Treating mental and physical health problems together delivers better patient outcomes and savings for the NHS, according to new analysis.
NHS England plans that by 2020/21 each year over 1.5 million people with common mental health problems will access psychological therapies. These people often also have physical long-term conditions such as diabetes, lung disease and heart problems.
NHS England awarded Improving Access to Psychological Therapies (IAPT) services in the Oxford AHSN region ‘Early Implementer’ funding to lead the way in setting up integrated treatments for patients with long-term conditions (LTCs) alongside mental illness. Four of the first 22 services selected nationally were in the Oxford AHSN region.
These new treatment services are co-located in primary care and delivered in multi-disciplinary teams. IAPT psychological therapists work with colleagues with expertise in fields related to long-term conditions – such as diabetic nurses, cardiac rehabilitation nurses and physiotherapists specialising in chronic obstructive pulmonary disease – to provide holistic treatments.
A rigorous evaluation of clinical and health economics outcomes demonstrated the value of the new approach coordinated by the Oxford AHSN Anxiety and Depression Network working with Talking Therapies in Berkshire, Talking Space Plus in Oxfordshire and Healthy Minds in Buckinghamshire.
This study was carried out by health economist Professor David Stuckler, formerly of the University of Oxford, now based at the University of Bocconi, Italy, supported by NHS South, Central West Commissioning Support Unit. It focused on one of the first groups of patients (more than 450 people) who started receiving new, integrated IAPT-LTC treatments in 2017.
The evaluation concluded that after receiving integrated IAPT treatment patients with LTCs:
- reported fewer symptoms of anxiety/depression
- made less use of primary and secondary healthcare services*
- will save the health system on average an estimated £1,870 per patient over a two-year period (taking into account IAPT treatment costs)
Read more on the findings of the clinical and health economics evaluation here.
Patient feedback
‘After my heart attack I was feeling chest pain and I was going to A&E and hospital but they said I was fine. Then I saw the Heart2Heart therapist and realised I was depressed. I’ve got a long way to go but I can get out of the house now and I am thinking of returning to work.’
‘One of the biggest benefits of the group was the opportunity to meet other people living lives where every day they face the challenges of a long-term health condition. It’s been a huge encouragement.’
‘I feel relieved now that I know how to manage my diabetes better.’
‘I’ve got my bounce back. I’m a lot less angry. I’m a lot less tearful, and feeling much happier in myself.’
Professionals’ feedback
‘We have seen excellent outcomes for patients accessing these joined up services including increased confidence, increased independence and an ability to manage disabling anxiety associated with breathlessness.’
‘The benefits of integrated working are endless. Endless. When mental and physical health services work closely together and collaboratively, we have an accountable care system.’
*Primary care activity: GP appointments, practice nurses, specialist nurses. Secondary care activity: accident and emergency, outpatient and inpatient