Improving Access to Psychological Therapies (to give it its full name) is a government programme set up to treat the 6.1M people estimated to be suffering from depression and/or anxiety in England.
The current programme is set to run until the end of March 2015 and IAPT has been providing quarterly figures on it’s Key Performance Indicators since April 2011; here are the key things you need to know about the KPIs:-
- The programme uses recognised scoring systems1, to determine whether or not a patient is “at caseness” i.e. is suffering from anxiety or depression.
- Patients are deemed to be “moving to recovery” when their scores shift to show they are no longer “at caseness”.
Simply put, “caseness” = suffering and “moving to recovery” = better
The Executive Summary issued with the latest set of figures, confirms the aim of the programme is for at least 50% of those completing treatment to be “moving to recovery”. Currently they report (data quality issues not withstanding) that they expect 3.2 million people to access IAPT over it’s lifetime, 2.6m of these to complete a course of treatment, and therefore 1.3 M to achieve recovery; a figure which represents only 21% of the total 6.1 million sufferers. But actually we may never know the final results because the reporting mechanism has changed from 1/4/13 with the cessation of PCTs and I suspect we may find that that the new IAPT dataset does not allow like for like comparisons – maybe that’s a cynical view, but we’ll see.
In the meantime, , my own back of an envelope forecasts2 suggest that IAPT can expect 4M likely referrals by 2015, of which, 1.5M will complete treatment. However just over half a million of these (539,792) will have moved to “recovery” which represents 39%, of those treated rather than the targeted 50%. And if we go back to the figure of 1.6M suffers in total then the figure of recovery reduces to 10%.
Ultimately it seems as if the number of referrals to IAPT is greater than anticipated, but the recovery rate less than expected.
As I was writing this I was phoned by a man wanting sign me up to a website to be used by GPs to refer clients to talking therapies outside of IAPT as part of their new roles as commissioners. He wanted £299 to list my practice, and was not particularly interested in how I worked or what my experience was.
Al l of which leads me to conclude that IAPT has barely scratched the surface of number of people needing talking therapies, and that changes to the commissioning system are likely to reward advertisers rather provide any real choice of quality services to patients.
1 Patient Health Qestionnaire (PHQ9) for Depression and Generalised Anxiety Disorder (GAD7) for Anxiety.
2 Based on number of people completing treatment between April 2011 and March 2013.