The government has been accused of making “optimistic” claims over the success of its £400 million investment in the Improving Access to Psychological Therapies (IAPT) programme.
Minister of State for Care Services, Norman Lamb, repeated the claim that ‘recovery rates are in excess of 45%’ in his foreword to the Department of Health’s recent IAPT Three-Year Report.
IAPT was launched in 2008 to increase access to talking therapies such as cognitive behavioural therapy. In 2010, the government committed an additional £400 million to IAPT over four years to 2014/15.
However, Professor Patrick Pietroni, director of the University of Chester’s new Centre for Psychological Therapies in Primary Care, disputes the government’s claim. Writing in Public Service Review: Health and Social Care, he said: “The preferred measure of Key Performance Indicators for IAPT is the percentage of patients ‘moving to recovery’ as a proportion of those who completed treatment – at first sight, an impressive percentage of 44%.”
However, this fails to take account of the high drop-out rate from courses of therapy, Professor Pietroni added. “If claims are to be made about population health outcomes, then the denominator should be the widest possible. The Centre therefore applied the denominator ‘patients referred’. Using this, ‘the moving to recovery’ outcome rate is 12%.”
Professor Pietroni pointed to a 2012 report, Completing the Revolution, by right-wing think-tank the Centre for Social Justice, which came to a similar conclusion but presented it more negatively. It said that IAPT figures claim recovery as over 40%… but from the point of view of commissioners and referring GPs, 86% are not being helped by the IAPT service.
“These points are not trivial,” said Professor Pietroni. “An earlier study of progress made by sites in the first rollout year of the programme (2008/9) suggests that 53% of referrals had one or fewer contacts with the programme, including 42% who were not assessed. Recognition and understanding of the needs and experience of these patients is as important as measuring the outcomes of those who completed more than one treatment session.
“Commissioners of psychological therapies in primary care will want to exercise their own judgement as to which of these figures offers transparency to support analysis of outcomes.
“Given the level of investment and the claims made, it is imperative that outcome data should be widely available in a form that helps commissioners to understand the nature of the patient journey through IAPT from referral.”