What needs to happen if change is to be achieved?

It is evident that the current statistics on mental health in Wales do not meet users’ needs. The implementation of the Welsh Government’s mental health dashboard is a useful first step in bringing together the existing information into one place so that it is more accessible to users. For users to truly be able to answer their questions, however, there needs to be a step change in the data that are available.

Fundamental to achieving this will be the successful development and implementation of the core mental health dataset for Wales. It is crucial, therefore, that the barriers to implementing the dataset are challenged and overcome.

We believe that in order to start to address these barriers, there are some key questions that must be answered.

Who is responsible for driving change?

Strong and effective leadership will be fundamental for effective change. Many things need to be in place for the core mental health dataset to be successfully delivered. In addition to developing the dataset itself, suitable systems must be established in the health boards, and appropriate training provided to those responsible for inputting data so that the data submitted is in line with specified standards. This will require investment both in finance and resources. It will also be crucial to address any barriers related to the challenge of balancing the demands of providing care to individuals with the need for accurate data entry. Without strong leadership to ensure that these issues are tackled, it is unlikely that the core dataset will be successfully implemented.

Digital Health and Care Wales (DHCW) is identified in the Welsh Government’s ‘Mental health and wellbeing strategy’ delivery plan as the organisation responsible for developing a digital and data plan for mental health services in Wales. The delivery plan also notes that a Data, Digital & Outcomes Group has been established to provide oversight to the systemwide work. It remains unclear whether DHCW or the group that has been established has the authority or the capacity to take forward the wider work necessary for successful implementation of the dataset. Questions remain about who will ensure that the right systems and training are available in the health boards and who will fund these efforts. How, for example, will challenges such as resistance from chairs of the health boards be overcome? While collective responsibility is needed, somebody also needs to take on a clear leadership role.

The Welsh Government has created a Minister for Mental Health and Wellbeing. Some stakeholders that we spoke to suggested that the minister could provide greater oversight and challenge. However, there was a feeling that data and the digital agenda may not be a current priority.

How should data collection be mandated?

These issues lead naturally into the question of whether the Welsh Government should mandate data collection or not. Currently, there is no national mandate for mental health data collection in Wales – it is voluntary, unlike in England. There was a perception among users that this lack of mandate is closely linked to the lack of data maturity in some health boards.

It is unclear whether DHCW, the organisation identified by the Welsh Government as being responsible for developing a digital and data plan for mental health services in Wales, has the powers to mandate data collection, and how it would do this if so.

Mandating data collection is a complex issue and again, will depend on suitable systems and adequate training being put in place. Users we spoke to had mixed views on whether data collection should be mandated. On one hand, some felt that mandating health boards to collect and publish data could be a step towards better transparency, accountability and improvements in data quality.

However, users were also conscious of the pressures that clinical staff are under, so they felt that the lack of data was understandable. Discussions focussed on the differing scale in Wales compared to England; in Wales, teams and budgets are smaller, people are multitasking and there are fewer specialist staff. Any attempt to mandate data collection, therefore, would need to take into account and address these difficult issues, and at a minimum, adequate training in systems and data entry would need to be given.