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IAPT and Choice


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I have just discovered that my referral to a particular psychological service has been cancelled and have been re-referred to another organisation. The original referral was some months ago and I feel that the communications from my local IAPT have not been good. I would prefer to go to the organisation to which I had been originally referred to. To what extent do you have a choice? Does anybody know? Welcome people's knowledge and opinion.

Edited by Angst
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Hiya,

There is the NHS England's 'Right to choose' which states that a person is entitled to choose their treatment provider (from existing commissioned services), but this is not to be confused with choosing 'treatment' levels. So if you've been referred for treatment via IAPT and you simply want to choose IAPT provider B, rather than you're own local IAPT provider A you are entitled to request that under the 'right to choose'.  

When using 'right to choose' you can't self-refer, you must ask your GP to make the referral to the out of area IAPT service for you.

 

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I live in Lambeth in London. I was originally referred to the Centre of Anxiety and Trauma by my IAPT. I had therapy there previously about 4 or 5 years ago. Although the Centre is based in Southwark at the Maudsley site - at least after my initial telephone interview - it was decided to refer me there. SLAM covers four London boroughs including Lambeth.

I originally talked to my GP about being being re-referred to the Centre of Anxiety but the GP indicated that it would be too costly. I then went via the IAPT route. The GP as the gatekeeper to services blocked my initial request. 

I think that there are a number of providers serving Lambeth as it has the highest rate of serious mental illness in Europe according to reports which I have read. 

I have found that GPs have different attitudes to mental health and indeed commitment to budgetary restrictions. But I don't know if my initial referral was blocked by the local commissioning group, the Centre of Anxiety or some other agency. I am expecting a letter which might explain things. I asked on the phone but given no details.

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It depends which level of service you had at CADAT previously, they offer a secondary care service too, so if it was that (rather than national referral) in theory there is no reason the GP can't refer you back there.  Equally, can you not talk to the IAPT service you have been referred to and ask them if they can re-refer you like previously?

 

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Thanks for the replies Ashley. I am expecting a letter and a return phone call from the IAPT people on Tuesday. I'll look into the paperwork about the previous referral to CADAT. I always find it helpful to be aware of the options available before making a choice or trying to achieve my preferred choice. Should be able to make a decision on Tuesday.

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Hello Angst,  I have been through the process of referral to CADAT and had an assessment there which was really great.  I recommend you make an appointment with a supportive GP for Tuesday afternoon onwards.  That way, if the IAPT don't help, you can go to the GP, and if they do help, you can always cancel the appointment.

You have the legal right to choose to have your first outpatient assessment in a "new episode of care" wherever you want to go  - i.e. you can (and should!) choose to go to CADAT, because it's a centre of excellence, and because living in Lambeth, you will be able to get to their outpatient service easily.   It is not up to the GP to block it on grounds of cost.  I wouldn't recommend going to that GP for anything ever again!  A good GP will know what patients' legal rights are and will support you in making the choice which is best for you - clinically, not financially! 

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Thanks for that. I agree with you about the GP which I saw. I have a sympathetic GP who I see when I can. Your strategy is a good one. Thanks again.

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Found the letters. I was originally referred under 'secondary care'. I read the information about this on the site as well. Be an interesting conversation tomorrow.

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I am again being referred by secondary care but to another organisation it will be with a clinical psychologist. I will wait until I have further details before I react or not react as the case may be. There will be an opening interview similar to that conducted by CADAT, apparently. I think that I will try to discover more by contacting local mental health charities in the area to see if they can provide more local info.

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Good idea to try to get further details. It's crucial to have researched your options before you have your first appointment because it might be too late to change providers later.  The CADAT assessment is 2 hours' long and you fill out about 14 questionnaires in advance of the appointment.  So if you are going to compare providers, perhaps see how long the other assessment is and what assessment tools they use, what interventions they offer and where...

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Thanks for the input. Some good criteria for choice there. Their professional approach can be gauged in their approach to initial assessment. And given that I have checking and hoarding OCD, at least some home visits are important.

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Even if the secondary care provider is not CADAT, it's possible they can still offer good, effective quality therapy.   The other thing to remember too is that if sadly you don't access good effective therapy, then you have ticked a box of secondary care, so would be one step closer being able to access CADAT through a national referral too. 

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