NHS Northamptonshire ICB partnered with NHS Arden & GEM CSU to strengthen the management of complex mental health funding requests. These requests relate to individuals with complex needs who require access to specialist or non-routine treatments that fall outside of standard commissioned services.
By introducing a structured, transparent and standardised process, the partnership has improved consistency in decision-making, supported equitable access to care, and ensured funding is directed towards interventions that deliver meaningful outcomes for patients and the wider system.
The challenge
The wide range of recognised mental health conditions, the variability in symptoms experienced by patients, and the complex interactions between mental and physical health conditions mean it is not possible to routinely commission mental health services that meet all needs. In NHS Northamptonshire ICB, commissioners were seeing an increase in both the number and complexity of requests for specialist mental health funding.
A more streamlined and consistent approach was needed to manage complex mental health funding requests for both adults and children and young people. Greater structure was required to support consistent decision-making, ensuring patients could access appropriate treatments where suitable, while avoiding precedents that could create inequity in access to care.
Our approach
Northamptonshire ICB partnered with Arden & GEM’s Clinical Services directorate to design and deliver a structured, end-to-end process for complex mental health funding requests. This approach balances clinical need, evidence of effectiveness and system-wide equity.
By combining operational expertise and robust governance a standardised approach was introduced. Key elements included:
Collecting and reviewing information
With any health or care professional able to submit a referral, there was a need to improve the consistency and completeness of information provided.
- A single point of referral was introduced, alongside a comprehensive funding application form.
- All requests were triaged by a highly experienced mental health nurse to ensure referrals were complete and appropriate.
- Additional information was gathered where gaps existed or where standard commissioning pathways had not been fully explored.
Managing a monthly panel
A structured monthly funding panel was established and chaired by the CSU, with clinical and commissioning representation, to review cases and make decisions.
- Dedicated administrative support was put in place to prepare case documentation, including redaction, and to take minutes.
- A clear communication process ensured outcomes were relayed promptly to referrers to enable coordination of onward care.
- Where further information or evidence was needed, this was sourced by the CSU team.
Supporting policies and procedures
To embed the new approach, a dedicated policy and standard operating procedure (SOP) were developed through an iterative process, strengthening consistency, transparency and governance
The CSU team’s detailed knowledge of mental health conditions and pathways also enabled them to identify if a commissioned pathway was in place and also identify where low-volume contracts were available.
The overall approach ensured each case was assessed fairly, consistently and in line with clinical guidance, while maintaining flexibility for highly individual patient needs.
Outcomes
Since implementation, the service has delivered measurable improvements in both process and decision-making:
- Improved consistency and transparency, with a standardised process in place for all requests
- More equitable access to treatment, reducing variation and ensuring decisions are based on evidence and need
- Enhanced value for money, with a clear focus on funding treatments that deliver meaningful outcomes for patients
- Stronger governance and assurance, supported by formal panel structures and clear decision-making frameworks
- Better patient outcomes, particularly for individuals with complex needs who may otherwise rely on crisis or emergency services.
"Arden & GEM has had a highly positive impact in supporting the complex mental health funding request process. The team provides clear, consistent guidance combined with strong clinical and operational expertise, which helps to streamline what can often be a complex and time-sensitive pathway.
Their responsiveness, attention to detail, and collaborative approach across organisations have been particularly valuable. This ensures that decisions are well-informed, robus, and remain person-centred. Overall, the support provided has enhanced both the efficiency and quality of the process, contributing to improved outcomes for individuals."
Claudia Slabon, MHLDA Programme Manager (Adult Mental Health), Integrated Care Northamptonshire
The service has also supported Northamptonshire ICB in meeting national policy ambitions to reduce health inequalities and ensure people experiencing complex mental health challenges receive timely, appropriate and effective care.
Find out more about the Clinical Services offered by Arden & GEM.