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Waiting list eradication in secondary care psychology: addressing an NHS blind spot.

OBJECTIVES
Waiting times for secondary care psychological therapy remain a 'blind-spot' in Serious Mental Illness (SMI) provision and their reduction is a priority within the National Health Service (NHS) Five Year Forward View. The paper describes the eradication of waiting times within a community-based NHS service and the effectiveness of strategies, whilst examining help-seeking behaviour, compliance and therapeutic need.


METHODS
Analyses are reported for treatment compliance and therapeutic outcomes for 208 waiting-list cohort individuals seen by the SMI psychology service over an 18-month period between October 2014 and March 2016.


RESULTS
No significant clinical or demographic differentiation between individuals who successfully completed therapy compared to those who disengaged was observed. Despite an average 2.20 years waiting time, this alone did not significantly impact on engagement with psychological treatment and all psychological therapies provided led to a significant clinical improvement and no individuals who completed therapy required re-referral at 12-month follow-up.


CONCLUSIONS
If imposed appropriately over a suitable time-frame evidence-based practice coupled with effective operationalisation can result in efficient needs-led psychological provision within SMI and secondary care. Potentially debilitating waiting times for service users and other referring professionals can be avoided whilst psychology provision retains a flexible, formulation-based and person-centred approach.