Data Collection in IAPT
The Importance of collecting data in
IAPT-compliant services
(References: The IAPT Data Handbook and Appendices
available from:
http://www.iapt.nhs.uk/services/measuring-outcomes)
Relieving distress, transforming lives
Clinical Outcome Measurement
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Rare in mental health
Great resistance from practitioners
Seen as fitting one clinical model only
Time consuming?
Interferes with patient therapist
relationship?
Wrong, wrong, wrong!
Patient-reported Outcome
Measures (PROMS)
To enable:
• Clinical governance
• Case Supervision
• Effective communication with patients
• Patient involvement in decision making
• Effective inter-professional
communication
Central Principles for data
collection in IAPT
• At each and every contact
• Data used by patients and IAPT workers
• Provides tangible evidence of treatment
progression
• Used by supervisors to review clinical work
• Used by managers to facilitate effective
service performance
• Used by commissioners & others
Ensuring Equality and Equity of
Access
• Equality Act 2010
• Services are legally required to recognise the diverse
needs of individuals in the community
• Must collect and analyse information of the different
experiences of individuals
• Collect information by age, ethnicity, faith, gender,
diagnosis and sexuality
• Links between physical and mental health
• Used for health needs assessments
Clinical Functions of Data
Collection
• Work collaboratively with patients at the
outset and throughout a treatment episode
• Use a combination of patient-centred
interviewing and outcome measurement tools
• Agree with patients the best treatments for
their difficulties
• Review continuing appropriateness of chosen
treatment
• Identify therapy targets
• Manage the therapy process
What do Patients Think?
• ‘It was easy to understand, not too technical’
• ‘For quite a long time they [the scores] stayed
the same and then they started dropping
slowly and that was a big boost’
• ‘He [the case manager] would go through the
questions. And I knew that I was getting
better, just through the answers I was giving’
Simpson et al (2008) Mental Health in Family Medicine
What do Patients Think?
• ‘It made you realise if you were having a good
week or a bad week. What you had managed
to do or how I was actually feeling’
• ‘I seemed to improve every time we filled that
in, so that was encouraging as well’
• ‘It was like a goal to try to bring it down’
Simpson et al (2008) Mental Health in Family Medicine
What do Workers Think?
• I liked it, [the PHQ9] I liked to use it every
session. I didn’t find it difficult at all. And
clients, even if they hadn’t the piece of paper
with them at certain times, it was ok….
• I liked the simplicity of the PHQ9, it was quite
simple, compared with [another widely used
measure] and that was really, really good
Richards et al (2006)
Critical importance of sessional
outcome data collection
• Recording accurately, regularly and frequently
improves the effectiveness of the stepped care model
• Ensure data available for >90% of all contacts
• Minimise missing data
• Use IAPT Clinical Record to improve patient
experience and benefits from the service
• Improve the quality of clinical interventions
• Aggregate outcomes data to define best practice
What do Workers Think?
It was good practice to get into it (PHQ9, etc)
every single time we saw a patient. It was
something that did not get skimped on. I’d
think, I’ve got forty minutes with you and
you’ve got a whole load of stuff to tell me,
……. I’ll just not do that questionnaire...…….
But it’s better to get it done …….. at the
beginning, because you always find things to
use the last five minutes of your
time.……….sometimes it also highlights things
to talk about.
Richards et al (2006)
Structure of IAPT Data Standard
Use fields in the IAPT Data Standard to collect:
• Patient details e.g. Age, faith, gender, ethnicity,
employment status, sexuality
• Disability details, e.g. Co-morbid physical or mental
health disability information
• Referral data e.g. ‘Provisional diagnosis’, to inform the
clinical approach, and key dates
• Appointment data e.g. Outcome scores including
anxiety disorder specific measures and key dates to
measure recovery rates
• Complete all required fields
Remember
• ALL patients should complete measures and
IAPT workers should ensure they are
accurately recorded in information systems
• Measures should be taken at EVERY contact
Implementation Messages
• Make data collection integral to the
management of patient pathways
• Use data as a clinical management tool not as
a management ‘bolt-on’
• Do not add to measurement burden
unnecessarily
And Finally….
• The IAPT Data Handbook contains detailed
information on the value and importance of
IAPT Data collection. Measurement tools are
contained in the separate appendices file
• The documents are free to download from
http://www.iapt.nhs.uk/services/measuringoutcomes
Thank You!