IAPT - Improving Access to Psychological Therapies - manages CG53!!

[Keela Too]

When writing our response (Hope 4 ME & Fibro NI) to NICE, I managed to include this IAPT info in the Q3 response. We then called for both the Topic Expert team, and the Review Panel to be disbanded.... and reformed ... without the mental health influence ..(worded better... )

Okay so we're probably talking to ourselves or into an echo chamber when those forms are filled in, but it felt good to say it.

I'm about to put our response up on our website, but need to take a break just now. It's been a hectic time.

 

[slysaint]

the results of PACE cannot be obtained with robots

Do robots get ME?

eta: metal fatigue?

 

[MEMum]

Only if they get a virus, which causes them to become inactive, then deconditioned , then afraid to exercise......
I think the robot reference was to high impact CBT trained "specialists".

 

[trishrhymes]

I think this is part of the sinister IAPT for MUS (including ME/CFS) that is being rolled out around the country.
See this NHS guide for commissioners of MUS services produced by the Mental Health Commissioners.

http://www.jcpmh.info/wp-content/uploads/jcpmh-mus-guide.pdf

More about IAPT for MUS here, written by the usual suspects (MossMorris, Chalder etc.) which has their BPS model spelled out in detail on pages 11-12, if you have a strong stomach:

https://www.uea.ac.uk/documents/246...plained-symptoms-positive-practice-guide-.pdf

I'm sure there are threads on these somewhere.

I suspect they have realised that providing therapists for all this is too expensive, so they want to replace it with on-line 'resources'. I see FITNET and GETSET as trials aimed towards this end, and feel sure they will be used as 'evidence' that these 'treatments' work. It is all deeply depressing.

I have a horrible feeling that the next step with the NICE guidelines will be to scrap the treatment section and replace it with IAPT generic MUS 'therapy'. So we can be 'treated' along with all the other 'heartsink' patients. Start weeping now.

 

[JohnM]

https://www.nice.org.uk/about/what-we-do/our-programmes/nice-advice/iapt#IAPT-conditions

My bolding ..

What is IAPT?
Improving Access to Psychological Therapies (IAPT) services provide evidence-based psychological therapies to people with anxiety disorders and depression.

We will assess digitally enabled therapies for anxiety, depression and medically unexplained symptoms which offer the potential to expand these services further.

I think the more likely scenario is that IAPT do not 'manage' NICE guidelines for ME, directly. They do, however, appear to be a department within NICE; their email contact info is given as iapt@nice.nhs.uk.

The assessment process, as indicated in the Nice IAPT Assessment Briefing flowchart (IAB flowchart), would seem to demonstrate this view of the relationship, at least on the surface? Also of interest is that this 'digital' programme has been commissioned by NHS England.

Another post to follow ..

 

[JohnM]

I'm damned sure that IAPT process of implementation regards proposed digitally-enabled therapies, will be used to provide yet more 'non' evidence which will support the maintenance of the status quo; that is the BPS model of illness and treatment, as is so inappropriately applied to #PWME. This view, can be evidenced from the 'interim' IAB process and methods statement.

Some notable extracts on a cursory glance of the first few pages of this statement, and as follows:

1.1.1 The statement details the process applied for topic selection of digitally enabled therapies for anxiety disorders and depression, and the main stages for IAPT assessment briefing development. This statement does not cover the process for testing in practice or the development of the IAPT report following testing in practice.

1.2.2 NICE has been commissioned by NHS England to assess selected, digitally enabled therapies (self-study online reinforced and supported by the therapist) for depression and anxiety using ongoing data collection .. The NICE and NHS England digital therapy technology endorsement for IAPT programme has 3 workstreams: selection and assessment, developmental support and evaluation in practice.

Note, how conditions with medically unexplained symptoms have already been inserted into the IAPT process, despite not being part of the 'original' NHS England commission, and as indicated by NICE.

In summary, further reading of the workstream processes indicate that the 'IAPT expert panel' have input and overall control of all stages of the procurement process, which will be signed off by NICE .. sound familiar? Though IAPT do not 'manage' our NICE Guidelines directly, I would argue that they seek to do so indirectly, such is the byzantine world that is UK healthcare.

This really does need to be sorted out in a court of law, sooner rather than later .. I recall mention of use of the Human Rights Act on another thread; will have to revisit when energies allow.

Wishing you all improved health and happiness, John

 

[slysaint]

high impact CBT trained "specialists.

Nurse Ratchet

 

[Barry53]

Only if they get a virus, which causes them to become inactive, then deconditioned , then afraid to exercise......
I think the robot reference was to high impact CBT trained "specialists".

