Is the access to therapies initiative helping?

You might have seen MIND complaining about how many people are waiting for talking therapies. Although the figures I found don’t quite match theirs I am prepared to say that regardless of whether it is 116000 people or the 112785 figure that I found for England, is correct, it is quite appalling that so many people are waiting more than 28 days for their assessment appointment.

However the figures do seem to imply that you would go into therapy straight away after this and as I have found out it doesn’t quite work like that. For myself I wasn’t seen within the 28 days it was more like 48, but who’s complaining, and having gone through several appointments for assessment found that I would not be able to start therapy straight away either. 
 

These figures are bench marks and as such are not necessarily helpful ones as they are not simply what they appear to be. There are many things to consider for instance how many more people are waiting but then how many more people are trying to access the services and how many more people are actually getting therapy than there were? All good questions I think and comparing the same quarter from a year ago I found these figures 2011/12  and 2012/13 

	2012/13	2011/12	Difference
Number of people being referred	252746	218458	34288
Number of people entering therapy	145361	130999	14362
Number of people waiting longer than 28 days	112785	84164	28621

Which just goes to show that with 34288 more people being referred and 14362 more people entering therapy than last year there have at least been some improvements in the service. Sadly though as a percentage of the total number of referrals the number waiting has also increased from 38.5 to 44.6%. Interestingly though the number entering therapy has only decreased from 60 to 57.5% but as I alluded to earlier these figures are not all that helpful.

Let me explain!

For a start these are just counts and as the therapies are of different lengths you may get more people ending therapies in one quarter than another, and is not a sign of through put as you might imagine.

You may also get people declining therapy who would have attended more than 2 sessions and so could be counted as having done therapy despite only having had an assessment and then declined.

And as I pointed out above the 28 days only applies to your first assessment and not to you starting therapy which may well have a waiting list of its own.

And please don’t get me started on the recovery data. It seems the recovery data is only collected for people who are considered via a questionnaire to be at a level of distress called ‘caseness’ now this can be helpful and certainly it is a way to assess if people improve their score however it is not applicable to all people who take up therapy. And clearly anyone who does not complete both questionnaires will not be included in the figures.

So what are the figures?

Well they report for this quarter 2012/13 10681 (in England) people completed therapy that were not at ‘caseness’ at initial assessment and there were 9664 the year before a rise of 12% and there was only a 10% rise in people entering therapy. However much as you might want to conclude that the wrong people are getting therapy it doesn’t mean that at all as caseness is just a level that they can measure and it is subject to the ups and downs of people emotions that could mean some people would score less than caseness in any given time frame or at any given moment and not at others.

But putting these things aside when you compared the numbers of those at caseness to start and not after they’ve finished you can get a basic percentage of how helpful therapy has been for them. In this case comparing the same quarters a year apart shows that 43.6% of people were not at caseness after therapy than before in this quarter in 2011/12 and 45% were in 2012/13. A significant problem here is that the figures do not make any indication of severity of problem but just that they have reached this level of need so again it’s not all that helpful.

But has the initiative helped?

Well overall more people are being referred and more people are getting therapy with the general trend of improving how many people are not at caseness who were, it looks like it is helping however the figures are only the start and quite frankly if you look at the experimental figures which are trying to estimate how many people who may need therapy are entering therapy you see that only 7.3 % are doing so in England in this quarter however this is up from 6.3% in the same quarter last year. 

The reality is there was never going to be a quick fix for this and so long as there is an upward trend I’d say it was improving things. The sad fact is that if these services become over run with people waiting there will come a point, if nothing is done to improve the waiting times when people who need the services will just stop trying to get them and really this needs to be addressed quickly so that it doesn’t happen. Last year I waited 8 months for therapy but how long would that wait have to be before people didn’t bother waiting, or GP’s stopped referring people?