This section of the website is designed to provide additional information for professionals about First Step. Whilst anyone is able to view this section of the website if you are not a health care professional you may find other sections of the site more helpful.
First Step is Cumbria's Primary Care Mental Health Service offering Guided Self help, CBT and counselling delivered by therapists in GP practices and community venues.
Referrals can be made to the service by letter or using the current form by fax, phone, secure email or post to the admin hub. From 1st December 2010 self referrals were accepted from patients.
First Step GP News
Previous First Step GP News
Gradual increase in capacity
For the first year considerable amounts of clinical time will be taken up by the comprehensive University Courses for the new workers and increased supervision. The capacity of the service will therefore increase gradually over time and GPs will be kept informed of this to allow referrals to increase appropriately and maintain rapid response times. The service will not be fully operational until September 2010
Who should I refer?
The main focus of First Step's work is providing guided self help, counseling and CBT for mild to moderate depression and anxiety disorders (including Obsessive Compulsive Disorder, Post Traumatic Stress Disorder, Generalised Anxiety Disorder, Phobias, Social Anxiety and Health Anxiety).
The team does not have the skills or systems to safely treat patients at risk of self harm, suicide or risk to others or patients with a psychotic illness - these patients should be referred to secondary mental health services via the Single Point of Access. If patients are inadvertently referred to First Step who are more suitable for the CMHT these referrals will be passed on but clearly this can cause a slight delay for the patient. Please click here for our referral form (this is a word document).
No upper age limit
Did you know there us no upper age limit for First Step ? To date fewer patients over 65 years of age have been referred than expected. Patients over 65 with anxiety or depression who would like to engage in either a CBT or counselling can be referred. First Step does not offer a domiciliary service and so patients requiring a home visit should be referred to the older people CMHT.
First step has now begun to offer extended opening hours for clients. Initially these have been offered in centralized venues but increasingly we would like to see these happening in GP surgeries linking in with days when premises are open later. If you are interested in having your First Step worker offer later appointments in your surgery please either speak to them directly or with your sector manager.
Supporting primary care
First Step is a service which aims to be based in Primary Care working alongside GPs to offer an intergrated service to patients. Access to appropriate resources including self help booklets and cCBT is essential.
Click on this link to visit our "self help resources page"
NHS guidelines can also be found on Map of medicine :
NHS Cumbria and Cumbria Partnership Trust are committed to facilitating training for Primary Care clinicians to support the work of First Step and to improve treatment of mental health conditions. This section of the website is still under development and further resources will be added over the next few months.
eLearning is valued resource to support this especially in a rural location like Cumbria. A wide range of eLearning resources can be found at: www.learning.bmj.com
To use the site you need to register. Some modules are free - other require either a BMA membership or an annual eLearning subscription currently £79 for GPs.
The Royal College of General Practitioners are also developing an eLearning resources for all UK GPs and trainees. This includes a module specifically written to IAPT support services like First Step.
This can be found at : elearning.rcgp.org.uk
A number of training packs are currently being developed by localities for use during Protected Learning Time.
A Protected Learning Time pack has been written to support First Step and includes information on the service, the Stepped Care model and the latest NICE guidelines for Depression and Anxiety. It is available from your practice First Step worker, practice CIM or from the admin Hub.
NHS Cumbria and Cumbria Partnership Trust have also developed a PLT pack on Suicide Prevention and are developing a pack on Learning Disability Health Checks. For more information please contact the admin hub.
Any Questions ?
If you have questions about the service please contact the First Step service admin hub by emailing Firststep@nhs.net or call 0300 123 9122.