Antidepressant prescribing rates in England have been increasing since the 1970s. The impact of the Improving Access to Psychological Therapies (IAPT) initiative on antidepressant prescribing rates is unknown. In a paper published in the British Journal of General Practice, Vaishnavee Sreeharan and colleagues from Imperial College London investigated the impact of the establishment of IAPT services on antidepressant prescribing rates in primary care trusts (PCTs) in England. They used a longitudinal time-series analysis, using PCT-level data from 2008 to 2011. They reported that antidepressant prescribing rates in England increased by 10% per year during the study period. The implementation of IAPT services had no significant effect on antidepressant prescribing. They concluded that the introduction of a large-scale initiative to increase provision of psychological therapies has not curbed the long-term increased prescribing of antidepressants in England. You can read commentaries on the article on the Pulse, Psychology Online and Psychologist websites.
NHS budgets are under considerable pressure. It is therefore unsurprising that many NHS Integrated Care Boards (ICBs) In England will aim to prioritise price in contract awards, But this approach is a significant threat to community-centred healthcare. While competitive tendering is a legally required, an excessive focus on costs in awarding NHS contracts risks overshadowing key factors such as established community trust, local expertise, and the long-term impact on continuity of care. This shift towards cheaper, often external, commercial providers threatens to cut the links between communities and their local health services. The argument that competitive tendering is solely about legal compliance, and not cost, is undermined by the very nature of such tendering, which by design encourages the lowest bid. This approach risks eroding the social fabric of local healthcare provision, where established relationships and understanding of specific community needs are essential. Establishe...
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