Quality statement 1: Assessment

Quality statement

People who may have depression receive an assessment that identifies the severity of symptoms, the degree of associated functional impairment and the duration of the episode.

Quality measure

Structure: Evidence of an assessment process for people who may have depression that identifies the severity of symptoms, the degree of associated functional impairment and the duration of the episode.

Process: Proportion of people who receive an assessment for depression that identifies the severity of symptoms, the degree of associated functional impairment and the duration of the episode.

Numerator – the number of people in the denominator receiving an assessment that identifies the severity of symptoms, the degree of associated functional impairment and the duration of the episode.

Denominator – the number of people receiving an assessment for depression.

What the quality statement means for each audience

Service providers ensure that a process is in place for assessing people who may have depression that identifies the severity of symptoms, the degree of associated functional impairment and the duration of the episode.

Healthcare professionals ensure that people who may have depression are assessed using a process that identifies the severity of symptoms, the degree of associated functional impairment and the duration of the episode.

Commissioners ensure they commission services that have an assessment process in place that identifies the severity of symptoms, the degree of associated functional impairment and the duration of the episode.

People who may have depression receive an assessment to find out how severe their symptoms are, how much they are affected by the depression and how long it has lasted for.

Definitions

The term 'people who may have depression' includes all people with a chronic physical health problem who may have depression.

For details of the assessment see appendix C of NICE clinical guideline 90 and 91. This should be supported by use of a formal rating scale for symptom severity (for example, Patient Health Questionnaire [PHQ-9], Hospital Anxiety and Depression Scale [HADS], Beck Depression Inventory [BDI]).

The assessment of functional impairment should include social perspectives of impairment as defined by the World Health Organisation International Classification of Functioning, Disability and Health.

Source guidance

NICE clinical guideline 90 recommendation 1.1.4.1 and NICE clinical guideline 91 recommendation 1.1.3.1 (key priorities for implementation).

Data source

Structure: Local data collection.

Process: Local data collection. Information on assessment of severity is collected by Quality and Outcomes Framework (QOF) indicator Depression 2: In those patients with a new diagnosis of depression, recorded between the preceding 1 April to 31 March, the percentage of patients who have had an assessment of severity at the outset of treatment using an assessment tool validated for use in primary care.

Equality and diversity considerations

Quality statement 1 should be supplemented with recommendation 1.3.1.5 (which is the same in NICE clinical guideline 90 and 91) in cases where the person with depression has significant language or communication difficulties.

Recommendation 1.3.1.5 states: 'For people with significant language or communication difficulties, for example people with sensory impairments or a learning disability, consider using the Distress Thermometer and/or asking a family member or carer about the person's symptoms to identify possible depression. If a significant level of distress is identified, investigate further.'