Transcript IAPT - Evidence and experience of supporting People

Kevin Jarman
Deputy Director - Adults
National IAPT Programme
Update on the National IAPT Programme
Improving Access to Psychological Therapies: Evidence and
experience of supporting People with Learning Disabilities.
Kendal, Cumbria
24th May 2013
IAPT – a groundbreaking
initiative
• Original Aim – to provide a universal primary
care psychological therapy service for people
with depression & anxiety disorders
• Use of NICE approved and evidence based
therapies within a stepped care model
• Collection of outcome data at every session
• Provided by a trained & supervised workforce
• Focus on employment
Initial Roll Out
October 08 – September 11
• 3,600 trained new psychological therapists
• 900,000 people entering treatment in first
three years
• 50% of those completing treatment
reaching clinical recovery
• 25,000 people moving off or sick pay &
benefits in first three years
Talking Therapies: four – year plan of action
• Complete roll-out of services for adults
• Improve access to psychological
therapies for people with Psychosis,
Bipolar Disorder, Personality Disorder
Talking
Therapies
2011 - 2015
• Initiate stand – alone programme for
children and young people
• Improve access for older people and
BME communities
Develop models of care for:
• Long Term Conditions
• Medically Unexplained Symptoms
Completing the Roll Out
October 11 to March 15
• 15% of prevalence (over 900,000 people
per year) entering treatment
• Recovery rates of 50% minimum
• 25,000 off sick pay and benefits per year
• Equitable access for all, especially for
older people and BME communities
• Train further 2400 new psychological
therapists
Progress: achievements so far
Since October 2008 nationally:
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An IAPT service in every PCT
4,670 new trainees in first four academic years
1,577,220 have entered treatment
959,621 have completed treatment
358,833 have reached recovery
63,653 have moved off of sick pay and benefits
Current Recovery rate 44.4%, highest 46.1% (Q1
2012/13)
• Meeting 63% of 2014-15 target prevalence, highest 67%
(Q2 2012/13)
(latest verified figures to 31 December 2012)
Access Performance to Q3 12/13
Recovery Performance to Q3 12/13
Performance to Q3 12/13
IAPT Training
YEAR
HIT
PWP
2008/09
487
510
997
2009/10
1004
727
1731
2010/11
623
517
52
44
69
76
1381
2011/12
285
535
68
46
33
82
1049
2012/13
327
511
141
100
61
159
1299
2726
2800
261
190
163
317
6457
Total
CfD
CTfD
DIT
IPT
Total
IAPT in 2013/14
• Small national team sited in Improving
Quality Directorate in NHS England
• Clinical Networks at regional level linked to
national team.
• North West Collaborative meeting 23rd July
• Focus of future work: CYP IAPT, Data
LTC/MUS, SMI, PbR, Equalities.
Children & Young Peoples IAPT
• Service transformation project embedding IAPT quality markers of in
existing CAMHS Services:
• evidence based therapy,
• session by session outcome monitoring,
• close supervision
• with partnership with children and young people in existing CAMHS
• Wave 3 bids received, decision by late June / early July
• Wave 1 sites staff training in Interpersonal Psychotherapy (IPT) and
Systemic Family Practice (SFP)
• Aim to provide 60% of 0 -19 year olds with access to a transformed
CAMHS service by April 2015.
• In addition, the Multi Systemic Therapy Programme (MST) is
undertaking research and increasing the capacity of childrens
services to provide evidence based treatment packages for very
difficult children and their families in conjunction with the Department
for Education
LTC/MUS
• Aims to extend the benefits of improved access
to NICE recommended psychological therapies
for anxiety and depression to people with longterm physical conditions and/or medically
unexplained symptoms.
• People with one LTC are 2-3 times more likely to
develop depression
• People with more than one LTC are up to 7 time
more likely to have depression
• 12-18% of expenditure on LTCs is linked to poor
mental health and wellbeing
LTC/MUS Pathfinders
• 15 Pathfinder sites selected across England covering a range of
LTC and MUS care pathways using £2million of central funding in
2012/13
• Phase 1 Pathfinder Project ran from April 2012 – March 2013
• Final data submission from Pathfinder sites to evaluation agency in
April 2013
• Pathfinder report with findings - Autumn 2013
• Extending the majority of pathfinders into 2013/14 using further
£1.8million of central funding.
Pathfinders looking to test:
• Is there an optimal stepped care pathway?
• What core therapy competencies, experience and training required?
• How potentially cost-effective and efficient are the different models
of care?
Severe Mental Illness
• Over £1million invested in 6 SMI demonstration
sites that started in November 2012
• Demonstrate improved access to NICE
recommended & evidence based psychological
therapies for SMI
• Developing a provisional data set for SMI
• Competency Frameworks for Psychosis, BiPolar Disorder and Personality Disorder
available via link from IAPT website
• Need to create cirricula and training materials in
line with Competency Frameworks
SMI Demonstration Sites
• Providing surgeries and workshops on a regular basis
promoting best practice to visiting services
• Interrogate and provide good quality historic data on
health utilization, clinical and patient reported outcomes
• Provide information on their workforce profile,
supervision, education and training structure
• Champion psychological therapies for SMI
Forthcoming Demonstration Site event in North West
• Lancashire Early Intervention Service – 4th June –
Blackpool
• Halliwick Personality Disorder Service – 22nd July Preston
Payment by Results
• Aim: to develop a national outcome based currency for
use in commissioning of IAPT services
• 23 commissioned IAPT services to develop and test the
feasibility of a draft currency model started on 1st April
2012 with initial phase ended on 31st March 2013
• Final data submission for analysis provided in January
with final feasibility report published by June 2013
• Plan to extend the current currency development pilot in
an increased number of IAPT sites in 2013/14 with view
to road testing the currency from April 2015
Equalities
• Need to ensure that access and outcomes by those with
protected characteristics as defined by the Equality Act
2010 are in line with total population
• Funding to DH Strategic Partners to work to increase
IAPT access from BME communities, faith communities,
gypsies and travellers, lesbian and gay people
• Data collection refined to capture equalities information
• National data currently available for referrals only
• From Q1 2013/14 national reports available for those
entering and completing treatment.
Older people
• Key area of priority for new Secretary of State
for Health
• Only 6% of IAPT service users are 65 and over,
should to be 18% to reflect population and need
• Curriculum for training of IAPT therapists to work
better with older people available
• Online CBT for carers of people with dementia
• Advertising campaign delivered through Age UK
to ensure older people are aware that IAPT is for
them
IAPT for people with learning
difficulties
• In January 2009 IAPT published a Positive Practice Guide for IAPT
services encouraging them to provide appropriate treatment for
people with learning difficulties
• In Q2 2012/13 1,270 people with Learning Difficulties were referred
for IAPT assessment and treatment. This number increased in Q3
to 1,414
• From September 2013 this will allow the IAPT central team to track
progress of people with learning difficulties through IAPT services.
We will be able to see if IAPT services are providing people with
learning difficulties with IAPT treatments and what outcomes they
are getting following completion of treatment
• Things are happening elsewhere, this afternoon there is a meeting
of an IAPT Advisory Group in London organised by the Foundation
for People with Learning Difficulties
• IAPT central team will look to join up these initiatives and use
information from today to inform the updating of the Positive Practice
Guide
Further Information & Contact Details
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IAPT website: www.iapt.nhs.uk
E-mail: [email protected]
Telephone: 0207 972 1617
Mobile: 07824 569291