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KCA New Thoughts IAPT Service, Surrey - Name and Shame


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#1 Ashley

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Posted 03 March 2012 - 12:41 AM

The IAPT, or to use its full name, Improving Access to Psychological Therapies programme has one principal aim, that is to support Primary Care Trusts in implementing National Institute for Health and Clinical Excellence (NICE) guidelines for people suffering from depression and anxiety disorders, like OCD by improving access to evidence based talking therapies and treatment choice by the expansion of the psychological therapy workforce and services. In layman’s terms to, it was designed to provide faster access for people with depression and anxiety disorders like OCD to talking therapies such as Cognitive Behavioural Therapy (CBT) and the then Labour Secretary of State for Health, Alan Johnson, announced substantial new funding of £173 million to fully implement the IAPT programme over the subsequent three years.

So now, some four years later since the first investment into IAPT how is the service fairing?

Well let's take a look in Surrey, first a little history as I know it (clarification on these points welcomed), but this is how I understand it. Prior to IAPT the CBT was provided by the local mental health Trust, in this case it was Surrey and Borders Partnership Foundation Trust. They were commissioned by NHS Surrey and other PCT's to provide mental health services to residents of the area the Trust covered. Then, the tenders went out for IAPT and if I am understanding correctly the tender to provide primary level IAPT services for Surrey was awarded by NHS Surrey to an organisation called KCA, and the KCA New Thoughts IAPT service was born, in 2010 or early 2011 I think. Their website says 'KCA is a charity and a company limited by guarantee, established in 1975. The organisation has many years experience delivering drug, alcohol and mental health services and an established network of service centres in London and the South East.'

Now this is where the problems begin, because IAPT was supposed to target getting people back into work, or ensuring they stay working by improving access to CBT, certainly within a target of NHS national waiting times (18 weeks). For some reason, KCA did not simply get funding to implement a brand new IAPT service, instead they appear to have taken the waiting lists from the existing Surrey and Borders Partnership Foundation Trust. I personally think that Surrey and Borders should have retained their waiting list and worked through it, allowing KCA to start with a new service, but, that is not what happened, and KCA must have agreed to take on the service, and will be paid for it and therefore have no reason to moan about the fact they have a 2000 long waiting list for CBT they inherited, but they did, and they are and they shouldn't.

This is a perfect example of why Mr Cameron and Mr Lansley should not be allowed to get away with their plans to push for greater involvement from the private sector and charities, because as in this case I fear we may see cheaper tenders won, but at the cost of the patients and blame being passed from service to service.

Back to the problems of today.

For many weeks now I have been working with one of our members to help her gain access to CBT through her local service. Sadly for her she lives in Surrey and KCA provide that service now. Her GP referred her for CBT in January 2011, she eventually received a phone call from the IAPT service in August which lasted all of 10 minutes, I believe the conversation went like this "well yes Miss X, you have OCD, we can treat you and we will be in touch at some point". She never heard from them again. She then received the attached letter (I do have permission to share this).

Attached File  KCA.jpg   936.17KB   31 downloads

As you can see, despite having waited over a year for CBT, thankfully she is doing ok'ish and not desperate, she was able to see the funny side of it, 'yes we might offer you CBT at some point, we are not sure when, but it might be soon'....

KCA should never have sent such a letter, it is like 'look at us, our problems are so bad, blah, blah', well I can assure KCA that their problems are nothing compared to the lady with OCD, and no doubt everyone else on that waiting list. I don't care one bit about KCA problems, they should never have accepted the contract if they cant provide the staff or the service.

