Psychology and
Psychotherapy strategy
engagement event
Thursday 30th October 2014
Welcome
Dr Jane Sayer – Director of Nursing,
Quality and Patient Safety
Scene setting
Claire Lussignea - Professional Lead for Psychology
and Psychotherapy , Norfolk and Waveney
Time
What
Who
9.15am–10.00am
Registration and refreshments
All
10.00am–10.10am
Introduction
Director of Nursing, Quality and Patient Safety
10.10am–10.20am
Scene setting
Claire Lussignea - Professional Lead for Psychology
and Psychotherapy , Norfolk and Waveney
10.20am–10.55am
Presentation
Anna Vizor - Professional Lead for Psychology and
Psychotherapy, Suffolk
10.55am–11.05am
General principles for the psychology and
psychotherapy workforce - exercise 1
All
11.05am–11.25am
Question 1 – your views
All
11.25am-11.45pm
Break
All
11.45pm–1.00pm
Questions 2, 3, 4, 5 - your views
All
1.00pm–1.45pm
Lunch
All
1.45pm-2.45pm
Questions 6,7,8 - your views
All
2.45pm–3.15pm
Overall view - Option 1, 2 or 3? - your views
All
3.15pm – 3.45pm
Questions and answers
All
3.45pm – 4pm
Summary and closing remarks
Claire Lussignea and Anna Vizor - Professional Leads
for Psychology and Psychotherapy
Presentation
Anna Vizor - Professional Lead for Psychology
and Psychotherapy, Suffolk
"If local NHS commissioners want to improve
their budgets, they should all be expanding
their provision of psychological therapy.”
"It will save them so much on their physical
healthcare budgets that the net cost
will be little or nothing.”
Professor Lord Layard (2012)
Psychology (psychologists)
demand and supply
• BPS 2005 recommended increase in clinical psychologists
of 15% per year, yet commissioning has stayed stable
• DCP 2004 – need 7300 across NHS for adult and adult LD
services: have 6900 in 2010 across all services
• E of E weighted population is 10.3%: population of
psychologists is 8.5%
• CfWI 2012 – predict need for more psychologists
CfWI recommendations 2013
1. All providers of NHS commissioned psychological therapy
services to gather workforce intelligence
2. Further work to be done to raise the profile and secure the
future supply of the psychological therapies workforce
3. Employers and providers to undertake workforce capacity
assessments for their psychological therapies workforce
Service users surveys – what’s
the view?
•
Strong public demand for psychological therapies yet many people still
find it difficult to access them, therapy is not yet available to all those who
may benefit from it, and that waiting times from referral to treatment are
too long and vary significantly across the country MIND 2012
•
One in five people had been waiting over a year, and one in 10 had
waited over two years to receive treatment. In addition service users
reported they did not always receive sufficient sessions to make genuine
progress, and there was not always a real choice of effective treatments
available MIND 2010
•
Consultation questions – exercise – each question introduced for 5
minutes followed by 15 minute table top discussion
Principles
Anna Vizor - Professional Lead for Psychology and
Psychotherapy, Suffolk
Psychology and psychotherapy
strategy document: part one
Principles that underpin all our work and that
stakeholders can assess us against:
The psychology and psychotherapy workforce should:
1.
2.
3.
4.
Be used to try to meet demand
Help to reduce or prevent problems
Help to develop practice based evidence
Be used to develop new ways of working that reduce
distress
5. Demonstrate their cost effectiveness
6. Be accessible to others
7. Be clear about what they do
Question 1: Service users who need
therapy should always be seen by a qualified
psychologist or psychotherapist
Pros
Cons
High standard
Assessed practice
Governed practice
Fits with NICE guidelines
Expensive to deliver
Takes a long time to
develop workforce
Long waits
Restricts available
interventions
Question 2: We should see
everyone who wants therapy
Pros
Cons
Responsive to service users Inverse care law
Equal access to those who Unnecessary time in
ask for it
treatment
Question 3: How can we offer
something to everyone who needs it
What the psychology workforce said:
1. Develop the workforce – use supervision and training
more
2. Use technology to reach more people
3. Make sure there is a psychological understanding of
everybody
4. Understand the needs of hard to reach groups better
5. Develop new and better psychologically informed
services
6. Work with other agencies to reach more people
Model of role of
psychologists/psychological therapists
Society
Organisations
Staff teams
Sometimes discussed but hardly
ever doing interventions here
Hardly discussed, poorly
understood
Understood but poorly
addressed
Caseloads
Referred cases
Sometimes discussed,
insufficient knowledge to prevent
problems/address early need
Over focus: End point, most
complex, skewed
Psychologists/psychotherapists should assess and intervene at all levels
1.
