Workforce

Working for Improving Access to Psychological Therapy Services

Clinical psychologists, Counselling psychologists, Nurse therapists, Primary Care counsellors and other qualified Mental Health professionals are eligible to train in delivering High Intensity therapy (AfC Bands 6 and 7)

To become a High Intensity trainee, you will need to have had considerable experience and training in providing psychological therapies. Some of the staff who would be considered might currently be working as nurses, occupational therapists & social workers, counsellors, experienced graduate workers, psychotherapists or newly qualified clinical psychologists.

People from a wide range of backgrounds with a special interest in therapy are eligible to train in delivering Low Intensity therapy (AfC Band 4)

For the Low Intensity trainees, we would be looking for people, who have preferably worked in local mental health services or local communities, who can demonstrate that they can meet the academic levels in the training programme and are interested to work with this client group. These can be graduates or non graduates.

Advertisements and recruitment will begin April 2009 in every Strategic Health Authority area . Search the latest vacancies www.jobs.nhs.uk Keyword - IAPT

Job Descriptions

How can you apply for IAPT jobs/trainee posts?

More than 700 people commenced new training posts in Autumn 2008 , recruitment took place in summer 2008.

Some IAPT services advertising roles for qualified staff; these can be found on NHS Jobs , http://www.jobs.nhs.uk/ search with the keyword : IAPT

It is likely that there will be posts advertised for staff, who have already trained and have the level of skills and competency required and can start working in IAPT services, as well as for trainees.

NHS and other psychological therapy providers setting up and expanding the capacity of psychological therapies services should consider:

  • How many of what types of staff are required to deliver the service
  • How we can ensure they are competent to do so
  • How we can recruit and retain staff

Service commissioners benefit from a clear understanding of these workforce issues because they affect the deliverability, cost and quality of the service more than any other element of the project.

Key factors

IAPT Workforce Planning

The IAPT Programme has made some assumptions about the required workforce in:

These include nationally defined need, demand, interventions required and the mix of staff that could deliver these services within a stepped care psychological therapy services model.

The IAPT Workforce Capacity Tool accompanied by Frequently Asked Questions can help commissioners work through IAPT workforce planning step-by-step this is current under review .

Further useful guidance on assessing demand and staffing can be found in Neglected Majority -Sainsbury Centre for Mental Health 2005.

Staffing IAPT Services

Large numbers of staff - including nurses, clinical and counselling psychologists, counsellors and psychotherapists, working in the NHS or the private and voluntary sectors, are likely to be able to contribute to the new IAPT services.

Commissioners and providers can use the IAPT Worker Registration Form to assess the levels of skills and training in the existing workforce and establish a workforce profile that will support their recruitment effort.

Two types of psychological therapy workers provide interventions in an IAPT service:

  • low intensity therapy workers and
  • high intensity psychological therapists

Trainee and qualified staff posts exist for both roles and training curricula have been developed.

Low Intensity Therapy Workers

Qualified low intensity therapy workers employed at AfC-Band 5, provide high volume, low intensity cognitive behaviourally-based interventions at Step 2 including guided self help.

Trainee low intensity therapy workers, employed at AfC-Band 4, will attend a one year low intensity training programme including one day a week training. They will provide supervised IAPT services four days a week. When they graduate at post graduate certificate level, they will be eligible to apply for Low Intensity Therapy Worker posts at AfC-Band 5.

One of the underlying principles of this role is that there should be a diversity of backgrounds to match local communities, included in the guidance on access to Low Intensity Training for Non Graduates.
At present there is no system to accredit LI courses in the same way HI courses will be accredited by BABCP. A group of experts are meeting in an Oversight Group Accreditation for IAPT training (OGAIT) to decide the best way forward for monitoring and accredit high and low intensity courses and other evidence based training as they are agreed. Recommendations will be forthcoming from this group

Training materials for low intensity staff have been developed by Professor David Richard and Mark Whyte , these are available to download

Job Descriptions

High Intensity Therapy Workers

Qualified High Intensity Psychological Therapists provide a course of cognitive behavioural therapy (CBT) at Step 3. These roles are likely to be delivered by a mix of professions including CBT therapists, clinical psychologists , counsellors, nurses, occupational therapists, and psychotherapists. However they are required to be an accredited/accreditable BABCP practitioner or able to demonstrate equivalence.

Trainee High Intensity Psychological Therapists, employed at AfC-Band 6 or 7 & will attend a one year training programme two days a week, undertaking supervised practice in IAPT services for three days a week. When they graduate with a post-graduate diploma for BABCP accreditation, they will be eligible to apply for High Intensity Psychological Therapy Posts at AfC-Band 7. Guidance on KSA for entry into High Intensity Training without a core profession is available .

IAPT practitioners also need access to staff with expertise in employment support, benefits and housing who can offer sound advice and information to the people accessing IAPT services and those who support them.

Job Descriptions

Working in IAPT services

Training and job opportunities for IAPT services are advertised via NHS Jobs search “IAPT” , Primary Care Trusts providing IAPT services can be found at on our Regions pages

Workforce

Supervision, Management and Leadership

IAPT supervisors should be trained in supervision and able to supervise five trainee therapists or therapy workers.

IAPT services are expected to link into existing services. In some areas, some staff from other services may deliver some aspects of the IAPT service, such as supervision. Training courses for IAPT staff who want to become supervisors are being developed.

All High Intensity Psychological Therapists will have the opportunity to progress their careers to AfC Bands 8a , 8b , 8d and 9, depending on the expansion of their capabilities and competence.

IAPT senior staff are expected to demonstrate competence in clinical leadership, training delivery, governance, audit, evaluation, service design and improvement. They are also expected to commit themselves to the ongoing clinical supervision and case management essential to setting up and managing stepped care systems.

The service lead is a senior member of staff carrying overall accountability. This level of responsiblity and supervision will have a bearing on the amount of clinical work they can carry out.

Job Description Service Lead Band 8b Job Description (Word, 60K) and AfC Profile Matching (Word, 60K)

Further guidance can be found in Delivering the Government’s Mental Health Policies: Services, staffing and costs (SCMH,2007).

Competences

Different skill mixes can result in different cost effectiveness so, rather than prescribing the exact workforce numbers and types of staff, IAPT workforce guidance emphasises the functions/competences and levels of work of staff in IAPT services.

Resources developed to assist services in this are:

Future competence resources will include:

This work will inform how the skill mix should develop in future years as the programme develops.

Clinical Supervision Principles and Guidance

Supervision is a key activity, which will determine the success of the IAPT programme. We are in the process of supporting the commissioning of training for all IAPT supervisors throughout the SHA regions based on a supervision framework specifically developed for IAPT (http://www.iapt.nhs.uk/2008/02/supervision-comptences-framework/ )

We recognise that as most services and training courses are about go live in October 2008, a summary of principles of IAPT supervision is required for Clinical and Course Directors.

Principles of supervision for an IAPT service

This guidance applies equally to all staff employed and working therapeutically within an IAPT service including both IAPT trainees and qualified staff, and those delivering high and low intensity interventions. Supervision for all these staff should entail:

Amount of supervision:

  • Be provided weekly on a regular basis and consist of a minimum of one hour of individual supervision with an experienced and trained supervisor, and located within the IAPT service.
  • In some circumstances, group supervision will be appropriate but will require sessions of a longer duration to be effective.
  • Supervision should address the review of all ongoing clinical cases, and routinely be informed by an individual client’s IAPT outcome measures. For low intensity practitioners this will consist of individual supervision provided from a case management perspective.
  • The discussion of individual clinical cases during supervision should be prioritised according to clients’ needs and a pre-determined schedule. All cases should have been regularly reviewed within a reasonable period of time (2-4 weeks).

