Supporting MHA s117 activity – managing growth and recovery
As part of our continuing efforts to support statutory partners in financial recovery, Dr Gail Newmarch, Transformation Director at Liaison Care, and Catherine ORourke Director of Development, take us through the challenges of managing Section 117 aftercare arrangements.
20 November 2024
Localities are grappling with dramatic increases in the costs of s117 aftercare. Here, we look at some of the reasons behind this, and how looking both backward and forward can result in transformation beneficial for systems and, of course, the individual.
What is Section 117?
Section 117 of the Mental Health Act 1983 (as amended, 2007) places a legal obligation on NHS and councils to provide aftercare for people who have been detained under certain qualifying sections of the Mental Health Act. Its core aim is to guarantee support and services to people after being discharged, to try to avoid or minimise the person being readmitted to hospital.
Section 117 (s117) arrangements are positive objectives to prevent deterioration, not just to prevent readmission due to a particular disorder, so arrangements should aid continued recovery and where identified, provide therapeutic interventions. Care arrangements should be outcome focused (and monitored), and be subject to statutory review at least annually.
The challenge of s117 aftercare
Integrated Commissioning Boards (ICBs) are responsible, with their partner Local Authorities, for the management of their s117 cases. This includes the reviews and the financing of the packages of care. Some may devolve this to local organisations, including their Mental Health Provider, but they retain the overall statutory responsibility.
Several Mental Health Trusts have contacted us to help with the review of their s117 packages of care, while others are discussing how we can help them manage to commission new packages of care that meet individual care and support needs.
Across the UK, we are seeing the impact of inflation and increasing housing costs over the last few years on the costs of these s117 packages.
Looking back, and facing forward
In supporting system partners, Liaison Care offers two areas of support. We can undertake the s117 reviews using our highly experienced clinical teams to assess how the package of care currently meets an individual’s needs. Secondly, our Transformation team can then renegotiate packages of care, including housing requirements, and establish new contracts and performance metrics to support future assessments.
Integral to this work is a focus on the individual, this means ensuring support is relevant, outcome-focused, and based on ‘me and my life’. We look at the needs of the individual and the details of the s117 arrangements, checking how the care, recovery pathway and outcomes are being provided.
The analysis and activity is completed by experts who have extensive experience in providing strategic and operational analysis and intervention in right-sizing statutory care arrangements, looking at benchmarking, causal variation, pricing, and standardisation alongside completion of statutory reviews to give a rounded improved position and forward plan.
The overall factors affecting MHA s117 costs are unlikely to reduce in the current climate, but having a team who can support individuals alongside a necessary awareness of pressures is valuable in any local partnership.