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South Region Early Intervention
in Psychosis Preparedness
Program
Briefing & EIP Matrix Update
20th July 2015
The 15/16 Access & Waiting Time Standard for EIP
By April 2016:
• More than 50% of people experiencing a first episode of
psychosis will be treated with a NICE approved care package
within two weeks of referral.
Policy Drivers
Why a Standard?
12th Feb 2015
Access & Waiting Time Guidance
“Both elements of the standard will be
measured – the wait from referral to
treatment and whether the treatment
accessed is NICE concordant.”
Supporting funding
“The new standards for 15/16 will be supported by an £80m funding
package: £40m recurrent funding to support delivery of the early
intervention in psychosis standard”
“Monitor and the NHS Trust Development Authority (TDA) have highlighted
the importance of prioritising achievement of the new standards in their
planning frameworks for providers for 15/16.”
Assurance
Expectations of Commissioners and Providers
“Commissioners should agree robust implementation plans
with providers as part of their 15/16 contract development
work.”
“Commissioners are required to agree service development
and improvement plans (SDIPs) as part of their 15/16
contract with mental health providers, setting out how
providers will prepare for and implement the new standards
during 2015/16 and achieve them on an ongoing basis from 1
April 2016.”
Expectations of Commissioners
“NHS England’s expectation is that the additional £40m funding being
made available recurrently should be invested recurrently in EIP services to
support sustainable delivery of the new access and waiting time standard.
EIP services are subject to local agreement on pricing, and so commissioners
should ensure that increases in the level of local investment take into
account baseline performance against both elements of the EIP standard:
Referral to treatment waiting times; and current levels of NICE
concordance.”
South Region EIP Preparedness Programme
1. Raise awareness of the requirements of the A&WT standards.
2. Bring together local experts and establish quality improvement networks, ensuring effective linkage with
existing networks of expertise.
3. Understand levels of demand in constituent CCGs and any inequities in access relative to the levels and
patterns of psychosis incidence in the population.
4. Understand baseline performance against the A&WT standards in partner Trusts through analysis of
locally collected data, in advance of the introduction of the standard.
5. Undertake a gap analysis of current EIP team structures, staffing mix and training and development needs
for each partner Trust.
6. Support Trusts and CCGs in developing local preparedness action plans to meet the A&WT standards.
7. Allocate targeted funding to accelerate the implementation of preparedness action plans over 2015/16.
8. Support and facilitate local workforce development programmes, working with Trusts and Health
Education England.
South Region Preparedness Programme Chart
NHS England
(South)
NHS England
Preparedness Programme
Board
Preparedness Clinical Group
Provider Trusts and CCGs across NHS South region
Oxford AHSN
15
Demographics
• 12.5 million population
• 50 CCGs
• 16 mental health providers
• 25 Early Intervention in Psychosis (EIP) teams
• 280 EIP staff
• Serving 3982 people with first episode psychosis
South Region Early Intervention in Psychosis Website
http://time4recovery.com
17
Who works in EIP teams?
How many EIP staff have the training to deliver NICE
recommended interventions for psychosis?
1. Cognitive Behavioural Therapy (CBT)
2. Family Therapy Interventions
3. Vocation Support
4. Physical Health Monitoring & Low Key Interventions
5. EIP Standard Outcome Measures
EIP Staff Survey Results (in %)
January 2015
19
24
19
24
30
76
81
76
70
0 25 50 75 100 125
CBT Skills
Family Interventions
Vocational Support Skills
Physical Health Monitoring
Have Training Require Training
• NHS England (NHSE) & the Department of Health jointly published plans to introduce access and waiting times standards in 2016, and announced that £40m was to be targeted recurrently on EIP, £30m on liaison psychiatry and £10m on IAPT for adults.
• Monitor and the NHS Trust Development Authority (TDA) highlighted the importance of prioritising achievement of the new standards in their planning frameworks for providers for 15/16.
• Based on NICE Guidelines and IAPT SMI pilot sites it was calculated that £40 million was necessary for EIP services in England to meet the new Waiting Times Target.
• CCGs have had their new EIP money as part of the ‘baseline’. (Most mental health trusts chose the ‘Enhanced Tariff Option’ (ETO) which meant that they would receive a share of the new funding.)
• Apparently Cornwall is the only trust in the SW whose CCG-trust contract for 2015/16 specifies any new funding for EIP (only £100k).
• Trusts will not meet the new EIP targets without enhancing the quality of their response to people with FEP (e.g. accredited therapists) and increasing staffing to respond to people at risk of psychosis.
Issues
Next Steps
1.CCG/Trust level preparedness assessments and action plans
2.Proposal detailing funding allocation
3.Targeted training and capacity building
EIP Matrix South Region Early Intervention in Psychosis
Service Self Assessment & Action Planning Tool
This EIP Matrix was developed by the South EIP Programme Board and
Clinical Group to support organisations prepare for the EIP Access &
Waiting Time Standards
Choosing what to Measure
• Meaningfulness: What is the significance of the measure to the different groups concerned with health care? Is the measure easily interpreted? Are the results meaningful to target audiences?
• Health importance: What is the prevalence and overall impact of the condition in the population? What are the significant health care aspects that the measure will address?
• Financial importance: What are the financial implications resulting from the actions evaluated by the measure? Does the measure relate to activities that have high financial impact?
• Cost effectiveness: What is the cost benefit of implementing the change in the health care system? Does the measure encourage the use of cost-effective activities or discourage the use of activities that have low cost-effectiveness?
• Strategic importance: What are the policy implications of implementing the measure? Does it encourage activities that use resources efficiently to maximize health?
• Controllability: What impact does the organization have on the condition or disease? What impact does the plan have on the measure?
• Variance among systems: Will there be wide variations across systems?
• Potential for improvement: How much room is available for plans to improve performance?
Scientific Soundness
• Clinical evidence: What is the strength of the evidence supporting the measure? What guidelines have been published
for the condition? What do guidelines say about aspects of the measure? Is there evidence that documents the link
between clinical processes and outcomes that the measure addresses?
• Reproducible: Does the measure produce the same results when repeated in the same population and setting?
• Valid: Does the measure make sense logically and clinically?
• Accurate: Does the measure precisely evaluate what is actually happening?
• Risk adjustment: Is it appropriate to stratify the measure by age or some other variable?
• Comparability of data sources: If different systems use different data sources for a measure, are accuracy,
reproducibility and validity affected?
We can edit future editions of the tool e.g. if new EIP guidance is
published
The programme SRO will be able to view a summary of all the EIP teams i.e. how many
EIP teams across the 16 providers have self-rated as Bronze/Silver/Gold
More Information Available on Request
http://time4recovery.com
@Time4Recovery #ei2015
Thank You
Please do not hesitate to contact us if you have any queries.
