Children and Young People’s
IAPT
New Partnerships briefing
March 2012
Kathryn Pugh
IAPT Website: www.iapt.nhs.uk
Plan for Today
• Context setting
• The Children and Young People’s IAPT
Project
• The bidding process
Context: Policy
New Mental Health Strategy, 2011
- Life course approach: Quality Driven
- Implementation Plan being prepared
NHS and Social Care Bill, 2011
- Outcomes frameworks, NHS, Social Care, Public Health
Commissioning developments
– QIPP, CQUIN
– CAMHS PbR
Data & IT, Choice
- Data to support quality and choice
New investment announced
does not impact on your application
• Existing package through existing
collaboratives
• Increase in geographical reach of
collaboratives
• Introduction of new therapies – IPT and SFT
• E packages
- universal staff
- counsellors
-Computerised CBT for CYP
Context: Current Services
• Lack of systematic evidence of
– what services deliver
– and what is missing is major weakness
Project assumptions
• CYP IAPT will learn from Adult IAPT but will
be specific to the needs of children and
families
• The budget is still modest and will be
available until the next Comprehensive
Spending Review.
• Participation in the CYP IAPT project will be
offered to existing CAMHS - not necessarily
exclusively provided by the NHS.
Transforming CAMHS through IAPT
• Working in partnership with children and young people
• Embed EBP by service development
• Building on established local relationships
• Training CAMHS staff in RCT validated techniques
• Enhance supervision and monitoring of outcomes
• Maximise the value of investment
• Deliver quick and visible change
• Optimise local flexibility
2011-2012
• Year one
– CBT for anxiety and depression & parenting
training for conduct disorder
• Training for supervisors
• Training for therapists – Targeted/specialist (T2/3)
– Training in the use of outcomes information
– Training programme to support service managers
• Excluded from year one
– Training of staff at universal and early targeted
levels
– NICE recommended modalities other than CBT
and parenting training
CYP IAPT Learning Collaboratives
• Core group of providers delivering high quality training to a
wide area
• Working in collaboration to maximise chance of delivering
service change
• Local CAMHS partnerships to contribute to designing and
delivering training
–
–
–
–
–
–
technical input
clinical supervision
involvement of service users
peer evaluation
oversight
skills exchange schemes
• Encouraging HEIs to invest in a long term response to training
CAMHS-IAPT Learning Collaboratives
Partnership 1
NHS CAMHS
VS
Commissioners
Partnership 3
NHS CAMHS
VS
HEI
•Assure quality
•Organise training
•Deliver content
(in partnership)
Partnership 2
NHS CAMHS
VS
Commissioners
Commissioners
Building a Lasting Collaborative
Mentorship
Partnership 4
NHS CAMHS
Partnership 1
NHS CAMHS
Peer Support
VS
Partnership 5
VS
Commissioners
NHS CAMHS
VS
Commissioners
Peer Support
Partnership 3
NHS CAMHS
HEI
•Assure quality
•Organise training
•Deliver content
(in partnership)
VS
Commissioners
Mentorship
Partnership 2
NHS CAMHS
Commissioners
Mentorship
Partnership 6
NHS CAMHS
VS
Commissioners
Peer Support
Commissioners
VS
Year one collaboratives
Reading
•Ox and Bucks
•Wilts, Bath and NE
Somerset
•Gloucs
•Swindon
•Bournemouth,
Dorset and Poole
UCL & KCL
•Lambeth &
Southwark
•Herts
•Sussex
•Westminster
•Haringey
•Cambridge
•Wandsworth
•Greenwich
Salford
•Derby
•Manchester and
Salford
•Pennine North
•Pennine South
•Barnsley
What does our offer include?
