|Contact||Ipswich and East Suffolk CCG|
|Address||Rushbrook House, Paper Mill Lane, Bramford, Ipswich, IP8 4DE|
Why we did it?
- According to GP Quality and Outcome Framework (QOF) registers from 2010-2011, there was a lower prevalence of mental health in Ipswich and East Suffolk than the England average but a much higher prevalence of depression.
- The Integrated Wellbeing Approach was developed to expand the improvements delivered by the Improving Access to Psychological Therapies (IAPT) scheme.
- IAPT was implemented nationally as a three year pilot. During that time it became apparent to GP leaders, our member practices, providers and service users that the IAPT clinical model of care did not provide the holistic approach that was needed to meet both the social and physical aspects of individuals presenting with less serious mental health issues. These limitations were evident in primary care consultations.
What was done?
- The new service ensures there is one single accountable provider. This offers GPs a comprehensive service for individuals presenting with lower end mental health issues. There is a strong emphasis on recovery and empowering service users to take control of their own lives.
- The initial concept was developed in partnership with the Department of Health, Sainsbury’s Centre for Mental Health and the GP Mental Health Network.
- The CCG collaborated with West Suffolk CCG to design a service across Suffolk.
- Mental health lead GP Dr John Hague, led a comprehensive engagement programme to refine the concept and develop the specification. This included providers from all sectors, service users, carers and social care. The work with service users was extensive and their views were represented in the final specification.
The final service specification for the Wellbeing Service:
- Fulfils the requirements of the IAPT model
- Integrates seamlessly with secondary mental health services and brings together a range of mental health providers
- Is accessible to the whole population, aged over 13 years
- Focuses on early intervention, prevention and recovery
- Empowers people to manage their own mental wellbeing
- Meets the outcomes of the cross government strategy ‘No Health Without Mental Health’
- Offers mental health support for people with long term conditions and medically unexplained symptoms.
- Achieves QIPP targets, including financial savings
How was this achieved?
- The CCG was an innovator in recognising the gap in service for children and young people, and people with long-term physical conditions and medically unexplained symptoms not covered within the Psychological Therapies Service (IAPT) or secondary care mental health service. The GP experience of these service gaps in practices was instrumental in designing the comprehensive specification.
- The tender process sought a single accountable provider who would subcontract from local third sector organisations in order to support and enhance the local market. The procurement evaluation panel was led by GPs with managers and Suffolk County Council.
What benefits were achieved?
- Improved understanding of procurement process and importance of clear contractual arrangements
- The new provider began operating in July 2012. The CCG has learnt valuable lessons regarding the importance of clear contractual and governance arrangements as a result of this complex re-commissioning project.
- New Wellbeing Services quality standards
The project benefits realisation plan will be monitored contractually. This is expected to deliver:
- Access standards of 10 working days from referral for all step 1 and 2 therapies and 28 working days from referral for step 3.
- Quality standard 60% recovery rate (50% national target for conventional IAPT).
- People are supported to live in their local community as independently as possible.
- The service intervenes early in a person’s mental health with the lowest level, least intrusive, and most effective intervention.
- The service offers a bio-psycho-social model of care to maintain and improve social inclusion and remove stigma
- The service works collaboratively with a range of different organisations including the contracted partners, other NHS, Local Authority, private and voluntary sector providers.
- Education is at the heart of developing robust clinical interventions and supervision with a ‘centre of excellence’ approach.
- The service supports people throughout their life from age 13, as well as their family.