Two scores, one step, and a line rather than two dots

PHQ-9 and GAD-7 at referral and at every session, steps two and three held as clinical decisions, waiting counted from referral, and recovery worked out from the whole line.

1 Stepped care, and the score that moves you

NHS Talking Therapies runs on two numbers and a step. PHQ-9 for depression, GAD-7 for anxiety, taken at referral and at every session, and a step — two for guided self-help and low-intensity work, three for high-intensity therapy. Everything about the service is those three things moving over time.

The queue carries the presenting problem in the words a therapist would use — generalised anxiety disorder, depression following bereavement, panic disorder — the referral source, the step and the PHQ-9 at referral. A score of 17 with a self-referral marked urgent gets seen differently from an 8 that arrived from a GP as routine, and both facts are on the row.

2 The session is where the outcome comes from

Recording a session writes the scores again, so recovery isn’t something calculated at discharge from two data points months apart. It’s a line. That’s what makes the recovery rate mean anything, and it’s why the service tracks waiting, active and discharged as three separate states with counts on each.

A practitioner is named against each active case. Where nobody has been allocated yet the column is empty and says so, which is the honest version of a waiting list.

3 Access, waiting and the national return

The service is measured on access and on waiting times as much as on recovery, and both have their own tab.

Waiting is counted from referral, not from allocation, because the person has been waiting the whole time either way. The MHSDS reporting tab carries what goes to the national dataset each month.

Where it lives in commvita