• Training and ‘backfill’ for staff
– Trainees
– Supervisors
– Managers/leaders
• For partnerships: funding for service
development, IT infrastructure, participation,
accreditation
• Creating change agents within CAMHS
• Funding for a further year for data capture
across the service
Principle Behind the Core Offer:
Rigorous Adherence to Protocol
•National curriculum to define teaching content
•Well-defined competencies to evaluate individual trainees at
selection and at the end of training
•Strong front-ending of supervisor training
•HEIs to ensure competence of practice and implementation
•Unwavering emphasis on outcomes monitoring and
outcomes-informed practice
•Learning from the evidence at individual therapist, speciality
and service organisation levels
Principle Behind the Core Offer: Flexibility
•Allowing variation in structures for the construction of
learning collaboratives that effectively meet IAPT priorities
given local organisational constraints
•Creating (modularised) training programme structures
that optimally match skills needs
•Encouraging collaboration between HEIs and partnerships
and between partnerships to make optimal use of local
knowledge and skills
•Within Collaborative Clusters organisation of the funding
for the programme (including backfill and infrastructure)
The funding formula - each collaborative has a
package based on
Therapist to supervisor ratio 5:1
Staff & Fees
-Therapist backfill (per therapist)
-Supervisor and leadership backfill
-Therapist training
-Supervisor training
Infrastructure
-Service manager/lead training
-IT
-Participation
-Service development e.g. self referral
-Accreditation of services
£30K
£60K
£12K
£ 5K
£100K
£ 5K
£40K
£10K
£35K
£10K
Changes to the formula since year
one
If you apply for a supervisor and have less than 5 trainees,
formula is
Supervisor training + backfill for 4months+ funding to
supervise the number of trainees applied for at £8K per
trainee
Eg – partnership applies for 4 therapists, supervisor
funding is
5K +20K plus (4x8K) = £57K
Using the funding
• Can be used flexibly – but we do ask how
you plan to use the money to meet the
commitments you sign up to • For example
– Agreeing extra supervision or support from HEI
– Setting up new systems e.g. telephone triage
Criteria to Evaluate Bids: Partnerships
• Vision for enhancing service by embedding EBP
therapy and commitment to training
• Markers of stability (e.g. funding TMHS)
• Vision and commitment to outcomes monitoring
• Vision to improve access to therapy including
self referral
• Ensuring access and waiting times are sustained
• Matching community aspirations
• Existing ratio of need to current resources
Routine Outcome Monitoring
• Full details and resources are on the web –
www.iapt.nhs.uk
• Measures at assessment, session by session and
at review/end
• Embedding outcome monitoring
– in the therapeutic relationship
– in supervision
– Across all practitioners not just IAPT trainees
– Data information sessions 19 March 2012
The CYP-IAPT Implementation
Feedback Process
•
•
•
•
•
Develop a Collaborative Partnership
Adapt for Contexts & Culture
Train Professionals
Evaluate Effectiveness
Evaluate Fidelity – Certification and
Accreditation – video observation
• Make Sustainable – Supervision and
recertification
Quality Assurance and Evaluation
• Accreditation in development
• Sites and Collaboratives to be evaluated
using outcomes monitoring and CYP
evaluations
• We are intent on evaluation of the process
as a whole
Timeline for 2012-Phase One
Febof
2012
End
July
rd
April 23
2012
End
of July
June
End
of2012
July
November
2012
End of July
January
2013
End
of July
Advertise for
phase one sites
Completed
applications to
be submitted
Select sites
Supervisors and
Service
managers begin
training
Therapists
begin training
The Application Process
• Application process – our interest is in
commitment to transformation : sign up to the
fixed aspects of the project and understanding
how you will approach areas where method of
delivery is not determined
• Evaluation methodology and weighting is in the
Offer
• The size of the bids are not predetermined
• Funding will flow via PCTs/CCGs
Documents you will need to
consider
• National Curriculum - understand the nature of the
training for your teams
• Core offer
– Sets out in detail our offer to you
– Sets out the calculations sitting behind the funding
package
– Sets out what we are looking for in competitive bids
Documents continued
• Joining and existing collaborative Application Form
• Requires senior level sign off
– Word applications for all qualitative information
– Excel workbook
• One worksheet for each HEI/Training Provider
• One worksheet for each local partnership
• Financial macros calculate the funding package
Lessons learned from year one
• Make sure you fully understand the paperwork and what
you are agreeing to do
• Start having discussions now about Information
Governance eg filming cases, data flowing to the centre
• Sort out local governance – money will come to the PCT,
how will it get to suppliers?
• Discuss with clinical teams the routine outcome
monitoring - don’t assume you will ‘make’ everyone do it
After 23rd April
• Bids are sent to SHA leads for comment – each
SHA has been asked to nominate a lead/link for
the project
• Short listing by collaboratives and members of
the Service Development Group who are not
bidding
• Interview appointments sent out for interviews
• Interviews in June
You are applying for
• Existing CBT, parenting and Service
development package
• You will have the opportunity to train in
the new therapies when we know how
they will be delivered
• www.iapt.nhs.uk
• Kathryn.pugh@dh.gsi.gov.uk