Trainees:

  • High Intensity IAPT trainees should also receive during their two-day attendance on the course, additional in depth supervision of training cases, usually in groups of two to three trainees, and lasting for around 1.5 hours per week.
  • Low Intensity IAPT trainees should also receive, in addition, to case management supervision, both individual and group supervision aimed at case discussion and skills development. This should normally be around 1 hour per fortnight.

Supervisors:

Supervisors should have a working knowledge and experience of the interventions for which they are providing supervision. Where there are gaps in experience (e.g. low intensity working), these might be addressed by supervisor training and familiarisation with specific services.

Supervision of trainees will be shared between supervisors who might be university-based and provide specific input into training cases, and supervisors providing routine clinical supervision within the service. Clinical directors and course directors should ensure that appropriate governance arrangements exist for all supervision provided and where appropriate university-base supervisors have honorary contracts etc.

IAPT is commissioning short training courses (5 days) for supervisors within IAPT services, although these are not currently available in all SHA regions. It is expected that most IAPT supervisors will eventually be trained around the specifics of supervising within an IAPT service by attending one of these courses. Courses will address IAPT requirements for supervision of both high intensity practitioners, together with case management supervision for the low intensity practitioners.

Other considerations:

  • Low intensity practitioners should have access to an experienced supervisor to consult on assessment and risk issues. Clinical decisions to either step up treatment to high intensity, discharge or refer on to specialist services will need to be discussed within regular case management supervision.
  • Services should consider how they support their supervisors and ensure that they have sufficient time and adjusted caseloads to allow them to provide quality supervision. They should also have access to peer/group support and continuing professional development.
  • All staff should access to professional and managerial supervision, as appropriate to their role, which will be in addition the clinical supervision arrangements detailed above.
  • It should also be stressed that the number of hours of supervision identified within this document are the minimum recommended for full-time staff. Flexibility should be adopted for staff on part-time contracts or with reduced caseloads arising from other non-clinical responsibilities.
  • A named senior therapist should be responsible for overseeing and monitoring the effectiveness of supervision provided within the IAPT service, in conjunction with the Clinical Director and Course Directors concerned.

Future supervision guidance is provided will include the different forms of supervision expected within an IAPT service and the importance of issues such cultural sensitivity and how supervision can be tailored to meet the needs of clients, supervisees and the service.

Download the IAPT Supervision Guidance December 2008

Education, Training and Development

Strategic Health Authorities have commissioned Higher Education Institutions to deliver the training, which will use the low and high intensity curricula. Existing courses for graduate workers and CBT therapists are being reviewed to ensure they fit the IAPT model.

An audit tool for assessing Cognitive Behavioural Therapy courses and the Cognitive Behavioural component in Clinical Psychology Programmes is being developed by BABCP and BPS. It will be available at the end of summer 2008.

IAPT and the Wider Workforce

Person centred values and psychological awareness are being factored into local training strategy and implementation plans to raise the psychological awareness and person-centred values among primary and secondary care staff. The 10 Essential Shared Capabilities is a useful starting place for this work; new guidance on what is required for those who work at Step 1 in primary care and in local communities is also expected.

Accreditation by Professional and Regulatory Bodies

Seven professional bodies are engaged in a significant piece of work preparing a system of accreditation for the IAPT workforce. They are:

Further Resources for Workforce Development

Workforce redesign underpins the development of new services and these NIMHE Workforce Programme resources may be useful:

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Contact Us

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You can contact Improving Access to Psychological Therapies:

At national level:

By post: Department of Health, Room 227, Wellington House, 133-155 Waterloo Road, LONDON SE1 8UG

By email: IAPT@dh.gsi.gov.uk

In your region:

By contacting: IAPT Regional Leads

Or leave a comment below , please note these comments are moderated and will not appear immediately .

Add your own comment

(not for publication)
(if you have one)

East of England

NHS East of England are supporting 4 sites for 2008/9 they are

Bedfordshire PCT
Cambridgeshire PCT
West Hertfordshire PCT
Suffolk PCT

Training is being commissioned from the following organisations

University of East Anglia
University of Hertfordshire
Anglia Ruskin University

For jobs and training in these areas please visit NHS Jobs www.jobs.nhs.uk search IAPT

Contact details for these organisations and the new psychological therapy services are shown below. Latest news, events and publications are shown to the right .

Eastern Regional IAPT Programme
Fiona McMillan-Shields IAPT Programme Manager, email fiona.mcmillan-shields@eoe.nhs.uk

More information on the NHS East of England IAPT Website

West Midlands

NHS West Midlands are supporting 3 PCTs in the programme in 2008/09. They are:

Dudley PCT
Shropshire PCT
Stoke PCT

Training is being commissioned from the following organisations:

Birmingham City University
University of Birmingham

Contact details for these organisations and the new psychological therapy services are shown below. Latest news, events and publications are shown to the right.

West Midlands Regional IAPT Programme
Jenny Dalloway, IAPT Programme Lead email jenny.dalloway@wmrdc.org.uk

For jobs and training in these areas please visit NHS Jobs www.jobs.nhs.uk and search IAPT.

London

NHS London and IAPT London Working for Wellness are supporting 5 sites for 2008/9 they are
Camden PCT
City and Hackney PCT
Ealing PCT
Southwark
Haringey

Training has been commissioned from the following organisations

Institute of Psychiatry
University College London
Royal Holloway University of London in conjunction with Central North West London Mental Health Trust

For jobs and training in these areas please visit NHS Jobs www.jobs.nhs.uk search IAPT

Contact details for these organisations and the new psychological therapy services are shown below latest news , events and publications are shown to the right .

IAPT London - Working for Wellness
Mark Needham IAPT Programme Lead email Mark.Needham@londondevelopmentcentre.org

Further Information

London’s IAPT programme, Working for Wellness produces a bi-monthly e-newsletter full of news, updates and case studies.

To read the latest issue,

Yorkshire and Humber

NHS Yorkshire and Humber are supporting 4 new PCTs in the programme for 2008/9. They are:

North Lincolnshire PCT
Leeds PCT
East Riding PCT
Sheffield PCT

Training has been commissioned from the following organisations:

University of York
University of Sheffield

Contact details for these organisations and the new psychological therapy services are shown below. Latest news, events and publications are shown to the right.

North East Yorkshire and Humber
Karen Lynch, IAPT Programme Lead Yorkshire and the Humber email: Karen.Lynch@yorksandhumber.nhs.uk

For jobs and training in these areas please visit NHS Jobs www.jobs.nhs.uk and search IAPT.

East Midlands

NHS East Midlands and are supporting 2 PCTs for 2008/9. They are:

Nottingham City
Lincolnshire

Training is being commissioned from the University of Derby and University of Nottingham.

For jobs and training in these areas please visit NHS Jobs www.jobs.nhs.uk and search IAPT.

Contact details for these organisations and the new psychological therapy services are shown below. Latest news, events and publications are shown to the right.

East Midlands Regional Programmes
Dena Adamson, IAPT Programme Lead email: Dena.Adamson@eastmidlands.nhs.uk

South Central

NHS South Central are supporting 2 sites for 2008/9

Buckinghamshire (locality)
Berkshire West (locality)

Training will be provided by the following organisations

University of Reading

For jobs and training in these areas please visit NHS Jobs www.jobs.nhs.uk search IAPT

Contact details for these organisations and the new psychological therapy services are shown below latest news , events and publications are shown to the right .

