Supporting Patients with Physical Long-Term Conditions Through Psychological Interventions

Project Aim

Originally launched in 2008, the Improving Access to Psychological  Therapies (IAPT) programme is a large-scale initiative that aims to increase the availability of NICE-recommended psychological treatments for depression and anxiety disorders. People with longterm physical health conditions – the most frequent users of health care services – commonly experience mental health problems such as depression and anxiety. As a result of these co-morbid problems, the prognosis for their long-term condition and the quality of life they experience can both deteriorate markedly, unless they are supported in an integrated way. For example, 40{79f878acaa41f375dcd804cc8c058b5459a5482f20a3b9f87269b26c8734749b} of patients locally with diabetes show symptoms of psychological distress. Thames Valley HIEC co-ordinated four related projects in Berkshire, Buckinghamshire and Oxfordshire, as part of a national Pathfinder programme, that provide psychological interventions to patients with specific long-term conditions. The project teams agreed to share the learning between themselves during the life time of the projects, and to contribute to the rapid dissemination of the outcomes of the Pathfinder nationally.

Project Summary

Each of our local projects is focusing on patients with a different long-term condition. In Berkshire, the aim is to provide a specialist psychological service for patients with diabetes, as a component of improving their general well-being. In Oxfordshire, patients with cardiac disease/cardiac failure are receiving integrated physical and mental support in both community and hospital settings. In Buckinghamshire, an integrated physical and psychological stepped care model is being implemented for patients with chronic respiratory conditions. Finally, the fourth project, which is running in Berkshire, is concerned with patients who have medically unexplained symptoms, which may have a physical, or a psychological basis, but where no diagnosis has yet been made. This latter project offers a multi-agency stepped care pathway across primary care, psychological services and liaison psychiatry. As a critical element of the work is to develop the evidence base for the efficacy of the application of psychological therapies to patients with LTCs, all four projects have a rigorous evaluation methodology in place. The University of Sussex has been commissioned by DH to carry out the independent evaluation of all the Pathfinder sites.

In November 2012, a Rapid Learning Transfer Event was held for all the participants, the evaluators and the national team, to share learning between the projects and to gain critical insights into ways to improve the project outcomes, while the work is still in progress. Through facilitated learning circles, the project teams were offered feedback and insights, that they then turned into action plans to inform the next stages of their work.

Project Outcomes

All four regional projects are starting to deliver measurable clinical outcomes.

A successful Phase II bid was submitted that sees the projects continued into the year 2013/14. A regional “sharing event” was held in Southampton on 4th July 2013.

The Knowledge Team continues to proivide support to the Pathfinder Steering Group.  


For a summary of the report: HIEC summary LONGTERM CONDITIONS


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