Improving Access to Psychological Therapies

Improving Access to Psychological Therapies (IAPT) is a national NHS programme across England, offering National Institute for Health and Care Excellence (NICE) approved interventions to treat people with depression and anxiety disorders. IAPT was fundamental to the implementation of the mental health strategy, ‘No health without mental health’ and is central to the NHS strategy of improving waiting times and achieving parity of esteem with physical health as outlined in the ‘Five year Forward View’ and ‘Achieving Better Access to Mental Health by 2020’ (Taken from Trust wide operational policy for IAPT, Pennine Care NHS Foundation Trust 2017)

Why this matters

  • By integrating IAPT services with physical health services we can provide better support to people with long term conditions and achieve better outcomes, such as better compliance with medication and improved recovery rates
  • There are benefits to patients with depression and anxiety disorders from earlier access to psychological therapies. They have better recovery rates
  • Older people (65+) have better recovery rates than the general population so ensuring that there is good access for this age group will improve recovery rates across Greater Manchester
  • Black, Asian and minority ethnic groups are under-represented in IAPT services and therefore Black, Asian and minority ethnic populations in Greater Manchester will benefit from improved access and recovery

Our aims

National priorities for service development are:

  • Expanding services so that 1.9m adults access treatment each year by 2024
  • Focusing on people with long term conditions. Two thirds of people with a common mental health problem also have a long term physical health problem. This greatly increases the cost of their care by an average of 45% more than those without a mental health problem. By integrating IAPT services with physical health services the NHS can provide better support to this group of people and achieve better outcomes
  • Supporting people to find or stay in work. Good work contributes to good mental health, and IAPT services can better contribute to improved employment outcomes
  • Improving quality and people’s experience of services. Improving the numbers of people who recover, reducing geographic variation between services, and reducing inequalities in access and outcomes for particular population groups are all important aspects of the development of IAPT services

Where we are now

  • We’re working towards improving access rates by investing more in services and by looking at the way we’re delivering services eg including digital therapies.
  • Organisations in Greater Manchester who provide and commission services are working closely with education providers and national and regional representatives through a Greater Manchester steering group and a workforce group. These groups are  identifying opportunities and themes where we can work together to improve services for patients in Greater Manchester .
  • We’ve produced guidance on access for Black, Asian and minority ethnic groups and on IAPT long term conditions provision
  • We’re currently piloting a GM centralised recruitment process to ensure more places for trainee IAPT practitioners are filled and improve retention of trainees following completion of training.

Since the introduction of the access and waiting time standards in 2016, Greater Manchester has improved recovery rates from 44.92% (July 2016) to 50% (February 2020) and has increased the rate of access to psychological therapies from 3.98% (July 2016) to 5.3% (February 2020) – these are 3 month rolling access figures.  The data showing the trend in access rates is taken from NHS Digital.

What’s next 

We plan to achieve the national standards set out in the IAPT programme:

  • Waiting times: 75% of people referred to IAPT services should start treatment within 6 weeks of referral, and 95% should start treatment within 18 weeks of referral. These targets were introduced in the 2015 access and waiting time standards and the Five-Year. Forward View NHS England. Whilst these are secondary measures they’re important as they impact on the primary access and recovery standards
  • Access standard: IAPT services providing timely access to treatment for people with anxiety disorders and depression. The expected access rates (percentage of prevalence) for March 2020 is 22% (March 2021 is 25%)