It feels to me like the whole BPS thing is a virus, infiltrating subversively into the very fabric of our lives, fooling society's normal immune systems into thinking they are OK, whilst actually destroying what we hold dear.

 

[Keela Too]

Our response to Q3 uses the IAPT detail. Although I perhaps misunderstood the detail in that I thought IAPT was in fact managing the CG53 guideline, the comment is still valid even if IAPT only has influence on patients treated under CG53 (hate that term CFS/ME )
http://hope4mefibro.org/wp-content/uploads/2017/07/Hope-4-ME-Fibro-NI-comments-form-2.pdf

 

[Barry53]

Our response to Q3 uses the IAPT detail. Although I perhaps misunderstood the detail in that I thought IAPT was in fact managing the CG53 guideline, the comment is still valid even if IAPT only has influence on patients treated under CG53 (hate that term CFS/ME )
http://hope4mefibro.org/wp-content/uploads/2017/07/Hope-4-ME-Fibro-NI-comments-form-2.pdf

Will look at this in more detail later

 

[Hutan]

Our response

http://hope4mefibro.org/wp-content/uploads/2017/07/Hope-4-ME-Fibro-NI-comments-form-2.pdf

That's a great response. I'm persuaded.

It would be good to see all responses in a separate thread also.

 

[medfeb]

More about IAPT for MUS here, written by the usual suspects (MossMorris, Chalder etc.) which has their BPS model spelled out in detail on pages 11-12, if you have a strong stomach:
https://www.uea.ac.uk/documents/246...plained-symptoms-positive-practice-guide-.pdf

This reference lists the "Membership of the IAPT Medically Unexplained Symptoms Evaluation Task and Finish Group (2012-13)" on page 15-16. Rona Moss-Morris is the chair, Trudie Chalder is a member and Peter White provided input. This might suggest that the NHS IAPT program creates task groups charged with specific topics, in this case MUS guidance.

One note - they develop a practice guide for MUS and then recommend against using the term MUS with patients and instead state that "patients should be given a specific diagnosis of a syndrome which describes their central symptom(s) [e.g. CFS] without inferring that the aetiology is psychological."

Suzy Chapman posted a lot of information on MUS services and integration into NHS - http://forums.phoenixrising.me/inde...ary-care-whats-happening-across-the-uk.48710/

 

[AndyPR]

http://hope4mefibro.org/wp-content/uploads/2017/07/Hope-4-ME-Fibro-NI-comments-form-2.pdf

That's a great response. I'm persuaded.

It would be good to see all responses in a separate thread also.

IiME, MEAction, AfME and Hope 4ME/Fibro responses linked in this thread http://forums.phoenixrising.me/inde...-friday-21-july-2017.52380/page-4#post-878666

 

[lilpink]

For how IAPT is being used to cut costs in the NHS see following link and read application form to the bottom. This shows that getting IAPT funding is dependent on providers showing how savings will be achieved from secondary care/ physical healthcare budgets.


https://www.england.nhs.uk/wp-content/uploads/2016/12/tf-mental-health-app-form-part-a-iapt.docx

 

[A.B.]

Our response to Q3 uses the IAPT detail. Although I perhaps misunderstood the detail in that I thought IAPT was in fact managing the CG53 guideline, the comment is still valid even if IAPT only has influence on patients treated under CG53 (hate that term CFS/ME )
http://hope4mefibro.org/wp-content/uploads/2017/07/Hope-4-ME-Fibro-NI-comments-form-2.pdf

Great response!

 

[user9876]

Only if they get a virus, which causes them to become inactive, then deconditioned , then afraid to exercise......
I think the robot reference was to high impact CBT trained "specialists".

More likely a virus that would encrypt certain systems within the robot until the robot owner had paid a 'specialist' an appropriate number of bitcoins to get them decrypted and functional again.

 

[dangermouse]

whilst actually destroying what we hold dear.

That sentence powerfully hits home.

 

[Jonathan Edwards]

Perhaps perhaps they will be happy to be convinced that troublesome CG53 is misplaced under IAPT and will be keen to move us onto another department?!

At least Cochrane seem to be aware that having ME under mental health is tricky.
But NICE is about saving money. Someone has been persuaded that therapists are cheaper than drugs. So getting NICE to change placement is a much tougher issue.

 

[Cheshire]

At least Cochrane seem to be aware that having ME under mental health is tricky.
But NICE is about saving money. Someone has been persuaded that therapists are cheaper than drugs. So getting NICE to change placement is a much tougher issue.

If it's all about money, why don't they recommand nothing? Nothing is even cheaper than CBT.

 

[Daisymay]

If it's all about money, why don't they recommend nothing. Nothing is even cheaper than CBT.

And preferable!