There are several components to the National Clinical Audit of Anxiety and Depression (NCAAD), one of which is a focussed 'spotlight' audit on psychological therapies in secondary care which follows on from the National Audit of Psychological Therapies.
The focused audit is being led by a partnership between the Royal College of Psychiatrists and the British Psychological Society, and will begin in the latter half of this year. It is expected that all providers of NHS-funded care in England will participate.
The audit will look at the quality of psychological assessment, formulation and therapy delivered by secondary care mental health services to people aged 18 and over. The audit will include an audit of practice (case note audit) along with a survey for therapists and feedback from service users.
Key areas of focus include:
- Equity of access
- Shared decision making
- Waiting times
- Training and supervision of therapists
- Measuring and monitoring service user outcomes
- Provision of the NICE recommended therapies
- The Trust/organisation routinely collects data to assess equity of access. Guidance: This includes age, gender, ethnicity, employment and accommodation status.
- Service users have timely access to inpatient care when required.
- Service users’ assessments are comprehensive and include consideration of:
Identification of social support and/or stressors in relation to finance, education/employment and relationships;
Previous traumatic experiences or associated symptoms;
Previous treatments and response to them (if applicable).
- Service users’ physical health is considered as part of their assessment and treatment, with support, advice or onward referral offered where appropriate. Guidance: This includes blood pressure; BMI; blood tests, and Lifestyle factors (e.g. diet, exercise, smoking, drug and alcohol use).
- The needs of service user’s family members, friends or carers are considered as part of the assessment process and they are offered an assessment of their needs.
- Care plans are jointly developed with service users and their family member, friend or carer (if applicable), and they are given a copy with an agreed date for review.
- Psychotropic medication is provided in line with the relevant NICE and BNF guidance for the service user’s diagnosis/condition.
- Psychological therapies are provided in line with relevant NICE guidance for the service user’s diagnosis/condition.
- Within 24 hours of discharge a discharge letter is emailed to the service user’s GP and a copy of the service user’s care plan is sent to the accepting service (if applicable).
- The service user and their family member, friend or carer (if applicable), receives at least 24 hours’ notice of discharge and this is documented.
- Service users discharged from an inpatient setting receive a follow-up within 48 hours of discharge.
- Service users have a crisis plan agreed and in place prior to discharge from an inpatient service.
- Assessments include the use of an appropriately validated outcome measures (e.g.symptoms, level of functioning and/or disability) which are used to monitor, inform and evaluate treatment.