• New data shows integrating talking therapies services with physical health services saved £200,000
  • Evaluation of the early implementer IAPT for long term conditions service in Cambridgeshire and Peterborough reduced use of physical health services
  • Biggest savings in reducing A&E attendances and hospital admissions among the cohort of patients

Providing talking therapies to patients with long term conditions saved nearly £200,000 for physical health services in one trailblazing site, data shared exclusively with HSJ shows.

The data is from part of NHS England’s evaluation of the first and second wave early implementation sites for integrating improving access to psychological therapies services with physical health pathways.

Cambridgeshire and Peterborough Clinical Commissioning Group found introducing IAPT services to diabetes, cardiovascular and respiratory pathways saved £193,000 from October 2016 to September 2017.

This comprised reducing the number of times these patients needed to visit GPs, physiotherapists, specialist and practice nurses, and accident and emergency, as well as being admitted to hospital.

The evaluation found that for the 500 patients involved in the integrated IAPT for long term conditions in the area:

  • A&E attendances fell by 61 per cent and hospital inpatient admissions by 75 per cent;
  • GP appointments across the three specialties fell by 73 per cent;
  • the model saved £122,000 in hospital admissions and £5,300 in A&E; and
  • the greatest savings came from the cardiovascular pathway, worth more than £88,000.

NHS England pledged more than £70m in 2016-17 and 2017-18 to train new staff and deliver integrated IAPT long term condition services.

The national body selected 37 early implementer sites to develop integrated psychological therapy services, with the first wave of 22 sites announced in October 2016, and the second wave of 15 sites launched in September this year (see box).

This is part of the plans set out in the Five Year Forward View for Mental Health implementation document, to increase access to IAPT to 1.5m people a year. As part of this expansion, 3,000 new mental health therapists will be co-located in primary care.

Claire Murdoch

Source: Neil O’Connor

Claire Murdoch: ‘Integrated physical and mental health care is the cornerstone of our transformation plans’

From 2018-19, the funding to extend these services, worth nearly £700m, will be invested into CCGs’ baseline allocations.

NHS England national mental health director Claire Murdoch said: “Integrated physical and mental health care is the cornerstone of our mental health transformation plans.

“Psychological therapies for people with long term health conditions like diabetes can have an important, positive impact as the results of our new IAPT services show.”

Other early implementer sites have also reported significant results, though with much smaller patient cohorts, from their IAPT long term condition services, including:

  • Buckinghamshire and Oxfordshire reducing A&E attendances in their patient cohort to zero;
  • Oxfordshire reducing hospital admissions by 100 per cent;
  • Herts Valley and West Essex CCGs reducing the average number of physical healthcare appointments from 4.8 to 3.4; and
  • Calderdale, Berkshire West and Berkshire East reducing GP appointments by nearly 50 per cent.

First and second wave integrated services sites

The 22 first wave early implementer sites are:

  • Aylesbury Vale and Chiltern
  • Blackburn with Darwen and East Lancashire
  • Calderdale
  • Cambridgeshire and Peterborough
  • Coastal West Sussex, Crawley and Horsham and Mid Sussex
  • Greater Huddersfield and North Kirklees
  • Harrogate and Rural District
  • Herts Valleys and West Essex
  • Hillingdon
  • Northern, Eastern and Western Devon
  • North East Hampshire and Farnham
  • North Staffordshire and Stoke on Trent
  • North Tyneside
  • Nottingham West
  • Oxfordshire
  • Portsmouth
  • Richmond
  • Sunderland
  • Swindon
  • Warrington
  • Windsor, Ascot and Maidenhead, Slough and Bracknell and Ascot
  • Wokingham, Newbury and District, North and West Reading, and South Reading

The 15 second wave sites are:

  • Bath and North East Somerset, and Wiltshire
  • Coventry and Rugby, South Warwickshire, Warwickshire North
  • Nottingham City
  • Sheffield
  • Solihull
  • South East Staffordshire and Seisdon, Cannock Chase, Stafford and Surrounds, and East Staffordshire
  • Thurrock
  • Blackpool, Wyre and Fylde, Chorley and South Ribble, West Lancashire and Lancashire North
  • Haringey and Islington
  • Brent, Harrow, Central London, West London, Hammersmith and Fulham, Ealing and Hounslow
  • Dorset
  • Ashford, Canterbury and Coastal, South Kent Coast and Thanet
  • North East Lincolnshire
  • Hardwick, North Derbyshire, Southern Derbyshire and Erewash
  • Telford and Wrekin

Significant savings from mental and physical health integration pioneers