I have spent a fair while on the phone to KCA in February, and they have told me porkies that that they have tried to call and email the lady, they hadn't, they told me the number was wrong it was not connecting, but the fact is the number was fine, I had given the lady at KCA her email address on the 7th February too, so when KCA told me this week that they could not reach the lady, I asked 'why did you not email her then if the phone was not working as I gave you the email address on the 7th February Elaine', 'oh, eeer, well I thought we did' Elaine told me, I reply, 'So Elaine, when we spoke on the 6th and 7th Feb, you refused to discuss with me, you wanted to talk to the client, what did you want to talk to the client about was it to offer her CBT?', 'When can she expect CBT to begin Elaine, this month, April, May, June?'. I was being pretty firm and hard at this point because she had lied to me about trying to contact our member.

To this day they still will not tell our member or myself when they can expect to be in a position to offer CBT. I don't expect an exact date, but a rough 2 month period estimate would be nice.

So, my question to our members is this. Have you been offered CBT through KCA, if so, did you have to wait long? Or are you still on the waiting list. I would like to hear some good positive stories that KCA are doing a good job. But if you are in the same boat as our other member, let me know because it is time to go above KCA to the commissioners.

"Nothing in this world that's worth having comes easy" - Dr Bob Kelso

 

"The best form of defence is attack" - The late great Brian Clough. The perfect analogy for OCD, you can only beat it by attacking it.


#2 Bec

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Posted 03 March 2012 - 09:11 AM

I know I've probably mentioned this to you before but I thought I'd add it here in case it rings any bells for others.

I was sent to the KCA in Kent by my GP. They did an initial assessment phone call and then I had some face to face sessions with a 'well-being practitioner' which were very basic and she told me she couldn't help me much. After this they told me about a pilot scheme they were taking part in which involved allocating people a pot of money and allowing them to go off and access their own treatment. They said that these Personal Health Budgets were being allocated randomly and that some people would be staying in the normal NHS system (they would have to wait longer for treatment). I obviously said yes I'd take part and was given a budget of £600 to spend on whatever I wanted to improve my health. I went for CBT... they obviously checked out the person I suggested and handled the money side. This paid for 7 sessions after which I applied for more and got funding for a further 5. During this time I had a letter from the KCA saying they had discharged me back to the care of my GP as I was officially 'off their books' so to speak.

I've had a few forms to fill in asking how things are going but this seems to be for the purposes of assessing the success of the pilot. I've got 2 CBT sessions left and it hasn't been as successful as I'd hoped it might be... probably my fault for not trying hard enough. I've been told I've had the maximum allowed under the scheme so if I need more help in the future I'll be back to square one with the GP again.

I know I've been lucky to have had this opportunity but I can't help thinking that Personal Health Budgets are being used to reduce the burden on the NHS and to reduce the waiting lists. I feel that I've been effectively dumped by the NHS and they're not bothered about how it's working now that I'm off their list.

Sorry to sound negative when I know I've been lucky compared to others.

#3 Ashley

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Posted 05 March 2012 - 07:05 PM

Purely by chance, I assume, the lady was offered a CBT appointment today for April, which she is pleased about. I remain less pleased it took them 13 months to offer this appointment.

"Nothing in this world that's worth having comes easy" - Dr Bob Kelso

 

"The best form of defence is attack" - The late great Brian Clough. The perfect analogy for OCD, you can only beat it by attacking it.


#4 Nitai

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Posted 04 April 2012 - 04:53 PM

Hi Ashley

I have been on the waiting list with KCA Surrey since Feb 2012 - looks like im in for a LONG wait lol. I am practising the Four steps with some sucess, looks like i will have to grab onto to the Four steps. Not much chance of any CBT for me for a while now - i must be number 1998. /whistling.gif' class='bbc_emoticon' alt=':whistling:' />
You cant stop a bird (OCD thoughts and feelings) flying over your head but you can stop the bird making a nest in your hair (ie seeing them for the OCD nonsense that they are).

#5 med123

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Posted 04 April 2012 - 09:26 PM

I think you'll find that the commissioners are well aware of (and thus far willing to accept) the gross underperformance of KCA. I would suggest you call them and ask them what happened to all patients referred before July 2011, and why Nitai is likely to have a much better experience of the service (relatively) than Ashley.
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