South East Regional Programme
Jackie Prosser IAPT Programme Lead Jackiea.Prosser@csip.org.uk

South East Coast

NHS South East Coast are supporting 4 sites for 2008/9 they are

East Sussex Downs and Weald PCT
Hastings and Rother PCT
Brighton and Hove City PCT
West Kent (locality)

Training has been commissioned from the following organisations

University of Brighton
Salomons (Canterbury Christ Church University, Tunbridge Wells campus)
University of Surrey

Contact details for these organisations and the new psychological therapy services are shown below latest news , events and publications are shown to the right .

South East Regional IAPT Programme

Paul Johanson, IAPT Programme lead South East Coast paul.johanson@dhsocialcareprogrammes.org.uk

For jobs and training in these areas please visit NHS Jobs www.jobs.nhs.uk search IAPT

North West

NHS North West are supporting 5 sites for 2008/9. They are:

Eastern and Central Cheshire
Western Cheshire
Knowsley
Salford
East Lancashire

Training has been commissioned from the following organisations:

University of Chester
University of Cumbria
Greater Manchester West Mental Health NHS Foundation Trust in conjunction
with the University of Manchester.
University of Manchester
University of Central Lancashire
John Moores University Liverpool

Contact Wayne Eckersley, IAPT Programme Lead email Wayne.Eckersley@northwest.nhs.uk

For jobs and training in these areas please visit NHS Job www.jobs.nhs.uk and search IAPT.

South West

NHS South West are supporting 4 sites for 2008/9. They are:

Bournemouth and Poole PCT
Cornwall and the isles of Scilly PCT
Dorset PCT
Swindon PCT

Training will be provided by the following organisations:

University of Plymouth
University of Exeter

Contact details for these organisations and the new psychological therapy services are shown below. Latest news, events and publications are shown to the right.

South West IAPT Programme
Alex Stirzaker IAPT Programme Lead, email Alex.Stirzaker@csip.org.uk

For jobs and training in these areas please visit NHS Jobs www.jobs.nhs.uk search IAPT.

North East

North East NHS are supporting two PCTs in the programme in 2008/09. They are:

North Tyneside
South Tyneside

Training has been commissioned from the University of Newcastle.

Contact details for these organisations are shown below. Latest news, events and publications are shown to the right.

North East Regional IAPT Programme
Liam Gilfellon IAPT Project Manager , North East email: Liam.Gilfellon@nimheneyh.nhs.uk

Further information on the North East Regional Programme - North East Yorkshire and Humber website

For jobs and training in these areas please visit NHS Jobs www.jobs.nhs.uk and search IAPT.

About Us

The Improving Access to Psychological Therapies (IAPT) programme has one principal aim, to support Primary Care Trusts in implementing National Institute for Health and Clinical Excellence (NICE) guidelines for people suffering from depression and anxiety disorders. At present, only a quarter of the 6 million people in the UK with these conditions are in treatment, with debilitating effects on society.

The programme began in 2006 with Demonstration sites in Doncaster and Newham focusing on improving access to psychological therapies services for adults of working age. In 2007, 11 IAPT Pathfinders began to explore the specific benefits of services to vulnerable groups.

These pilot services, through routine collection of outcome measures, showed the following benefits for people receiving services:

  • Better health and wellbeing
  • High levels of satisfaction with the service received
  • More choice and better accessibility to clinically effective evidence-based services
  • Helping people stay employed and able to participate in the activities of daily living

On World Mental Health Day 2007, Health Secretary Alan Johnson announced substantial new funding to increase services over the next three years:

  • £33 million for 2008/9
  • A further £70 million to a total of £103 million in 2009/10
  • A further £70 million to a total of £173 million in 2010/11

This funding will allow:

  • In 2008/09 34 Primary Care Trusts to implement IAPT services, with more to follow in the next two years
  • Regional training programmes to deliver 3,600 newly trained therapists with an appropriate skill mix and supervision arrangements by 2010/11
  • 900,000 more people to access treatment, with half of them moving to recovery and 25,000 fewer on sick pay and benefits, by 2010/11.

Contact Us

0

You can contact Improving Access to Psychological Therapies:

At national level:

By post: Department of Health, Room 227, Wellington House, 133-155 Waterloo Road, LONDON SE1 8UG

By email: IAPT@dh.gsi.gov.uk

In your region:

By contacting: IAPT Regional Leads

Or leave a comment below , please note these comments are moderated and will not appear immediately .

Today’s websites are driven by allowing people to create their own content and comment online.

Improving Access to Psychological Therapies champions programme-wide knowledge sharing, so that, information and experience is shared inside and outside the programme.

This website provides an opporunity for people to engage in and influence the programme and its services via Have Your Say

Regular articles, videos and latest news prepared by the programme for Have Your Say  (summarised on the right).

Participants are encouraged to read and respond by adding comments and sharing suggestions.

The comments stream also provide the opportunity for mini-discussions between participants in relation to articles. You will be asked to provide a valid email address and responses will be regularly reviewed by the programme team.

Guidelines for contributions are available in Have Your Say Guidelines

Add your own comment

(not for publication)
(if you have one)

Publications

Publications provided by Improving Access to Psychological Therapies can be found following the links on the left.

The Department of Health Website also provides publications including statistical reports, surveys, press releases, circulars and legislation, in electronic format. Hard copies of most documents can be ordered.

RSS Feeds

Subscribe to our RSS Feed for the RSS feedLatest news

Related RSS Feeds

RSS feedDepartment of Health - Recent stories

What are RSS Feeds ?

Using RSS feeds (RSS stands for ‘Really Simple Syndication’), you can pull together all the latest posts from your favourite websites into one place – where they’ll update automatically any time something new is published.

Other ways to receive RSS feeds

There are several ways of following RSS feeds, but the technology is moving forwards and adapting very quickly. The main method is to use a program called a ‘News Reader’. You can then set up this program to receive RSS information from whatever websites you wish that offer it, and browse headlines and story summaries that link through to the full story on the website.

There are several News Reader programs available for all platforms, many of which are free. See a list here. There are also several excellent web-based news readers - which means you can view your feeds on any computer. The most widely used are probably Google Reader and Bloglines.

Special Interest

The personal and economic costs of mental ill heath affect all parts of society and it is important to offer a psychological intervention to everyone who will benefit from it. This programme has working groups looking at the particular needs of a range of special interest groups.

In November 2008 guidance was produced for  Commissioning for the Whole Community PDF 300K

Experts in each of these areas, working together as Special Interest Groups, have produced  short Positive Practice Guides giving ‘top-tips’ on commissioning  IAPT services for those specific communities.

Leading academics and professionals from all relevant disciplines and sectors, including the mental health voluntary sector, NHS, and professional bodies are involved, along with representatives from the IAPT Pathfinder sites.

The Special Interest Groups have fostered the Pathfinder sites, evaluating appropriate service models, developing care pathways and ensuring appropriate outcome measures are taken so that the needs of the whole population are met and positive outcomes are demonstrated for all sections of society.

PCTs’ special interests are:

Black and Minority Ethnic Communities
Derby PCT
Ealing PCT

Older People
East Riding of Yorkshire PCT
Hertfordshire PCT
Buckinghamshire PCT
Stoke PCT

Perinatal – New Mothers and Fathers
Hertfordshire PCT
Salford PCT

Offenders
Dorset PCT

Children and Young People
Bury PCT

Long Term Conditions
East Riding of Yorkshire PCT
North Tees PCT
Dorset PCT
Hertfordshire PCT
Stoke PCT
Salford PCT

Medically Unexplained Symptoms
Stoke PCT

Services

Treatments

National Institute for Health and Clinical Excellence (NICE) recommends a range of psychological therapies to treat people with depression and anxiety disorders and bring them to recovery. It also recommends these therapies are used to provide a system of stepped care, shown in the diagram below. Stepped care has two principles:

  1. Treatment should always have the best chance of delivering positive outcomes while burdening the patient as little as possible.
  2. A system of scheduled review to detect and act on non-improvement must be in place to enable stepping up to more intensive treatments, stepping down where a less intensive treatment becomes appropriate and stepping out when an alternative treatment or no treatment become appropriate.

