Psychological Therapies in the NHS
Wednesday 3 February 2016 — Thursday 4 February
Millennium Conference Centre, London
A limited number of FUNDED FREE PLACES are currently available on a first come first served basis for IAPT Managers/Clinical Leads or Commissioners when booked at the same time as a full paying colleague – bookings need to be emailed to firstname.lastname@example.org quoting hcuk241iapt detailing the name and details of the paying delegate and the name and details of their IAPT colleague, commissioner/senior manager. (T&Cs apply)
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The theme for this year's conference is how evidence based therapy and welfare support will fare in a climate of austerity. As ever our line up of keynote speakers is unrivalled. We are also set for a fascinating discussion about the place of evidence based guidelines and the role of NICE, in particular, in the run up to a new Depression guideline in the making. Professor David Healy, a leading scientist in depression research, as well as a severe critic of the influence of the pharmaceutical lobby, will deliver the closing keynote on day 1, offering a radical critique of NICE"s evidence based guidelines. Professor David Haslam, Chair of NICE, will deliver our opening keynote on day 2, defending the vital importance of an independent body for quality standards, without which health inequalities would worsen.
-We need to find ways to operate the benign ratchet of government policy to build on what we achieved under the Coalition” Rt. Hon. Alistair Burt MP, Minister for Community and Social Care 12.10.15. In his first public statement on mental health priorities the new Minister singled out IAPT as one of the success stories he had inherited from Norman Lamb. Somewhat unusually he paid tribute to his predecessor for his personal commitment to mental health and for introducing waiting times in mental health as an example of what Burt calls 'the benign ratchet". By this he means policy levers that can continue to expand and improve provision of mental health services. Delegates to this year"s conference will be able to hear more detail about government plans directly. The BBC"s Mark Easton will be primed to interrogate the Minister on the outcome of the Comprehensive Spending Review. Will we see an upwards shift in the budget for mental health overall? Will the benign ratchet see an increased proportion allocated to talking therapies, and who will benefit from this? Will the new government take a fresh look at where there are gaps in provision, for example, or will it be left to whoever has pushed their way to the front of the queue?
It so happened that sitting next to me in the Committee Room in Parliament at that event was a journalist. He told me he was receiving treatment for depression in an IAPT service. How long had he had to wait? Six months. Had he been offered a choice of therapy? No, he was told he needed CBT. Had he been told what the other NICE-approved options were so he could be involved in that decision? No. He was just grateful to be offered any therapy. Given we had the Minister in front of us it was a good opportunity to use his own example. What happens when an IAPT service provider is not meeting the waiting times target (6 weeks) – will the patient or their GP be able to choose an alternative provider who can? What happens if an IAPT service provider is not able to offer the patient"s preferred choice? Everyone welcomes the fact that three million people have been able to access IAPT since it started but the equally compelling fact remains that two million people did not recover. When Lord Layard set out the case for IAPT originally it was based on meeting unmet need. So who will meet the needs of those two million people who still need help? The Minister gave a cautious answer: yes, he acknowledged, the system may not be working for everyone as well as we would want, and he wouldn"t just rely on what the statistics were saying e.g. on waiting times; he wanted to talk to patients and therapists directly. We can expect him to have formed a view about the benign ratchet for IAPT should now work by the time of the next conference.
One thing for sure is that this government intend to make welfare savings, and that this will have a major impact on people with mental health issues in receipt of welfare benefits. Whatever happens to IAPT, if help and support fails to reach people now at risk of benefit sanctions we have all failed in our task – across the whole of mental health and social care. Two years ago the Minister for Welfare Reform, Lord Freud, spoke at the conference and announced a series of pilots into different ways of offering access to talking therapies for the population on welfare benefits and this year he returns to tell us their results. He will also set out a strategy that will require joined up working between the two Departments, Health and Work and Pensions, overseen by a new Joint Health and Work Unit. Equally, the leadership and practitioners in mental health and social care will need to look outside their own silos if we are going to provide an integrated offer of support to those most in need. If you think following an evidence-based protocol is all you need to do, think again!