Cats, elephants, alligators and the fantasy of the Sopranos: A qualitative study of the experiences of commissioners and managers delivering IAPT services using the Any Qualified Provider policy

Baker, Tamany

Abstract

Background: Primary Care Psychological Therapy services (PCPT) face pressure to deliver effective services due to the increasing prevalence, complexity and societal costs of Common Mental Health Disorders (CMHDs). Furthermore, commissioners and managers deliver services within a complex system of evolving policy and healthcare practice where successive policy changes, such as Improving Access to Psychological Therapies (IAPT), have significantly shaped PCPT design. Any Qualified Provider (AQP) represents one policy aimed at addressing financial pressures, extending patient choice and stimulating quality-assured competition. AQP shares features with several NHS developments which will arguably impact Counselling Psychology going forward, such as partnership working in ‘Sustainability and Transformation Partnerships’, and the increased use of ‘Payment by Results’. However, to date, there has been little significant discourse within Counselling Psychology around AQP, service design and the practical implications of policy changes.

Aims: This research investigated the impacts of AQP on existing IAPT services and considered implications for Counselling Psychology in the context of policy change and new models of care for effective PCPT. It aims to inform and support clinical leaders with an awareness of the wider impacts of policy to improve the real-world effectiveness of services to address the rising problems with mental health.

Method and analysis: Semi-structured interviews with a cross section of commissioners and managers in different regions and organisations generated leadership perspectives on AQP. Thematic Analysis offered a broad overview of the impacts of AQP in IAPT.
Results: Four superordinate themes were identified: Resources and AQP delivery; Partnership working in AQP; Bureaucracy in AQP; and Patient experience in AQP.

Conclusions: AQP offers insights into the partnership working of clinical leaders in a local IAPT service, and their adaptations to financial and bureaucratic pressures. To address increasing CMHDs, PCPT needs adequate funding to provide quality patient-centred care. Clinical leaders are willing and able to work within new quasi-market structures, but they prioritise clinical and relational values. Policy makers should embed these values in policies impacting PCPT to ensure the quality of services. This is an area where Counselling Psychology could – and should – engage more effectively with service design and policy.

Citation

Baker, T. Cats, elephants, alligators and the fantasy of the Sopranos: A qualitative study of the experiences of commissioners and managers delivering IAPT services using the Any Qualified Provider policy. (Thesis). University of the West of England. Retrieved from https://uwe-repository.worktribe.com/output/1698806

• Thesis Type: Thesis
• Deposit Date: Jul 24, 2019
• Publicly Available Date: Nov 12, 2020
• Keywords: Any Qualified Provider, AQP, Improving Access to Psychological Therapies, IAPT, commissioning, mental health policy, Counselling Psychology
• Public URL: https://uwe-repository.worktribe.com/output/1698806
• Award Date: Nov 12, 2020