Kevin MullinsNational IAPT Director

National IAPT Programme UpdateDecember 2011

IntroductionProgramme Aims

– complete the roll out of IAPT services – expand access to IAPT in specific areas of need

Deliverables– an appropriately trained workforce, – specific quality standards ie NICE compliance, equitable access, integrated employment

options– session by session outcome measures, – stepped care model relying on flexible referral routes

 Extended Scope– children and young people,  – those with physical health long-term conditions and mental health issues,– those with medically unexplained symptoms and – those with severe mental illness

Outcomes– improved access to evidence-based psychological treatments; – improved mental health and wellbeing;– more people with lived experience of these situations involved in leading the changes– more people able to resume or start normal working lives

Benefits of £400m investment– over £700 million savings healthcare, tax and welfare gains – further 1.2 million people able to access therapies with effective services available across

the country – of these, 0.5 million helped to move to recovery or measurable improvement.

Start Point & Planning Assumptions

Service TargetsSHA

Regional Allocation

Prevalence2015 Referrals

East of England 10.26% 684,797 92,509

East Midlands 8.13% 448,652 75,619

London 15.86% 1,018,112 137,683

North East 5.59% 330,385 51,179

North West 14.83% 1,004,581 133,390

South Central 6.96% 384,730 61,432

South East Coast 7.90% 430.321 70,020

South West 9.59% 613,546 86,310

West Midlands 10.75% 568,463 97,363Yorkshire & Humber 10.12% 630,658 94,495

Totals 100.00% 6,114,245 900,000

Performance Management• NHS Operating Framework for 11/12

– Access - The proportion of people entering treatment against the level of need in the general population, and

– Conversion - The proportion of those entering treatment against the number referred

• NHS Operating Framework for 12/13– Access – full roll out by 2014/15 (BME & Older People)– Recovery – 50% in fully established services– Scope – SMI & LTCs

• Performance Focus– Incomplete KPI data is returned – Access numbers below trajectories – Treatment completers falls below 66% of those entering – Recovery rates fail to improve– Waiting lists increase

Performance – Q1 11/12 Entering Treatment

121,608

331,025

500,540

730,485

900,540

310,603

89,77583,94675,17961,703

100,00088,857

300,000

92,682 116,735

17,40126,39123,074 21,991

0100,000200,000300,000400,000500,000600,000700,000800,000900,000

1,000,000

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Treatment Completed

5,099 8,092 11,320 13,942 28,775 38,833 50,446

200,000

64,402 74,498 75,345

214,245

382,307432,208

648,974

179,510

61,45666,66738,453

050,000

100,000150,000200,000250,000300,000350,000400,000450,000500,000550,000600,000650,000

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Yr 3 Projecte

d460k

Yr 3 Projecte

d300k

Moving to Recovery

862 2284 3896 457611618 8390

13849 1729121139

60669

2239925966 28502

76867

149,154

0

20000

40000

60000

80000

100000

120000

140000

160000

People moving off sick pay and benefits

128 440 832 9562,356 2,778 1,929 2,525 3,179 3,975

11,608

8,333

4,241 4,927 5,001

14,16911,036

28,133

22,147

0

5,000

10,000

15,000

20,000

25,000

30,000

Performance – Q1 11/12 Yr 3 Projecte

d20k

Yr 3 Projecte

d100k

Recovery Rates

16.9%28.2%

34.4%39.6% 33.8%41.8%39.3%

50.0%39.6%39.4%42.8%40.6%

50.0%

0.0%

38.8%38.9%50.0%

32.2%

0.0%

20.0%

40.0%

60.0%

80.0%

100.0%

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Waited More than 28 Days

9650 12458 13671 1504050819 60525 66429 71938 67089

265981

67903 69373 91599

228875

545,675

0

100000

200000

300000

400000

500000

600000

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Performance – Q1 11/12

National Training Summary Table 2011/12

Type MPET / Training Plan

Intentions

Commissioned Deficit

CBT (High Intensity) 559 414 -145

PWP (Low Intensity) 567 460 -107

Counselling for Depression

Interpersonal Psychotherapy (IPT)

Dynamic Interpersonal Therapy (DIT)

Couples Therapy for Depression

67

66

66

66

83

133

49

45

+16

+67

-17

-21

Supervision Training 260 616 +356

TOTAL 1,651 1,800 +149

  CBT Trainees Non - CBT trainees

SHA

PWP New

PWP Turnover

HITNew

HIT Turnover

Couple Therapy for Depression

Counselling For

Depression

DIT (Brief Interpersonal Therapy for Depression)

IPT (InterpersonalPsychotherapy for

Depression)

East Midlands 19 17 9 22 2 5 5 13

East of England 16 28 8 27 5 5 5 5

London 35 15 52 6 0 0 15 16

North East 12 16 16 26 0 0 0 22

North West 51 4 57 5 5 20 5 10

South Central 40 34 25 12 12 35 9 20

South East Coast

25 9 40 3 2 0 3 10

South West 46 26 7 11 8 11 4 15

West Midlands 27 10 63 0 6 2 2 2

Yorks & Humber 5 25 5 20 5 5 1 20

Total 276 184 282 132 45 83 49 133

Target 320 247 480 79 67 66 66 66

Variance 36 67 229 57 21 17 17 67

New Trainees 11/12SHA HI PWP TOTAL EXPECTED DIFFERENCE

East Midlands 9 19 28 66 - 38

East of England 8 16 24 83 - 59

London 52 35 87 123 - 36

North East 16 12 28 45 - 17

North West 57 51 108 117 - 9

South Central 25 40 65 56 + 9

South East Coast 40 25 65 63 + 2

South West 7 46 53 78 - 25

West Midlands 63 27 90 86 + 4

Yorkshire & Humber 5 5 10 82 - 72

Total 282 276 558 800 - 242

Resources AvailablePolicy 2011/12 2012/13 2013/14 2014/15

Completing roll out 43 88 133 133

Children & Young People Pilots

8 8 8 8

MUS/LTC Pilots 2 tbc tbc tbc

Total 53 96 141 141

Assumptions for 11/12:•Further training & education commissions - £32m•PCT costs associated with employment support - £11m

SHA “bundle”:•IAPT Central Team Costs - £1.5m •SHA IAPT Team & other costs - £3.5m

Governance – MH StrategyCabinet sub-Committee

on Public Health

Mental Health StrategyMinisterial Advisory Group

Cabinet Committee on Social Justice

Ministerial Advisory Group on Equality in mental health

Departmental Co-ordinating group

Mental Health Strategy work streams

OffendersEqualities e.g. BME age physical and

mental health

Public Mental HealthSuicide Prevention

DH Equality and Diversity Council

Mental Health Strategy Advisory Group

Health and Criminal Justice Board (DH

and MoJ) chaired by David Behan

Other work streams

Risks & Opportunities

• Mandate & Operating Framework(s)• Commissioning Structures (Outcome

Frameworks)• Information Standard Notice Implementation• Payment By Results• Any Qualified Provider• Quality Innovation Prevention & Productivity• Education & Service Commissioning