This statistical release is the annual report on the Improving Access to Psychological Therapies (IAPT) programme from 1st April 2020 to 31st March 2021. IAPT is run by the NHS in England and offers NICE-approved therapies for treating people with anxiety or depression. The publication contains analyses on activity, waiting times and outcomes such as recovery in 2020-21. In addition, the report covers a range of demographic analyses including outcomes for patients of different ages, ethnic group and separately for ex-British Armed Forces personnel. This is the first annual publication of psychological therapies data since the transition into IAPT dataset version 2.0. This was a significant change to the structure of the underlying data. For further details about how this has impacted these analyses, see the Data Quality Statement page of this report, and also the Methodological Change Note available from https://digital.nhs.uk/iaptreports. NOTE: On 17 November 2022, the main csv, therapy role csv and therapy type csv were mainly updated to include some missing breakdowns and apply some further suppression where needed. Due to the move from v1.5 to v2.0 of the dataset part way through the year, the amended main csv file now also includes some v2.0 data that was previously missing for one measure (CountTherapyEndTreatment_EmploymentSupport). These changes do not affect any of the national estimates previously published.

This statistical release makes available the most recent NHS Talking Therapies for anxiety and depression monthly data, including activity, waiting times, and outcomes such as recovery. NHS Talking Therapies is run by the NHS in England and offers NICE-approved therapies for treating people with depression or anxiety. This release also includes Employment Adviser statistics. Due to the coronavirus illness (COVID-19) disruption, it would seem that this is affecting the quality and coverage of some of our statistics, such as an increase in non-submissions for some datasets. We are also seeing some different patterns in submitted data. For NHS Talking Therapies, whilst the number of submitters remains unchanged, there is a significant change in the rates for recovery and improvement since pre-Covid-19 months. We hope this information is helpful and would be grateful if you could spare a couple of minutes to complete a short customer satisfaction survey. Please use the survey in the related links to provide us with any feedback or suggestions for improving the report.

The IAPT programme aims to improve access to evidence based talking therapies in the NHS through an expansion of the psychological therapy workforce and services. (http://www.iapt.nhs.uk/about/) The workbook includes monthly information by Primary Care Trust (PCT) on the following: - The number of people who have entered IAPT programme psychological therapies - The number of people who have completed IAPT programme psychological therapies moving off sick pay & benefits per month - Recovery Rates (%) for people completing IAPT programme psychological therapies Total Activity by Gender of Patient (numbers of people entering IAPT programme psychological therapies - Total Activity by Ethnic Group of Patient (numbers of people entering IAPT programme psychological therapies Data source: Commission Support for London Improving Access to Psychological Therapies http://www.workingforwellness.org.uk/ This data is being published by NHS London alongside other datasets related to depression. The aim is to develop a resource to support the public’s knowledge of this common condition, to raise awareness of treatments and how health services are meeting needs, and to support health policy and commissioning.

The experimental figures presented in this first annual report provide a picture of activity in Improving Access to Psychological Therapies (IAPT) services and the people that use them in 2012/13. Throughout the year Key Performance Indicator figures were also collected that provide an authoritative picture of levels of IAPT activity during this period. The KPI data is available separately on the HSCIC website. The IAPT programme is designed to provide services for those suffering from anxiety and depression disorders and the purpose of the IAPT dataset is to support reporting on the treatment of these individuals, although locally IAPT services may also have expanded to treat other psychological disorders. The information presented uses version one of the IAPT dataset, which was first reported on in quarter one of 2012/13. The report also uses the latest population figures from the Office for National Statistics 2011 Census.# As 2012/13 is the first year of reporting from this dataset, statistics are only reported for those referrals that were received in the year. It is recognised that there is some under counting of figures as may be expected when moving to a new dataset, particularly in the first half of the year. However, there has been marked improvement throughout the year as the quality and completeness of data provided by services has increased. Referrals that started before April 2012 are excluded.

The Improving Access to Psychological Therapies (IAPT) programme is designed to support the NHS in delivering by 2014/2015:

Evidence-based psychological therapies, as approved by the National Institute for Health and Clinical Excellence (NICE), for people with depression and anxiety disorders; Access to services and treatments by people experiencing depression and anxiety disorders from all communities within the local population; Increased health and well-being, with at least 50 per cent of those completing treatment moving to recovery and most experiencing a meaningful improvement in their condition; Patient choice and high levels of satisfaction from people using services and their carers; Timely access, with people waiting no longer than locally agreed waiting times standards; Improved employment, benefit, and social inclusion status including help for people to retain employment, return to work, improve their vocational situation, and participate in the activities of daily living. The vision for the IAPT programme over the next spending review cycle was set out in the Department of Health publication “Talking Therapies: A four-year plan of action” and the IAPT KPIs will support measurement of the following objectives:

