The Care Forum’s Voluntary Sector Service - is carrying out this survey on behalf of Bristol, North Somerset and South Gloucestershire Clinical Commissioning Group (BNSSG CCG). The survey questions tell you a bit more about the CCGs ideas for commissioning a new Improving Access to Psychological Therapies (IAPT) service. Your feedback will be used to help in developing the new IAPT service model. This survey is confidential – you will not be identified from your answers.

Introduction to IAPT

What is IAPT?
Improving Access to Psychological Therapies (IAPT) is a programme to support people of all ages who are experiencing low mood, anxiety and depression, stress, excessive worry or difficulties controlling emotions. These therapies are sometimes known as ‘talking therapies’.  Typical treatments include cognitive behavioural therapies, mindfulness, counselling, couples therapies, psychodynamic therapy, psychosexual therapy, and group-based support.

National priorities for service development and delivery
The national priority is to expand services so that at least 1.5 million adults can access care each year by 2020/21. Within this there is a specific focus on and increasing access for people with depression, anxiety issues, long-term physical health conditions and medically unexplained symptoms. There is a national commitment to improve quality and people’s experience of services and recovery rates, while reducing geographic variation between services and inequalities in access and outcomes across population groups. There is also a drive to supporting people to find or stay in work.

Local situation
The current contracts for IAPT jointly commissioned between Bristol and South Gloucestershire are delivered through 16 separate contracts as part of the model. Services are commissioned for all ages. The contract for North Somerset is different, with a contract with one provider.  Services are commissioned for adults only, with an additional 16-18 year old pathway to the adult services. The current contract terms are overdue for recommissioning for Bristol and South Gloucestershire. North Somerset’s contract will come to an end in March 2019.

BNSSG CCG wants to take this opportunity to re-design and re-procure a new IAPT service for the people of Bristol, North Somerset and South Gloucestershire. This presents an opportunity to improve the service without cutting the service or reducing the budget.

* 1. 1 – Values and approaches

BNSSG CGG aims to commission a single service with one lead provider and an outcomes-based specification, which places IAPT treatments into a wider social, cultural and economic context, by:

  • embedding equality
  • taking a holistic approach
  • offering a flexible and responsive service
  • deploying a wide range of approaches
  • providing a timely service
  • improving access to the service
  • improving recovery rates
  • communicating strongly

Based on your experiences of IAPT, do you think that these are the right principles and approaches?

* 2. Question 2 – Referral

The CCG wants the new service to be more holistic by linking in with other existing services, including:
  • primary care
  • secondary mental health services
  • other health pathways – long-term conditions, medically unexplained symptoms etc.
  • perinatal mental health pathway
  • social care
  • wellbeing and healthy lifestyles provision
  • social prescribing
  • welfare rights/debt advice
  • housing and homelessness services
  • sexual violence services
  • substance misuse services
  • employment and job retention support

Based on your experiences, how do you think this more holistic approach could work?

* 3. Question 3 - Geography and place

There are currently geographic inequalities and service differences in the provision of IAPT: your ability to access IAPT is disproportionately determined by where you live.

Based on your experiences, what do we need to think about that would help the service work better for everybody?

* 4. 4 - Learning and improvement

The CCG want to take an approach to monitoring and improving the service that:

  • sets local outcomes and performance indicators to satisfy national reporting requirements
  • learns from the current services
  • learns from South Gloucestershire’s research pilot
  • adopts practice from elsewhere
  • takes note of National guidance, research and review evidence
  • takes note of The experience of people who have used and not used IAPT services
  • proceeds by testing, exploring and experimenting

What would you like the commissioners to hear about your experiences that would help develop the new IAPT service?