The Improving Access to Psychological Therapies (IAPT) Programme

What is IAPT?

The Improving Access to Psychological Therapies (IAPT) programme was launched in 2008 by the Department of Health to support the NHS to implement National Institute for Health and Clinical Excellence (NICE) guidelines for people suffering from depression and anxiety disorders.

The programme supports the development of NHS services in England to improve access for the whole of the population to evidence based psychological treatments. It promotes the use of evidence based approaches and patient choice, use of a stepped care framework with embedded quality supervision and routine outcome measurement. The programme was targeted people of working age, but in 2010 was broadened to include adults of all ages along with the addition of IAPT for Children & Young People (C&YP).

Background to the IAPT programme

In 2006, the London School of Economics (LSE) Centre for Economic Performance published the Depression Report (2006), in which economist Richard Layard presented evidence outlining the impact and costs of not providing timely help to individuals suffering from common mental health problems. This report built on the work began at the start of the new millennium with the new NHS Plan (2000) and the National Service Framework for Mental Illness (1999) which clearly placed mental ill health and psychological wellbeing on the top list of NHS priorities. The Depression Report also resonated with mental health campaigning groups such as The Mental Health Foundation, MIND and the Sainsbury Centre for Mental Health (now The Centre for Mental Health) who were also highlighting concerns about the lack of access to talking therapies.

The IAPT programme started in 2006 with two demonstration sites in Doncaster and Newham focusing on improving access to psychological therapies services for adults of working age. In 2007, 11 pathfinder sites began to explore the specific benefits of services to vulnerable groups. These pilots provided the economic case for the programme by estimating that investment in psychological therapies could save the NHS up to £272million and the wider public sector would benefit by more than £700 million.

By 31 March 2011:

  • 142 of the 151 Primary Care Trusts in England had an IAPT service in at least part of their area and just over 50 per cent of the adult population had access
  • 3,660 new practitioners – a combination Psychological Well-being Practitioners (PWPS) & High Intensity Cognitive Behaviour Therapists (HITs) had been trained through new accredited training programmes
  • over 600,000 people started treatment, over 350,000 completed it, over 120,000 moved to recovery and over 23,000 came off sick pay or benefits (between October 2008 and 31 March 2011)
  • approved curriculums for further post qualification training in Interpersonal Psychotherapy; Couples Therapy for Depression; Counseling for Depression; Dynamic Interpersonal Therapy had been developed had been developed.

The strength of the original case for IAPT, and its ongoing collection of clinical evidence has ensured that the programme has continued to receive support. The publication of 'Talking Therapies: a four-year plan of action' in 2011, one of a suite of documents supporting 'No Health without Mental Health', the cross-government mental health strategy for people of all ages, outlines the continuing plans for IAPT between April 2011 to March 2015 to:

  • Complete the nationwide roll-out of psychological therapy services for adults.
  • Initiate a stand-alone programme for children and young people.
  • Develop models of care for people with long-term physical conditions, medically unexplained symptoms and severe mental illness.
  • Improve access for older people, people from black and minority ethnic backgrounds and other under-represented groups of people, such as deaf people and people with learning difficulties.

IAPT North West

To support the implementation of IAPT, local teams were established in each of the regions of England.

The North West Implementation team has worked with commissioners, universities, service providers, clinicians, and partners in social care and employment to support its 24 Primary Care Trusts to meet the workforce target of 532 new IAPT practitioners and trainees in place within the first three years by 2011.

The first Wave of implementation (2008-9) involved 5 PCT sites. This was followed by a further 11 PCTs in Wave 2 (2009-10), with the remaining 8 PCTs joining in Wave 3 (2010-11). Waves 4 to 5 (2011 – 2013) focussed on bringing the size of workforce up to the required numbers to meet the target of PCTs having capacity to provide a service to 15% of prevalence at any one time, and helping those PCTs who were experiencing difficulties in achieving this. Wave 6 (2013 – 14) has a focus on legacy planning, working to ensure that systems are in place to maintain the capacity of IAPT services, and further develop the capability of the workforce for the future.

Over this five year period 45 service providers and 8 Universities have been actively supported by the Regional Implementation Team.

To support this work the IAPT NW Collaborative was set up in 2008, and has successfully ran since this time with average attendances of between 50 -100. It has been an invaluable forum for sharing of experience, knowledge and decision making with the first wave sites providing insights into the rapidly developing model to share with and support subsequent waves. Showcasing successes and encouraging PCT sites to open report to the collaborative each month to reflect on progress has also been extremely helpful. The unique nature and role of the collaborative has enabled successful IAPT implementation and the development of innovations including the development of a regional to approach to recruitment, and a number of clinical projects.

Alongside PCTs and service providers, eight universities from across the region have worked together in a unique way, sharing expertise and supporting each other with the process of establishing accredited clinical training programmes. They continue to meet on a regular basis at the IAPT Education Board.

IAPT services in the North West
A list of IAPT teams and contacts in the North West is available on the IAPT website.

Regional developments & clinical innovation

IAPT North West has supported the development of a number of innovative clinical initiatives. These often involve partnership working, and aim to increase access to patients who traditionally experience difficulties accessing psychological therapies, and develop more integrated care pathways.

Building Networks Across the North of England: the Northern IAPT Practice Research Network (IAPT PRN)

The IAPT PRN brings together representatives from a number of psychological therapy services aligned to the 'Improving Access to Psychological Therapies' Programme in the North of England.

The network's mission is to generate practice-based evidence that will influence and influence the development of high quality evidence based psychological services in England. The network's aspiration is to develop a research culture through a 'bottom-up' process of research carried out in the front line of mental healthcare. The network will forge links with key stakeholders, funding bodies and policy makers in its goal to influence practice.

Key contacts

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