Staffing

Two types of psychological therapy practitioners are required:

  • High Intensity therapists trained in cognitive behavioural therapy for people with moderate and severe depression and anxiety disorders
  • ­Low intensity therapy workers trained in cognitive behavioral approaches for people with mild to moderate anxiety and depression. These approaches include guided self help and delivering psycho-educational groups. Services will also have administrative staff, employment advisors, a GP advisor and links with other services such as housing, drugs advice and benefits

Choice

It is important that people have a say in what kind of treatment they receive. This helps ensure the best health outcome for them. Clinicians should explain which treatment they are recommending and why they think it is suitable for the patient.

Access

Some people will refer themselves to the service but most will be referred for therapy by their GP or a member of the practice team. The team and their patients should have clear information about local services and the treatment choices available.

Outcomes

IAPT services routinely measure people’s health outcome. This charts their progress and has therapeutic benefit. It is part of ongoing, collaborative service evaluation too, providing feedback on elements of treatment that are helpful or unhelpful.

    Further information on service development can be found on the pages shown on the right.

Regions

The country’s 10 strategic health authorities have each chosen between two and five Primary Care Trusts to deliver new or expanded psychological therapy services in their area in 2008.

They have also commissioned higher education institutions to start training the newly recruited workforce, using the newly-developed IAPT national curricula for high and low intensity therapy workers.

This will deliver 700 more therapy workers in 2008/09 and 3,600 by 2010/11.

More PCTs will join the programme as further funding comes on stream in the next two years.

As a result, 900,000 more people will receive NICE-approved talking treatments by 2011. About half of these will move to recovery and 25,000 fewer of them are likely to be on sick pay and benefit.

Strategic Health Authorities are delivering regional IAPT programmes for more information and to find out about service developments and career opportunities in your area please follow the links on the right of this page.

Follow this link for more information on workforce and services

Home

Relieving distress, transforming lives

People with depression and anxiety disorders are being offered more talking treatments, through significant Government investment in the Improving Access to Psychological Therapies (IAPT) programme.

The psychological therapy workforce is expanding fast and there are many career opportunities as new and larger services are commissioned.

Guidance and frameworks have been developed to help the teams planning services.

Job/Training Opportunities Frequently Asked Questions

The following is provides as a series of frequently asked questions for people interested in training /job opportunities

How can I determine which training / job opportunities I am suitable for?

Further information including, IAPT job descriptions , Person Specifications, accreditation process & course curricula, is available on: http://www.iapt.nhs.uk/services/workforce/

To become a High Intensity trainee, you will need to have had considerable experience and training in providing psychological therapies. Some of the staff who would be considered might currently be working as nurses, occupational therapists & social workers, counsellors, experienced graduate workers, psychotherapists or newly qualified clinical psychologists.

For the Low Intensity trainees, we would be looking for people, who have preferably worked in local mental health services or local communities, who can demonstrate that they can meet the academic levels in the training programme and are interested to work with this client group. These can be graduates or non graduates.

To date, for both groups of staff, we have had a very high level of interest.

How can I apply for IAPT jobs/trainee posts?  

More than 700 people commenced new training posts in  Autumn 2008 ,  recruitment took place in summer 2008.

However some IAPT services will still  advertising roles for qualified staff; these can be found on NHS Jobs , http://www.jobs.nhs.uk/ search with the keyword : IAPT

It is likely that there will be posts advertised for staff, who have already trained and have the level of skills and competency required and can start working in IAPT services, as well as for trainees.

New or expanded IAPT sites for 2009 have yet to be determined by Strategic Health Authorities. These will be announced in Spring 2009 and recruitment will begin for job/training opportunities at that time so it is advisable to register yourself on NHS Jobs http://www.jobs.nhs.uk/ 
 for forthcoming opportunities.

Registration the NHS jobs site with the Keyword IAPT means opportunities will be emailed directly to you as soon as they become available.

Can I apply to attend training courses independently?

Places on the IAPT courses are limited to those employed by the new IAPT services. The posts which people apply for are trainee positions which have the training linked to the posts. This ensures trainees are working in a stepped care model of service delivery, have an appropriate caseload and supervision for their professional development . We would ask you not to contact training organisations directly.

 

 

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IAPT Service Leads & Training Course Materials

Publications that were commissioned by the Improving Access to Psychological Therapies programme ( IAPT) to support training courses for practitioners delivering low Intensity psychological interventions. Authored by Dave Richards and Mark Whyte of the University of York in association with Rethink, these documents are recommended for use by those courses to facilitate consistent and high quality standards across England.

Published as part of the IAPT implementation plan - National guidelines for regional delivery (PDF, 838K)

Curricula for both high and low intensity therapy workers provide a framework for the development of regional training programmes to deliver the high and low intensity therapy first described in A Practical Approach to Workforce Development.

Copies of these materials have been provided to both the low and high intensity training providers.

For further workforce resources including job descriptions and cirricula for low and high intensity workers please see workforce.

 IAPT also has a discussion group available at for commissioners training providers & service leads

Subscribe to Primary Care , GP , IAPT Service Leads and Training Providers Discussion Forum

Email:

Visit this group

For an invitation to this group or you have any course materials you wish to make available please contact IAPT@dh.gsi.gov.uk to request a password.


Workforce

Working for Improving Access to Psychological Therapy Services

For more information on IAPT jobs and training the  IAPT programme has put together a series of frequently asked questions Click here for IAPT Training and Workforce Frequently asked questions

Clinical psychologists, Counselling psychologists, Nurse therapists, Primary Care counsellors and other qualified Mental Health professionals are eligible to train in delivering High Intensity therapy (AfC Bands 6 and 7)

To become a High Intensity trainee, you will need to have had considerable experience and training in providing psychological therapies. Some of the staff who would be considered might currently be working as nurses, occupational therapists & social workers, counsellors, experienced graduate workers, psychotherapists or newly qualified clinical psychologists.

People from a wide range of backgrounds with a special interest in therapy are eligible to train in delivering Low Intensity therapy (AfC Band 4)

For the Low Intensity trainees, we would be looking for people, who have preferably worked in local mental health services or local communities, who can demonstrate that they can meet the academic levels in the training programme and are interested to work with this client group. These can be graduates or non graduates.

Advertisements and recruitment will begin  April 2009 in every Strategic Health Authority area . Search the latest vacancies www.jobs.nhs.uk Keyword - IAPT

Job Descriptions

IAPT Workforce Planning

NHS and other psychological therapy providers setting up and expanding the capacity of psychological therapies services should consider:

  • How many of what types of staff are required to deliver the service
  • How we can ensure they are competent to do so
  • How we can recruit and retain staff

Service commissioners benefit from a clear understanding of these workforce issues because they affect the deliverability, cost and quality of the service more than any other element of the project.

Key factors

The IAPT Programme has made some assumptions about the required workforce in:

These include nationally defined need, demand, interventions required and the mix of staff that could deliver these services within a stepped care psychological therapy services model.

The IAPT Workforce Capacity Tool accompanied by Frequently Asked Questions can help commissioners work through IAPT workforce planning step-by-step this is current under review .

Further useful guidance on assessing demand and staffing can be found in Neglected Majority -Sainsbury Centre for Mental Health 2005.

Staffing IAPT Services

Large numbers of staff - including nurses, clinical and counselling psychologists, counsellors and psychotherapists, working in the NHS or the private and voluntary sectors, are likely to be able to contribute to the new IAPT services.

