Kevin JarmanDeputy Director - Adults

National IAPT ProgrammeUpdate on the National IAPT Programme

Improving Access to Psychological Therapies: Evidence and experience of supporting People with Learning Disabilities.

Kendal, Cumbria24th 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 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

• Improve access for older people and BME communities

• Complete roll-out of services for adults

• Initiate stand – alone programme for children and young people

Talking Therapies: four – year plan of action

• Improve access to psychological therapies for people with Psychosis, Bipolar Disorder, Personality DisorderTalking

Therapies 2011 - 2015

Develop models of care for:• Long Term Conditions• Medically Unexplained Symptoms

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

Progress: achievements so farSince 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)

Access Performance to Q3 12/13

Recovery Performance to Q3 12/13

Performance to Q3 12/13

IAPT TrainingYEAR 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

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 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

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, Bi-

Polar 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 SMIForthcoming 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

• IAPT website: www.iapt.nhs.uk• E-mail: kevin.jarman@dh.gsi.gov.uk • Telephone: 0207 972 1617• Mobile: 07824 569291