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

2. 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.

3. 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.

4. 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.

5. 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

6. ‘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

7. ‘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)

8. 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

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

10. 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

11. 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.

12. 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

13. 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

14. 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

15. 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.

16. 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

17. 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

18. 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

19. 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.

20. 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

21. 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 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.

22. 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

23. 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

24. 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

26. 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