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Delivering a high fidelity IPS service
From conducting several drop-in sessions for Employment Specialists (ES’s) and Team Leaders (TL’s), the main thing services are trying to achieve is a combination of attaining against the Commissioner/NHS Long Term Plan (LTP), whilst still remaining a high fidelity service.
We are aware that the 5-year plan within the NHS for IPS is to support over 55,000 people by the end of 2024 with an even more ambitious target of 115,000 by 2028-2029. This target means services should be growing their workforce each year to attempt to meet the LTP and support as many service users as possible who wish to source long-term, sustainable employment. For further information on the NHS LTP click here.
Which stakeholders are most important to an effective and integrated IPS Service?
Services are encouraged to develop strong, meaningful relationships with Community Mental Health Teams (CMHTs) in their local NHS Trusts working in a variety of mental health treatment sectors such as Early Intervention (EI), Early Intervention Psychosis (EIP) and Enhanced Primary Care (EPC). Recent announcements from NHSE/I have also suggested services branch out into Primary Care with a strong focus in building relationships with local GP Practices.
By educating the clinicians about the purpose and benefits of IPS, ES’s hope to encourage clinicians to refer service users who are interested in sourcing employment. Links with the DWP, their designated commissioner and Senior Executives in the Trust are also important for delivering an effective and integrated IPS service.
With more service users accessing an IPS Service, Team Leaders and Commissioners need to ensure that there are enough ES’s to support the number of people requiring IPS support whilst still remaining within the anchors of fidelity.
What support is available from IPS Grow?
IPS Grow Regional Leads support services by offering a mixture of guidance. This includes onsite field mentoring, online workshops/resources and attending meetings such as Steering Groups to ensure all members understand the anchors of fidelity and how by working towards them, higher access and outcome rates can be achieved.
A specific example of this links to Item 5 within fidelity; Integration of supported employment with mental health treatment through frequent team member contact. Research within IPS indicates that a positive relationship with clinical teams leads to increased referrals. ES’s are expected to attend weekly Multi-Disciplinary Team Meetings (MDTs) discussing individual clients and their employment goals with shared decision-making with the clinician team.
ES’s work in the clinical setting or in proximity, and documentation is shared to create an integrated single client record. By having this joint up approach, ES’s help clinicians think about employment for those who haven’t yet been referred to the service.
The Future NHS Collaboration Platform holds a wealth of resources for clinicians on the benefits of IPS. If a service is still struggling to engage with clinicians and obtain referrals, Regional Leads may offer to observe or field mentor an ES within an MDT, assessing what the barriers might be.
National data identifies that the clinical mindset is often a difficult hurdle to overcome with some feeling a client’s mental stability should come before employment is considered.
Regional Leads support the service to challenge this mindset with National Reports emphasising how employment can in fact improve a person’s mental health.
ES’s are also encouraged to circulate good news stories to MDT’s to evidence the positive changes IPS is making to their client’s lives.
One of the most powerful ways to show this is through lived experience. We strongly encourage IPS Services to employ clients who were once on their caseload as an ES. Not only can these individuals form a fantastic rapport with future clients, but they can also educate and reassure clinical teams that their mental health does not define them, nor their capability to work.
Many ES’s have shared in fidelity reviews the “turning point” with clinicians expressing:
The best way to change the mindset of clinicians is to offer to support a client whom they don’t feel could obtain employment. Once we show them we can do this, the floodgates open with referrals.
Employment Specialist
We have found this to be one of most successful ways to ensure referrals come through to IPS Services. Clinicians have often expressed to us that this approach to supporting client’s is new to them but is positively impacting upon their client’s lives and mental health recovery.
I feel it’s a valuable service that has really helped our service users find their strengths. I’ve seen services grow and seen some of the people that have really developed through the IPS platform.
It’s an invaluable service that has changed the lives of a lot of our clients and we have seen them develop so much.
Clinical Team Member
IPS Grow aims to support services wherever possible to ensure a strong, collaborative approach between the IPS Service and clinicians is achieved and maintained. In the future, we aim to offer further support in this area through dedicated workshops for clinicians in understanding the role of IPS, and by producing further papers showcasing the amazing outcomes local IPS Services are achieving with client’s experiencing a SMI.