Commissioners and providers can use the IAPT Worker Registration Form to assess the levels of skills and training in the existing workforce and establish a workforce profile that will support their recruitment effort.

Two types of psychological therapy workers provide interventions in an IAPT service:

  • low intensity therapy workers and
  • high intensity psychological therapists

Trainee and qualified staff posts exist for both roles and training curricula have been developed.

Low Intensity Therapy Workers

Qualified low intensity therapy workers employed at AfC-Band 5, provide high volume, low intensity cognitive behaviourally-based interventions at Step 2 including guided self help.

Trainee low intensity therapy workers, employed at AfC-Band 4, will attend a one year low intensity training programme including one day a week training. They will provide supervised IAPT services four days a week. When they graduate at post graduate certificate level, they will be eligible to apply for Low Intensity Therapy Worker posts at AfC-Band 5.

One of the underlying principles of this role is that there should be a diversity of backgrounds to match local communities, included in the guidance on access to Low Intensity Training for Non Graduates.
At present there is no system to accredit LI courses in the same way HI courses will be accredited by BABCP. A group of experts are meeting in an Oversight Group Accreditation for IAPT training (OGAIT) to decide the best way forward for monitoring and accredit high and low intensity courses and other evidence based training as they are agreed. Recommendations will be forthcoming from this group

 

Training materials for low intensity staff have been developed by Professor David Richard and Mark Whyte , these are available to download

Job Descriptions

High Intensity Therapy Workers

Qualified High Intensity Psychological Therapists provide a course of cognitive behavioural therapy (CBT) at Step 3. These roles are likely to be delivered by a mix of professions including CBT therapists, clinical psychologists , counsellors, nurses, occupational therapists, and psychotherapists. However they are required to be an accredited/accreditable BABCP practitioner or able to demonstrate equivalence.

Trainee High Intensity Psychological Therapists, employed at AfC-Band 6 or 7 & will attend a one year training programme two days a week, undertaking supervised practice in IAPT services for three days a week. When they graduate with a post-graduate diploma for BABCP accreditation, they will be eligible to apply for High Intensity Psychological Therapy Posts at AfC-Band 7. Guidance on KSA for entry into High Intensity Training without a core profession is available .

IAPT practitioners also need access to staff with expertise in employment support, benefits and housing who can offer sound advice and information to the people accessing IAPT services and those who support them.

Job Descriptions

Working in IAPT services

Training and job opportunities for IAPT services are advertised via NHS Jobs search “IAPT” , Primary Care Trusts providing IAPT services can be found at on our Regions pages

Workforce

Supervision, Management and Leadership

IAPT supervisors should be trained in supervision and able to supervise five trainee therapists or therapy workers.

IAPT services are expected to link into existing services. In some areas, some staff from other services may deliver some aspects of the IAPT service, such as supervision. Training courses for IAPT staff who want to become supervisors are being developed.

All High Intensity Psychological Therapists will have the opportunity to progress their careers to AfC Bands 8a , 8b , 8d and 9, depending on the expansion of their capabilities and competence.

IAPT senior staff are expected to demonstrate competence in clinical leadership, training delivery, governance, audit, evaluation, service design and improvement. They are also expected to commit themselves to the ongoing clinical supervision and case management essential to setting up and managing stepped care systems.

The service lead is a senior member of staff carrying overall accountability. This level of responsiblity and supervision will have a bearing on the amount of clinical work they can carry out.

Job Description Service Lead Band 8b Job Description (Word, 60K) and AfC Profile Matching (Word, 60K)

Further guidance can be found in Delivering the Government’s Mental Health Policies: Services, staffing and costs (SCMH,2007).

Competences

Different skill mixes can result in different cost effectiveness so, rather than prescribing the exact workforce numbers and types of staff, IAPT workforce guidance emphasises the functions/competences and levels of work of staff in IAPT services.

Resources developed to assist services in this are:

Future competence resources will include:

This work will inform how the skill mix should develop in future years as the programme develops.

Clinical Supervision Principles and Guidance

Supervision is a key activity, which will determine the success of the IAPT programme. We are in the process of supporting the commissioning of training for all IAPT supervisors throughout the SHA regions based on a supervision framework specifically developed for IAPT (http://www.iapt.nhs.uk/2008/02/supervision-comptences-framework/ )

We recognise that as most services and training courses are about go live in October 2008, a summary of principles of IAPT supervision is required for Clinical and Course Directors.

Principles of supervision for an IAPT service

This guidance applies equally to all staff employed and working therapeutically within an IAPT service including both IAPT trainees and qualified staff, and those delivering high and low intensity interventions. Supervision for all these staff should entail:

Amount of supervision:

  • Be provided weekly on a regular basis and consist of a minimum of one hour of individual supervision with an experienced and trained supervisor, and located within the IAPT service.
  • In some circumstances, group supervision will be appropriate but will require sessions of a longer duration to be effective.
  • Supervision should address the review of all ongoing clinical cases, and routinely be informed by an individual client’s IAPT outcome measures. For low intensity practitioners this will consist of individual supervision provided from a case management perspective.
  • The discussion of individual clinical cases during supervision should be prioritised according to clients’ needs and a pre-determined schedule. All cases should have been regularly reviewed within a reasonable period of time (2-4 weeks).

Trainees:

  • High Intensity IAPT trainees should also receive during their two-day attendance on the course, additional in depth supervision of training cases, usually in groups of two to three trainees, and lasting for around 1.5 hours per week.
  • Low Intensity IAPT trainees should also receive, in addition, to case management supervision, both individual and group supervision aimed at case discussion and skills development. This should normally be around 1 hour per fortnight.

Supervisors:

Supervisors should have a working knowledge and experience of the interventions for which they are providing supervision. Where there are gaps in experience (e.g. low intensity working), these might be addressed by supervisor training and familiarisation with specific services.

Supervision of trainees will be shared between supervisors who might be university-based and provide specific input into training cases, and supervisors providing routine clinical supervision within the service. Clinical directors and course directors should ensure that appropriate governance arrangements exist for all supervision provided and where appropriate university-base supervisors have honorary contracts etc.

IAPT is commissioning short training courses (5 days) for supervisors within IAPT services, although these are not currently available in all SHA regions. It is expected that most IAPT supervisors will eventually be trained around the specifics of supervising within an IAPT service by attending one of these courses. Courses will address IAPT requirements for supervision of both high intensity practitioners, together with case management supervision for the low intensity practitioners.

Other considerations:

  • Low intensity practitioners should have access to an experienced supervisor to consult on assessment and risk issues. Clinical decisions to either step up treatment to high intensity, discharge or refer on to specialist services will need to be discussed within regular case management supervision.
  • Services should consider how they support their supervisors and ensure that they have sufficient time and adjusted caseloads to allow them to provide quality supervision. They should also have access to peer/group support and continuing professional development.
  • All staff should access to professional and managerial supervision, as appropriate to their role, which will be in addition the clinical supervision arrangements detailed above.
  • It should also be stressed that the number of hours of supervision identified within this document are the minimum recommended for full-time staff. Flexibility should be adopted for staff on part-time contracts or with reduced caseloads arising from other non-clinical responsibilities.
  • A named senior therapist should be responsible for overseeing and monitoring the effectiveness of supervision provided within the IAPT service, in conjunction with the Clinical Director and Course Directors concerned.

Future supervision guidance is provided will include the different forms of supervision expected within an IAPT service and the importance of issues such cultural sensitivity and how supervision can be tailored to meet the needs of clients, supervisees and the service.

