title: Mapping mental health service access: achieving equity through quality improvement.
abstract: BACKGROUND
  Improving access to psychological therapies (IAPTs) services deliver evidence-based care to people with depression and anxiety. A quality improvement (QI) initiative was undertaken by an IAPT service to improve referrals providing an opportunity to evaluate equitable access.
  
  
  METHODS
  QI methodologies were used by the clinical team to improve referrals to the service. The collection of geo-coded data allowed referrals to be mapped to small geographical areas according to deprivation.
  
  
  RESULTS
  A total of 6078 patients were referred to the IAPT service during the period of analysis and mapped to 120 unique lower super output areas (LSOAs). The average weekly referral rate rose from 17 during the baseline phase to 43 during the QI implementation phase. Spatial analysis demonstrated all 15 of the high deprivation/low referral LSOAs were converted to high deprivation/high or medium referral LSOAs following the QI initiative.
  
  
  CONCLUSIONS
  This work highlights the importance of QI in developing clinical services aligned to the needs of the population through the analysis of routine data matched to health needs. Mapping can be utilized to communicate complex information to inform the planning and organization of clinical service delivery and evaluate the progress and sustainability of QI initiatives.
authors.affiliation: NIHR CLAHRC for Northwest London, Imperial College London, London SW10 9NH, UK. stuart.green@imperial.ac.uk
authors.forename: Stuart A
authors.initials: SA
authors.lastname: Green
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Poots
authors.forename: Jose
authors.initials: J
authors.lastname: Marcano-Belisario
authors.forename: Edgar
authors.initials: E
authors.lastname: Samarasundera
authors.forename: John
authors.initials: J
authors.lastname: Green
authors.forename: Emmi
authors.initials: E
authors.lastname: Honeybourne
authors.forename: Ruth
authors.initials: R
authors.lastname: Barnes
mesh_terms: D001007:Anxiety / Q000628:therapy; D003695:Delivery of Health Care / Q000458:organization & administration*; D003863:Depression / Q000628:therapy; D062305:Geographic Mapping; D006297:Health Services Accessibility / Q000458:organization & administration; D054625:Healthcare Disparities; D006801:Humans; D008131:London; D008605:Mental Health Services / Q000458:organization & administration*; D058996:Quality Improvement; D012017:Referral and Consultation