Ten years from now – will NHS healthcare be more psychological?
The NHS Long Term Plan landed in the inboxes of NHS staff across England last week. This is a plan designed to set the direction and to target NHS funding for the next ten years. Many of us in the psychological professions are working hard to try to create more and better psychological healthcare as part of the NHS. So will the new plan help us to achieve this? I am optimistic.
Looking ahead to the next ten years of the NHS I have been reflecting on the last ten. We have come a really long way. Helen, one of the service user consultants who works with the Psychological Professions Network in Kent, Surrey and Sussex closed our recent conference by reminding us of how ten years ago psychological therapies were scarce, with long waiting times and a postcode lottery of service. She had personally struggled to get psychological therapy for many years. Helen reflected that the adult IAPT programme, which celebrates its tenth birthday this month, has dramatically turned this around. Hundreds of thousands of patients have overcome depression and anxiety through this programme. Many children and young people have benefitted from the Children and Young Peoples’ IAPT services that were launched slightly later, and we have more psychological professionals working in the NHS than ever before, shaping psychological healthcare across mental health and other services.
We now have before us a long term plan for the NHS that repeatedly specifies expanding psychological therapies and other psychological ways of working as cornerstones of policy: to extend the adult IAPT programme to an additional 380,000 adults with anxiety and depression each year, to provide psychological therapies and interventions to many more children and young people, to 24,000 new mothers with personality issues and to more people with severe mental health conditions. There are other opportunities too. These include helping to shape a better offer of assessment and support for autism, supporting people adjusting to major health conditions such as cancer, dementia or diabetes, enabling the digital delivery of psychological interventions and supporting the NHS workforce through wellbeing interventions, clinical supervision, training and by working in new and extended roles, for example as responsible clinicians. Of course there may be missed opportunities and more that could have been included in the plan, but when we compare it to equivalent plans from nearer to twenty years ago, there are many reasons to be cheerful. The 2000 NHS Plan and the National Service Framework for Mental Health (1999) contained nowhere near this ambition for psychological healthcare.
This new plan is good news. There will be huge challenges in taking it forward, however. The money is tight and we will need to learn how to work together in new integrated care systems and realigned arm’s length bodies to make best use of resources under competing pressures. It will also be very challenging to address the workforce pressures we are facing. To deliver the plan we will need many more psychological professionals, and we will need the eleven different psychological professions to work in closer harmony so that they can be trained and deployed efficiently and to maximum impact. This will include bringing psychological knowledge to the whole system of care through existing and new roles. We will need a comprehensive workforce plan for the psychological professions that makes best use of existing roles as well as creating new expansion roles. To make all of this happen we need a strong and joined up voice for the psychological professions in the NHS regions, and at national level, including to shape the national workforce plan. The Psychological Professions Networks are helping to create a co-ordinated source of knowledgeable input to the system. There is now also a strong argument for a Chief Psychological Professions Officer role to help deliver the ambitious agenda for psychological healthcare. Together psychological professionals can all play a part in making sure in ten years’ time people using services can say “haven’t we come a long way since 2019!”.
Adrian Whittington, Chair of the Psychological Professions Network: Kent, Surrey & Sussex