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Early Intervention in Psychosis (EIP) Programme – North

Meeting the new national standard and ensuring vulnerable young people are understood

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Tuesday, 7 June 2016

Meeting the new national standard and ensuring vulnerable young people are understood

Well April has been and gone and the new Access and Waiting Times Standard for EIP is now live. To coin an often used phrase, the scale and pace of activity has been immense and everyone involved in implementing the new standard has worked incredibly hard. We need to recall that the standard was a Cabinet Office announcement and the system has responded to the challenge despite some real issues.

One of the challenges we now face is to ensure that we don’t end up with some of the mistakes associated with meeting any new standard.  I have concerns when I hear about teams already repeatedly meeting the standard for 100 per cent of people, I’m not sure this is a good thing. Making a clinical decision on whether someone has psychosis is a complicated process, which requires a great deal of skill and understanding - no simple point of care diagnostics are available to guide clinicians. Some cases are relatively straightforward; the necessary symptoms associated with psychosis are presented, which also meet frequency and duration criteria and impact on the person sufficiently to allow a diagnosis of psychosis. However, much more frequently it requires a much more time consuming process of engaging with a young person, who may be mistrustful of services - in some cases driven by the very symptoms they experience, but additionally from the stigma associated with mental health difficulties.

We also need to be mindful that placing someone on the wrong pathway due to a desire to look good for targets has enormous implications for our clients. Placing someone on a FEP pathway exposes them to treatments, which whilst hugely beneficial, also come with significant side effects. This is the importance of assessment.

In the North region, NHS England North has commissioned training for clinicians working in EIP to use structured clinical assessments in order to accurately ensure someone is correctly allocated to the right pathway of either FEP, ARMS or not suitable for either. This was a “train the trainers” model of teaching, where participants were required to demonstrate understanding of the criteria by correctly allocating cases to the correct pathway. The training consisted of three days of initial training, but with a further three days to ensure continued compliance and accuracy of rating.  Each Trust now has someone who has been trained,

We feel this model of training is vital to ensure that alongside the provider organisations and trusts meeting the standards, the vulnerable young people who come to us are correctly understood and assessed and allocated the correct evidence based treatments they deserve.

Finally, we are pleased to launch a new video resource which describes collaborative process of developing EIP services between Salford Commissioners and Greater Manchester West which can be accessed via the link below http://bit.ly/1tekQz3

Paul French

paul.French@gmw.nhs.uk