The Improving Access to Psychological Therapies (IAPT) programme is designed to support the NHS in delivering evidence-based psychological therapies for people with depression and anxiety disorders in England.
The previous access standard for IAPT services was to provide timely access to treatment for at least 15% of the community prevalence of depression and anxiety disorders (900,000 people). The Five Year Forward View for Mental Health set out that this should increase to reach 25% of need so that at least 600,000 more adults with depression and anxiety can access IAPT services each year by 2020/21. The NHS Long Term Plan then increased this target to an additional 380,000 adults accessing IAPT services by 2023/24.
The number of referrals to IAPT and the number of referrals starting treatment have both increased over time. In 2011/12 there were 887,452 referrals to IAPT, and this increased to 1,676,985 referrals in 2019/20 (an 89% increase). The number of referrals starting treatment more than doubled, from 533,550 in 2011/12 to 1,165,747 in 2019/20. The 2015 access target has been met, but the number of people starting IAPT treatment must still increase considerably if the 2023/24 target of 1.88 million is to be reached.
As well as looking at annual numbers of referrals to IAPT, we can also examine monthly data for detail of more recent changes. In 2019, the number of referrals to IAPT fluctuated at around 140,000 each month and the number starting treatment remained at around 100,000 each month. Both fell in December 2019 but recovered in January 2020.
Between February and April 2020, the number of referrals to IAPT more than halved following the onset of the Covid-19 pandemic. This may be due to reductions in the number of patients presenting at GP surgeries during the lockdown period. The number of referrals starting treatment fell by 24% over the same time period. Since then, both the number of referrals and the number starting treatment have increased, but remain below the levels seen in 2019.
In August 2020, referrals to IAPT and those starting treatment fell slightly on the previous month. There were 116,102 referrals to IAPT (11% lower than in August 2019) and 79,281 referrals started treatment (12% lower than in August 2019).
Finishing a course of treatment is only one outcome for those referred to IAPT. Other outcomes include: declining or dropping out of treatment, being referred to another service, not being suitable for IAPT treatment or dying before they reach an outcome.
The number of people successfully finishing a course of treatment increased by 63% between Q1 2012/13 and Q1 2016/17, from 88,162 to 143,983, but since then improvement has stalled. In Q1 2020/21 (April to June 2020), during the Covid-19 pandemic, the number of people finishing a course of treatment increased to 167,655, however the mechanisms behind this increase are unclear.
When patients begin treatment through the IAPT programme they are clinically assessed for scores of anxiety and depression; those who score highly are considered a clinical case. When reassessed at the end of treatment, people who no longer score as highly for anxiety and depression (so are no longer a clinical case), are considered recovered. The recovery rate is the proportion of people who start treatment with a high score, and complete treatment having reduced their score below the clinical threshold.
The recovery rate increased gradually between Q1 2012/13 and Q4 2018/19, from 46.1% to 53%. Since then, it has decreased to 49.6% in Q1 2020/21. The target recovery rate of 50% was first achieved in Q4 2016/17, and was met until Q4 2019/20 when the recovery rate fell to 49.8%.
About this data
Improving Access to Psychological Therapies (IAPT) is an NHS programme in England that offers interventions approved by the National Institute for Health and Care Excellence (NICE) for treating people with depression and anxiety.
A patient referred to IAPT has moved to recovery if they were defined as a clinical case at the start of their treatment and not as a clinical case at the end of their treatment. This is measured by scores from questionnaires tailored to their specific condition. The Government target is that 50% of eligible referrals to IAPT services should move to recovery.
For more information about the data, please see the NHS Digital website.