Research reveals £400m Government investment in psychological therapy falls short of claims
A research paper published today (Monday, June 24, 2013) by the University of Chester’s new Centre for Psychological Therapies in Primary Care finds that claims made for the success of the Government’s £400m investment in its Improving Access to Psychological Therapies (IAPT) programme are optimistic.
Norman Lamb, the Minister of State for Care Services, repeated the claim that ‘recovery rates are in excess of 45%’ in his foreword to the Department of Health’s recent ‘IAPT Three-Year Report’. However, Professor Patrick Pietroni, Director of the new Centre, writes today in an article for the Public Service Review: Health and Social Care: ‘The preferred measure of Key Performance Indicators for IAPT is the percentage of patients ‘moving to recovery’ as a proportion of those who completed treatment – at first sight, an impressive percentage of 44%’.
But Clinical Commissioning Groups, now responsible for commissioning mental health services, will want to know what happens to all the patients GPs refer, not just the far lower proportion of patients who complete treatment, Professor Pietroni argues. The claims do not take account of a high dropout rate. He writes: ‘If claims are to be made about population health outcomes, then the denominator should be the widest possible. The Centre therefore applied the denominator ‘patients referred’. Using this, ‘the moving to recovery’ outcome rate is 12%’.
He added: “A 2012 report by the Centre for Social Justice (founded by Ian Duncan Smith, Secretary of State for Work and Pensions) came to a similar conclusion but presented it more negatively.
“IAPT figures claim recovery as over 40 per cent… but from the point of view of commissioners and referring GPs, 86 per cent are not being helped by the IAPT service.”
Professor Pietroni concluded: “These points are not trivial. An earlier study of progress made by sites in the first rollout year of the programme (2008/9) suggests that 53% of referrals had one or fewer contacts with the programme, including 42% who were not assessed. Recognition and understanding of the needs and experience of these patients is as important as measuring the outcomes of those who completed more than one treatment session.
“Commissioners of psychological therapies in Primary Care will want to exercise their own judgement as to which of these figures offers transparency to support analysis of outcomes.
“As the Centre for Psychological Therapies in Primary Care concludes, given the level of investment and the claims made, it is imperative that outcome data should be widely available in a form that helps commissioners to understand the nature of the patient journey through IAPT from referral.”