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GPs need to be in on conversation over talking therapies

By Richard Hoey

The Government's Improving Access to Psychological Therapies programme is one of its more impressive achievements, but a top-down rollout won't endear it to GPs, says Pulse editor By Richard Hoey

When the Department of Health announced funding for 3,600 new therapists as part of its IAPT programme, the assumption was that this would deliver a brand new service.

All those impressive projections for the impact therapists would have on psychological – and indeed physical – illness, presumably relied on the programme coming over and above existing provision.

So it's disappointing that in some, perhaps even many, areas of the country, that's not necessarily been the case.

Pulse this week reported on a warning from the charity Mind that some PCTs were using the rollout of IAPT as an excuse to implement cuts elsewhere in the mental health budget.

Well, I spent this morning at the RCGP with a group of GPs plus the architect of IAPT, Lord Richard Layard – and it was clear that this displacement of existing services, particularly of counselling, is a growing issue.

Now, I'll declare an immediate interest here. I've always been a bit of a fan of Lord Layard, and his relentless, single-minded campaign to bring psychological therapies to the masses.

His intervention was much needed, and I suspect most GPs would firmly back the principles of the IAPT programme (please do correct me if I'm wrong).

But it's worrying if the Government is taking the same, unsubtle, infuriatingly top-down approach to IAPT that it has adopted in so many other areas of health policy.

Lord Layard argues that a bit of ruffling of feathers was perhaps inevitable, because some existing counselling services just aren't quite up to standard – or at least, that their evidence base doesn't match that for CBT.

But he also concedes that IAPT itself relies heavily on counselling in some areas of the rollout.

GPs aren't going to be very happy if their established, and valued, in-house counselling services face the chop in favour of a pretty similar service imposed from the outside.

And it would be a great shame if lack of consultation with GPs left the profession feeling disengaged from IAPT – because it has such potential.

Early findings suggest the provision of therapy is not only improving patients' mental health and getting them back to work – but also sprucing them up physically and cutting down on hospital admissions.

Given the pressure on hospital activity, that's a pretty nice bonus, and suggests the programme has the potential to save some serious cash.

But if GPs are to take full advantage, they will need to be both engaged and involved.

By Richard Hoey, Pulse editor