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Tijdschrift voor Psychiatrie 59 (2017) 11, 702 - 709

Essay

Why Dutch mental health care practitioners should have second thoughts about adopting the English cluster model

T.G. Broekman, G.M. Schippers

background Administrators and policymakers in the Netherlands have concluded, after considerable deliberation, that the existing Dutch diagnosis-related group (drg)-based system of diagnosis treatment combinations for funding mental health care should be replaced by the so-called English model. The details, however, need to be analysed very carefully by Dutch professional health care practitioners.
aim To make the reader aware of the reasons why the English model should not be adopted in the Netherlands.
method We describe and analyse the English cluster model and the referral instrument (the Honos, supplemented by six items) and we demonstrate how it is applied in England. We also describe and analyse the actions and activities pursued by the Dutch Healthcare Authority (nza) to introduce the model in the Netherlands.
results There are strong objections to the English model. One of the most important is that the mental health care system will suffer when its connections are severed between its funding sources from internationally recognised and scientifically important classification systems such as dsm, icd and icf. Another major objection is that the proposed clustering system is conceptually weak and is not based on convincing analyses. Furthermore, the Honos is an instrument for measuring outcomes and is not appropriate for assigning patients to specific types of care. In England the model is very rarely used as an instrument for assigning patients to care.
conclusion Dutch mental health care practitioners should have second thoughts about deciding to adopt the English model.

keywords funding model, drg-based structure, English model