Our primary strategic objective as a charity at UKCP is to increase access to psychotherapy.
This cannot be achieved without making a wider range of therapies available to people from all walks of life through the NHS. Currently, there are too few opportunities for psychotherapists to work in NHS services. This not only limits the choice of working context for psychotherapists, it also denies a choice to NHS service users in many parts of the country who cannot access the talking therapies they need.
For those who are not able to pay for therapy privately, the lack of access to appropriate talking therapy through the NHS can be devastating. And, with the health, social and economic impacts of Covid-19 beginning to take hold, this problem only stands to get worse.
That’s why we are calling on the national government, local government, MPs and the NHS to take action now.
To improve access to high quality psychotherapy and psychotherapeutic counselling in the private and public sectors, we are calling for:
1. A Government commitment to provide a genuine choice of talking therapies through primary and secondary care NHS services across the four nations.
We’ve met MPs and Peers from all major parties to build political awareness of the need to provide service users with a choice of therapies. As a result, we’ve secured offers to ask parliamentary questions and raise our concerns during Health Select Committee sessions. We’ve also secured an agreement from a senior Conservative MP to write to the Health Secretary on UKCP’s behalf.
2. Action to avoid over-reliance on an underfunded voluntary sector in providing key mental health services in the wake of Covid-19.
We’re concerned that the government will continue to rely on the voluntary sector to pick up additional demand post Covid-19. We’ve worked with BACP and BPC, as well as more than 20 supporter organisations, to demand properly funded involvement of the psychotherapy and counselling workforce in responding to the many psychological impacts of the pandemic. More than 10,000 people have signed our petition in support of our key asks.
3. People with complex mental health needs to have access to longer-term therapies, instead of being funnelled through Improving Access to Psychological Therapies (IAPT) services designed for mild to moderate difficulties.
As part of our work with the Talking Therapies Taskforce, we’ve commissioned the Centre for Mental Health to conduct a health economic analysis of the use of NHS services by people with complex needs. From people inappropriately signposted to IAPT to people who end up as long-term inpatients, we hope to demonstrate the cost benefit of investing in long-term psychotherapy services in secondary care.
4. The student loan system to be extended as a matter of urgent priority, improving access to affordable funding for psychotherapy training.
Cost of training is a major barrier to the profession, with a disproportionate impact on BAME students, which reflects wider societal inequalities. We’ve written to the Universities Minister requesting that the postgraduate student loan scheme be extended to non-university higher education providers.
5. Health Education England (HEE) to commit to rectifying the proportionate underrepresentation of Dynamic Interpersonal Therapy, Counselling for Depression, Couples Therapy and Interpersonal Therapy in IAPT services in England as part of the expansion promised in the NHS Long Term Plan.
As a member of the HEE workforce stakeholder group we have a unique opportunity to influence workforce planning for the implementation of the NHS Long Term Plan, including IAPT provision. These therapies, which our members are qualified to deliver, are already IAPT-approved but remain massively underrepresented in IAPT provision. This must change.
6. Funded trainee places in IAPT for non-Cognitive Behavioural Therapy (CBT) practitioners.
Currently, it’s almost impossible for non-CBT therapists to be paid for trainee work in IAPT despite, in many instances, already having qualified. We are asking Health Education England to remove this major barrier to increasing the range of therapies available to service users.
7. An end to benefit sanctions.
Work-related benefit sanctions were suspended at the outbreak of Covid-19. We’ve signed a joint statement calling for the suspension to be extended for a further six months. We’re also urging the Department of Work and Pensions (DWP) as part of a coalition of mental health organisations to permanently end sanctions, which have devastating consequences for many people with mental health issues.
8. VAT exemption for counsellors and psychotherapists.
Many health services are exempt from VAT, but counselling and psychotherapy are not. Extending VAT exemption to talking therapies is long overdue and would remove a needless barrier to people accessing care. Currently, VAT requirements on therapists contradict legislation on ‘parity of esteem’ between physical and mental health, and represent unfair and unfounded distinctions between mental health practitioners. Earlier this year we submitted a proposal to the Government proposing this exemption and are renewing our efforts in light of separate changes to Government fiscal policy in the wake of Covid-19.
9. Action to diversify the NHS workforce as a priority.
We responded to the NHS ‘Vision for the psychological professions’ consultation demanding that the NHS gives higher priority to recruiting a more diverse psychological workforce. The disproportionate whiteness of the professions currently can only be addressed with firm commitment and action, and the NHS is uniquely placed to do this. We will continue to push for this change of emphasis as part of the coalition for diversity and inclusion in the psychotherapy and counselling professions.
10. An updated NICE Guideline for Depression in adults which is fit for purpose.
The NICE Guideline for Depression in adults will have major implications for service provision in the public and private sector. We’ve played a leading role in a coalition of stakeholders raising concerns about the development of this key guideline, including securing the support of more than 60 parliamentarians. In response to pressure from the coalition, NICE have responded to all six of our methodological concerns and committed to making changes in the third revision of the guideline, now due to be published in May 2022. We will continue to apply pressure to ensure our concerns are fully addressed.