Kevin Jarman Deputy Director - Adults National IAPT Programme

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Kevin JarmanDeputy Director - AdultsNational
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

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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

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Initial Roll OutOctober 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

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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

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Completing the Roll OutOctober 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

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Progress achievements so far

• Since October 2008 nationally
• 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)

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Access Performance to Q3 12/13
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Recovery Performance to Q3 12/13
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Performance to Q3 12/13
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IAPT Training
YEAR HIT PWP CfD CTfD DIT IPT Total
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
Total 2726 2800 261 190 163 317 6457
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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.

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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

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LTC/MUS

• Aims to extend the benefits of improved access to
  NICE recommended psychological therapies for
  anxiety and depression to people with long-term
  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

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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?

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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, Bi-Polar
  Disorder and Personality Disorder available via
  link from IAPT website
• Need to create cirricula and training materials
  in line with Competency Frameworks

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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

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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

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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.

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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

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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

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Further Information Contact Details

• IAPT website www.iapt.nhs.uk
• E-mail kevin.jarman_at_dh.gsi.gov.uk
• Telephone [phone]
• Mobile [phone]