Early intervention in psychosis services

The national early intervention in psychosis access and waiting time standard aims to ensure that people with first episode psychosis receive prompt assessment and access to evidence-based interventions.

Services in Greater Manchester are working closely together to improve both the physical and mental health of people with a suspected first episode of psychosis and have implemented Greater Manchester clinical guidelines in order to make the patient experience better.

We’re taking a whole system approach across Greater Manchester to ensure that 60% of people with a serious mental illness (390,000 people) receive physical health checks. Clinical commissioning groups (organisations that bring together local GPs and health professionals to plan, buy and monitor services) are offering National Institute for Health and Care Excellence recommended screening and access to physical care interventions. These are delivered across primary and secondary care. For early intervention in psychosis success is measured via a national audit – National Clinical Audit of Psychosis.

Due to a combination of lifestyle factors and the side-effects of antipsychotic medication, there’s a high incidence of cardiovascular disease causing premature death in people with serious mental illness (15 years for bipolar disorder and 25 years for schizophrenia). It’s therefore necessary that people with a serious mental illness have an annual physical health check to identify risk factors for cardiovascular disease  .

Why this matters

Early intervention in psychosis services can improve clinical outcomes, such as admission rates, symptoms and relapse, for people with a first episode of psychosis. They do this by providing a full range of evidence‑based treatment including pharmacological, psychological, social, occupation and educational interventions.

What we’ve achieved so far

In Greater Manchester overall we’ve:

  • achieved the 2019/20 target of 25% of specialist early intervention in psychosis services graded at least Level 3
  • exceeded the target of 53% with 76.8% of people in Greater Manchester receiving treatment in 2 weeks during January 2020 (MH Core data pack March 2020)
January 2020 % seen within 2 weeks
England 72.7%
North West 69.8%
GMHSCP 76.8%

How teams are graded

                    % of people accessing EIP service

Level 2 Level 3
Timely access
% engaged by care coordinator within 2 weeks > 25% > 50%
Effective treatment
Cognitive behavioural therapy for psychosis > 12% > 24%
Supported employment take up > 10% > 20%
Family intervention take up > 8% > 16%
Physical health review and interventions > 70% > 80%
Carer focused education > 25% > 50%
Well managed service
Two or more outcome measures > 25% > 50%

What’s next

By March 2021

  • 56% of people receiving treatment in two weeks
  • 50% of specialist early intervention in psychosis services graded at least Level 3 by the end of the year