General Practitioners in Leicestershire from the LCRPCT Mental Health Clinical Forum wished to design a service that would operate within the primary care setting, be owned by primary care, that would upskill clinicians at the surgery level, reduce barriers to care and minimise perverse incentives to refer patients on.
With a background in psychogical therapies, a track record in research into implementing evidence based therapies in realistic settings and experience of general practice as an established GP, I was able to use my clinical networks to pull together a team that could meet the needs of GPs.
The Good Thinking Therapy Service is provided by a consortium that includes a local mental health trust, an association of General Practitioners and is led by a mental health charity.
Rethink provided expertise in running IAPT services, overall responsibility, IT and audit.
Not just CBT....
Leicestershire GPs did not wish the stepped care model to act as a barrier in primary care. The Good Thinking Therapy service also manages the Mental Health Facilitators who take on patients whose clinical conditions are severe but stable enough to be managed in primary care.
This developing role bridges the gap between secondary care psychiatry and the local surgery with the aim of reducing NHS costs while providing seamless care for vulnerable people.
Contracting after the Health and Social Care Act
The GPCo, hosted by Assura, was bought out by VirginCare and subsequently dissolved in October 2012. From then until 31st March, GP engagement was directly contracted by Rethink.
From the 1st April, GP engagement transferred to the new Clinical Commissioning Group mental health leads.