Somerset Partnership NHS Foundation Trust. An IAPT Demonstration Site for Personality Disorder.

1. Relational Recovery: A Treatment Approach for Personality Disorders across Primary and Secondary Care Somerset Partnership NHS Foundation Trust.An IAPT Demonstration Site for Personality Disorder.

2. What are we doing and for whom?Creating a locally-designed approach to PD across the whole care pathway. Building psychological mindedness in generic community and inpatient teams, , backed by ‘Guided Formulation’, supported by embedded specialist workers – Personality Disorder Locality Leads. In primary care we usegeneric therapy and counselling models enhanced by our in-house ‘Guided Formulation’.In secondary care we use CAT, CBT, Art Therapy, Psychodynamic Therapy and Group Analysis.

3. Whole-systems approach (from primary care through to inpatient wards): eg, adapted DBT Based Emotional Skills Groups, and our Guided FormulationCoordinated point of access to psychological therapies in primary care and secondary / tertiary mental health services: no more bouncing between services. Senior Clinical Review Panel to help teams look at the treatment for people whose treatment has become ‘stuck’ for any reason – many of these are people with PD. New full-time Service User Involvement Lead

4. Our key deliverables: Building provision for people with PD, across the spectrum of severity, using senior clinical leadership to work across the ‘whole system’ by harnessing local expertise Developing from scratch the role of service users with PD in service development and delivery and publications Demonstrating the performance of Primary Care Talking Therapies for people with PD; including evaluation using MDS, SAPAS, PEQ and Family & Friends Test. Enhanced performance management using our ‘MORES’ approach and using QIPP principles Development of e-learning for GPs and GP receptionists

5. Early Challenges:Developing and collecting data sets across different areas with different systemsDeveloping effective and user friendly methods of collecting the dataWebsite development Ensuring sustainability – eg, staff turnover – keeping up with the need for training

6. Early Findings Primary Care: • 87.8% of people receiving Step 3 Psychological Therapies other than CBT scored a SAPAS 3+ indicating a relatively high level of PD in this area of primary care • Moderate scores for depression and anxiety • Sub threshold for phobias • Significantly low mental wellbeing • Significant functional impairment • Poorer health status

7. PD Service: • Job Satisfaction: Baseline at 77% satisfaction • Family & Friends Test: Staff reported being Extremely Likely (58%) and Likely (42%) to recommend service to family and friends • Clinical Supervision: Staff receive an average 2.25 hours per week • Sickness/Absence: Average 0.34% in last 6 months (National average is 2.6%) Guided Formulation 160 service users have had a Guided Formulation, providing a psychologically mindedness approach to treatment and treatment planning.

8. Emerging PD Service: Early findings using the MORE (Measuring Output Reporting Evidence) evaluation show a trend towards reduction in psychiatric admissions and other health utilisation, improved quality of life and reduced cost. Reponses to input around PD: Almost universally positive response from teams and individual staff to training, supervision and guidance around PD in primary and secondary care, across all staff groups and levels of experience and training.

9. We are holding an open day event on: Thursday 25 April 2013 For further information and to book a place contact Chris Gordon 0771770148 PDService@sompar.nhs.uk