Download the IAPT Supervision Guidance December 2008

Education, Training and Development

Strategic Health Authorities have commissioned Higher Education Institutions to deliver the training, which will use the low and high intensity curricula. Existing courses for graduate workers and CBT therapists are being reviewed to ensure they fit the IAPT model.

An audit tool for assessing Cognitive Behavioural Therapy courses and the Cognitive Behavioural component in Clinical Psychology Programmes is being developed by BABCP and BPS. It will be available at the end of summer 2008.

IAPT and the Wider Workforce

Person centred values and psychological awareness are being factored into local training strategy and implementation plans to raise the psychological awareness and person-centred values among primary and secondary care staff. The 10 Essential Shared Capabilities is a useful starting place for this work; new guidance on what is required for those who work at Step 1 in primary care and in local communities is also expected.

Accreditation by Professional and Regulatory Bodies

Seven professional bodies are engaged in a significant piece of work preparing a system of accreditation for the IAPT workforce. They are:

Further Resources for Workforce Development

Workforce redesign underpins the development of new services and these NIMHE Workforce Programme resources may be useful:

 

Workforce Frequently Asked Questions

This list is regularly updated with questions from IAPT sites and stakeholders , answered are provided by the IAPT National Team and advisors.

We would welcome further questions or request for clarification these  can be emailed to IAPT@dh.gsi.gov.uk or you can post a comment using the form below .

The following is provides as a series of frequently asked questions for people interested in training /job opportunities

How can I determine which training / job opportunities I am suitable for?

Further information including, IAPT job descriptions , Person Specifications, accreditation process & course curricula, is available on: http://www.iapt.nhs.uk/services/workforce/

To become a High Intensity trainee, you will need to have had considerable experience and training in providing psychological therapies. Some of the staff who would be considered might currently be working as nurses, occupational therapists & social workers, counsellors, experienced graduate workers, psychotherapists or newly qualified clinical psychologists.

For the Low Intensity trainees, we would be looking for people, who have preferably worked in local mental health services or local communities, who can demonstrate that they can meet the academic levels in the training programme and are interested to work with this client group. These can be graduates or non graduates.

To date, for both groups of staff, we have had a very high level of interest.

How can I apply for IAPT jobs/trainee posts?  

More than 700 people commenced new training posts in  Autumn 2008 ,  recruitment took place in summer 2008.

However some IAPT services will still  advertising roles for qualified staff; these can be found on NHS Jobs , http://www.jobs.nhs.uk/ search with the keyword : IAPT

It is likely that there will be posts advertised for staff, who have already trained and have the level of skills and competency required and can start working in IAPT services, as well as for trainees.

New or expanded IAPT sites for 2009 have yet to be determined by Strategic Health Authorities. These will be announced in Spring 2009 and recruitment will begin for job/training opportunities at that time so it is advisable to register yourself on NHS Jobs http://www.jobs.nhs.uk/ 
 for forthcoming opportunities.

Registration the NHS jobs site with the Keyword IAPT means opportunities will be emailed directly to you as soon as they become available.

Can I apply to attend training courses independently?

Places on the IAPT courses are limited to those employed by the new IAPT services. The posts which people apply for are trainee positions which have the training linked to the posts. This ensures trainees are working in a stepped care model of service delivery, have an appropriate caseload and supervision for their professional development . We would ask you not to contact training organisations directly.

 

 

 

 

 

 

 

Events

 Improving Access to Psychological Therapies (IAPT) programme hosts events to support the work of the programme and its stakeholders regionally and nationally .

Details of past and future events can be found by following the links on the right of the page, If you wish to promote an event please contact us

Protected: Resources for SHA , PCT , RDC Leads and IAPT sites

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Resources for PCTs/SHAs

These pages contain information for IAPT implementation available for IAPT Regional Development Centre Leads and Strategic Health Authority IAPT Leads who request a password from iapt@dh.gsi.gov.uk

To access the members only area <click here > you will be prompted for your password

An alternative page is provide for Service Leads and Training Providers including a dicussion group is available at click here

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Read our privacy policy

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Please let us know if you wish to link directly to pages on the IAPT website by emailing the team at IAPT@dh.gsi.gov.uk

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We may at any time revise these terms and conditions without notice. Please check regularly. Continued use of IAPT.nhs.uk after a change has been made is your acceptance of the change

Useful Links

British Association for Behavioural and Cognitive Psychotherapies. British Association for Behavioural and Cognitive Psychotherapies. (BABCP) The lead organisation for cognitive Behavioural therapy.

www.babcp.com

Department of Health Website

www.dh.gov.uk

New Savoy Partnership . Organisations working together to bring psychological therapies to the NHS and improve access for all who need them. It comprises professional bodies, charities, service providers and welcomes other partners

http://www.newsavoypartnership.org/

NHS Jobs

http://www.jobs.nhs.uk/

NHS Choices Official site of the National Health Service. Get expert information on conditions, treatments, local services and healthy living.

www.nhs.uk

National Institute for Health and Clincal Excellence (NICE) Clinical Guidelines on mental health and behavioural

http://www.nice.org.uk/guidance/index.jsp?action=byTopic&o=7281

We Need to Talk is a campaign by five leading mental health organisations to increase investment in and widen access to psychological therapies on the NHS.

http://www.weneedtotalk.org.uk/

Royal College of General Practioners

http://www.rcgp.org.uk/

Time to Change

Time to Change is England’s most ambitious programme to end discrimination faced by people who experience mental health problems.

http://www.time-to-change.org.uk/about-us

Veterans

People leaving the Armed Forces become the responsibility of the NHS although the Ministry of Defence meets the individual costs of treating some veterans for conditions related to their service.

The NHS provides most of the support and intervention required, through both General Practitioners and specialist services. The Ministry of Defence also provide a range of services, including a network of Regional Welfare Workers, access to psychological help and residential care at one of the three centres run by Combat Stress, a charity largely funded by the MoD.

This is appropriate as many servicemen express a strong preference for their health needs, both during and after active service, to be met within the military network.

The Department of Health is working closely with the Ministry of Defence to ensure that our two services work more closely together and is piloting new arrangements aimed at improving access for veterans in six mental health trusts. Theses pilots will be evaluated and lessons learnt with a view to rolling out best practice nationally.

In March 2009,  the Improving Access to Psychological Therapies ( IAPT) programme published the commissioning guidance for Veterans .

In November 2008 guidance was produced for  Commissioning for the Whole Community PDF 300K

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New Improving Access to Psychological Therapy Sites and Training Providers 2008

In 2008/09, 35 Primary Care Trusts (PCTs) will receive a share of the £33 million first instalment of new money announced by Health Secretary Alan Johnson on World Mental Health Day last year.

The funds will help the NHS create a new workforce to offer properly supervised low intensity therapeutic interventions and high intensity therapy, slashing waiting times and helping patients achieve recovery they can clearly see.

This recovery will be in line with the evidence from clinical trials that has been independently reviewed by the National Institute for Health and Clinical Excellence (NICE).

The country’s 10 strategic health authorities have each chosen between two and five Primary Care Trusts (PCTs) to take this forward and commissioned higher education institutions to deliver the newly developed national curricula for high- and low-intensity therapy workers from the autumn.

More PCTs will join the Improving Access to Psychological Therapies programme as further money comes on stream in the next two years - a total of £103 million in 2009-10 and rising to £173 million in 2010-11.

