National Audit Office Offers No Evidence That The £0.5 Billion, Per Year, Spent on Talking Therapies Is Value For Money

The £4 billion plus spent on the Improving Access to Psychological Therapies (IAPT) programme over the last decade could have been better spent improving the lot of Nurses. On March 6th 2021, I received a reply from the National Audit Office (NAO), ironically from the Director of the Health value for money Team, saying that it had no intention of mounting an investigation into UK Government’s, Improving Access to Psychological Therapies (IAPT) programme. The Director adds ‘but you raise important issues – around data quality, levels of performance, outcome measurement, and what has been achieved for the spend – that would be important to cover in any report we consider on mental health services’.  

The Director informed me they have been preoccupied with the effects of Covid!  In 2017 the NAO  initiated an investigation into IAPT  but a year later it was discontinued because of ‘Brexit, the collapse of Carillion and concerns about spending on generic medicines’. The NAO never published their findings.  It seems that the NAO will always have an excuse to kick a focus on IAPT into the long grass. But in 2016 it had asked the Department of Health  to investigate why  IAPT was exempt from Care Quality Commission scrutiny.  The DOH made no response – friends in high places?

There appears to be an implicit assumption that just throwing money at mental health must be good. The NAO has signally failed to manage the public purse. At a time when this purse is near empty, and there are clearly pressing needs amongst Care and Nursing staff, this is appalling. 

Dr Mike Scott


35 replies on “National Audit Office Offers No Evidence That The £0.5 Billion, Per Year, Spent on Talking Therapies Is Value For Money”

It seems that David F Marks has thrown down the gauntlet to CBT therapists in his blog - in which he highlights that there is a lack of any good evidence that ME/CFS and medically unexplained symptoms/ ‘MUS’ are caused by or exacerbated by unhelpful beliefs. If CBT therapists think there is evidence, that there is a case to the contrary – i.e. that ME/MUS patients may be helped via CBT addressing their unhelpful beliefs, then it appears that he’s more than happy to consider their evidence and reconsider his conclusion. You can’t say fairer than that, can you?

Where would IAPT be without LTC and MUS patients being redirected to them from physical healthcare services in order to reduce physical healthcare spend? That’s what the IAPT funding model is founded on, isn’t it? If CBT doesn’t work for MUS then surely IAPT is doomed to fail and will never represent value for money?

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