Children and Young People’s IAPT

New Collaboratives briefingMarch 2012

IAPT Website: www.iapt.nhs.uk

Plan for Today

• Context setting

• The Children and Young People’s IAPT Project

• The application process

Context: Policy

New Mental Health Strategy, 2011

- Life course approach: Quality Driven

- Implementation Plan being prepared

NHS and Social Care Bill, 2011

- Outcomes frameworks, NHS, Social Care, Public Health

Commissioning developments

– QIPP, CQUIN

– CAMHS PbR

Data & IT, Choice

- Data to support quality and choice

Context: Current Services

• Lack of systematic evidence of – what services deliver – and what is missing is major weakness

Project assumptions

• CYP IAPT will learn from Adult IAPT but will be specific to the needs of children and families

• The budget is still modest and will be available until the next Comprehensive Spending Review.

• Participation in the CYP IAPT project will be offered to existing CAMHS - not necessarily exclusively provided by the NHS.

Transforming CAMHS through IAPT • Working in partnership with children and young people

• Embed EBP by service development

• Building on established local relationships

• Training CAMHS staff in RCT validated techniques

• Enhance supervision and monitoring of outcomes

• Maximise the value of investment

• Deliver quick and visible change

• Optimise local flexibility

2011-2012 • Year one

– CBT for anxiety and depression & parenting training for conduct disorder

• Training for supervisors• Training for therapists – Targeted/specialist (T2/3)

– Training in the use of outcomes information– Training programme to support service managers

• Excluded from year one– Training of staff at universal and early targeted

levels– NICE recommended modalities other than CBT

and parenting training

CYP IAPT Learning Collaboratives

• Core group of providers delivering high quality training to a wide area

• Working in collaboration to maximise chance of delivering service change

• Local CAMHS partnerships to contribute to designing and delivering training – technical input– clinical supervision– involvement of service users– peer evaluation– oversight– skills exchange schemes

• Encouraging HEIs to invest in a long term response to training

CAMHS-IAPT Learning Collaboratives

HEI•Assure quality

•Organise training•Deliver content (in partnership)

NHS CAMHS VS

Commissioners

Partnership 1

NHS CAMHS VS

Commissioners

Partnership 3

NHS CAMHS VS

Commissioners

Partnership 2

Building a Lasting Collaborative

HEI•Assure quality

•Organise training•Deliver content (in partnership)

NHS CAMHS VS

Commissioners

Partnership 1

NHS CAMHS VS

Commissioners

Partnership 3

NHS CAMHS VS

Commissioners

Partnership 2

NHS CAMHS VS

Commissioners

Partnership 6

NHS CAMHS VS

Commissioners

Partnership 4

NHS CAMHS VS

Commissioners

Partnership 5

Mentorship

Mentorship

MentorshipPeer Support

Peer Support

Peer Support

Year one collaboratives

•Ox and Bucks

•Wilts, Bath and NE

Somerset

•Gloucs

•Swindon

•Bournemouth, Dorset

and Poole

•Lambeth & Southwark

•Herts

•Sussex

•Westminster

•Haringey

•Cambridge

•Wandsworth

•Greenwich

•Derby

•Manchester and Salford

•Pennine North

•Pennine South

•Barnsley

Reading UCL & KCL Salford

What does our offer include?• Training and ‘backfill’ for staff

– Trainees– Supervisors– Managers/leaders

• Funding for service development, IT infrastructure, participation,accreditation

• Creating change agents within CAMHS• Funding for a further year for data capture

across the service

The Curriculum

• Five modules for Supervisors (1), Service Manager/leaders (1) and Therapists (3)

• One core module for both CBT and parenting• Two specialist modules either for CBT or

parenting• Outcomes focus• Service Managers and leads – elements of

core plus organisational change management

Principle Behind the Core Offer: Rigorous Adherence to Protocol

•National curriculum to define teaching content

•Well-defined competencies to evaluate individual trainees at selection and at the end of training

•Strong front-ending of supervisor training

•HEIs to ensure competence of practice and implementation

•Unwavering emphasis on outcomes monitoring and outcomes-informed practice

•Learning from the evidence at individual therapist, speciality and service organisation levels

Principle Behind the Core Offer: Flexibility

•Allowing variation in structures for the construction of learning collaboratives that effectively meet IAPT priorities given local organisational constraints

•Creating (modularised) training programme structures that optimally match skills needs

•Encouraging collaboration between HEIs and partnerships and between partnerships to make optimal use of local knowledge and skills

•Within Collaborative Clusters organisation of the funding for the programme (including backfill and infrastructure)

The funding formula - each collaborative has a package based on

Therapist to supervisor ratio 5:1Staff & Fees-Therapist backfill (per therapist) £30K-Supervisor and leadership backfill £60K-Therapist training £12K-Supervisor training £ 5KInfrastructure £100K