3.2 million people will access IAPT, receiving brief advice or a course of therapy for depression or anxiety disorders; Access to services will increase and by 2014/15 a minimum of 15 per cent per annum (3.75 per cent per quarter) of those in need will be able to access psychological therapy services; 2.6 million patients will complete a course of treatment; Up to 1.3 million (50 per cent of those treated) will move to measurable recovery. From quarter one of 2011/12 IAPT KPIs will also be used to support the NHS Operating Framework. Two IAPT indicators are included in the NHS Operating Framework to measure quarter-on-quarter improvement in:

1.Number of people entering treatment over the level of need, i.e. the number of people with depression and anxiety disorders in the population; 2.The number of people entering treatment over the number of people with depression and anxiety disorders referred for psychological therapies. The level of need in the general adult population is known as the rate of prevalence, defined by the Psychiatric Morbidity Survey. For common mental health conditions treated in IAPT services, it is expected that a minimum of 15 per cent of those in need would willingly enter treatment if available.

The experimental figures presented in this annual report provide a picture of activity in Improving Access to Psychological Therapies (IAPT) services and of the people that used them in 2013-14. The IAPT programme is designed to provide services for those experiencing anxiety and depressive disorders and the purpose of the IAPT dataset is to support reporting on the treatment of these individuals. Locally IAPT services may have expanded to treat other psychological disorders. The information presented uses version one of the IAPT dataset, which was first reported on in quarter one of 2012-13. The report also uses the latest (mid-2013) population estimates from the Office for National Statistics.

The Improving Access to Psychological Therapies (IAPT) data set is a regular return of data generated by providers of NHS-commissioned IAPT services in England (including services provided by independent organisations). It was mandated as a monthly return from 1 April 2012 and collects details of all people accessing these services. Submissions are received by the Health and Social Care Information Centre as record level anonymised data from patient-administration systems. This publication comprises national- and provider-level data quality measures of some key data items in the IAPT dataset: postcode; birthdate; gender; ethnicity; general medical practice code; NHS number; religious belief; sexual orientation; presence of a long-term physical health condition; provisional diagnosis; source of referral; Patient Health Questionnaire (PHQ 9) score; Generalised Anxiety Disorder (GAD) score; Work and Social Adjustment Scale score; appointment type; therapy type; disability. These measures are provided as both counts and percentages of all eligible IAPT records and will be of interest to stakeholders (e.g. the Department of Health and service commissioners), data providers and users of our statistics (e.g. mental health organisations including charities, and service users and their representatives). Note that amendments to the construction of some data quality measures, agreed with the Department of Health, have been implemented in this release. These revisions affect the following measures: DQM26 Patient Health Questionnaire (PHQ 9) Score; DQM27 Generalised Anxiety Disorder (GAD 7) Score; DQM28 Work and Social Adjustment Scale Score; DQM29 Appointment Type; DQM30 Therapy type. The rules for the Data Quality Measures can be found in the following link and any revisions will be documented: - General Notes The Health and Social Care Information Centre does not presently have permission to hold person-identifiable data. It is therefore only been possible to validate person-identifiable data items such as NHS number, Postcode and Date of Birth by using data items which have been derived from these items (as specified in the validation rules).

Many pregnant smokers need support to quit successfully. In the United Kingdom, trained smoking cessation advisors deliver structured behavioural counselling alongside access to free nicotine replacement therapy (NRT); known as the ‘Standard Treatment Programme’ (STP). Pregnant smokers who access STP support are more likely to quit, but uptake is low. A digital intervention could be offered as an adjunct or alternative to existing STP support to increase cessation rates. However, there are few pregnancy-specific digital options routinely available and, among those that are, there is limited evidence of their effectiveness. This study investigated experts’ views on the feasibility of translating the STP into a comprehensive digital intervention. Virtual group and individual interviews were undertaken with 37 experts (11 focus groups, 3 interviews) with a real-time voting activity in the focus groups to prompt discussion. Framework Analysis was applied to the data to examine themes and patterns. Experts were supportive of a digital translation of the STP and considered most behavioural counselling content to be transferable. However, replicating human-to-human accountability, empathy and the ability to go ‘off-script’ was thought more challenging. Suggestions for how this might be achieved included tailoring and personalisation, use of artificial intelligence tools, peer support and the option to escalate contact to a human advisor. Experts had mixed views on the role that exhaled breath carbon monoxide monitoring might have in a digital cessation intervention for pregnancy. Electronic provision of free NRT, and potentially e-cigarettes, without interpersonal support was generally well received. However, experts had concerns about it exacerbating low NRT adherence, governance issues (e.g. being accountable for the suitability of recommended products), and people’s ability to misrepresent their eligibility. The STP was considered largely transferable to a digital intervention and potentially helpful for cessation in pregnancy, so merits further development and evaluation.