The successful PCTs chosen to take part in the first year are:

North West
Eastern and Central Cheshire
Western Cheshire
Knowsley
Salford
East Lancashire

Regional Training Providers: Greater Manchester West Mental Health NHS Foundation Trust in conjunction
with the University of Manchester. University of Central Lancashire Liverpool John Moore’s University, University of Chester, University of Cumbria

South West
Bournemouth and Poole
Cornwall and the isles of Scilly
Dorset
Swindon

Regional Training Providers: University of Plymouth, University of Exeter

East of England

Bedfordshire
Cambridgeshire
West Hertfordshire
Suffolk

Regional Training Providers: University of East Anglia, University of Hertfordshire, Anglia Ruskin University

Yorkshire and Humber
North Lincolnshire
Leeds
East Riding
Sheffield

Regional Training Providers: University of York (HI/LOW), University of Sheffield (HI/LOW)

East Midlands
Nottingham City
Lincolnshire

Regional Training Providers: University of Derby (HI), University of Nottingham (LOW)

London
Camden
City and Hackney
Ealing
Southwark
Haringey

Regional Training Providers: Institute of Psychiatry/University College London, Royal Holloway/Central North West London MHT

West Midlands
Dudley
Shropshire
Stoke

Regional Training Providers: Birmingham City University (LOW), University of Birmingham (HI)

South East Coast
East Sussex Downs and Weald
Hastings and Rother
Brighton and Hove City
West Kent (locality)

Regional Training Providers: University of Brighton (HI), Salomons (Canterbury Christ Church University) H/Low

South Central
Buckinghamshire (locality)
Berkshire West (locality)

Regional Training Providers: University of Reading (LOW/HI)

North East

South Tyneside
North Tyneside

Regional Training Providers: University of Newcastle

Older People

Older People

There is a good range of evidence supporting the effectiveness of psychological therapies in treating mental health problems among older people.

The IAPT Pathfinder sites Buckinghamshire PCT, Stoke PCT, East Riding and Hertfordshire have demonstrated that older people can and will access psychological treatments provided that appropriate, proactive approaches are used to raise their awareness of the service and engage them with it, and to ensure staff have the correct training.

The positive practice guidance developed by the Pathfinder sites and Special Interest Groups

In November 2008 guidance was produced for  Commissioning for the Whole Community PDF 300K

Experts in each of these areas, working together as Special Interest Groups, have produced  short Positive Practice Guides giving ‘top-tips’ on commissioning  IAPT services for those specific communities.

Older People

Children and Young People

Child at Play

Improving Access to Psychological Therapies for children and young people has been investigated by the following Pathfinder sites and Children and Young People Special Interest Group:

  • Bury PCT

Positive practice guidance will be published in October 2008 and offer measures of health outcomes from psychological therapies tailored to children and young people. It will also explore:

  • specific barriers and
  • positive benefits

relating to psychological therapies for children and young people and consider appropriate workforce and service flexibility to meet their needs.

Children and Young People

Medically Unexplained Symptoms

Long Term Conditions

Medically Unexplained symptoms (MUS) commonly present in primary care and result in a considerable use of health resources. There is randomized controlled trial evidence that improving access to psychological therapies for people with such symptoms may improve function and reduce health expenditure.

Along with the Pathfinder site, Stoke PCT, the IAPT MUS Special Interest Group has been exploring:

  • Benefits
  • Recognition and treatment strategies
  • Economic issues

relating to delivering psychological therapies to people with medically unexplained symptoms.

In November 2008 guidance was produced for  Commissioning for the Whole Community PDF 300K

Experts in each of these areas, working together as Special Interest Groups, have produced  short Positive Practice Guides giving ‘top-tips’ on commissioning  IAPT services for those specific communities.

Download the Medically Unexplained Symptoms Positive Practice Guide PDF300K

Perinatal - New Mothers & Fathers

Mother, Father & Baby

Improving Access to Psychological Therapies for new mothers and fathers can reduce distress caused by antenatal and post-natal depression or anxiety, which can have both short and long term consequences for the family and the child.

IAPT Pathfinder sites and the IAPT Perinatal Special Interest Group have been examining:

  • specific barriers and
  • positive benefits

for new mothers and fathers and considering the appropriate workforce and service flexibility that will meet their needs.

In November 2008 guidance was produced for  Commissioning for the Whole Community PDF 300K

Experts in each of these areas, working together as Special Interest Groups, have produced  short Positive Practice Guides giving ‘top-tips’ on commissioning  IAPT services for those specific communities.

Offenders

Primary Care Trusts have a responsibility to ensure the health needs of offenders are effectively met, including Improving Access to Psychological Therapies for depression and anxiety disorders.

The IAPT Pathfinder site in Dorset PCT and the IAPT Offender Special Interest Group have examined:

  • specific barriers and
  • positive benefits

for offenders and considering how to develop appropriate workforce and service flexibility to meet their needs.

In November 2008 guidance was produced for  Commissioning for the Whole Community PDF 300K

Experts in each of these areas, working together as Special Interest Groups, have produced  short Positive Practice Guides giving ‘top-tips’ on commissioning  IAPT services for those specific communities.

Download positive practice guidance Offenders PDF 300K

Other positive practice guides

Long Term Conditions

Testing

People with long term conditions including

  • Cardiology
  • Chronic Obstructive Pulmonary Disease
  • Diabetes
  • Pain
  • Chronic Fatigue Syndrome / ME
  • Arthritis
  • Sickle Cell and other genetic disorders
  • Irritable Bowel Syndrome
  • Headache and other neurological conditions
  • Stroke

may benefit from psychological therapies, with improved outcomes for their physical condition as well as their mental health.

In November 2008 guidance was produced for  Commissioning for the Whole Community PDF 300K

Experts in each of these areas, working together as Special Interest Groups, have produced  short Positive Practice Guides giving ‘top-tips’ on commissioning  IAPT services for those specific communities.

The Special Interest Group has supported work in the following Primary Care Trust areas:

  • East Riding of Yorkshire
  • North Tees
  • Dorset
  • Hertfordshire
  • Stoke
  • Salford

Black and Minority Ethnic (BME) Communities

Black and Minority Ethnic (BME) Communities

Services need to understand the particular requirements of people accessing them. Individuals from BME communities may have specific language, cultural and religious requirements, which should be met if the service is to be both appropriate and effective.

Services should therefore be provided in community-based, non-stigmatizing and culturally sensitive settings in which:

  • Equality, diversity awareness and competency training is given to all staff
  • Advocates and/or interpreters are available
  • Information is provided in a variety of formats and languages
  • Services in a culturally-relevant format are accessible to local people

In November 2008 guidance was produced for  Commissioning for the Whole Community PDF 300K

Experts in each of these areas, working together as Special Interest Groups, have produced  short Positive Practice Guides giving ‘top-tips’ on commissioning  IAPT services for those specific communities.

Other positive practice guides

IAPT Pathfinder Programme

The Department of Health extended the Improving Access to Psychological Therapies (IAPT) programme in 2007/08, supplementing the early successes of the two IAPT Demonstration Sites Doncaster and Newham.

Three-quarters of the country’s primary care trusts wanted to join and half sent in a fully-worked up bid. Funding was limited and 11 were chosen to take part. They used service redesign techniques to develop

  • a defined care pathway
  • service specification
  • service framework and
  • routine outcome monitoring .

Each Pathfinder site also identified an interest in addressing the specific barriers and positive benefits for improving access to psychological therapies for particular sections of their local population. Experts were invited to support these PCTs through special interest groups offering advice and support focussed on the needs of the specific sections of local communities.

