Opportunities to work in a range of
IAPT-accredited therapies
13 February 2015
•
•
•
Kevin Jarman - National Director, IAPT NHS England
Neil Ralph - Workforce Development Lead for Mental Health
Education North Central & East London
Matthew Dance - Project Manager, IAPT NHS England
In the beginning
• The IAPT programme started in October 2008 with
IAPT services established in 35 PCTs.
• Asked to provide NICE approved and evidence based
psychological therapies to 15% of people with
depression & anxiety with 50% of those completing
treatment reaching recovery.
• Programme asked to train 6,000 new psychological
therapies to provide high & low intensity brief
Cognitive Behavioural Therapy interventions
IAPT-accredited therapies
To provide a choice of therapy, in addition to CBT, the IAPT programme
worked with professional bodies to develop competency frameworks
and curricula for four psychological therapies to broaden the range of
therapies available to patients at step 3
1.
2.
3.
4.
Brief Dynamic Interpersonal Therapy for Depression (DIT)
Counselling for Depression
Interpersonal Psychotherapy for Depression (IPT)
Couple Therapy for Depression
Four non-CBT psychological therapies training
• Delivered both by High Intensity Therapists trained to deliver an additional
modality of therapy or by therapists beyond the CBT workforce
• CPD training programmes targeted at experienced staff who already accredited by
their professional body
• Relatively brief training (5 days) to up-skill them in specific additional competences
surrounding their specific modality combined with supervised clinical practice for 6
to 9 moths to demonstrate through the assessment of recorded sessions that they
have achieved the required level of competency.
• Supervision training programmes provide additional training in supervision to
experienced practitioners who have successfully completed the practitioner
training programme.
2014 IAPT Workforce Composition
Total Funded
Establishment of
5967 WTE
Employment
Support
2%
Qualified CBT
High Intensity
Therapist (HIT)
42%
Non-IAPT
‘qualified’
counsellors &
therapists
19%
PWP
28%
Total Four nonCBT HIT
modalities
9%
Information
submitted from
IAPT service
providers April
2014
95% return rate
IAPT workforce (Step 3) - expansion
2012 WTE
2014 WTE
Variance
Composition
change
2012-2014
CBT High Intensity Therapist (HIT)
2019
2521
+502
-4%
Counselling for Depression
123
262
+139
+3%
Couples Therapy for Depression
75
86
+11
-
Brief Dynamic Interpersonal Therapy
42
66
+24
-
Interpersonal Psychotherapy
93
140
+47
+1%
Total Four non-CBT HIT modalities
333
554
+221
+4%
Total step 3
2352
3075
+723
-
The Government’s new Mental Health
Agenda
Achieving Better Access to Mental Health Services by 2020
2015/16 IAPT Waiting times standards
• Measured from receipt of referral to entering first treatment
• Standard is for patients finishing a course of treatment (completing
2+ treatment appointments)
75% within 6 weeks
95% within 18 weeks
• Local monitoring is expected of all patients in Q4 and thereafter
• CCG’s have been asked to submit plans to meet this and we will start
to report from April 2015
15-16 IAPT Waiting times standards
• We are also developing number of contextual measures to guard
against unintended consequences:
A. giving a larger proportion of patients a single session of
assessment and advice, rather than a course of therapy
B. reducing the average number of sessions that are given to those
people who have a course of therapy
C. artificial treatment starts where patients have an early
appointment but are then put on an ‘internal’ waiting list before a
full course of treatment starts
• offering a limited choice of NICE approved and evidence based
therapy for depression and anxiety disorder (ACT)………
Action for Choice in therapy (ACT)
• Single forum for decision making between NHS England
IAPT team, Health Education England (HEE), professional
bodies and experts by experience in relation to ensuring a
choice of NICE approved and evidence based psychological
therapies is available in IAPT services throughout England
• Support CCGs & IAPT services to offer & deliver an effective
choice of IAPT approved therapies
• To monitor and evaluate the volume of different therapy
session and patient outcomes delivered by IAPT service
and CCG’s to inform future education commissioning
Workforce and Education
Planning Process
Dr Neil Ralph
Workforce Development Lead for Mental
Health (Psychological Therapies Lead for
London Region)
IAPT training commissioning for
London
• HEE mandate- IAPT is a priority:
– To train a sufficient workforce with the right skill mix
• HEE Local Education and Training Boards (LETBs):
– Workforce planning and commissioning
– Responsive to local service needs and national strategy
– HENCEL is the lead in London for IAPT (HENWL and HESL)
• My role (Since June 2014):
– To provide professional leadership, supporting NCEL with it’s
mandated responsibility
www.hee.nhs.uk
www.ncel.hee.nhs.uk
Workforce development
• Other modality training is workforce development or CPPD
–
–
–
–
–
Not future workforce development (HIT and PWP)
Accessed by staff already employed in IAPT
Courses are delivered by accredited training providers
Have own entrance criteria
Supervision during training provided either in service or courses provide
support with finding supervision
– On going supervision is a service issue
www.hee.nhs.uk
www.ncel.hee.nhs.uk
How is training funded?
• Workforce Development Programme
• LETBs invest in this via different funding streams:
• Direct allocation: Money goes to NHS Trusts based upon
head count to use as they choose
• Services bid internally for staff to go on IAPT other modality
training and supervisor training
• This is based upon their perceived/ commissioned service
needs
– However…….
www.hee.nhs.uk
www.ncel.hee.nhs.uk
How is training funded?
• Transformation Fund to invest in system-wide transformation
projects linked to HEE Mandate and local priorities, for example:
–
–
–
–
–
–
–
–
–
Dementia, Mental Health and Perinatal Mental
Children and Young People
End of Life Care
Cavendish Care Certificate
Public Health
Clinical Academic Careers
Cardiovascular Disease
Improving Access to Psychological Therapies
Widening Participation in Healthcare Careers
www.hee.nhs.uk
www.ncel.hee.nhs.uk
London highlights for this year
• Targeted transformation fund projects:
– Investment in other modality training (training and supervision)
•
•
•
•
•
Counselling for Depression
Dynamic Interpersonal Therapy
Interpersonal Therapy
Couples Therapy for Depression
Behavioural Couples Therapy
20
14
26
9
28
– Collaboration with Tavistock & Portman Trust
• Today’s ‘open day’
• Projects to support the future developments
www.hee.nhs.uk
www.ncel.hee.nhs.uk
Predictions for the future
(caveat- my opinion only)
• IAPT will remain a mandated priority:
– We will work closely with IAPT services and national strategy
leads
– We will support a coordinated approach: making best use of
money available
• Projects may include:
– Supporting courses to deliver training effectively
– Supporting services to increase choice
– Supporting services with access to supervision
www.hee.nhs.uk
www.ncel.hee.nhs.uk
Any questions?
Contact us: ENGLAND.iapt@nhs.net
www.iapt.nhs.uk
www.hee.nhs.uk
www.ncel.hee.nhs.uk