Early Intervention in Psychosis Annual Report 2015-16
Waiting times and access standards can be used to measure and improve services as well as identifying an expected standard of care. In physical health, the NHS Constitution guarantees patients’ right not to wait more than 18 weeks for consultant-led treatment, but mental health treatment has historically been excluded. For the first time, in April 2015 NHS England committed to waiting time standards for mental healthcare, supported by £80 million of investment targeting first episode psychosis in 2015/16. The new access and waiting time standards require health systems to ensure >50% of people with suspected first episode psychosis receive a NICE recommended package of care within 14 days of referral.
Early Intervention in Psychosis (EIP) Teams were originally set up as part of the National Service Framework for mental health in the late 90’s but despite mounting evidence of their effectiveness, have seen a significant decline in resources over the years. The new EIP access and waiting time standards mandate a reinstatement of EIP teams, with a statute to deliver the range of evidence based NICE recommended interventions.
Purpose of Document
Developed in partnership with members of the South Region EIP Preparedness Clinical Group (Appendix 1), the purpose of this paper is to provide the reader with a single report that establishes local levels of psychosis incidence, current levels of performance against the new standard and the workforce skill mix and related training needs. The report intends to identify key areas of focus and also good practice, to help ensure equitable EIP services across the South Region.
The findings in this report are based on data submitted by EIP teams in the South Region between August and September 2015. Whilst some of the results are encouraging and reflect the commitment and compassion of front line staff and managers, there are significant areas that cause concern and require urgent action. The data brings into stark focus the major investment needed to build the workforce capacity and skill set to deliver the full range of NICE recommended interventions within EIP teams.
Of particular concern is the low provision of CBT for Psychosis, Family Interventions, and Individual Placement Support (IPS). Only 21% of the region’s caseload has access to individual psychotherapy such as CBT for Psychosis. This is lower than the national findings of the National Audit for Schizophrenia (NAS2, 2014) which found a total of 29% of those accessing mental health services had access to CBT for psychosis.2 Of the total 4,205 people accessing EIP services in the South Region, only 17% have been able to access Family Interventions and 41% have received support to attain or retain their employment or educational activities.
The above findings are unsurprising given the wide variation in the funding and staffing of EIP teams across the region. Differing commissioning priorities, provider history and practices appear to have culminated in a variety in structures and capacity of EIP services across the South Region and ultimately a vast difference in performance and outcomes.
Read Full Report: 2015-16 South Region EIP Programme Report