• CCGs in Kent have been told they can continue using non-accredited staff
  • NHS England initially “recommended” non-accredited staff not carry out work but reversed decision over fears about patient care
  • All IAPT clinicians required to have completed training programme since 2018

Counsellors without the required accreditation are providing NHS-funded therapy services, despite NHS England tightening the rules for providers.

Clinical commissioning groups in Kent have been told they can continue to fund Improving Access to Psychological Therapies counselling by non-accredited staff, after fears were raised patient care could be affected if the IAPT workforce was reduced.

Since 2018, NHSE has required all IAPT clinicians nationally to have completed an IAPT-accredited training programme. It is not known what proportion of the current IAPT workforce is unaccredited but a 2015 national workforce census showed 18 per cent of those delivering low intensity IAPT services and 15 per cent of those delivering high intensity therapies were not accredited.

According to governing body papers for Dartford, Gravesham and Swanley CCG, NHSE initially “recommended” non-accredited counsellors in Kent should not carry out one-to-one counselling after a workforce review of the service in the south east. However, it later agreed with CCGs the counsellors could continue working as long as providers have plans to move towards accreditation.

At South Kent Coast CCG, providers have agreed to work towards accreditation for 90 per cent of counsellors by March 2020. A clinical review of those who were not accredited but had been treating patients showed their work was “clinically safe and effective,” the CCG said.

The CCG declined to say how many of the IAPT counsellors it commissions were not accredited.

Kent is heavily dependent on the IAPT services it commissions from private providers. CCG governing body papers raised concerns some IAPT practitioners will opt not to work with the NHS because of the accreditation process, which varies according to the therapy delivered and involves several professional bodies.

One of SKC CCG’s providers, the Dover Counselling Centre, said some therapists had left because of the accreditation issue. “It has been a big upheaval as a service,” said Sally-Anne Spicer, chief executive of the centre.

An NHS spokesman said: “In the past year alone IAPT has had over 1 million people referred for care, and most importantly has helped hundreds of thousands of people to overcome their depression and anxiety, and better manage their mental health.

“The IAPT manual is quite clear; all staff are expected to have some form of an IAPT qualification if they are delivering therapy, and from next year this will also be monitored through the collection of a new data set.”

But Martin Bell, head of policy and stakeholder engagement for the British Association for Counselling and Psychotherapy, said: “We’re concerned that some IAPT services have misinterpreted requirements within the IAPT manual, leaving staff in fear of redundancy.

“There should be transitional requirements for staff in place to help them and give them time to meet the requirements. Therapists who have a realistic chance of completing the appropriate training and achieving the relevant accreditation should be given the support to do so.”

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