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(MRC DTP) Mental health and social care integration for patients with complex needs: how to inform equitable and efficient funding to local organizations


Project Description

Mental illness has been recognised as of equal importance to other forms of illness (so-called ‘parity of esteem’), but in spite of commitments to strengthen care provision, gaps in funding and care provision still exist. Patients in need of mental health care are often in need for social care, especially amongst the most deprived populations. In England both mental health care and social care are key priorities, and integration of health and social care has been promoted as a more effective way or organising the delivery of interventions in a number of countries, including England. However, we do not know how social care services (provided by Local Authorities) may affect the need for mental health care (mainly provided by NHS), and vice-versa.

This PhD aims at understanding the relationships between social and mental health care services, and to use that knowledge to better provide an equitable and efficient allocation of funding to local health organizations commissioning services for patients.

The specific objectives are:

Developing a framework to conceptualise the link between mental health and social care and the way these may affect current resource allocation;

Developing methods to assess the extent to which social care and mental health care services complement or substitute each other (including assessing the effects of social care on mental health care needs and vice-versa);

Modelling needs and funding allocations in the future, taking account differences in the epidemiological pressures and the changing policy contexts through microsimulation techniques to inform equitable and efficient funding allocations.

The theoretical framework will be based on existing economic models applied to health. The empirical analysis will use causal inference and micro-simulation methods applied to survey and administrative data sources currently accessible to the supervisory team (e.g. hospital episode statistics, mental health services use and social care receipt, Health Survey for England, Understanding Society, the English Longitudinal Study of Ageing). The candidate will have a strong background in economics and applied econometrics.

The research will contribute to better design and delivery of integrated health and social care, providing better methods for allocating scarce resources to relevant organizations in England and elsewhere.

The student will develop his/her project under the supervision of Dr. Laura Anselmi, Prof. Matt Sutton, Dr. Marcello Morciano, Prof. Peter Bower. He/she will join the Health Organisation, Policy and Economics (HOPE) research group in the Centre for Primary Care and Health Service Research at the University of Manchester. An advisory team including multidisciplinary expertise in mental health and social care will be set up during the first year.

Centre for Primary Care and Health Services Research
https://www.bmh.manchester.ac.uk/research/primary-care/
Institute for Health Policy and Organisation
https://www.alliancembs.manchester.ac.uk/research/centres-and-institutes/institute-for-health-policy-and-organisation/
Laura Anselmi
https://www.research.manchester.ac.uk/portal/laura.anselmi.html
Marcello Morciano
https://www.research.manchester.ac.uk/portal/marcello.morciano.html
Matt Sutton
https://www.research.manchester.ac.uk/portal/matt.sutton.html
Peter Bower
https://www.research.manchester.ac.uk/portal/peter.bower.html

Entry Requirements:
Applications are invited from UK/EU nationals only. Applicants must have obtained, or be about to obtain, at least an upper second class honours degree (or equivalent) in a relevant subject.

Funding Notes

This project is to be funded under the MRC Doctoral Training Partnership. If you are interested in this project, please make direct contact with the Principal Supervisor to arrange to discuss the project further as soon as possible. You MUST also submit an online application form - full details on how to apply can be found on the MRC DTP website View Website

As an equal opportunities institution we welcome applicants from all sections of the community regardless of gender, ethnicity, disability, sexual orientation and transgender status. All appointments are made on merit.

References

Anselmi, L., Everton, A., Shaw, R., Suzuki, W., Burrows, J. N., Weir, R., Tatarek-Gintowt, R., Sutton, M. & Lorrimer, S. (2019), "Estimating local need for mental health care to inform fair resource allocation within the NHS in England: cross-sectional analysis of national administrative data linked at person-level", British Journal of Psychiatry, 8:1-7. doi: 10.1192/bjp.2019.185.

Bower, P., D. Reeves, M.Sutton, et al. (2018),Improving care for older people with long-term conditions and social care needs in Salford: the CLASSIC mixed-methods study, including RCT, Health Services and Delivery Research, No. 6.31

Hancock, R., Morciano M., and Pudney S. (2018),‘Public support for older disabled people: evidence from the English Longitudinal Study of Ageing on receipt of disability benefits and social care subsidy’. Fiscal Studies, 40(1):19-43

Murphy M., Hancock R., Wittenberg R., Hu B., Morciano M. and Comas-Herrera A. (2018), Modelling Ageing
Populations to 2030: Financing Long Term Care in England. In:Walker, A, (ed.) The new dynamics of ageing volume 1. Policy Press, Bristol, UK, pp. 15-34. ISBN 978-1447314738

Stokes, J., Y.-S.Lau, S. Kristensen, M. Sutton (2019) ‘Does pooling health & social care budgets reduce hospital use and lower costs?’, Social Science & Medicine, 232: 382-388

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