New guidance from NHS England will encourage doctors to place mental health therapists in practice surgeries – bringing more mental and physical health services under one roof.
These new therapists will be integrated into primary care teams and focus on common mental health disorders such as anxiety and depression, particularly where this occurs in patients with a long term physical health condition such as diabetes, respiratory or heart problems.
Evidence suggests 9 out of 10 adults with mental health problems are supported in primary care, and broadening the range of services for patients, means local health services are better equipped to deal with patients’ physical and mental health needs.
Claire Murdoch, NHS England’s national director for mental health said: “Joining up talking therapy services in primary care settings is another big step forward for our patients and a key plank in putting mental health at the centre of the long-term plan for the NHS. We are on track to deliver 3,000 therapists in primary care, with over 800 in surgeries at the end of last year and this handy guidance should convince those practices that are yet to take the plunge of the benefits.”
Dr Nikita Kanani, NHS England’s acting director of primary care, said: “General practice is the front door of the NHS. We continue to support the expansion of the workforce so patients have access to a range of different health professionals so that we can better support both their physical and mental health needs.”
In house mental health therapists, largely provided through collaboration with local Improving Access to Psychological Therapies (IAPT) services are expected to be full members of the primary healthcare team – receiving self-referrals from patients as well as GPs, clinical pharmacists, practice nurses and healthcare assistants. In addition they should:
- Attend practice meetings
- Provide specialist advice to support to ensure mental health is taken on-board and considered as part of treatment and care in the surgery
- Link in with clinicians across other mental and physical health services on behalf of the patient and practice.
This closer way of working usually means the patient doesn’t have to travel far for their psychological treatment encouraging attendance and for some patients, receiving treatment in their GP surgery reduces the perception of stigma associated with having a mental health problem.
Intervening at an earlier stage and addressing common mental health issues can also improve care, while closer team-working can help reduce the number of referrals to hospital or community care – releasing capacity.
Many parts of the country have already pressed ahead with plans to transform mental health and primary care services this way, including:
- In Sheffield, IAPT practitioners provide updates on the patient record on GP systems at each appointment. This provides the doctor with useful information on how the patient is getting on and enables them to have a fully informed conversation about their physical and mental health needs
- In Calderdale, the IAPT service uses the GPs’ diary system, which means practice staff can book appointments with the therapist directly. Practitioners get weekly case management supervision from supervisors in the service
- In Cambridge and Peterborough, early results show that timely and effective mental health care for people with diabetes, cardiovascular or respiratory illnesses have resulted in a three-quarters reduction in inpatient hospital attendance and a two-thirds drop in A&E admissions, freeing up £200,000 of NHS funding.