FOI 2025/1423

I would like to make a formal request under the Freedom of Information Act 2000.
I wish to understand the testing and implementation of the outcome-based payment approach for NHS Talking Therapies (formerly known as Improving Access to Psychological Therapies (IAPT)) undertaken in your ICB area. To provide context, in the financial years 2017/2018 and 2018/2019, NHS England implemented a policy change relating to the reimbursement of treatment costs in NHS Talking Therapies. This relates to Local Pricing Rule 8 of the 2017/19 National Tariff, which required the adoption of an outcomes-based payment approach using the 10 national outcome measures collected in the IAPT dataset. The NHS England Strategic Finance team stated the 10 national outcome measures, and nominal weightings of each measure in the outcome element of the outcomes-based payment approach, include:
• Clinical outcomes – 50%.
• Patient satisfaction – 11.25%.
• Reducing disability and improved wellbeing – 10%.
• Employment outcomes – 10%.
• Patient choice – 3.75%.
• Access for BAME groups – 3%.
• Access for over 65s – 3%.
• Access for self-referrals – 3%.
• Access and waiting times standard – 3%.
• Access for specific anxieties – 3%.
Clinical Commissioning Groups (CCGs) and NHS Talking Therapies service providers were supposed to shadow-test an outcomes-based payment approach from April 2017, with full implementation planned for April 2018.
Given the time period this information relates to, I refer to the following CCGs that transitioned into NHS Greater Manchester ICB:
• NHS Manchester CCG (formed by merger in 2017; part of Manchester Health and Care Commissioning).
• NHS Heywood, Middleton and Rochdale CCG.
• NHS Oldham CCG.
• NHS Salford CCG.
• NHS Stockport CCG.
• NHS Trafford CCG.
• NHS Tameside and Glossop CCG.
• NHS Wigan Borough CCG.
• NHS Bolton CCG.
• NHS Bury CCG.

Please could you provide the following information:
1. The date (year and month) each Clinical Commissioning Group region shadow tested an outcomes-based payment approach for NHS Talking Therapies treatment in the date range of 2008 to the latest available data.
2. The date (year and month) each Clinical Commissioning Group region fully implemented an outcomes-based payment approach for NHS Talking Therapies treatment in the date range of 2008 to the latest available data.
3. If all NHS Talking Therapies service providers within a Clinical Commissioning Group region adopted the change in reimbursement scheme at the same time. If not, which providers were selected for shadow testing, and when did all providers adopt the change.
4. If possible, the criteria/targets and associated weightings of the 10 outcome measures for each Clinical Commissioning Group region, once the outcomes-based payment approach was implemented from its introduction and each subsequent financial year up to the latest available data.
If possible, could you provide the information/data in a CSV/XLSX file in the following column format:
• Clinical Commissioning Group organisation/entity ID code.
• Clinical Commissioning Group organisation/entity name.
• The year when shadow testing of the new payment approach began.
• The month when shadow testing of the new payment approach began.
• The year when shadow testing of the new payment approach ended.
• The month when shadow testing of the new payment approach ended.
• An indicator of whether all service providers in the region participated in the shadow testing.
• NHS Talking Therapies service provider organisation/entity ID codes of providers not included in shadow testing (If not all).
• NHS Talking Therapies service provider organisation/entity ID codes of providers included in shadow testing (If not all).
• The year when the new payment approach was fully implemented.
• The month when the new payment approach was fully implemented.
• The criteria/targets and associated weightings of the 10 outcome measures for the Clinical Commissioning Group region (per financial year).

1. The date (year and month) each Clinical Commissioning Group region shadow tested an outcomes-based payment approach for NHS Talking Therapies treatment in the date range of 2008 to the latest available data.

While each CCG put in place an outcome cased framework using the outcome-based approach, this was never formally shadow-tested as the mandate for this was relaxed, allowing CCGs to put in place an outcome framework for reporting only

2. The date (year and month) each Clinical Commissioning Group region fully implemented an outcomes-based payment approach for NHS Talking Therapies treatment in the date range of 2008 to the latest available data.

See response to Q1. The outcome framework was put into place from 01/04/2017 and is still used

3. If all NHS Talking Therapies service providers within a Clinical Commissioning Group region adopted the change in reimbursement scheme at the same time. If not, which providers were selected for shadow testing, and when did all providers adopt the change.

See response to Q1. No providers adopted the framework for shadow testing.

4. If possible, the criteria/targets and associated weightings of the 10 outcome measures for each Clinical Commissioning Group region, once the outcomes-based payment approach was implemented from its introduction and each subsequent financial year up to the latest available data.

The table below was used an the IAPT outcome framework, with the attached weightings utilised.