Kevin Mullins
National IAPT Director
National IAPT Programme Update
December 2011
Introduction
Programme Aims
– complete the roll out of IAPT services
– expand access to IAPT in specific areas of need
Deliverables
– an appropriately trained workforce,
– specific quality standards ie NICE compliance, equitable access, integrated employment
options
– session by session outcome measures,
– stepped care model relying on flexible referral routes
Extended Scope
– children and young people,
– those with physical health long-term conditions and mental health issues,
– those with medically unexplained symptoms and
– those with severe mental illness
Outcomes
– improved access to evidence-based psychological treatments;
– improved mental health and wellbeing;
– more people with lived experience of these situations involved in leading the changes
– more people able to resume or start normal working lives
Benefits of £400m investment
– over £700 million savings healthcare, tax and welfare gains
– further 1.2 million people able to access therapies with effective services available across the
country
– of these, 0.5 million helped to move to recovery or measurable improvement.
Start Point & Planning Assumptions
900k
present to
services
6m in
need
600k
complete
treatment
300k Recover
(25k Move off Benefits)
Service Targets
SHA
East of England
East Midlands
London
North East
North West
South Central
South East Coast
South West
West Midlands
Yorkshire &
Humber
Totals
Regional
Allocation
10.26%
8.13%
15.86%
5.59%
14.83%
6.96%
7.90%
9.59%
10.75%
Prevalence
684,797
448,652
1,018,112
330,385
1,004,581
384,730
430.321
613,546
568,463
2015 Referrals
92,509
75,619
137,683
51,179
133,390
61,432
70,020
86,310
97,363
10.12%
630,658
94,495
100.00%
6,114,245
900,000
Performance Management
• NHS Operating Framework for 11/12
– Access - The proportion of people entering treatment
against the level of need in the general population, and
– Conversion - The proportion of those entering treatment
against the number referred
• NHS Operating Framework for 12/13
– Access – full roll out by 2014/15 (BME & Older People)
– Recovery – 50% in fully established services
– Scope – SMI & LTCs
• Performance Focus
–
–
–
–
–
Incomplete KPI data is returned
Access numbers below trajectories
Treatment completers falls below 66% of those entering
Recovery rates fail to improve
Waiting lists increase
Yr 3
Projecte
d
460k
Performance – Q1 11/12
Entering Treatment
900,540
730,485
500,540
310,603
331,025
300,000
Cumulative Trajectory
(end of Q2 - 2011/12)
Cumulative Total
Traj Yr3
Year 3 (to date)
Q1 11/12
Q4 10/11
Traj Yr2
Year2
Q3 10/11
92,682 116,735121,608
89,775
Q2 10/11
83,946
Q1 10/11
75,179
Q4 09/10
Q3 09/10
Traj Yr1
Year1
88,857 100,000
61,703
21,991
Q2 09/10
Q1 09/10
26,391
23,074
Q4 08/09
17,401
Q3 08/09
1,000,000
900,000
800,000
700,000
600,000
500,000
400,000
300,000
200,000
100,000
0
Yr 3
Projecte
d
300k
Treatment Completed
648,974
432,208
382,307
214,245
Cumulative Trajectory
(end of Q2 - 2011/12)
Cumulative Total
Traj Yr3
Year 3 (to date)
Q1 11/12
Q4 10/11
Traj Yr2
Year2
Q2 10/11
Q1 10/11
Q4 09/10
Q3 09/10
Traj Yr1
Year1
Q3 10/11
64,402 74,498 75,345
66,667
61,456
28,775 38,833 50,446
11,320 13,942 38,453
Q2 09/10
8,092
Q1 09/10
5,099
Q4 08/09
179,510200,000
Q3 08/09
650,000
600,000
550,000
500,000
450,000
400,000
350,000
300,000
250,000
200,000
150,000
100,000
50,000
0
Yr 3
Projecte
d
20k
Performance – Q1 11/12
Yr 3
Projecte
d
100k
0
Cumulative Trajectory (end of Q2 2011/12)
