1. THE NEW ACCESS & WAITING TIME
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1 1. THE NEW ACCESS & WAITING TIME from referral to treatment Treatment delivered in accordance with NICE guidelines
2 Anyone (children, young people, adults) with a first episode of psychosis start treatment in early intervention in psychosis services within 2 weeks of referral. The standard is two-pronged. Both conditions must be met: 1. A maximum wait of two weeks from referral to the Trust to start of treatment; AND 2. Treatment delivered in accordance with NICE guidelines for psychosis and schizophrenia Commencing treatment means that someone: has had an initial assessment, AND is allocated to and engaged by an EIP care co-ordinator, AND is in an EIP service able to provide the full package of NICE-concordant care for psychosis or an at-risk mental state. time4recovery.com
3 2. Why is EIP important? improved quality of life reduced costs across services
4 The costs of early intervention in psychosis 40,000 30,000 20,000 10, ,422 14,394 One-year costs 26,568 40,811 Three-year costs There is a wealth of evidence which shows that EIP teams significantly improve people s prospects of recovery, education, employment and reduces the likelihood of them relapsing or taking their own life. Numerous peer reviewed economic studies have shown average savings of 7,447 per person seen by EIP team per year. In September 2015, there were 4,205 people with first episode psychosis who were accessing EIP teams in the South of England giving the health economy a saving of 31 million in the next 1-3 years. EI Standard care Source: McCrone P, Park A & Knapp M, 2010: Economic evaluation of early intervention (EI) services, phase IV report. PSSRU Potential annual savings from EI compared to standard care services Per person savings Annual savings Short-term (1-3yrs) 7,447 (5,360 reduced service costs, 2,087 reduced lost productivity Long-term (4-10yrs) 3,124 (2,087 reduced lost productivity, 957 reduced suicides, 80 reduced homicide) 51.4 million 21.6 million The table shows the annual savings compared to standard care due to 100% El provision. This is based on a one-year cohort 6900 patients (the estimated incidence of psychosis in England) receiving care. The savings in service costs are based on our earlier work (McCrone et al, 2009). Clearly, more savings will accumulate as EI is used in subsequent years. Savings are reduced beyond three years because we have conservatively assumed that admission rates are then the same for EI and standard care. time4recovery.com
5 OFFER THE RANGE OF NICE RECOMMENDED TREATMENTS FOR PSYCHOSIS deliver Treatment to >50% of people within 14 days 3. What is a NICE concordant EIP service?
6 A NICE concordant EIP service is able to offer and deliver the following NICE recommended treatments to >50% of people within 14 days of referral: Cognitive Behavioral Therapy for psychosis Family interventions Clozapine (if 2 antipsychotics have proven ineffective) Education & employment support Physical health assessments Wellbeing Support (eat healthily, physical activity, stop smoking) Carer focused education & support time4recovery.com
7 teams RECORD DELIVERY OF NICE RECCOMENDED TREATMENTS NHS England to accredit EIP teams AGAINST THIS EVIDENCE 4. How will the EIP standards be assessed
8 NHS England will be undertaking a programme to accredit EIP teams that can evidence the ability and capacity to deliver the NICE recommended treatments for psychosis. time4recovery.com
9 5. What do you need to prepare for the EIP Access & Waiting Time Standards before April 2016? work together recruit and train EIP staff
10 Providers and commissioners need to involve people who use their services and work together to ensure the EIP teams have resources to be able to provide NICE recommended packages of care. Together, we must recruit and train EIP staff so that people with first episode psychosis can access EIP services that can allocate to an EIP Care Coordinaor within 14 days of referral AND deliver: CBT for Psychosis (CBTp) Individual Placement Support (IPS) for education and employment Family Interventions Medicines management Comprehensive physical assessments Support with diet, physical activities and smoking cessation Carer-focused education and support programmes time4recovery.com
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