Psychological therapies and interventions specification: consultation analysis

5 Outcome 2: I am fully involved in decisions about my care

Introduction

This chapter presents feedback on Outcome 2 which aims “To make sure that people are fully involved in their care and care planning; and collaboration between professionals is crucial”. It then sets out a number of statements that describes how this will be achieved.

Question 14

How far do you agree that the specifications within Outcome 2 will improve the experiences of people accessing psychological therapies and interventions?

Table C10 presents the quantitative response to Question 14. This shows that:

• three-quarters of all consultation respondents who answered Question 14 either agreed or strongly agreed (75%) that the statements within Outcome 2 will improve the experiences of people accessing psychological therapies and interventions
• 17% neither agreed nor disagreed
• 8% either disagreed or strongly disagreed

Question 15

How far do you agree that the statements within Outcome 2 will improve the outcomes of people accessing psychological therapies and interventions?

Table C11 presents the quantitative response to Question 15. This shows that:

• almost two-thirds of all consultation respondents who answered Question 15 either agreed or strongly agreed (62%) that the statements within Outcome 2 will improve the outcomes of people accessing psychological therapies and interventions
• a relatively large proportion of respondents neither agreed nor disagreed (28%) with this statement
• 9% either disagreed or strongly disagreed

Question 16

How far do you agree that the statements within Outcome 2 successfully sets out to individuals, their families and carers what they can expect when being fully involved in the decisions about the care offered?

Table C12 presents the quantitative response to Question 16. This shows that:

• around three-quarters of all consultation respondents who answered Question 16 either agreed or strongly agreed (76%) that the statements within Outcome 2 clearly set out to individuals, their families and carers what they can expect when being fully involved in the decisions about the care offered
• 15% neither agreed nor disagreed
• 10% either disagreed or strongly disagreed

Question 17

We know that currently not everyone has the same experiences or outcomes when they access psychological therapies and interventions. We want the specification to help make sure that services meet your needs whoever you are and whatever your background. How far do you agree that the statements within Outcome 2 will help do this?

Table C13 presents the quantitative response to Question 17. This shows that:

• over two-thirds of all consultation respondents who answered Question 17 either agreed or strongly agreed (70%) that the statements within Outcome 2 will help to support equitable access to psychological therapies and interventions
• 20% neither agreed nor disagreed
• 11% either disagreed or strongly disagreed

Question 18

The statements within Outcome 2 are intended to support collaboration between professionals. How far do you agree that the statements within Outcome 2 will do this?

Table C14 presents provides the quantitative response to Question 18, which shows that there was relatively mixed feedback with:

• almost half of all consultation respondents who answered Question 18 either agreed or strongly agreed (45%) that the statements within Outcome 2 will support collaboration between professionals
• a similar proportion (43%) neither agreed nor disagreed
• 12% either disagreed or strongly disagreed

Question 19

Do you have any other comments on Outcome 2?

Around three-quarters (73%) of all consultation respondents answered Question 19 which asked respondents whether they had any other comments regarding Outcome 2. The main themes are presented below.

Theme 1: A repeat of key themes that emerged from the consultation

Some respondents repeated points that they had made earlier - see Chapter 2 for more detail. For example:

• further action may be required to build workforce capacity
• additional funding, resources and other support to ensure effective implementation of Outcome 2

Theme 2: Feedback on specific statements

Some respondents provided feedback on specific statements in Outcome 2 that they could be amended, reworded, reframed, enhanced, and/or further strengthened in some way. This feedback in part reflects calls from respondents for more detail, specification and/or greater clarity on these statements, including terms used.

More detail is provided in Appendix D, however, a couple of selected examples include:

• concern that staff supervision and access to clinical expertise would only be available “where possible”
• that statement 2.1 should include informed consent and consider possibility of an abusive/coercive relationship – this led to suggestion to amend wording that staff, communities and services “must work with family/carers and me” with removal of “must”

Theme 3: There could be more explicit reference to improved collaboration between professionals

A few respondents, mostly individuals, felt that there could be more explicit reference within the statements to improved collaboration between professionals and the role of multidisciplinary teams to help ensure consistency and continuity of care.

While important, these respondents felt that the statements currently placed more emphasis on increased collaboration between professionals and people accessing the services. It was suggested that a better balance could be struck in this regard.

Additional points

Raised to a lesser extent, a few respondents felt that:

• there would require to be a balance between personal choice/preference and clinical/professional judgement, particularly where a person is unable to be fully involved in care decisions due to a range of factors, including cognitive disabilities – similarly, more detail was requested on what happens where a person is unable to provide informed consent or decision under Adults with Incapacity (Scotland) Act 2000 or Mental Health Act 1983
• greater clarity could be provided on the roles and responsibilities of professions and services within Outcome 2 to ensure appropriate and clear lines of accountability required to deliver the specification
• some statements may not be appropriate or applicable for people in forensic settings