One of the important functions traditionally carried out by pharmacists has been patient counselling. That is, pharmacists provide information about medications, foster treatment compliance and act as the first point of contact in the health care system. The study sought information about the counselling (advice giving) practices and attitudes of community pharmacists. Variables in the data set include the frequency of the public coming to the pharmacy as the first point of contact, the kind of problems for which people sought advice, who gave this advice, the proportion referred to a medical practitioner, problems not referred but treated by a pharmacist, evaluation of pharmacists' training, perceived responsibility, number of patients counselled per day, percentage related to NHS prescriptions, average time spent counselling, type of patient counselled and patient medication records. Background variables and pharmacist in charge details include sex, age, years in full-time employment, hours worked, qualifications, employment status, membership of professional associations, professional journals received and pharmacy details: use of computers, pharmacy location, trading hours and staff levels. Also covered are attitudinal responses to the role and behaviour of community pharmacists and job aspects which provide personal satisfaction.

Summary The Improving Access to Psychological Therapies (IAPT) dataset is a regular return of data generated by providers of NHS-commissioned IAPT services in England (including services provided by independent organisations). It was mandated as a monthly return from 1 April 2012 and collects details of all people accessing these services. Submissions are received by the Health and Social Care Information Centre as record-level anonymised data from patient-administration systems. This publication is the first release of data from version 1.5 of the IAPT dataset and comprises national and provider level data quality measures of some key data items in the dataset: NHS number; postcode; gender; ethnicity; code of commissioner; general medical practice code; mental health care cluster; religious belief; sexual orientation; provisional diagnosis; source of referral; Patient Health Questionnaire (PHQ 9) score; Generalised Anxiety Disorder (GAD) score; appointment type; therapy type; disability; IAPT care pathway end reason; code of IAPT stepped to provider; stepped care intensity delivered; employment status; psychotropic medication use; statutory sick pay indicator; the five component parts of the work and social adjustment score (work, home management, social leisure activities, private leisure activities and relationships); anxiety disorder specific measures; reason for suspension of activity. These measures are provided as both counts and percentages of all eligible IAPT records and will be of interest to stakeholders (e.g. the Department of Health and service commissioners), data providers and users of our statistics (e.g. mental health organisations including charities, and service users and their representatives). This monthly file also contains activity data detailing the number of referrals received, entering treatment and completing treatment in the month, by CCG of GP Practice for July and August. Some changes to the methodology used in this analysis are described in the Methodological Change paper and a Release Note is provided to assist users in interpreting the impact of the changes and to provide a summary of the main data quality issues. The Methodological Change paper and rules for the Data Quality Measures are referenced in the Related Links below. General Notes The Health and Social Care Information Centre does not presently have permission to hold person-identifiable data. It is therefore only been possible to validate person-identifiable data items such as NHS number and Postcode by using data items which have been derived from these items (as specified in the validation rules).

This publication provides the timeliest picture available of people using NHS funded secondary mental health, learning disabilities and autism services in England, excluding those who are solely in contact with Talking Therapies. This information will be of use to people needing access to information quickly for operational decision making and other purposes. More detailed information on the quality and completeness of these statistics is available in the Data Quality section, as well as within the Data Coverage and Data Quality VODIM and Integrity files available under 'Resources'. Some amendments to methodologies have been made in this publication. Previously, in some metrics, data for Kooth Digital Health Limited was handled in a different way due to them providing online anonymous services. This methodology has been extended to a second provider, MeeToo Education. Additionally, there have been some amendments to the referral spells methodology (metrics starting MRS). These include extending the list of teams in the exclusion and inclusion lists to include depreciated codes and introducing the use of the referral rejection and closure dates where the service discharge date is not available.

This statistical release makes available the most recent Improving Access to Psychological Therapies (IAPT) monthly data, including activity, waiting times, and outcomes such as recovery. This is the first release of data from version 2.0 of the IAPT dataset. We have summarised the changes from previous IAPT reports in the Methodological Change Notice which can be found in the related links at the bottom of this page. IAPT is run by the NHS in England and offers NICE-approved therapies for treating people with depression or anxiety. This release also includes experimental statistics from the IAPT Employment Adviser pilot. COVID-19 and the production of statistics Due to the coronavirus illness (COVID-19) disruption, it would seem that this is now starting to affect the quality and coverage of some of our statistics, such as an increase in non-submissions for some datasets, including IAPT. We are also starting to see some different patterns in the submitted data. For IAPT, whilst the number of submitters remains unchanged, there is a significant change in the rates for recovery and improvement for this month compared to the last 12 months. Therefore, data should be interpreted with care over the COVID-19 period. For the duration of the COVID-19 period, we are now doing some early reporting to help with monitoring of any impact using provisional IAPT data. A link to this is available in the Related links below. We hope this information is helpful and would be grateful if you could spare a couple of minutes to complete a short customer satisfaction survey. Please use the survey in the related links to provide us with any feedback or suggestions for improving the report.