NHS Education for Scotland: Supporting NHS Boards to Hit the Target

HEAT Target – A12 NHS Boards are responsible for meeting the target. ‘During 2010/11 the Scottish Government will work with NHS Boards to develop an access target for psychological therapies for inclusion in HEAT 2011/12’. NHS Boards are responsible for meeting the target. NES supports Boards to deliver.

THE NES Brief NHS Education for Scotland (NES) was charged by the Mental Health Division to : prioritise and fund an increase in the range and availability of training in evidence-based Psychological Therapies. in order to increase the capacity within the current workforce to deliver Psychological Therapies. support service change to ensure that the new resource was used effectively in practice.

THE NES Brief To deliver evidence-based psychological interventions in practice we need to have staff trained to recognised standards, and having the competences necessary to deliver psychological interventions effectively to the tier of service within which they work; delivering well-articulated interventions for which there is an evidence base, and adhering to the appropriate model; operating within a well-governed system which offers regular high quality, model-specific clinical supervision, support and relevant CPD.

Supporting Boards to ‘Hit the Target’ - The NES Work Plan The Matrix Competence Frameworks Supervision Specific PTs training PTTCs CAMHS The PIT Values-based care What we have been doing and what we will be doing 5

‘The Matrix’- What have we been doing ? Working in partnership with SGHD to produce ‘The Matrix’: A guide to delivering evidence-based Psychological Therapies in Scotland’ Evidence of effectiveness of particular therapies for particular patient groups – The Matrix Tables Effective delivery -Training -Supervision -CPD

‘The Matrix’- What will we be doing? Updating and Expanding Older People---------------Draft available CAMHS----------------------Draft available Trauma ----------------------Work in progress Forensic----------------------Work in progress Alcohol and Substance Misuse----Work in Progress Update - (not ‘The Matrix Re-Loaded’) to coincide with publication of the ‘refresh’ of Delivering for Mental Health)

Competences – What have we been doing? Worked in partnership with ‘Skills for Health’ to commission competence frameworks from Steve Pilling and Tony Roth for :- Cognitive and Behavioural Therapies Psychoanalytic/Psychodynamic Humanistic Supervision Supported the re-structuring and development of training around the competence frameworks

Competences - What will we be doing? Commissioning CAMHS competence framework-in progress ??

PTs Supervision – What have we been doing? Adequate supervision capacity key to equip Boards to meet any future access target Based on work already developed by NES, and the Roth and Pilling PTs Supervision competences Developed and piloted generic PTs Supervision curriculum – March 09 Developed and piloted a ‘Training for Trainers’ – March 10 This course will be rolled out to NHS Boards using a ‘Training for Trainers’ model, and co-ordinated by the NES Psychological Therapies Training Co-ordinators, ensuring that each Board has the capability to train PTs Supervisors in line with local requirements and timescales

PTs Supervision - What will we be doing? Develop and pilot modality and profession-specific ‘bolt-ons’. Roll out in each Board area. Assessment of competence. In line with Local strategic planning.

Training in Evidence-based Therapies Supported work on the re-structuring of CBT training Mindfulness Mentalisation Therapy Behavioural Family Therapy (BFT) Inter-Personal Therapy (IPT) Cognitive-Behavioural Integrative Therapy (C-BIT) Particular focus on Trainers and Supervisors

Psychological Therapies Training Co-ordinators (PTTCs) Current Role To integrate the NES PTs work at local level To provide Boards with additional capacity to scope PTs services and identify gaps To build educational infrastructure necessary to plan and support appropriate and sustainable training in Psychological Interventions

PTTCs – cont Future developments will lead in embedding the NES PTs Supervision Training in the NHS Boards areas will liaise with the new Psychological Interventions Team to collect good quality workforce data to inform the proposed PTs access target and the subsequent training initiatives will begin to widen the psychological therapies agenda to other key service areas such as the delivery of Psychological Interventions to Older People Contact details in conference pack

CAMHS It is estimated that around 10% of children and young people in Scotland have mental health problems which are so significant that they impact on their daily lives. Improving the mental health of children and young people remains a priority for the Scottish Government.

CAMHS (cont) Work in support of PIs in CAMHS With respect to Child and Family services, NES and the SHGD have supported training in: Cognitive Behavioural Therapy for Children and Families Parenting Skills Systemic and Family Therapy Child Psychotherapy We have focussed not only on training staff to deliver the interventions, but in supporting and developing our own trainers and supervisors to ensure sustainable service provision in Scotland. 16

CAMHS (cont) Work in support of PIs in CAMHS NES has also commissioned an MSc in Child Psychology for Children and Young People which equips psychology graduates with a range of skills, including the delivery of evidence-based psychological interventions, which enable them to make a significant contribution to CAMHS services Clinical Psychology posts are being aligned to CAMHS services to meet projected workforce requirements

CAMHS (cont) Work in support of PIs in CAMHS CAMHS Competence Framework Framework covers all areas of CAMHS, and will inform the production of ‘Essential CAMHS’, which will replace ‘New to CAMHS’ Given that psychologically based interventions form a significant proportion of the CAMHS work, there will naturally be a substantial section on PIs competences within the framework

The Psychological Interventions Team (PIT) Funded by the Mental Health Division - hosted within NES work closely with dedicated staff in ISD to gather meaningful information on workforce and service capacity. develop referral thresholds and pathways for psychological interventions and therapies. identify training opportunities to improve general access to evidence-based Psychological Interventions and Therapies in Scotland.

The Psychological Interventions Team (PIT) develop the psychological literacy of key groups working in health and care settings in Scotland. act as a ‘centre of gravity’ and point of co-ordination for the strategic planning and development of psychological therapies across Scotland, working with such partners as NHS ISD, NHS 24, NHS QIS, NHS Health Scotland, START, Living Better etc

The Psychological Interventions Team (PIT) It is intended that the work cover both Adult Mental Health Services and CAMHS, and the team be set up for two years in the first instance, starting in March 2010. The team manager is already in post, and the processes for recruiting the rest of the team are well advanced. The PIT training initiatives will focus on Government priority areas - Older People’s Services; Learning Disabilities; Trauma; Forensic Services and Services for Alcohol and Substance Misuse.

Review of Psychology Training In a fundamental review of Psychology training, NES will seek to adapt elements of current Psychology training programmes for multi-professional access with the aim of increasing the availability of psychological interventions across the board 22

Coherent Strategic Planning The Mental Health Division has been driving the implementation of the Psychological Therapies commitment through a co-ordinated programme of work at Board level linking: QIS and Mental Health Integrated Care Pathways (ICPs), with their focus on good practice statements and standards for care the work of the Mental Health Collaborative in increasing capacity by supporting the development of efficient model of service delivery and the training function of NHS Education for Scotland

Coherent Strategic Planning NHS QIS have developed an accreditation process around the ICPs. Boards have all achieved Stage 1 of this process, and are now working towards Stage 2 accreditation, and the requirement to measure variation in practice. QIS will be working in partnership with NES to ensure that training initiatives dovetail with the variances identified at Board level

Workshops Capacity Modelling and Training Implications Psychological Care in Older Peoples services Translating Practice to Research and Research to Practice The New CAMHS Competence Framework Mainstreaming Trauma - Developing a ‘Trauma-informed’ Service Alcohol Misuse: A Training Route for Staff in Specialist and General Services Guided Self-Help: Staff Training and Service Delivery