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GPs go forth

GP practices will not be funded to employ therapists despite GPFV pledge

Exclusive A vast majority of the 3,000 new ‘practice-based’ mental health workers promised in last year's GP Forward View will not be working in practices after all, Pulse has learned.

The GP rescue package published last April had said NHS England would be funding ‘3,000 new fully funded practice-based mental health therapists’ by 2021.

It had said this would provide enough therapists to provide ‘an average of a full time therapist for every 2-3 typical sized GP practices’.

But, asked for clarification, NHS England has confirmed to Pulse that all 3,000 are linked to an already announced expansion of the Improving Access to Psychological Therapies (IAPT) scheme to people with long-term conditions.

As such, the therapists will not be employed directly by GPs and only some of the new practitioners will work in practices.

NHS England bosses insisted this was not a ‘broken promise’ as the therapists will be part of ‘primary care teams’.

But the RCGP, which has been calling for every practice to get access to a mental health therapist, called for ‘reassurance’ from NHS England that the therapists would be ‘genuinely integrated’ with GP practices.

NHS England told Pulse: ‘Practice-based therapists can mean co-location, for example at a local hub, but not directly employed by practices.’

Asked how GPs will be able to get access to the therapists, an NHS England spokesperson told Pulse: 'It will be a CCG-commissioned service, and so for them to discuss with CCG and IAPT service.'

NHS England’s director of primary care Dr Arvind Madan said: ‘It is wrong to say we have broken any promises. There are going to be 4,500 extra mental health therapists planned under the IAPT programme by 2020/21, including 3,000 mental health therapists based in practice buildings or within primary care teams, depending on what makes sense for local patients and services.’

But RCGP chair Professor Helen Stokes-Lampard said: ‘Ensuring that every GP practice has access to a mental health therapist was a key pledge in NHS England’s GP Forward View – and essential in the drive to achieve parity of esteem between the physical and mental health care we provide our patients.

‘We understand that this access will largely be delivered through IAPT providers – as opposed to GP practices employing mental health therapists directly – and as such we need assurances from NHS England that the therapists will be genuinely integrated with general practice, not simply an expansion of existing IAPT teams.'

Mental health therapists – broken dreams or promises?

Last year the RCGP called for all GP practices to get access to a mental health worker, and lobbied NHS England ‘in parallel’ with the Mental Health Taskforce to get this on the agenda.  

NHS England subsequently endorsed the Mental Health Taskforce's recommendations, including expansion of the IAPT programme to people with long-term conditions, as well as better core training of GPs in mental health.

The RCGP had said it wanted to 'ensure that GP practices have targeted access to mental health professionals – ideally for them to be based in practices as part of the practice team, in a similar way that practice-based pharmacists are currently being rolled out across England'.

NHS England had appeared to step up to the plate with its pledge to provide '3,000 new fully funded practice-based mental health therapists' in the GP Forward View, published last April.


Readers' comments (5)

  • Cobblers

    Don't be surprised. It's doublespeak. Classic headline grabbing announcement then deflation as the small print is read.

    Expect a lot more of this.

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  • Vinci Ho

    Same question to you from me again:
    Have you written to Sarah Wollaston? And by the way, Sarah , where are you?

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  • Vinci Ho

    Oh , the first question is for you , Helen.

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  • That's strange. Simon said the other day he's demolishing CCGs and giving power to STPs soon. Anyone sane in CCG will be looking to wind down and transfer the power over the next couple of years just like PCTs did only 4 years ago!

    So I suspect CCGs will be commissioning this in smallest way possible to satisfy the mandate - not through their choice butto comply with NHSE's own rule!

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  • I strong support the RCGP stance. Current mental health services are not well integrated with general practice whilst practice workload particularly in supporting patients with mental health problems and dual diagnosis is rising inexorably. Restrictive criteria and 'turf' wars between different services abound.
    The practice as a hub of integration is a key principle which we must adhere to

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