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Case study: early intervention leads to better outcomes and cuts costs

The Early Intervention in Psychosis service has been the stepping stone that I needed. The team has helped me step up and leave my mental problems behind. They gave me support to apply to university. They gave me so much encouragement.

Lead AHSN and joint partners

Oxford AHSN Early Intervention in Mental Health Clinical Network, National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care Oxford, Johnson & Johnson.

Key points at a glance

Our thorough analysis – carried out with partners in research and industry – found strong evidence that specialist early intervention for young people when presenting with first instance psychosis leads to better outcomes and reduces demand for mental health services. It also brings estimated annual savings of up to £7,000 per year for each patient which equates to up to £7m per year across the Oxford AHSN region alone. These findings are informing the development of national guidelines around referral to treatment times ahead of the introduction of the first mental health waiting time standards.

Background summary

Psychosis is relatively common, disabling disorder affecting thousands of young people every year. It has a hugely detrimental impact on young lives and costs the UK economy an estimated £11.8bn per year. Early intervention in psychosis (EIP) services are a key priority identified in the NHS Five Year Forward View and in the development of a first national referral to treatment time target for mental health.

Challenge identified and actions taken

A comprehensive evaluation of the impact of early intervention services in the Oxford AHSN region over a three year period for people with psychosis aged 16-35 was carried out with Johnson & Johnson. It found that only approximately one in five were receiving support from specialist community treatment teams but evidence indicated that this input was making a difference both in terms of the positive impact on individuals – with 38% in education or employment compared to 25% of those not receiving the specialist support – but also in overall reduced demand on health services. Higher use of community services by this group was more than outweighed by reduced use of more expensive hospital services, with 10% fewer admissions and less time spent in hospital. Annual savings in reduced bed days amount to approximately £5,000 per patient. Reduced use of secondary care services saves a further estimated £2,000 per patient per year. With almost 1,000 young people presenting in the Oxford AHSN region with first episode psychosis every year, total annual savings of £5m-£7m are estimated.

Outcomes

Local improvement plans have now being put in place through our NHS partners. Every early intervention in psychosis service in the Oxford AHSN region has received additional investment to build their clinical teams to respond to this challenge.

Plans for the future

The Oxford AHSN Early Intervention in Mental Health Clinical Network, which aims to improve health and social outcomes for young people with first episode psychosis, is moving from establishing evidence of effectiveness of EIP services to supporting implementing this evidence into practice. This work is also informing the development of national guidelines around referral to treatment times ahead of the introduction of the first mental health waiting time standards.

Further information

Read more in this poster, produced June 2015.

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