise – recognising where others may be better
placed or more cost effective in delivery – facilitating
partnerships between secondary care and third sector (rehab
pathway work).
• Exploring prime contractor models and capacity building in
third sector
National/Regional/Sub Regional
A National CQUIN?
Equal application of Tariff Deflators?
10 High Impact Changes for parity?
Promotion to GPs and recognition in all
directly commissioned services
• Joined up approach with specialised services
• Calls for parity of esteem from outside of the
Mental Health System?
Thank you and any questions or

Leeds is a city that values people`s mental wellbeing equally to their