Background

In Norfolk and Waveney, we have an NHS Talking Therapies service (previously known as IAPT), which is called Wellbeing locally. This service supports people experiencing depression and anxiety-based disorders.  

The current contract for NHS Talking Therapy ends in Autumn 2024 and we have a duty to ensure the service we have in place can best meet the needs of the people of Norfolk and Waveney. Therefore, NHS Norfolk and Waveney is currently asking providers to put forward their plans for delivering this service. 

Before we asked them to do this, we worked with a wide range of audiences, including our staff, people and communities to help plan and develop how this service is delivered in the future. We wanted to understand things such as: 

• Where would you go to find out about talking therapies?  
• What will help you to access the service if you need it? and   
• How would you want a talking therapy service to communicate with you?  

We asked our staff, people and communities for their views, whether they had or had not used talking therapy services. As part of the process, we also engaged with a wide range of local stakeholders to ascertain and understand their views in relation to the future of the NHS Talking Therapies service, and how it works alongside other organisations across the system. 

Our approach 

Surveys: For a period of six weeks between the 12 June 2023 and 24 July 2023, we carried out an engagement exercise via online surveys. We asked people questions to understand how we can ensure the best accessibility, access, communications and joint working in the future NHS Talking Therapies service. Accessible formats of the survey including audio, languages other than English and Easy Read versions were available. 

Face-to-face: We worked alongside an independent organisation – Engaging People – who conducted face-to-face surveys with people in locations such as food banks, local markets, town centres and local festivals to enable those who find digital options less accessible were not excluded from taking part in the survey. 

Focused conversations: We also worked with Community Voices and Norfolk Community Foundation, to broaden the reach ensure of our engagement process. Early analysis of the engagement identified some groups were under-represented, so Norfolk Community Foundation undertook face-to-face engagement with eight local voluntary sector organisations who support people in these groups. These organisations were: 

• MensCraft 
• Men’s Shed 
• GYROS 
• Norfolk Polonia 
• New Routes 
• Zainab Project 
• Community Sports Foundation 
• Reel Connections 

The surveys  

There was a total of 608 respondents for the general public survey. Of these: 

• 61.4% were previous and/or current service users 
• 77.7% were between the ages of 25 to 64 
• 90.3% reported their ethnicity as white 
• 78.6% reported their gender as female 
• 26.2% lived in Norwich 

We also carried out a survey for the current NHS Talking Therapies workforce in Norfolk and Waveney, which gained 121 survey responses. Of these: 

• 61.9% were employed by the Norfolk and Suffolk Foundation Trust, and 38.1% were employed by Norfolk and Waveney Mind 
• 45.3% were Step 3 practitioners 
• 21.4% were Step 2 practitioners 

Lastly, we carried out a survey for professionals working in Norfolk and Waveney services and/or organisations who either direct or refer people into the NHS Talking Therapies service, which had 54 respondents. 

We received a total of 783 survey responses.  

The feedback 

Key themes of the three surveys were: 

Access: The general public told us that they wanted to self-refer or have their GP or professional refer them into the service.  

Accessibility: The general public told us that face-to-face support with appointments available within 5-10 miles of home and free car parking was important for accessibility alongside quick access to care and support outside of ‘working’ hours (9am to 5pm).  

Communications: The general public told us that they would like to be kept informed about their progress, waiting times and information about other services that can support them, and that they would like this information via Text or Email on a weekly basis. 

Working with other services: The general public told us it is important for the NHS Talking Therapies service to work closely with their GP and other professionals supporting their mental and physical health. Those working within the NHS Talking Therapies service told us they feel it is important for NHS Talking Therapies to work more collaboratively across the Norfolk and Waveney system, including providing outreach to areas which need support in engaging with the service. 

Being seen quickly: Both the general public and the internal NHS Talking Therapies workforce surveys told us that support being available quickly was paramount. 

Reducing health inequalities: Respondents from ethnic minority backgrounds reported that readily available information in other languages, both written and spoken, was important for them to be able to access the service. People from ethnic minority backgrounds and those aged 16 to 25 reported that it was important for them that a clinician shared similar demographics to themselves. Additionally, males reported that consideration of the use of terminology around mental health was important for them to access an NHS Talking Therapies service. 

Role of the Voluntary Sector: The voluntary sector told us that it is important that VCFSE organisations play a role in supporting people who are seeking support from NHS Talking Therapies services, as they can provide wraparound support – such as with other factors that may impact someone’s wellbeing. They also told us that it is important that they have defined access routes, and clear guidance information about referral criteria. 

Flexible working: The Talking Therapies workforce told us that flexible working hours and days, and having the option to work both face-to-face and virtually was important for the NHS Talking Therapies service to be a good place to work. The general public survey responses also reflected a preference for both face-to-face and virtual support. 

Good support network: The NHS Talking Therapies workforce told us that it is important to receive good support from their team members. 

Use of technology: Professionals working within Norfolk and Waveney told us that they want to be able to find information on NHS Talking Therapies via the website, and to have information shared with them via email. 

Supported self-referral: Professionals working within Norfolk and Waveney told us that they prefer to support the service user to self-refer into the NHS Talking Therapy service, rather than referring them. 

Information sharing: Professionals working within Norfolk and Waveney told us that it’s important they have information on the service offer, referral criteria and feedback on referrals. They also reported being able to refer quickly and with ease as being important. 

In summary 

The engagement conducted by the ICB showed that the local population needs have changed significantly since the NHS Talking Therapies service contract was last awarded in 2015. Our engagement has highlighted the need for the future NHS Talking Therapies service to improve accessibility, particularly for seldom-heard groups; expand the online support offer; and work more collaboratively with other services and VCFSE organisations within the Norfolk and Waveney system. 

What we did 

Alongside other sources of information, the ICB has used the feedback and information from local people, the internal Talking Therapies workforce and professionals and partners, we designed the new NHS Talking Therapies service. The service is currently available from 16 October 2023, for potential providers to bid on. The successful bidder of the contract will provide the service from September 2024 to August 2029.