"Poorly organised mechanistic and ineffective"

This is a really poor service. The staff conducting the telephone assessments have a low skill level. As a patient you are expected to chase around them. There seems to be no understanding of the importance of reducing barriers to engagement. You get one chance to get it right with this service or you are out. The assessment process has at least two stages, both conducted on the telephone which is inappropriate for a number of people. This cannot be classed under any circumstances as a comprehensive assessment. I also do not believe it is is safe as people are poorly prepared, given no advice about its impact and left for their families to pick up the pieces - if they have one. The staff are disrespectful and unwelcoming. Examples of the way this service operates include: excluding people from the service if they don't answer one phone call. The phone call is not made at an agreed time and despite having given permission for a message to be left, no message was left. The service offer is effectively limited to low quality CBT. You have to complete this CBT in order to be offered anything else. This is a huge barrier for people who actually need a more intensive intervention. There is no flexibility on appointment times - so you have to agree appointments for weeks in advance which is impossible if you're a casual or shift work - or a single parent. If you don't accept this you're classed as non compliant and kicked out. Whoever commissioned this service appears to have absolutely no understanding of the basic minimum standards of psychological services and no understanding of the principles of engagement. My guess is that this service on the whole creates far more distress than it relieves. This is an utterly disgraceful piece of commissioning and provision.

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Responses

Response from Iapts Team

Thank you for your comments regarding the service and we really appreciate any feedback as we are constantly trying to improve and reduce barriers to access. I would really value the opportunity to discuss your comments and concerns relating to your contact with us and I would be grateful if you could contact myself as the service lead on lucy.cotterill@sssft.nhs.uk or the Customer Services team at: customerservices@sssft.nhs.uk or by ringing Freephone 0800 318850.

However, there were a number of comments that I wish to address here. We do offer a number of different approaches, each of which are supported by clinical research and we follow the recommendations of offering the least intrusive options where possible. All staff have or are working towards the relevant qualifications and trainee staff have the required supervision and training support. Following an initial telephone screening appointment, people are offered the support which is felt most appropriate at that time based on their individual need, which could be either group, telephone, face to face appointments or a more intensive CBT or NICE approved counselling approach. We do offer face to face initial screening appointments when requested, however we are trying to help a large number of people so we are unable to routinely offer this option and the telephone appointments do provide more flexibility for patients accessing the service. We do offer a range of flexible appointment times and try our best to accommodate individual circumstances, so I can only apologise if this has not been your experience. We certainly try our best to be as accessible and available as possible whilst also trying to offer a service to a large number of people.

Unfortunately, due to the high number of people we support on a weekly basis we do have guidelines around cancellations and non-attendance, to minimise the amount of wasted appointments and the affect this has on how long people will wait for sessions. However, as a result of your comments we are reviewing these guidelines and how this should best be communicated in a compassionate way. If you wish to support us with this then please contact me.

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