600000
Cumulative Total
Cumulative Trajectory (end of
Q2 - 2011/12)
Cumulative Total
Traj Yr3
Year 3 (to date)
Q1 11/12
Q4 10/11
39.6%39.4% 42.8% 40.6%
Traj Yr3
265981
Year 3 (to date)
Q1 11/12
Q4 10/11
60525 66429 71938 67089
Q3 10/11
50.0%
Q3 10/11
Traj Yr2
Year2
Q2 10/11
Q1 10/11
41.8% 39.3% 38.9% 38.8%
Traj Yr2
300000
Year2
Q2 10/11
Q1 10/11
33.8%
Q4 09/10
50.0%
Q4 09/10
50819
Q3 09/10
34.4% 39.6% 32.2%
Q3 09/10
Traj Yr1
Year1
Q2 09/10
60.0%
Traj Yr1
9650 12458 13671 15040
Year1
Q2 09/10
Q1 09/10
28.2%
Q1 09/10
100000
Q4 08/09
40.0%
Q4 08/09
Q3 08/09
20.0%
Q3 08/09
Performance – Q1 11/12
Recovery Rates
100.0%
80.0%
50.0%
16.9%
0.0%
0.0%
Waited More than 28 Days
545,675
500000
400000
200000
228875
67903 69373 91599
National Training Summary Table
2011/12
Type
MPET / Training
Plan
Intentions
Commissioned
Deficit
CBT (High Intensity)
559
414
-145
PWP (Low Intensity)
567
460
-107

67
83
+16
66
133
+67
66
49
-17
66
45
-21
260
616
+356
1,651
1,800
+149



Counselling for
Depression
Interpersonal
Psychotherapy (IPT)
Dynamic
Interpersonal
Therapy (DIT)
Couples Therapy for
Depression
Supervision Training
TOTAL
CBT Trainees
Non - CBT trainees
SHA
PWP
New
PWP
Turnover
HIT
New
HIT
Turnover
Couple
Therapy for
Depression
Counselling
For
Depression
DIT (Brief
Interpersonal
Therapy for
Depression)
IPT (Interpersonal
Psychotherapy for
Depression)
East Midlands
19
17
9
22
2
5
5
13
East of England
16
28
8
27
5
5
5
5
London
35
15
52
6
0
0
15
16
North East
12
16
16
26
0
0
0
22
North West
51
4
57
5
5
20
5
10
40
34
25
12
12
35
9
20
South East
Coast
25
9
40
3
2
0
3
10
South West
46
26
7
11
8
11
4
15
West Midlands
27
10
63
0
6
2
2
2
Yorks & Humber
5
25
5
20
5
5
1
20
Total
276
184
282
132
45
83
49
133
Target
320
247
480
79
67
66
66
66
36
67
229
57
21
17
17
67
South Central
Variance
New Trainees 11/12
SHA
HI
PWP
TOTAL
East Midlands
9
19
28
66
- 38
East of England
8
16
24
83
- 59
London
52
35
87
123
- 36
North East
16
12
28
45
- 17
North West
57
51
108
117
-9
South Central
25
40
65
56
+9
South East Coast
40
25
65
63
+2
South West
7
46
53
78
- 25
West Midlands
63
27
90
86
+4
Yorkshire & Humber
5
5
10
82
- 72
282
276
558
800
- 242
Total
EXPECTED
DIFFERENCE
Resources Available
Policy
Completing roll out
Children & Young
People Pilots
MUS/LTC Pilots
Total
2011/12
2012/13
2013/14
2014/15
43
8
88
8
133
8
133
8
2
53
tbc
96
tbc
141
tbc
141
Assumptions for 11/12:
•Further training & education commissions - £32m
•PCT costs associated with employment support - £11m
SHA “bundle”:
•IAPT Central Team Costs - £1.5m
•SHA IAPT Team & other costs - £3.5m
Governance – MH Strategy
Mental Health Strategy Advisory Group
Cabinet sub-Committee
on Public Health
Cabinet Committee on Social Justice
Mental Health Strategy
Ministerial Advisory Group
Health and Criminal
Justice Board (DH
and MoJ) chaired by
David Behan
Ministerial Advisory Group on Equality in
mental health
Departmental Co-ordinating group
DH Equality and
Diversity
Council
Mental Health Strategy work streams
Public Mental
Health
Suicide
Prevention
Offenders
Other work streams
Equalities e.g.
BME age
physical and
mental health
Risks & Opportunities
• Mandate & Operating Framework(s)
• Commissioning Structures (Outcome
Frameworks)
• Information Standard Notice Implementation
• Payment By Results
• Any Qualified Provider
• Quality Innovation Prevention & Productivity
• Education & Service Commissioning
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December 2011 - Healthcare for London