On 8th October 2014, following a crescendo of news relating to the length of Talking Therapies waiting lists, previously Improving Access to Psychological Therapies (IAPT), the government announced new waiting time targets for psychological therapies.
…by March 2016, 75% of people referred to the IAPT programme begin treatment within 6 weeks of referral, and 95% begin treatment within 18 weeks of referral. (Source)
Such announcements usually herald the arrival of an army of auditors, monitors and service improvement experts, coming down from on high to hail the compliant, tend the wounded and put the terminal cases out of their misery.
But so far the “rumours of war” (to quote the Bible) have been in the form of a threatened CCG-led capacity planning exercise to be undertaken on all IAPT services, supported, apparently, by a £10 million rescue fund to bring the wounded back to full health. We have seen nothing in writing. The rescue corp is currently no more than a drumbeat over the horizon, and actually we’re not sure if it’s thunder…
So, on Monday 27th April, Mayden invited select representatives from a number of IAPT services to our new offices in Bath for a roundtable conversation. We wanted to hear directly from our clients what form they expected this capacity planning exercise to take and how they were approaching the problem. From there, we asked how iaptus could support this new agenda.
Round Table Recap: IAPT Waiting Times and Online therapies
To launch the event we invited Dr Christos Vasilakis from the University of Bath to set the scene. Just prior to the launch of the IAPT programme in 2006, Dr Vasilakis had undertaken work with a number of mental health organisations to model activity and waiting times using a stepped care approach. Sound familiar?
An explanation of what modelling is and isn’t was quickly followed by an overview of the model Dr Vasilakis developed. You can simply key in a series of variables such as referral volumes, DNA rates, step up rates, etc, etc. and out pops the number we all want to know: what will be the consequent waiting time for patients?
The model was developed using the 2007 versions of Microsoft Access and Excel (so should be fine for most NHS organisations!) and we’re currently in discussions with Dr Vasilakis to see how we might resurrect his work to support our clients.
Most of the IAPT services around our table had already started to undertake their own modelling work, but in the absence of any official guidance, each had taken a different approach. If we had hoped we could put together a business case to claim some of the £10m support fund, though, it seemed we were to be disappointed. Our guests were already meeting the new waiting time standard. The trick now was to maintain this position in the face of increasing demand.
Cue the afternoon session, where we demonstrated our latest development project: the integration of iaptus with a number of online therapy services.
The use of digital therapies is currently being encouraged by NHS England through CCGs, following positive citations from the NHS Chief Medical Officer and the NHS Confederation among others; the premise being that online therapy can be just as effective as face to face therapy but also significantly cheaper. More to the point, online therapy in its purest form has no waiting list and may be the best answer to relieving the pressure within mental health services caused by long waiting lists. (Download our recent white paper to find out more).
Funded by the Small Business Research Initiative (SBRI), Mayden is developing functionality within iaptus that will allow patients to be referred to up to six online therapy platforms, and to then receive the outcomes back from these treatments into the iaptus patient record. Gradually, we hope to build the evidence base for online therapies and to provide a range of analytical tools to interrogate the data and help services select the most appropriate tool for a particular patient.
Not all the IAPT services who joined us for the event were using online therapies, but those that were cited positive results. Others were beginning to consider options, and all were starting to feel pressure from commissioners to explore this possibility.
With funding pressures mounting even as demand continues to increase, all services agreed that they will need to consider online therapies as part of their service offering going forward, if only to maintain waiting times within the new targets.
Our job then is clear: to make the process of integrating these new treatment modalities as seamless as possible.
