Approximately one third Primary Care Trusts (PCTs) are failing in their legal obligation to provide computerised cognitive behavioural therapy (cCBT) to patients, according to an article published today in Pulse.

Trusts blame financial cutbacks or a lack of funding for the failure to commission cCBT services, almost three years after the publication of a mandatory NICE technology appraisal. In fact, the article reveals that several trusts have even decommissioned cCBT services, saying the demand has been low or patients preferred face-to-face CBT.

Pulse surveyed 52 PCTs. Sixteen of them still had not commissioned either of the two NICE recommended programmes – Fear Fighter for anxiety, and Beating the Blues for panic and phobia. Another nine PCTs did not commission programmes which NICE had recommended because they preferred non-subscription cCBT programmes, such as Mood Gym for depression, or other free treatments for more general psychological problems such as low self-esteem.

The extended deadline for implementing the NICE appraisal ended in November 2007, but by February last year only about 40% of trusts had implemented it.

Although the situation has been improving, there are still a large number of trusts that are open to a legal challenge over their failure to implement the appraisal.

NICE insisted that PCTs were bound by its technology appraisals and said the slow rate of uptake of cCBT had been ‘disappointing’.

‘We are sorry to hear that, despite an extension, the guidance has still not been implemented fully,’ a spokesperson said.

David Stout, director of the NHS Confederation’s PCT network, said PCTs’ obligations were clear and would be reiterated in the NHS constitution.

He added: ‘NICE technology appraisals are a statutory direction, and therefore there’s a legal responsibility on PCTs to make the funds available for them.

‘The numbers of PCTs that have yet to commission a service suggests funding is an issue – but lack of funding does not excuse PCTs from the direction.’

Click here to read the full article online.

Written by John Robinson
Pulse.