NHS England has unveiled the sites receiving additional funding in wave-one of the integrated IAPT early implementer programme to develop psychological therapies services within long-term condition care pathways. Here, Felicity Dormon, the IAPT programme lead at NHS England discusses why it is needed and what is expected from them.
One of my favourite days at work this year was bringing together the 22 new integrated psychological therapies projects for the first time. The room buzzed with conversations on ambitions and practical plans, and the experience and enthusiasm of people as they spoke about what they have done so far and what they planned to achieve was humbling.
Early Implementers of integrated psychological therapies are a crucial part of NHS England’s strategy to expand access to treatment for people with common mental health problems and improve integration between mental and physical health – meeting our commitments in the Five Year Forward View for Mental Health.
There are 22 areas covering 30 CCGs involved so far, and from January they will be treating people’s mental health problems from within physical health pathways.
There’s good evidence that treating people’s mental and physical health problems in an integrated way leads to better outcomes. This means improvements in mental health, but also in people’s management of their physical health problem – leading to better physical health, fewer complications, and at least 20% lower physical healthcare costs.
There are obvious benefits for people in their clinicians talking to each other, and in reducing the number of different places and services they have to go to for healthcare. The need for this kind of service is significant – around half of people with anxiety disorders or depression have a long term physical health problem, that’s over 3.5 million adults in England.
Many of our early implementers are already working to integrate services – examples include therapists running groups for people with diabetes, being part of multidisciplinary teams in respiratory clinics, or in primary care working with people with medically unexplained symptoms. National funding is supporting them to expand – they are planning to treat 30,000 people in integrated services in 2017, often moving from one or two clinicians to a full team. This shift to ‘business as usual’ is exactly what we want to see – by 2020/21 1.5 million people a year will access Improving Access to Psychological Therapies (IAPT) services, and we expect at least 400,000 of them to be people with both mental and physical health problems doing this in integrated settings.
From 2018/19 funding for the expansion of IAPT is with CCGs, and we have asked all areas to develop their plans to reach 25% of local need, and to develop integrated services. To support areas in their preparations we are funding extra trainees this year and training for experienced therapists in working with people with long-term conditions or medically unexplained symptoms. We have also commissioned the National Collaborating Centre for Mental Health to produce an evidence-based treatment pathway – setting out the evidence on implementation clearly in one place.
We hope the areas will be a fantastic resource for learning how best to implement integrated IAPT, and for some initial ideas see our Buckinghamshire case study. As part of their commitment to the programme all areas are prepared to share their experiences and learning, and we are commissioning studies to help show the difference services make: including relieving pressure on other hard pressed parts of the system. The case for change is clear, and evidence from early implementers will yield hard figures of benefits and savings in the NHS context, and how best to obtain them. This will support Sustainability and Transformation Plan leaders, commissioners and providers in expanding services and prioritising mental health.
Effective new services for people with mental and physical health problems will be life changing for people that use them – the reason all of us working in the NHS come to work.
Felicity Dormon is the IAPT programme lead at NHS England. Prior to joining NHS England she worked at the Health Foundation as a Senior Policy Fellow. She has also worked for the Department of Health, undertaking policy roles in strategy, mental health and cancer in addition to a secondment as a social care commissioner in local government. She previously worked in defence research. She has a Masters in Health Policy from Imperial College, and a degree in Physics with Computing from the University of Warwick.