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Maintaining the momentum. Dr Alan Cohen GP and Primary Care Adviser to IAPT. Agenda. Savings to the NHS IAPT Clinical Record Currency and Tariff Wider impact . Savings to the NHS. Efficiency and cash savings of £600-£15,000 on average per patient successfully treated
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Maintaining the momentum Dr Alan Cohen GP and Primary Care Adviser to IAPT
Agenda • Savings to the NHS • IAPT Clinical Record • Currency and Tariff • Wider impact
Savings to the NHS • Efficiency and cash savings of £600-£15,000 on average per patient successfully treated • 3-5 fewer GP consultations • 1-2 fewer inpatient bed nights • 1 less outpatient procedure
IAPT Clinical Record • Sessional measurement of condition • Therapeutic in itself • Patient experience • Impact on • Employment/ purposeful activity • Physical symptoms (long-term conditions/ medically unexplained symptoms)
Long-term conditions • Strong link between physical long term conditions and psychological distress/disorder • Co-morbidity increases health care consumption, and self perceived patient need • Psychological treatment improves outcomes and reduces health care consumption • NICE recommends the use of psychological interventions in people with LTCs • e.g. Depression is twice as common in people with diabetes than the general population
Medically unexplained symptoms • People with medically unexplained symptoms have significant psychological distress • People with MUS have increased use of health care resources • MUS cost the NHS £3 billion (08/09) • Psychological treatments help people with MUS • There is no NICE guideline for MUS
Supporting the policy context • Equity and Excellence White Paper - Towards GP Led commissioning & PbR tariffs • Quality Innovation Productivity & Prevention (QIPP) agenda • Mental Health strategy - 2010 • IAPT and talking therapies
The White Paper • GP led commissioning - Joint work with the RCGP and RC Psychiatrists, including ADAS and NHS Confederation PbR • Development of mental health PbR tariffs • Development of care clusters • Moving towards outcome based tariffs
Talking therapies – next phase • Development of outcome based tariff • Development of other talking therapies • Increase access to: • Children and adolescents • People with physical health problems • People with severe and enduring mental illness
Suite of commissioning tools • IAPT currency and tariff • CQC • Monitor • Contract service specification • CQUIN 10
Currency and Tariff • Four currency outcomes • Access • Recovery/improvement • Employment/vocation • Choice and satisfaction 11
Next steps • Test the new clinical record (Demonstrate the data can be collected) • Test the currency and tariff assumptions • Alignment of IAPT to Care Clusters
Wider impact • For the individual – recovery, purposeful activity, effect on family/friends • GP and local NHS – more efficient • Local community • The Exchecquer