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Clinical Commissioning Groups (CCG’s) Incredibly Naive Re: IAPT

CCG’s are rubber stamping the funding of IAPT services, without questioning the alleged 50% recovery rate for depression and the anxiety disorders. But CCG’s would never give approval to the dissemination of a psychotropic drug based solely on the manufacturer’s claim. It seems that GP’s on CCG’s are too busy to critically appraise IAPT’s claim.  CCG members need to ask why £1bn has been spent on IAPT services that have never been independently evaluated using a rigorous methodology.  My own, by no means definitive study of 90 consecutive attenders at IAPT suggests a 10% recovery rate [ the paper ‘IAPT The Need for Radical Reform’ can be accessed by selecting below and right clicking https://connection.sagepub.com/blog/psychology/2018/02/07/on-sage-insight-improving-access-to-psychological-therapies-iapt-the-need-for-radical-reform/].  CCG’s are like the Titanic, heading towards an iceberg, on board are not only depressed and anxiety disorders passengers but a recent cohort of those with long term physical health conditions and medically unexplained symptoms:

 

 

Via my MP, Maria Eagle I put the following questions to the Liverpool CCG, (one of the CCGs covering the IAPT clients I examined in the North West) and their response dated March 6th 2018 was as follows:

Question 1.

 

Are the CCG aware that the recovery rate in the IAPT Service they fund is just 10% (far short of the 50% recovery rate targeted by Alan Johnson, then Labour Minister in 2007 when the service was set up).

 

Response 1.

 

Latest local data indicates that the current recovery rate for the service stands at 50%, targets for access and recovery are under regular review with performance reported to NHS England and published nationally and through LCCG Governing Body papers.

 

Question 2.

 

What, if any independent data do the CCG use in assessing the IAPT Service? Response 2.

All IAPT services must assess their performance using nationally mandated measures contained within the IAPT Minimum Data Set (v1.5). Information on these measures and the outcomes achieved by IAPT services can be obtained from NHS Digital.

 

Question 3.

 

Why have the CCG never asked IAPT service users their opinion of the service? Response 3.

All IAPT services routinely ask every IAPT service user their opinion of the services using 2 measures, the Patient Experience Questionnaire (Assessment) and the Patient Experience Questionnaire (Treatment). Information on these measures and the patient satisfaction levels achieved by IAPT services can be obtained from NHS Digital.

 

Question 4.

 

Why do the CCG consider it acceptable to continue to fund a service, were assessments are conducted by telephone by the least experienced and qualified staff? Are they supporting a double standard for physical and mental health?

 

Response 4.

 

LCCG has commissioned a service in line with NICE guidance both in terms of accessibility and responsiveness, but also the required skills of staff employed by the service.

 

Question 5.

 

What steps will the CCG take to ensure that evidence based treatment takes place in IAPT? Response 5.

All treatment provided by Talk Liverpool conforms to the following NICE Guidelines which lay out the evidence based therapies that should be offered for disorders of anxiety and depression:

 

NICE Guidance for depression in Adults (CG90)

NICE Guidance for Depression in adults with a chronic physical health problem (CG91) NICE Guidance for Common Mental Health Problems (CG123)

NICE Guidance for Generalised Anxiety Disorder and Panic Disorder in Adults (CG113) NICE Guidance for Obsessive Compulsive Disorder and Body Dysmorphic Disorder in Adults (CG31)

NICE Guidance for Post-Traumatic Stress Disorder (CG26) All the above can be accessed through;

https://www.nice.org.uk Question 6.

How will the CCG ensure that GPs are given comprehensive data on the functioning of their patients? Currently data is supplied to GPs on less than half of patents and purely in the form of psychometric test results, there are no ‘gold standard’ diagnostic assessments conducted at all. How will the CCG remedy that IAPT workers do not know what they are treating?

 

Response 6.

 

GPs are informed of the outcome of all their patients’ therapy episodes with Talk Liverpool. This includes both psychometric scores and clinical information. With regard to “gold standard diagnostic assessments”, the IAPT service is a treatment service and not a formal diagnostic service. Talk Liverpool provide problem descriptors (and not formal diagnoses) as mandated by the IAPT Dataset V1.5 set out by NHS England, using the nationally mandated psychometric tests (details of which can be found in the IAPT Data Handbook published by NHS England).

 

Links:

 

http://content.digital.nhs.uk/iapt

 

http://ipnosis .postle.net/PDFS/iapt–outcomes–toolkit–2008–november(2).pdf

 

Further information relating to IAPT nationally can be obtained through the National Collaborating Centre for Mental Health and NHS England who have recently published the IAPT Manual which outlines the model that all IAPT services should follow (including some of the procedures implemented by Talk Liverpool including some outlined in the responses given above).

 

Links:

 

http://www.rcpsych.ac.uk/workinpsychiatry/nccmh/mentalhealthcarepathways/improvingac cess.aspx

 

https://www.york.ac.uk/healthsciences/pc-mis/news– articles/lAPT%20Manual 30OCT17.pdf

 

 

I hope that you and Dr Scott this information helpful.

Yours sincerely

 

Ian Davies

Chief Operating Officer

 

Liverpool CCG show no evidence of having bothered to read my analysis of 90 cases, and have not answered my questions, they have simply acted as the mouthpiece for IAPT.

