Can a Deaf charity develop an effective relationship with over 200 CCGs?

Abstract

BSL Healthy Minds (BSLHM) is a national psychological therapy service in primary care that provides cognitive behaviour therapy (CBT) and counselling for deaf people who use British Sign Language (BSL). There are 211 clinical commissioning groups (CCGs) in England and BSLHM has the onerous task of developing a relationship with each one to set up a contract that would enable BSL users to have the same access to psychological therapies as the general population. This article will consider the obstacles faced when negotiating the ever-changing face of the CCGs, the complex relationships with commissioners, the issues Deaf people face when accessing mainstream mental health services and specialist status. There are possible solutions to the immense difficulties BSLHMs experiences when considering commissioning and this article offers recommendations for changes within the funding structure for the future.

Evaluating the effectiveness and cost-effectiveness of British Sign Language Improving Access to Psychological Therapies: an exploratory study

“…Since the changes in commissioning arrangements, with the move from PCTs to CCGs that happened during the life of the project, 110 access to BSL-IAPT through BSL Healthy Minds has declined, with block commissioning arrangements being increasingly replaced by the use of IFRs instead. 32 This is also apparent in the waiting time data reported in Chapter 4. The originating BSL-IAPT service provider submitted an application to the DH for National Specialist Commissioning status in 2015, but this was rejected.…”

“…However, service accessibility has been declining since April 2014 as a result of new commissioning arrangements subsequent to the transformation from a primary care trust (PCT) structure in England to Clinical Commissioning Groups (CCGs) instead. 32 Moreover, in the course of this study it became apparent that a few service providers, other than BSL Healthy Minds, were starting to develop specialist provision for Deaf people, including using qualified Deaf PWPs. Provider and model of provision were no longer synonymous.…”

“…Furthermore, the analysis of a large data set of patients who had used BSL-IAPT in terms of referral rates, adherence and clinical outcomes would enable calculation of recruitment targets should a full trial be indicated. BSL-IAPT, however, was available in only a limited number of areas in England; 32 this ranged from two to five PCTs over the life of the research project. Therefore, although it was assumed that Deaf people were accessing IAPT through standard services elsewhere in England, the number of patients was unknown.…”

‘Marginal voices’ – a quest to improve mental health diagnosis among the deaf community in the UK

“…Due to a low density of Deaf people residing in and seeking services in each Clinical Commissioning Group (CCG)-managed area in England, the Healthy Minds programme has referral numbers that are too high to be considered specialist and too low for CCGs to consider commissioning. 8 This move reinforces health inequalities for an already marginalised community in primary and secondary mental healthcare. Effective management of ensuring mental health in a culturally sensitive way should allow space for innovation at a local and national level.…”