Determining local service levels for a service providing cognitive behavioural therapy for the management of common mental health problems
Benchmarks for a standard population
Available data suggest that the standard benchmark rate of referrals for cognitive behavioural therapy (CBT) is 3%, or 3000 per 100,000 population, aged 15 years or older per year. This includes those people who would be suitable for and willing to participate in computerised CBT (CCBT).
For the purpose of this commissioning guide the adult population has been defined as people aged 15 years or older. This is due to the availability of population data at general practice level within certain age bands and its use within the commissioning ans benchmarking tool. Approximately 80% of the English population is aged 15 years or older.
For a standard primary care trust population of 250,000 (around 200,000 people are aged 15 years or older), the average number of people requiring referral for CBT would be 6000 per year (or 3% of the population aged 15 years or older).
For an average practice with a list size of 10,000 (around 8000 are aged 15 years or older), the average number of people requiring referral for CBT would be 240 per year (3% of the population aged 15 years or older).
The NICE clinical guideline CG90 on depression states that for mild depression a number of brief psychological interventions are effective. Many patients with milder depression respond to interventions such as exercise or guided self-help, although many improve while being monitored without additional help. More structured therapies, such as problem-solving, brief CBT or counselling can be helpful. The topic-specific advisory group suggested that commissioners may wish to focus their effort on commissioning CBT (high intensity) for people with moderate to severe depression as this is the area where there are greatest deficits in service provision, and where the greatest potential exists for commissioners to make a significant contribution to service improvement.
CBT is likely to fall under the programme budgeting category 205X (other mental health disorders).
Examine the assumptions used in estimating these figures.
Use the CBT commissioning and benchmarking tool to determine the level of service that might be needed locally and to calculate the cost of commissioning the service using the indicative benchmark and/or your own local data.
Further information
Sources of further information to help you in assessing local health needs and reducing health inequalities include:
- Annex A of the Commissioning framework for health and well-being outlines the process and data needed toundertake a joint strategic needs assessment
- Department of Health Delivering quality and value - focus on benchmarking
- NICE Health equity audit - learning from practice briefing
- PRIMIS+ provides support to general practices on information management, recording for, and analysis of, data quality, plus a comparative analysis service focused on key clinical topics.
This page was last updated: 05 May 2010
- Cognitive behavioural therapy service
- Commissioning a service providing cognitive behavioural therapy for the management of common mental health problems
- Specifying a service providing cognitive behavioural therapy for the management of common mental health problems
- Determining local service levels for a service providing cognitive behavioural therapy for the management of common mental health problems
- Assumptions used in estimating a population benchmark
- The commissioning and benchmarking tool
- Ensuring corporate and quality assurance
