1. Talking Therapies for LTC IAPT

2. Physical health and emotional well-being
Emotional well-being and mental health concerns are major health issues in their own right, but they can also greatly affect physical health
Having a physical health problem also impacts on mental health
Mental illness
Physical illness

3. How mental health affects physical health
Adherence - Physical health patients with depression are three times less likely to adhere to physical health care recommendations than patients without depression
DNA
Lifestyle choices – inactivity, diet, smoking, alcohol, self care
Life expectancy (increased risk of death for depressed patients with heart disease, diabetes and cancer)
Increased Suicide risk- 25.5% of cases cited a general health related problem suicide audit
NHS cost - £8 to £13 billion (England) - depression
increases costs by 33% to 169% over range of conditions

4. For contemplation….
“In the case of Type 2 diabetes, £1.8 billion of additional costs can be attributed to poor mental health. Yet fewer than 15 per cent of people with diabetes have access to psychological support”.

5. IAPT LTC Pilot site outcomes:
Cambridgeshire and Peterborough CCG Initial outcomes
61% reduction in A & E attendance in the cohort of patients accessing the integrated IAPT services
73% reduction in GP visits
75% reduction inpatient admissions
Berkshire East and West have initial findings:
75% increase in specialist nurse use
49% reduction in GP appointments
52% reduction in A & E attendances
80% reduction in X-Rays
Buckinghamshire can demonstrate initial evidence:-
57% reduction in Physiotherapy appointments
33% reduction in GP appointments
No A & E attendances from cohort completing treatment
50% reduction in admission to hospital
Oxfordshire can evidence initial evaluations showing:-
76% reduction in days off work due to sickness
33% reduction in Consultant appointments
100% reduction in admission to hospital

6. Why change is needed.. People die younger-
Integration of IAPT is a key part of the 10 Year Plan
Increased cost of care
Improved health outcomes
Improved efficiency of resource
People with severe and prolonged mental illness die on average 15 to 20 years earlier than other people – one of the greatest health inequalities in England (only 13 per cent of the NHS budget goes on such treatments)
People with long term physical illnesses suffer more complications if they also develop mental health problems, increasing the cost of care by an average of 45 per cent. Yet much of the time this goes unaddressed

7. Barriers..
Stigma – fears of being labelled as being “mentally ill” and this impacting on how they are perceived by family/friends
Healthcare workers, friends and family or patients may not recognise the signs of depression or feel it’s a normal response to the condition
30-50% not recognised in consultation
Not knowing where to find the help
Worries that they are a burden
Health care professionals may not feel fully equipped or that they have the time
The separation between mental health and physical health care
Trained to focus on a patient’s physical health

8. How to ask within tight time frames….
So you can get ‘just enough’ information to be able to signpost them on to get further support

9. Summary.. IAPT for LTC….. Improves health outcomes Reduces costs
Reduces GP appointments and A&E/ acute admissions
Supports CCG in reaching access targets

10. The 5 areas model: Situation/ Trigger Thoughts Feelings
Physical Symptoms
Behaviours
Give example to demonstrate how it can improve health outcomes/compliance

11. IAPT Services CBT based Guided Self Help
Cognitive Behavioural Therapy tailored for people living with Long Term Conditions, in the form of:
Face to face sessions
Telephone based sessions
Online Therapy (including physical health packages)
Groups
Counselling for depression
Discuss:
access targets
range of providers-something to suit everyone!
See providers for individual info

12. Who to refer Who 18+ Experiencing emotional distress LTC Carers
Common mental health problem
Work stress
Not at high risk of suicide
Any existing SMI must be stable
In agreement to referral
When
Offer to anyone with an LTC
Refer as soon as you recognise an issue

13. Guildford & Waverley CCG North West Surrey CCG East Surrey CCG
Guildford, Godalming, Haslemere, Milford, Chiddingfold, Hindhead Worplesdon, East Horsley & Cranleigh
 Centre for Psychology
DHC- NHS Talking Therapies or php
IESO Digital Health or ey
Mind Matters- NHS uk/surrey
ThinkAction Woking
Text TALK to 82085
North West Surrey CCG
Ashford, Walton, Chobham, Weybridge, Woking, West Byfleet, Shepperton, Chertsey, Addlestone, Egham, Stanwell, Staines,Virginia Water & Pirbright,
 DHC Talking Therapies or php
IESO Digital Health or ey
Mind Matters NHS uk/surrey
Talking Therapies Surrey Online or nhs.uk/surreyonline
ThinkAction Woking
East Surrey CCG
Redhill, Merstham, Reigate, Caterham, Warlingham, Horley, Whyteleafe, Lingfielf, Oxted & Godstone,
DHC- NHS talking therapies or php
ThinkAction
Text TALK to 82085
Centre for Psychology
Surrey Downs CCG
Tadworth, Dorking, Leatherhead, Thames Ditton, East Molesey, Ashtead, Epsom, Worcester Park, Ewell, Stoneleigh, Esher, Banstead, Oxshott, Brockham, Newdigate, Claygate, Bookham & East Molesey
DHC- NHS Talking Therapies or php
IESO Digital Health or ey
ThinkAction
Surrey Heath CCG
Ash Vale, Camberley, Frimley, Lightwater & Bagshot
Centre for Psychology
Mind Matters-NHS uk/surrey
Farnham and NE Hants CCG
Farnham only
Talk Plus

14. Suggested next steps?
Routinely Consider IAPT for all LTC clients and ensure IAPT resources are available
Consider integration of PHQ4 in review templates
Consider opportunities for co-location
Discuss:
access targets
range of providers-something to suit everyone!

15. Upon completion, a certificate of attendance will be emailed to you.
Please take a few minutes to complete an online evaluation of the event.
Upon completion, a certificate of attendance will be ed to you.
Thank you.