Lancashire Care NHS Foundation Trust Early Intervention Service Improving Access to Psychological Therapies: Psychosis Dr James Kelly, Project Manager Dr Warren Larkin, Clinical Director Mr Neil Caton, Service User Development Worker IAPT for SMI Stakeholder Event Chelsea Football Club 7 March 2013

Lancashire Early Intervention Service

Lancashire EIS Catchment Area Catchment population 1.3 million – 773 current service users

What Can Lancashire EIS Share? Whole Service Ethos of Psychosocial Care Matched care or tiered approach to delivering psychological care across whole workforce Education & Training PSI Training: All of our staff are trained in CBT-informed interventions (manualised, effective and accredited) Behavioural Family Therapy: We have 20+ staff trained and have our own BFT trainers CBT & CBFI: Cohort of staff trained to Masters & Diploma level REaCh: Routine Enquiry about Childhood Adversity

Psychosocial Interventions Training

A Matched-Care / Tiered Approach to Psychological Care Psycho- social interventions Case managers/ ST&R Tier 2 Tier 3 Formal CBT or FI, Discrete Problems Staff with: Formal CBT training or COPE Msc (under supervision) Complex / multiple problems longer term CBT or FI Tier 1 Specific PSI Training Supervision/ Consultation Cognitive Therapists Clinical Psychologists

Phase 1: Solid Foundations for Demonstrating IAPT in SMI Service User Engagement Developing sustainable and consistent SU partnership Service Delivery Mobile solutions – efficient use of valuable Therapist time Recruitment 2 therapists and Admin Assistant. Service Evaluation Assessed the feasibility of IAPT data set in Lancashire EI Service Preliminary Data Dissemination Radio 5 live, positive local media coverage on Demo Site North West IAPT Collaborative

Electronic Care Record & Mobile Application PROMS Forms built and available on the existing electronic care record Contacts planned in electronic care record generate work list in therapist diary on the mobile device PROMS forms available on mobile device can be completed by service users and / or practitioners We are in the 1 st phase of software development. Through an agile approach further functionality will be developed during 2013

Choice

Service User Experience & Involvement Childhood and teenage adversity Experiences of psychosis Lancashire EIS intervention Service User Development Strategy

Phase 2: What we will do next Service User Engagement Establish Service User Development Officer post A collaborative approach to service development… Service Delivery Improve access to NICE compliant CBT and FI Improve access to therapist support for Tier 1 PSI work throughout the system. Refine and improve staff training at all levels in line with identified psychosis competencies.

Phase 2: What we will do next Service Evaluation Systematic Data Collection with new cohort of SU’s Refine and develop Electronic Care Record and mobile device solutions Dissemination Engagement workshops with Clinical Commissioning Groups in Spring Planning a large scale event 4 th June & update events to report progress Winter 2013 Bespoke workshops with NHS and other organisations

Data Completion

Emergency Community Contacts

Occupied Bed Days

Challenges Developing IT systems alongside significant IAPT CAMHS project. Difficulty in recruiting therapists to 1 year posts. Sessional measurement a culture change to existing clients and to therapists.  Weekly monitoring improved rates. Influencing wider system

Conclusions Access to Psychological Therapies within SMI is inadequate across NHS We need to train more staff to deliver high quality Psychological Therapies in SMI Initial experience is that regular measurement of outcomes is possible in psychosis SU group Innovative use of technology can enhance efficiency and SU engagement Improving access in a changing NHS is possible through innovation and practice change