Shared learning database

Airedale NHS Trust
Published date:
January 2009

A project to adapt NICE guidance on anxiety and depression so it could be applied in the workplace.

Guidance the shared learning relates to:
Does the example relate to a general implementation of all NICE guidance?
Does the example relate to a specific implementation of a specific piece of NICE guidance?


Aims and objectives

To adapt NICE guidance on anxiety and depression so it could be used in the workplace Identify how the stepped care approach to mental health could be adapted to the workplace. Introduce first 2 steps of this model to our service. Evaluate benefits to employees and employers.

Reasons for implementing your project

Our Occupational Health Service exists to protect employees from ill-health, and promote health. Mental ill health is a national problem; a survey in 2006 showed a large proportion of absence in our Trust was due to mental health problems. The Occupational Health team felt they did not have the skills to support people presenting with mental health problems. In Spring 2007, The Care Services Improvement Partnership (now NIMHE) contacted the Head of Occupational Services and asked if we would be interested in becoming a demonstration site to look at NICE guidance on anxiety and depression and adapt the guidance so that it could be used in the workplace.

How did you implement the project

Occupational Health re-structured to offer a stepped care model; the first two steps were fitted into the model of 5. Intensive training for staff was given in Cognitive Behavioural Therapy. Existing screening tools for anxiety and depression were adopted. Results: Staff feel more confident in dealing with people with anxiety and depression. The number of clients referred to Counsellor have decreased. Ratio of nurse against doctor referrals was reversed with the implied cost savings. Days lost due to mental health significantly reduced: estimated saving £225,000 p/a Positive feedback received from employees.

Key findings

Database of patient's access to stepped care model including: referral date, provisional diagnosis, number of appointments attended, completion of treatment, length of sickness, referral to Counsellor, CBT, Step 4, Step 5, Clinical Score on admission and discharge. Pre and post treatment patient questionnaires. Sickness absence monitored: cause, length of time compared over same period in consecutive years. Data part of CSIP report. CSIP have presented interim report to NICE and in process of collating final report.

Key learning points

In last 18 months only 3 people have been stepped up to level 4/5. CCBT useful for keeping people at work. Helped those off work return sooner. Complimentary therapy enabled staff to remain at work.

Contact details

Caroline Booton
Clinical Audit Facilitator
Airedale NHS Trust

Secondary care
Is the example industry-sponsored in any way?