The emotional impact of long-term conditions

Training for Primary Care that focuses on Integrating psychological therapies when treating long-term conditions.


Project Overview and Background

Comorbidity of physical and mental health problems is a major challenge for health systems. Two-thirds of patients suffering from long-term physical health conditions (LTCs) face mental health problems, which, according to the Royal College of Psychiatrists, are experienced by 1 in 4 people visiting their GPs.[1] As well as the emotional burden of this for patients and staff, the cost implications on the NHS system are major. According to the Five-Year Forward View for Mental Health, costs of care for adult patients suffering from LTCs and mental health complications increased by 45%.

An integrated approach between physical and mental health (as championed by the Five-Year Forward View) goes a long way towards achieving the aims of expanding Improving Access to Psychological Therapies (IAPT) services to deliver psychological and emotional support to people with long term conditions. An initial wave of integrated IAPT testing sites was launched in January 2017 at 22 Early Implementation projects across the country. A second wave of 15 new sites, including Haringey CCG and Islington CCG, followed shortly after. From April 2018 all clinical commissioning groups are required to offer IAPT services integrated with physical healthcare pathways.

For this integration to occur, it is important, firstly, to explore with various primary care staff groups the challenges faced in building the links between physical and mental health; and secondly, to use this knowledge to raise awareness in primary care settings of the emotional and psychological impact of LTCs. The National Workforce Skills Development Unit hosted by the Tavistock and Portman NHS Foundation has been asked to develop and deliver, via expert reference liaison (ERL), a training package with these aims in mind.

Specifically, the project will support primary care staff in the management of patients with LTCs and related mental health issues. The focus of the training will be on identifying the psychological dimensions of  LTCs, highlighting appropriate links to local psychology services, and ensuring staff and surgeries are properly resourced for these tasks.

Project Deliverables

The project aims to deliver a tailored training to primary care staff across all five boroughs of the North Central London STP. The five boroughs are: Barnet, Enfield, Haringey, Islington and Camden. The training will consist of a combination of in-person delivery across primary care practices and online resource serving as the training website.

The project will also produce multimedia "train-the-trainer" materials, including vignettes, role-play activities, discussion resources, signposting information, and webcasts. 

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You can register your interest for project news and events in your borough.

[1] NHS England:

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