The PCTs and the special interests are:

  • Derby PCT: Black and Minority Ethnic Communities
  • Ealing PCT: Black and Minority Ethnic Communities
  • East Riding of Yorkshire PCT: Older People , Long Term Conditions
  • Hertfordshire PCT: Older People; Perinatal – New Mothers and Fathers; Long Term Conditions
  • Buckinghamshire PCT: Older People
  • Stoke PCT: Older People, Medically Unexplained Symptoms
  • Salford PCT: Perinatal – New Mothers and Fathers; Medically Unexplained Symptoms
  • Dorset PCT: Offenders; Long Term Conditions
  • Brighton PCT : Young People LGBT
  • Bury PCT: Children and Young People
  • North Tees PCT: Long Term Conditions

Evaluation of the Pathfinder sites will be published in October 2008

Demonstration Sites

Doncaster and Newham became national demonstration sites in 2006. Their mission was to test the effectiveness of providing significant increases in evidence-based psychological therapy services to people with the common mental health problems of depression and anxiety disorders.

Their aim was to improve health and well-being and either to keep people in work and joining in community activity or to or return them to it.

Doncaster PCT

Doncaster provided enhanced access to low intensity Cognitive Behavioural Therapy (CBT) interventions. Case managers are supervised by a psychological therapist. Referrals are received from a range of primary and community settings (e.g. GPs, Job Centre Plus, employers) and services are provided both in primary care and at the team base.

In 2006/07, Doncaster developed a comprehensive stepped care model of psychological therapy provision, including frontline services provided by case managers supporting over 4,500 people.

Newham PCT

The East London and the City Mental Health Trust (ELCMHT) provided a comprehensive CBT psychological therapy service to people presenting with common mental health problems in General Practices across the Borough.

The service was delivered by CBT-trained therapists and provided either in the individual’s practice or in a local treatment centre. Local employers access the service to help people stay in employment.

The programme is complemented by increasing access to Employment Coaches provided by Mental Health Matters (MHM).

In 2006/07, Newham treated an additional 800 people, developed culturally sensitive CBT interventions and a further 600 people were supported in seeking to return to work.

The sites have now been running for over twelve months and have recently released their first evaluation reports.

Primary Care

Primary Care

Strategic Health Authorities each have a Primary Care lead with a special interest in what IAPT can achieve for patients in primary care settings.

GPs warmly welcome IAPT services as they extend the range of interventions and the choices available to their patients.

Close links between GP practices and IAPT services are valued in the pilot sites and a number of resources are in development to support Practice Based Commissioning and supporting New Ways of Working in Primary Care.

Practiced Based commissioning to improve primary care mental health delivery »

On 10 October 2007, the Secretary of State for Health, Alan Johnson, announced new funding of £170 million to develop Improved Access to Psychological Therapies (IAPT).

As part of that announcement, he said that this money would be used to train 3,600 new therapists, treat 900,000 people with common mental health problems, and that, for those primary care trusts covered by the developing service, it would allow open access to GP referral.

In July 2008, the Department of Health published the final report of the Next Stage Review of the NHS, which included the development of primary and community services. At the heart of the policy is the development of World-Class Commissioning and Practice-Based Commissioning.
Primary care professionals know that the provision of high-quality psychological therapies is essential for the delivery of holistic care for people with a range of problems, from depression and anxiety disorders, through to those with medically unexplained symptoms and long-term conditions such as diabetes and ischaemic heart disease.

This collection of documents, templates, presentations, research papers and good practice examples provides the practice-based commissioner with all the information needed to commission an IAPT service for their community. It will allow the practice-based commissioner to develop a service specific to their local area, which will deliver a psychological therapy service that is in line with best evidence-based practice, as described by the National Institute for Health and Clinical Excellence and set out in the IAPT commissioning guide.
It provides the background information, including the published references to support the programme, and a template for the business plan that the commissioner will need to submit to their primary care trust. It also provides a tool to commission services for people with medically unexplained symptoms, as well as some proposals for good clinical practice based on published evidence.

Forward by   David Colin-Thomé OBE National Clinical Director for Primary Care

Background for IAPT and evidence
Whats in IAPT for GPs and Primary care Staff
Long Term Conditions and Positive Practice Guide
Reducing Hospitalisation

Pratice Based Commissioning for IAPT
A business case for IAPT
Economic Calculator

Medically Unexplained Symptoms
A guide to choosing psychological therapies in Ealing
Ealing Directory of Counselling Services
Ealing primary care mental health and wellbeing
Dorset Stepped Care referal guide
Looking forwards:
PHQ9 and GAD7

 

Primary Care GP

Measuring Outcomes

A key characteristic of an IAPT service is the effort individual therapists put into demonstrating the outcomes that are delivered.

Routine outcomes measurement is central to improving service quality - and accountability.

It ensures the person having therapy and the clinician offering it have up-to-date information on an individual’s progress, which is of therapeutic value in itself. At an overview level, where individual patients are anonymised, service providers and commissioners can see a performance pattern for the service, which can be publicly reported.

The IAPT Outcomes Toolkit being published shortly covers:

1. Importance of collecting routine outcomes data
2. What information should be collected
3. How information will be collected
4. How the data can be used: data flows and reporting
5. Information governance and consent

The following products are associated with IAPT Outcomes Management and Reporting

IAPT Outcomes Toolkit
IAPT sites in 2008/9 will begin collecting outcomes data from their commencement in September 08. This data will support the business case for further expanding IAPT and provide Key Performance Indicators that PCTs will be expected to complete quarterly.
For guidance including  the IAPT Minimum Data set and guidance on outcomes management and data systems click here

IAPT Key Performance Indicators Technical Guidance
The IAPT KPIs provide the agreed mechanism for demonstrating regional and national progress against the public commitments that were made when the Secretary of State (SoS) for Health announced additional funds rising to £173million for improving access to psychological therapies in the Comprehensive Spending Review (CSR) 2007.The Review of Central Returns Steering Committee – ROCR (reference number ROCR/OR/0231) has approved this data collection.

For IAPT Technical Guidance and specifications please click here

IAPT Data Quality Assurnace Process and Metrics
IAPT services have compelted a self assessment of their ability to provide data of sufficient quality to manage outcomes and report quarterly   IAPT Data Quality Metrics to accompany IAPT Key Performance Indicators

For more information click here

Involving People

Involving People

People who use psychological therapies services and those who care for them have a great deal of expertise to offer commissioners and clinicians planning and delivering IAPT.

Meaningful involvement requires time and investment.

To ensure equity of access, people using psychological services and those who support them need to :

  • Be well informed
  • Have choices about what exists in their local area
  • Be clearly signposted to services that best fit their needs
  • Know how to give feedback about the quality of services they have received

We would be very glad to hear from you if you have any suggestions or comments of how Involving People has worked in your local area, simply email us at: IAPT@dh.gsi.gov.uk.

Employment

Dame Carol Black’s 2008 review of the health of Britain’s working age population Working for a healthier tomorrow highlighted inadequate support for patients with early stages of illness.

This includes those with mental health conditions, which affect well over half the people who need the support of incapacity benefit and often affect people who have physical health conditions too.

IAPT pilot sites in Doncaster and Newham fulfilled expectations in helping people off statutory sick pay and back into work.

These employment support services should help their clients access psychological therapy services:

  • Local Pathways to Work, including Conditions Management Programmes
  • Job Centre Plus
  • Occupational Health Services
  • Voluntary sector organizations supporting employers and employees
  • Unions and employee representation groups

Commissioning

Commissioning

Commissioners are important local leaders in the NHS, specifying how psychological therapies and other services should be delivered and promoting health and wellbeing through strong partnerships with professionals, local government, employment services, people who use services and those who support them.

The IAPT programme gives commissioners a good opportunity to collaborate with providers from all sectors and find genuinely innovative ways of meeting local people’s common mental health needs and the routine collection of outcomes data ensures they can demonstrate progress quickly and clearly.

The Improving Access to Psychological Therapies (IAPT) Commissioning Toolkit can help PCTs improve or establish stepped care psychological therapy services following NICE guidelines.

Publications


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