The National Clinical Audit of Psychosis (NCAP) has published its latest national reports, which presents the findings for England and Wales from the 2019/20 Early Intervention in Psychosis (EIP) audit.
The reports provide national and organisation-level findings on the treatment of patients by EIP teams in England and Wales. They include findings from the service user survey which collected information from people treated by EIP teams about their experience of care. This is the first year a national report for Wales has been published.
England
All Trusts in England took part in the audit and provided data on over 10,500 patients treated by 155 teams. Data from this national audit show improvements in a number of areas of care for people with first episode psychosis. These include better physical healthcare and increased use of clinical outcomes.
The proportion of patients who start treatment within two weeks of referral was unchanged. Delivery of Family Interventions continues to be furthest behind recommended practice. Results from the service user survey show high levels of patient experience and satisfaction with care, but more can be done to improve the provision of evidence-based care in line with NICE quality standards.
Wales
Six Health Boards in Wales participated in the audit and provided data on over 200 patients. Data from this national audit show improvements in most areas over the last 12 months, in the context of low numbers of patients compared to those expected to present with a first episode of psychosis. Improvements include increased provision of Cognitive Behavioural Therapy for psychosis and increased support for carers.
One third of patients started treatment within two weeks of referral. Results from the service user survey show high levels of patient satisfaction with care, but more can be done to improve the provision of evidence-based care in line with NICE quality standards.
NCAP was carried out by the College Centre for Quality Improvement (CCQI) and commissioned by the Healthcare Quality Improvement Partnership on behalf of NHS England and the Welsh Government. The audit standards were based on the Early Intervention in Psychosis Access and Waiting Time Standard (NHS England, NICE & NCCMH 2016).
Key messages from the report (England):
- There have been improvements in a number of areas of care for people with first episode psychosis in England since 2018/2019.
- Collection of clinical outcome measurements have increased by 19% since the previous year. The rapid progress that has been made provides an opportunity to start reviewing clinical outcomes of people with FEP for the first time. Trusts should work with local teams to facilitate use of these outcome data.
- Three-quarters of people with first episode psychosis are receiving an assessment of their physical health, but interventions don’t always follow when they are needed: Don’t just screen, intervene!
- The area where performance of EIP services continues to be furthest behind recommended practice is in the delivery of Family Interventions, with four out of five people who may benefit from Family Intervention not receiving them. Commissioners, Trusts and frontline staff all have a role to play in increasing access to evidence-based Family Interventions.
- Results from the service user survey show high levels of patient experience and satisfaction with care, but one in four people told us that they did not have a current care plan.
Key messages from the report (Wales)
- The quality of care delivered by Early Intervention Psychosis teams in Wales has improved since 2018/19.
- One-third of people with First Episode Psychosis started treatment within 2 weeks of referral.
- More support is needed to deliver physical health screening and interventions with one-fifth (21%) of people receiving screening for all 7 physical health measures.
- Provision of outcome measurement remained low with just 5% of people receiving assessment with two measures at baseline and in the last year.
- These findings should be considered in the context of very low numbers of patients compared to those expected to present with a first episode of psychosis.
The full reports can be found on the NCAP site.