-Service manager/lead training £ 5K-IT £40K-Participation £10K-Service development e.g. self referral £35K-Accreditation of services £10K

Changes to the formula since year one

If you apply for a supervisor and have less than 5 trainees, formula is

Supervisor training + backfill for 4months+ funding to supervise the number of trainees applied for at £8K per trainee

Eg – partnership applies for 4 therapists, supervisor funding is

5K +20K plus (4x8K) = £57K

Collaborative received contribution towards project management and startup up - £50K

Using the funding

• Can be used flexibly – but we do ask how you plan to use the money to meet the commitments you sign up to -

• For example – Agreeing extra supervision or support from HEI– Setting up new systems e.g. telephone triage

Criteria to Evaluate Bids: HEIs • Capacity to select supervisors and trainees• Quality of curriculum delivery, competencies of

training staff & capacity to draw on external staff• Track record of working with local areas & other HEIs• To act as focus of activity for delivery of research

and training needs to NHS (HIACs, AHSCs)• Input from service-users and families into curriculum

and delivery• Delivery of teaching to distant sites while meeting

trainees’ needs

Criteria to Evaluate Bids: Partnerships • Vision for enhancing service by embedding EBP

therapy and commitment to training • Markers of stability (e.g. funding TMHS)• Vision and commitment to outcomes monitoring• Vision to improve access to therapy including

self referral• Ensuring access and waiting times are sustained• Matching community aspirations • Existing ratio of need to current resources

Criteria to Evaluate Bids: Learning Collaborative

• Quality of integration between HEI and partnerships in the IAPT programme– Previous joint working with other HEIs

• Plan for involving children and families• Capacity to disseminate and develop mentoring

relationship within the partnership• Capacity to maintain mentoring and peer support

relationships between trusts

Service Change: Embedding Evidence in Practice

• Effective liaison, consultation and training to partner agencies and referrers

• Embedding outcome monitoring – in the therapeutic relationship – in supervision

Routine Outcome Monitoring• Full details and resources are on the web –

www.iapt.nhs.uk • Measures at assessment, session by session and

at review/end • Embedding outcome monitoring

– in the therapeutic relationship – in supervision– Across all practitioners not just IAPT trainees – Data information sessions 19 March 2012

The CYP-IAPT Implementation Feedback Process

• Develop a Collaborative Partnership

• Adapt for Contexts & Culture

• Train Professionals

• Evaluate Effectiveness

• Evaluate Fidelity – Certification and Accreditation – video observation

• Make Sustainable – Supervision and recertification

Quality Assurance and Evaluation

• Accreditation in development

• Sites and Collaboratives to be evaluated using outcomes monitoring and CYP evaluations

• We are intent on evaluation of the process as a whole

Timeline for 2012-Phase One

Advertise for phase one sitesEnd of JulyFeb 2012

Completed applications to be submittedEnd of JulyApril 23rd 2012

Select sitesEnd of JulyJune 2012

Supervisors and Service

managers begin training

End of JulyNovember 2012

Therapists begin trainingEnd of JulyJanuary 2013

The Application Process

• Bidding process – our interest is in high quality training, sign up to the fixed aspects of the project and understanding how you will approach areas where method of delivery is not determined

• Evaluation methodology and weighting is in the Offer

• The size of the bids are not predetermined • Funding will flow via PCTs/CCGs

Lessons Learned in Year One

• The bid must be for all elements of the National Curriculum and offer – majoring on one therapy only or excluding service development is not advisable

• Big partnerships covering many boroughs are an added strain

• Governance and relationships are key• Make sure you and your staff are up for the challenge • Read the paperwork and ask questions • For DH – make the form a word document and extend

the time as much as possible

Documents you will need to consider

• National Curriculum – Sets out our requirements for HEIs and Training

Providers core offer • Core offer

– Sets out in detail our offer to you – Sets out the calculations sitting behind the funding

package– Sets out what we are looking for in competitive bids

Documents continued • Collaborative Application Form • Requires senior level sign off

– Word applications for all qualitative information – Excel workbook

• One worksheet for each HEI/Training Provider

• One worksheet for each local partnership

• Financial macros calculate the funding package

After 23rd April

• Bids are sent to SHA leads for comment – each SHA has been asked to nominate a lead/link for the project

• Short listing by members of the Service Development Group who are not bidding

• Interview appointments sent out for interviews• Interviews in June

2012-13 – new investment announced

• Existing package through existing collaboratives

• Increase in geographical reach of collaboratives

• Introduction of new therapies – IPT and SFT• E packages

- universal staff

- counsellors

-Computerised Therapies CYP

CYP IAPT Training

Year two additional modalities:

SFTIPT

CBT

Parent training

Service development

You are applying for

• Existing CBT, parenting and Service development package

• You will have the opportunity to supply/train in the new therapies when we know how they will be delivered

• www.iapt.nhs.uk

• Kathryn.pugh@dh.gsi.gov.uk