Minutes:
The Board considered a report of
the Strategic Director, Communities which highlighted
that 5BP had recently been awarded the
contract to provide the Improving Access to Psychological Therapies (IAPT)
service which went live on 1 August 2014.
It was reported that 5BP were the principal provider but were also
working in partnership with Self Help Services (SHS) to deliver the service.
The Board was advised
that IAPT was the Department of Health’s (DoH) mandated
model for providing talking therapies for anxiety and depression in primary
care. The main principles of the service
were:-
· Improving access;
· Improving quality; and
· Demonstrating effectiveness.
The Board was further advised that the IAPT model stated that provision
should be the least intrusive intervention first i.e. start with brief therapy,
if this was not successful, offer more intensive therapy. The three steps are as follows:-
·
Step
1 - GP interventions;
·
Step
2 (provided by the IAPT service) - Guided self help,
between 6 and 8 half hour sessions with lots of things to read and do between
sessions; and
·
Step
3 (provided by the IAPT service) - “Traditional” therapies, between 12 and 20
hour long sessions and Cognitive Behaviour Therapy (CBT).
It was reported that referrals for the service came in
writing from GPs. Clients were written
to and asked to call the service for an appointment and were usually assessed
within a week and placed on an appropriate waiting list.
The Halton model
had been based on the Award winning Wigan service provided by 5BP. This service was recently identified as
being in the top ten services in the country with regard to quality. The
model used a self-referral system that improved access to talking therapies
for clients and had the highest recovery rates in the North West. It had also met the 50% recovery rate
target “since records had begun. |
Staff were also supported
using a complex continuing professional development system to ensure that the
clinical quality of the service was good. The Board also
received a presentation from Mr Paul Campbell, Clinical Psychologist on the
IAPT service which included:- ·
The principles of the IAPT service; ·
The conditions that they treated within the service; ·
Details of what the service would look like including
the three steps in the process; ·
Explained that CBT was a type of therapy that helped
the client to understand how mood, behaviour, thinking and styles and
physical factors were all linked and the associated risks; ·
Undertook a short quiz; and ·
Highlighted how clients were referred to mental health
services. |
It was reported that 45
days was the average time on the waiting list and work was taking place to
reduce this to 28 days. It was also
reported that 45% of people recovered after receiving therapy. Evening appointments were also popular and
consideration was being given to offering the service on Saturdays.
The following comments arose from the presentation:-
·
It
was noted that therapies ranged from three weeks to 20/25 weeks;
·
It
was noted that there were only two clinical psychologists in the service as the
model worked in a process of steps and it meant that therapy was not always
required immediately i.e. if an individual was depressed, they would commence
treatment immediately with a mental health coach;
·
Concern
was raised that referrals were via a GP and it was very difficult to see the
same GP, there was no continuity and therefore this could result in the model
failing. In response, it was reported
that encouragement and training would be given to GPs, nurses and health
visitors etc to identify the issues and encourage
them to refer individuals as soon as possible;
·
It
was noted that there were currently 350 referrals a month and it was
anticipated that this number would increase as the service progressed. It was also noted that many of the referrals
had been from people who had been depressed for many years. The model, it was reported was designed for
people who had been depressed for a short time, but to date not many had been
referred to the service;
·
Concern
was raised regarding the self referral method which
relied on the individual contacting the service to make an appointment. It was
highlighted that if the GP did not undertake a follow up on whether an
appointment had been arranged, it could result in serious consequences. In response, it was reported that training
would be given to health care professionals and GPs would also have their own
therapist and mobile number which would help to address this potential issue;
·
Clarity
was sought on whether there had been any referrals from SAAFA or other military
groups. In response, it was reported
that there were a lot of hard to reach groups and there would be therapists
with lead responsibility for various hard to reach groups such as the military
and BME etc and would undertake visits. In Wigan, it was reported that the Veterans
Council had referred directly to the service;
·
Concern
was raised that 28 days was a long time if an individual was seriously
depressed. In response, it was reported
that 28 days was the target and the best case scenario would be for an
individual to receive an assessment and commence treatment a week later. However, it was highlighted that due to a
national crisis in recruiting staff for Step 2 individuals offering people a
service less than 28 days was very challenging;
·
The
Board noted the marketing strategy and the LEEF campaign; and
·
The
Board requested that an update report, including the response from GPs be
presented to the Board in six months.
RESOLVED: That
(1)
The
presentation be received and comments raised noted;
(2)
Paul
Campbell be thanked for his informative presentation; and
(3)
An
update report be presented to the Board in six months.
Supporting documents: