Disparity in caseloads/supervision

This section is for discussion relating to the Layard report, and subsequent schemes like Improving Access to Psychological Therapies where lower intensity inteventions are offered in primary care
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myotai
Posts: 36
Joined: Sun Mar 14, 2010 12:23 pm

Disparity in caseloads/supervision

Post by myotai » Tue Oct 11, 2016 9:17 am

Hi,

Do any of you working in IAPT services notice a palpable lack of parity in terms of Step 2 and Step 3 caseloads and management?

The service I work for monitors PWP's caseloads rigorously – rightly so. If we perform an assessment and they’re not moved on the care pathway within 48 hours we get an email from admin asking us to rectify. I know that there are people on Hi Intensity caseloads that have not been moved in months – the longest I saw was someone who had been assessed and was still there after 8 months. That’s scandalous!

Step 3 Hi Intensity are clearly not managed the way we (PWP’s) are and are obviously self managing.

I am really disheartened at this discovery…..and pi$$ed off!

Am I alone. Should I say something?

M…

LIWY
Posts: 284
Joined: Wed Jun 02, 2010 9:13 am

Re: Disparity in caseloads/supervision

Post by LIWY » Tue Oct 11, 2016 11:09 am

I see lots of bullying of Step3 staff also. Denying them working to NICE guidelines, insisting on over booking to meet targets, sending out into the community without proper workspace/admin facilities or support.

Overall, the trend seems to be to chase targets, however damaging that may be to patient care, so that misleading figures can be published here month after month:
http://content.digital.nhs.uk/iaptreports

The first move out of triage into the pathway means the person is counted in the figures as having accessed the service, that is a major KPI for a service and one they will focus on. If the person is then stuck in a hidden wait list, the urgency to deal with that is not there in my experience unless a lot of patients complain.

myotai
Posts: 36
Joined: Sun Mar 14, 2010 12:23 pm

Re: Disparity in caseloads/supervision

Post by myotai » Tue Oct 11, 2016 12:21 pm

Yep get that regarding the pressure to meet recovery rates, post Ax pathways etc.... I was specifically though thinking about those therapists that KNOW that they have very little management and take advantage of that. Its MUCH more comon than I think is realised and must be haemorraging money from the servies involved.

A massive shake up required before it gets out to the public domain - that wouldn't be good at all!

LIWY
Posts: 284
Joined: Wed Jun 02, 2010 9:13 am

Re: Disparity in caseloads/supervision

Post by LIWY » Tue Oct 11, 2016 1:19 pm

I think it would be great if it got out there because then there may be some honest conversations around the fact that services do not have enough budget to do the job they are being asked to do and that the original vision, that 2/3 of IAPT referrals would be Step 2 suitable, was flawed.

As for Step 3s being mostly unmanaged, maybe some years ago but really not the experience now of the many people I know working and locuming around IAPT. They have regular and frequent line management that looks at number of appointments offered, number attended, new patients taken on and number of patients discharged, plus recovery rates. Sounds like possibly your Service though is not working that way.

myotai
Posts: 36
Joined: Sun Mar 14, 2010 12:23 pm

Re: Disparity in caseloads/supervision

Post by myotai » Tue Oct 11, 2016 2:17 pm

Nope clearly not....going to have a think about this.

All other experiences welcome!

Highintensity
Posts: 14
Joined: Wed Jun 22, 2016 9:12 am

Re: Disparity in caseloads/supervision

Post by Highintensity » Wed Oct 12, 2016 8:30 am

My service puts more pressure on HITs to make clinical hours than PWPs as most of them have left and the HIT waiting list is... 1 year (we are one of the worst performing in the country)

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