Talking Therapies

Talking Therapies (previously known as Improving Access to Psychological Therapies (IAPT) and later locally as the CPFT Psychological Wellbeing Service) provides treatment for common mental health conditions at the higher levels of the stepped care model (Public Health England, 2019). It was first introduced in 2008 and has grown to support over 1.2 million people across England in 2021/22 (NHS England, 2023f). In Cambridgeshire and Peterborough, Talking Therapies can be accessed by anyone aged 17 or over, without the need for a mental health diagnosis. People can self-refer into this service or be referred in by CPFT professionals. Treatment offered includes:

Low intensity interventions
Cognitive behavioural therapy (CBT)
Computerised cognitive behavioural therapy (cCBT)
Virtual reality-based therapy
Interpersonal therapy (IPT)
Eye Movement Desensitisation Reprocessing (EMDR)
Wellbeing workshops and group treatments
Specialist support for people who are unemployed.

The introduction of the Psychological Skills Service (PSS) meets the needs of people whose mental health needs are ‘too complex’ for Talking Therapies.

Overview

An increasing number of people have entered treatment in Talking Therapies in Cambridgeshire and Peterborough over the past two years.
In the final quarter of 2022/23, 6% of referrals into this service were for adults over the age of 65.
In the final quarter of 2022/23, almost everyone (99%) received their first treatment appointment within 18 weeks of referral, and a very high proportion (93%) received their first appointment within 6 weeks of referral, meaning that Cambridgeshire and Peterborough performed better than the national standard in terms of waiting times.
However, the recovery rate for this service in the final quarter of 2022/23 was 48%, below the national target (50%). The recovery rate was also below the national target for people from Black, Asian or minority ethnic groups, similar to most local areas.

Figure 37: Performance overview of NHS Cambridgeshire and Peterborough ICS Talking Therapies, Q4 2022/23. Source: NHS Mental Health Dashboard

Note that these indicators should be interpreted with caution as some data is experimental and changes could be due to fluctuations in data quality. * green figures indicate a positive change for the indicator (the ‘better is…’ column shows whether this is a positive or negative change) and red figures indicate a negative change. A green circle in the ‘standard met’ column indicates that performance is better than the national standard where applicable, and a red circle indicates that performance is worse.

Access and waiting times

The number of people referred to Talking Therapies dropped substantially in December 2022 and has shown a fluctuating trend since then. However, the number of referrals finishing treatment has stayed relatively stable at around 1,000 people per month.

Figure 38: NHS Talking Therapy referrals received, accessing services and finishing treatment, Cambridgeshire and Peterborough ICB, May 2022 – May 2023

In May 2023, almost everyone (94%) referred to Talking Therapies in Cambridgeshire and Peterborough began treatment within 6 weeks; and 99% within 18 weeks. Waiting times for this service decreased slightly from May 2022 to May 2023.

Figure 39: NHS Talking Therapy waiting times, Cambridgeshire and Peterborough ICB, May 2022 – May 2023

Support type and outcomes

Since May 2020, more than 80% of all the appointments in the Talking Therapies service were CBT (cognitive behavioural therapy), guided self-help, pure self-help/information-giving only, integrative, and other low-intensity appointments.

Figure 40: Top 5 most common appointment types at CPFT Talking Therapies, March 2018 – September 2023. Data source: CPFT

What are the outcomes?

The majority of people completing a course of treatment in Cambridgeshire and Peterborough Talking Therapies show ‘improvement’ in their symptoms. Around half enter ‘recovery’, which is recorded using range of clinical measures which monitor symptom frequency and severity.
The rate of recovery, improvement, and reliable recovery has shown a fairly stable trend since May 2022.

Figure 41: NHS Talking Therapy outcomes, Cambridgeshire and Peterborough ICB, May 2022 – May 2023. Data source: Source: Workbook: TTAD_ProtectedCharacteristics (england.nhs.uk)

Recovery rates show fluctuations for White British and ethnic minority groups. The recovery rates for people from ethnic minority groups have been constantly lower than 50% since June 2022. Similarly, national research shows that people from minoritized ethnic groups experience poorer outcomes from Talking Therapies, although this gap has narrowed in recent years (Collaborating Centre for Mental Health, n.d.).

Figure 42: Talking Therapy recovery rates by ethnic group, Cambridgeshire and Peterborough ICB, May 2022 – May 2023. Source: Workbook: TTAD_ProtectedCharacteristics (england.nhs.uk)

The recovery rate for under 18-year-olds has been substantially lower compared to all other age groups. The recovery rate for 18-25 has been below 50% for most of the reporting periods.

Figure 43: Talking Therapy recovery rate by age group, Cambridgeshire and Peterborough ICB, May 2022 – May 2023. Source: Workbook: TTAD_ProtectedCharacteristics (england.nhs.uk)

Nationally, people living in more deprived areas are less likely to recover through Talking Therapies, compared to people living in less deprived areas. This may be due to wider factors, such as financial insecurity, that exacerbate poor mental health (Nuffield Trust, 2023).

What do people say about this service?

In Cambridgeshire and Peterborough, most people who have used NHS Talking Therapies report that this service was explained to them in a way that they understand; and that they were involved as much as they wanted in deciding which talking therapies to use. The score given to this service in the NHS Community Mental Health Survey (7.4 out of 10) was similar to the national average and did not change significantly between 2021 and 2022.

Figure 44: Score of Cambridgeshire and Peterborough NHS Trust on NHS Talking Therapies, compared to all NHS Trusts. Image source: NHS Community Mental Health Survey Benchmark Report 2022

Additional resources

References

Full list of references is included at the end of this chapter.