2.
3.
4.
5.
Referred clients receive services
Caseloads are properly understood, what is not referred and should it be?
Staff should be supported to work well
Organisations are understood – what influences workers for the better or worse
Society – how can society be changed to reduce psychological distress
impact of inverse care law
Question 4: We should improve
our clinical and cost effectiveness
Pros
Cons
Improve standards
Reduce costs
Improve outcomes
Reduce complaints
Takes time to collect and
analyse data
Restricts expensive options
Question 5: We should spend some
of our time testing new ways of doing things
and finding out what works
Pros
Cons
Develop new
services/interventions
Evaluate new approaches
Adapt to new presentations
more successfully
Takes time to try new things
out
Might stop us using what
already works for most
Lunch
Return at 1.45pm
Psychology and psychotherapy
strategy document: part one
Principles that underpin all our work and that stakeholders can assess us against:
The psychology and psychotherapy workforce should:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
Be used to try to meet demand – Leading not trying. Need not demand
Help to reduce or prevent problems Help to develop practice based evidence
Be used to develop new ways of working that reduce distress
Demonstrate their cost effectiveness – Humanity over cost
Be accessible to others
Be clear about what they do
Across all people working within the Trust
Responsive to individual need
Co-production/Recovery/Integrated care
Service user and carer involvement
Workforce intelligence
Question 6: We should spend time
supporting and developing the whole workforce
“…one in ten workers sought support from their doctors and 7
per cent started taking antidepressants for stress. Additionally,
their mental health needs were directly caused by the effects of
the recession on their workplace” CfWI 2013
Pros
Cons
Improve mental and
physical health of part of the
community
Improve knowledge and
skills
Improve working conditions
Improve recruitment and
retentions
Reduce staff sickness and
temporary staffing costs
Time with staff is time away
from service users
Time in training does not
always change practice
Question 7: We should spend more
time preventing difficulties by intervening
within our communities
Pros
Cons
Reduce or prevent problems
Integrated working
Change within other
community settings to support
mental wellbeing
Knowledge and skill
development in society
Reduce stigma
Community cultural change
Time spent working with
people who are not ill or
having problems
Time spent with staff, not with
service users
Change takes too long to
evaluate the impact of us on it
Buy in from other agencies
might not be good enough to
make change
Cultural change is too
complex for us to make much
difference
Question 8: We should spend some
of our time generating income to
support the NHS services
A Foundation Trust can make money from others outside of the
NHS budget, to support its ability to provide services paid for
within the NHS budget
Pros
Cons
Provide new and different
services
Motivating for staff
More money to provide
existing services
Time spent doing this is
time away from service
users
Might lead to two tier
systems and lack of
equitable service
Final view:
There’s a lot to do within a small workforce – what shall we do?
Current
model Option 1
Some people do
lots of some things,
others do lots of
other things –
existing model
Everything gets
done, and this is
balanced across a
well planned
workforce
Nothing is clear enough,
so some people do what
is needed and other
people do what they
want
Option 2
Everybody does
everything
Pros
Everything gets
done in equal
measure
Cons
Nothing gets done very
well and everybody is
overwhelmed
Option 3
Everybody does
most things but a
few things are left
out
Most things get done
without people being
too overwhelmed
Not all things get done
What would help to
provide more clarity
about who should do
what?
What should be left
out? What are your
priorities?
Questions
and
Answers
Summary
Thank you
Close