Measuring Waiting Times

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Measuring Waiting Times Understanding our
destination and key milestones along the way
Fiona BlackMental Health Programme Manager,
ISD
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Scope

• The target applies
• to the delivery of psychological therapies for
  mental illness or disorder
• where the therapy is delivered to individuals or
  groups on a face-to-face basis (inc. telephone
  and video link)
• to all ages (inc. CAMHS services)
• in inpatient as well as community settings
• in physical health settings where there is
  associated mental illness such as depression or
  anxiety e.g. chronic pain and cancer
• for substance misuse and for learning
  disabilities where there is associated mental
  illness or disorder

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Waiting Time Measurement Points
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Supporting the collection of national comparable
information

• Standard monthly reporting template
• Application of new ways waiting times guidance
  to mental health/ PT HEAT
• Data standards for recording psychological
  therapies in line with Matrix recommendations
• NHS HIS integrated care pathway standard for
  assessment for suitability (ICP 15)

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Information required for NATIONAL reporting Year 1 (Ends March 12) Year 2 (Ends March 13) Year 3 (Ends March 14)
Date referral received
Date of initial assessment of need/ suitability for therapy (ICP 15)
Suitable/ not suitable
Date of start of therapy
Type of therapy (grouping and intensity)
Date discharged from therapy
Therapy delivered out-with current evidence base
Referral to treatment adjusted waiting times reported (DNA, CNA, clock pause for unavailability, reasonable offer)
Referral to treatment waiting times reported for all services
Workforce data (inc. supervision and training)
Local use of routine clinical outcomes data
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HIGHLY SPECIALIST HIGH INTENSITY LOW INTENSITY
Cognitive and /or Behavioural Therapies Cognitive Behavioural Therapy (CBT)1 Dialectical Behaviour therapy (DBT) Integrative Therapies Cognitive Analytic Therapy Therapies out-with current evidence base This includes individually tailored therapies for highly complex cases for which the approach is extrapolated from the current evidence base such as Integrative Psychological Approaches It will also include therapies for highly complex cases for whom there is an emerging evidence base such as Cognitive Behavioural Analysis System of Psychotherapy (CBASP) Cognitive and /or Behavioural Therapies Behavioural Couples Therapy Behavioural Family Therapy Behavioural Modification Cognitive Behavioural Therapy (CBT) Couple-focused Therapy Mindfulness Family and Systems Based Interventions Family Therapy Functional Family Therapy Systemic Family Therapy Systems Based Therapies Integrative Therapies Interpersonal therapy (IPT) Psychodynamic Psychotherapies Child Psychotherapy Mentalisation Based Therapy Psychodynamic Psychotherapy Therapies out-with current evidence base This includes high intensity therapies/ interventions delivered out-with the current evidence base such as Cognitive Behavioural Integrative Therapy (C-BIT) and Arts Psychotherapies Cognitive and /or Behavioural Therapies Anger Management Anxiety Management Behavioural Activation Guided Self Help Motivational Enhancement Therapy Problem Solving Therapy (PST) Family and Systems Based Interventions Caregiver Interventions Parenting Interventions Family-Nurse Partnership Social Learning Based Parent Management Training Video Interaction Guidance Psychodynamic Psychotherapies Play Therapy Other Psychological Therapies Cognitive Stimulation Therapy Eye Movement Desensitisation and Reprocessing (EMDR) Motivational Interviewing Reminiscence Therapy Solution Focused Therapy Systems Training for Emotional Predictability and Problem Solving (STEPPS) Treatment Foster Care Validation Therapy Therapies out-with current evidence base This includes low intensity therapies/ interventions delivered out-with the current evidence base such as Cognitive Rehabilitation
DRAFT - FURTHER UPDATES REQUIRED

1 e.g. CBT for complex cases such as
personality disorder
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Implementation Progress

• TIME

• Local governance structures and arrangements
• Monthly submissions to ISD
• Monitored through the existing 6-monthly review
  visits
• PT Implementation and Monitoring Group meetings
• Stakeholder Reference Group meetings

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Future Work by end year 1

• Training/ materials to support waiting times
  capture
• Discussions re. national sharing of information
• Overlaps with CAMHS and drug/alcohol HEAT targets
• Implications of transfer of prison healthcare to
  NHS
• Pilot the capture of workforce data
• Scope the capture and use routine clinical
  outcomes

• TIME

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Resources and Support

• Frequently Asked Questions
• http//www.isdscotland.org/Health-Topics/Mental-He
  alth/Psychological-Therapies-FAQ.asp
• Service Improvement Tools
• http//www.evidenceintopractice.scot.nhs.uk/contin
  uous-improvement-in-healthcare/mental-health-colla
  borative.aspx
• Training and Education (NHS NES)
• www.nes.scot.nhs.uk/disciplines/psychology/psychol
  ogical-interventions
• Definitional Guidance and Measurement (ISD)
• http//www.isdscotland.org/Health-Topics/Waiting-T
  imes/Hospital-Waiting-Times/Rules-and-Guidance/
• Regular eNewsletters (2-3 monthly)
• Email NSS.ISDPsychTherapies_at_nhs.net to subscribe

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At present
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In future
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Table Activity

• TIME

• Discuss the FAQs with the colleagues at your
  table
• Are there any you feel require further clarity?
• Are there any answers which you disagree with?
• Is there anything you feel has not been addressed
  yet?
• Agree anything outstanding you would like to ask
  the panel during the QA session