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Unregulated Mental Health Service Has Run Away With £4 billion

Following a Freedom of Information request NHS Improvement confirmed to me yesterday that the the total cost of the Governments Improving Access to Psychological Therapies (IAPT) Service in 2017/18 was £394 million.  I had asked them for the annual cost of IAPT since its’ inception, but they said that they were unable to furnish such figures! The service is twelve years old, thus conservatively it has likely cost the taxpayer £4 billion. 

For Rail and Road we have a regulatory body the  Office of Rail and Road, that monitors the performance of Network Rail and the varying train operators, but for mental health there is no such independent regulatory body. IAPT polices itself, and makes unexamined claims of recovery rates to secure funding from Clinical Commissioning Groups, who have never performed an independent audit. In my own area, Talk Liverpool last October publicly claimed an 87% recovery rate  for those who completed treatment, unsurprisingly therefore the Liverpool CCG has increased its funding by 25% to 10 million in the coming financial year. My own research published in 2018 suggests an actual 10% recovery rate.

It is time that the Government and Dominic Cummings got to grips with this.

The dropbox link to the FOI  response is below:

https://www.dropbox.com/s/x5kza6e6bpft2b3/Scott%20Internal%20Review%20Decision%20Letter%2020.01.2020.pdf?dl=0

My own findings are in the dropbox link below;

https://www.dropbox.com/s/flvxtq2jyhmn6i1/IAPT%20The%20Need%20for%20Radical%20Reform.pdf?dl=0

more about these matters anon

Dr Mike Scott

406 replies on “Unregulated Mental Health Service Has Run Away With £4 billion”

(This kind of reminds me of HS2.) Do you know or have you enquired what the IAPT workforce is in Whole Time Equivalent WTE, because that total cost for 2017/18 looks rather low to me, given the expansion of the workforce that’s supposed to have happened over the last few years? But perhaps the therapists are being paid pathetically low wages or something. For a programme that’s supposed to be all about transparency, IAPT doesn’t seem to be very transparent. I’ve just found a document that says that ‘generic’ IAPT costs on average around £492 per person entering treatment. In 2017/18, 1.01 million referrals started treatment, so I make that nearly £497 million, about £100 million more than the figure you were given. It would be good to see a breakdown of the 2017/18 total cost figure, wouldn’t it? I do wonder what figure you’ve been given here Mike – is it the cost just to deliver the service or does it include training costs and the cost of central support/admin, the NHS Digital component etc?

Hi Liz
It is so difficult to get a clear picture, NHS Improvement gave me the 2017/2018 figure and the accompanying document, see dropbox link below
https://www.dropbox.com/s/3xlu6tipaeguk2c/FOI%20IAPT%20data.xlsx?dl=0
I am at a loss as to why they could give me the 2017/2018 figure but not that for other years
I am not familiar with WTEs. it looks like the figure is at least £4 billion, but if you can shed any light on it, i would be grateful. I’ll come back to the above link when i’ve got a bit of space and do a blog on it. But it is not at all transparent to me, but in fairness I’m not an Accountant.
Best wishes

Mike

Have you tried putting this information to the National Audit Office, Mike? These are pretty astounding figures, and it is just the kind of thing NAO reports on all the time. Amyas Morse used to do some quite scathing reports on government failure to keep proper track of spending on these projects once they had been given the go ahead. I think he may have retired now, and I’m not getting as many updates as I used to, but whoever took over ought to be very interested in £4 billion hand outs given to quacks with no strings attached!

Good work with the blog. I had not heard of this before. (y)

The NAO was going to audit IAPT a couple of years ago, but this was cancelled “owing to there being a General Election”. I have their email response to my inquiry. Surviving@Work (Dr Elizabeth Cotton) . Interestingly – and concerningly – as a now retired GP, I have been receiving increased calls from ex-patients unable to access the help they need for their longer/term anxiety/depression. The IAPT service in our Borough is named a ‘Wellbeing’ service

Hi Guys
the National Audit Office, has failed to audit IAPT see my blog of Nov 3rd 2019, a colleague is using an FOI to discover what prompted the NAO investigation. But whatever the findings the NAO has kicked audit of IAPT into the long grass
How long can turning a blind eye to IAPT go on?

I was just looking at the latest NAO report on HS2 today. In it they mention that progress on the report was held up in case the new government wanted to change some of the objectives. It may be that there were holds put on other reports until a new gov was settled in too. Probably worth asking again now they have both a new Auditor General and a new gov.

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