 

Dr Mike Scott

377 replies on “Clinical Commissioning Groups (CCG’s) Incredibly Naive Re: IAPT”

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娛樂城推薦與優惠詳解

在現今的娛樂世界中，線上娛樂城已成為眾多玩家的首選。無論是喜歡真人遊戲、老虎機還是體育賽事，每個玩家都能在娛樂城中找到自己的樂趣。以下是一些熱門的娛樂城及其優惠活動，幫助您在選擇娛樂平台時做出明智的決定。

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1. 富遊娛樂城
富遊娛樂城以其豐富的遊戲選擇和慷慨的優惠活動吸引了大量玩家。新會員只需註冊即可免費獲得體驗金 $168，無需儲值即可輕鬆試玩。此外，富遊娛樂城還提供首存禮金 100% 獎勵，最高可領取 $1000。

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娛樂城推薦與優惠詳解

在現今的娛樂世界中，線上娛樂城已成為眾多玩家的首選。無論是喜歡真人遊戲、老虎機還是體育賽事，每個玩家都能在娛樂城中找到自己的樂趣。以下是一些熱門的娛樂城及其優惠活動，幫助您在選擇娛樂平台時做出明智的決定。

各大熱門娛樂城介紹
1. 富遊娛樂城
富遊娛樂城以其豐富的遊戲選擇和慷慨的優惠活動吸引了大量玩家。新會員只需註冊即可免費獲得體驗金 $168，無需儲值即可輕鬆試玩。此外，富遊娛樂城還提供首存禮金 100% 獎勵，最高可領取 $1000。

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AT99娛樂城以高品質的遊戲體驗和優秀的客戶服務聞名。該平台提供各種老虎機和真人遊戲，並定期推出新遊戲，讓玩家保持新鮮感。

3. BCR娛樂城
BCR娛樂城是一個新興的平台，專注於提供豐富的體育賽事投注選項。無論是足球、籃球還是其他體育賽事，BCR都能為玩家提供即時的投注體驗。

熱門遊戲推薦
WM真人視訊百家樂
WM真人視訊百家樂是許多玩家的首選，該遊戲提供了真實的賭場體驗，並且玩法簡單，容易上手。

戰神賽特老虎機
戰神賽特老虎機以其獨特的主題和豐富的獎勵機制，成為老虎機愛好者的最愛。該遊戲結合了古代戰神的故事背景，讓玩家在遊戲過程中感受到無窮的樂趣。

最新優惠活動
富遊娛樂城註冊送體驗金
富遊娛樂城新會員獨享 $168 體驗金，無需儲值即可享受全場遊戲，讓您無壓力地體驗不同遊戲的魅力。

VIP 日日返水無上限
富遊娛樂城為 VIP 會員提供無上限的返水優惠，最高可達 0.7%。此活動讓玩家在遊戲的同時，還能享受額外的回饋。

結論
選擇合適的娛樂城不僅能為您的遊戲體驗增色不少，還能通過各種優惠活動獲得更多的利益。無論是新會員還是資深玩家，都能在這些推薦的娛樂城中找到適合自己的遊戲和活動。立即註冊並體驗這些優質娛樂平台，享受無限的遊戲樂趣！

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Пеларгонии сортовые
Пеларгонии элитные: прекрасный вариант для своего дома и участка

Если вы ищете растения, что будут радовать тебя их внешним видом и ароматом, вместе с тем не требуя трудного обслуживания, разновидности пеларгонии — наилучший вариант. Эти растения обладают уникальными достоинствами, что превращают их топовыми среди декоративных растений.

Почему сортовые пеларгонии?

Легкость и простота в уходе
Пеларгонии не требуют особых требований для развития и легко приспосабливаются к различным температурным режимам. Они идеально процветают как в доме, так и на свежем воздухе. Не беспокойтесь о прихотливых цветах — пеларгонии достаточно поливать по степени исчезновения влаги земли и получать удовольствие от их цветением.

Яркие и разнообразные цвета
Определенный сорт пеларгоний обладает свои уникальные оттенки и виды. Разновидности, например как, Ю Полонез, впечатляют насыщенными цветами и выразительными бутонами. Это растения, которые немедленно захватывают взоры и создают живые акценты в каждом пространстве.

Нежный запах, придающий комфорт
Пеларгонии не только декорируют жилище — они снабжают его легким, ненавязчивым благоуханием. Этот естественный благоухание помогает придать чувство уюта и уюта, а также действует как натуральный отпугиватель для мошек.

Длительное цветение
Сортовые герани не прекращают удивлять взоры своим красотой в течение многих периодов. Люди будут радоваться их внешним видом с начала сезона и до поздней осени сезона. Такое продолжительное период цветения — исключительное достоинство среди декоративных растений.

Идеальный вариант для различного окружения
Пеларгонии многофункциональны — их следует выращивать как в горшках на оконных рамах, так и в огороде. Компактные кусты, такие как ИВ Галина Уланова, идеально подходят в украшенных вазонах, а такие сорта, как Магнус, станут украшением участка.

Для чего необходимо остановиться на обязательно герани?
Эти цветы — не просто элемент интерьера. Они существенно выделяются между других цветов из-за своей простоте, красоте и продолжительному цветению. Их насыщенные тона формируют уникальную атмосферу, будь то в помещении или на участке. Герани — это идеальный баланс красоты и удобства.

Останавливайтесь на герани — сделайте вокруг красоту без лишних забот!

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