CareUK
Clinical Manual
The Mindler Clinical Manual serves as a comprehensive operational guide detailing standard clinical processes, governance, and treatment pathways for delivering care within Mindler. It covers the full patient journey - from initial referral and suitability assessment through treatment delivery and discharge
Referral, Eligibility, and Care Pathways
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Service Scope & Pathways: Details treatment delivery for Low Intensity (Step 2) and High Intensity (Step 3 / Step 3+) interventions across CBT, Counselling for Depression (CfD), Long-Term Conditions (LTC), and EMDR pathways.
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Eligibility & Exclusions: Defines suitable presentations (such as mild to moderate-severe depression, GAD, OCD, SAD, and Type 1 PTSD) and explicit exclusion criteria (including high risk, active eating disorders, psychosis, and Complex PTSD).
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Site Protocols: Outlines contract-specific NHS guidelines governing allocation, availability, delivery platforms (typed vs. video), and localized service requirements.
Starting Therapy: From Allocation to First Session
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Therapy Room Activation & Engagement: Requires room activation in IAPTUS and a mandatory welcome message sent to the patient within 48 hours of allocation.
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Initial Appointment & Expectation Setting: Establishes guidelines for assessing presenting problems, setting treatment expectations, agreeing on confidentiality, and confirming GP consent.
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Post-Session Actions: Outlines mandatory tasks within 48 hours of the first session, including recording clinical notes, confirming treatment steps, and logging presenting complaints.
Session Planning, Review, and Extension Guidance
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Proportionate Care & Session Ranges: Provides indicative treatment length ranges aligned with NICE and NHS Talking Therapies standards (e.g., typically 3 sessions for PWP Step 2; ~6–7 sessions for CBT Step 3/3+; 6–10 sessions for CfD; 6–12 sessions for EMDR)
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Clinical Reviews & Non-Caseness: Mandatory progress reviews by Session 3. Defines specific handling for clients scoring under caseness (PHQ-9 < 9, GAD-7 < 7).
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Extension Protocols: Details requirements for supervisory review, clinical justification, and clear documentation when extending care beyond standard ranges.
Supporting Engagement, Outcomes, and Communication
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Engagement & Between-Session Work: Sets expectations for response times (within 48 hours), regular contact (no gaps 7+ days), and utilising between-session tasks/transcripts.
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Minimum Data Set (MDS) & ADSMs: Mandates completion of core measures (PHQ-9, GAD-7, Phobia, WSAS) via patient SMS links at every appointment, along with appropriate Anxiety Disorder Specific Measures (ADSMs).
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Protocol Selection: Ensures evidence-based practice by requiring recorded secondary interventions matched to presenting complaints in IAPTUS.
Logging Sessions: Clinical Contacts and Appointment Types
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Documentation Timelines: Mandates completion of clinical contact logs in IAPTUS within 48 hours of session end.
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Contact Types: Categorizes appointment types into:
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MDS: Standard clinical appointments with complete minimum data set fields.
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Incomplete MDS: Sessions where required data could not be fully captured.
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Non-MDS: Administrative or clinical updates (e.g., referral rationales).
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Assessment Letters and GP Communication
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Assessment Letters: Sets guidelines for completing and sending structured assessment letters to patients and copying their GP (when in 'Assessment' pathway stage).
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GP Consent & Ad Hoc Contact: Establishes procedures for checking consent status, managing opt-outs/withdrawn consent, and handling risk-based exceptions or ad-hoc interim GP updates.
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Third-Party Supporting Letters: Clarifies restrictions regarding requests for non-clinical supporting letters (e.g., employment, housing, benefits).
Ending Therapy: Discharge and Next Steps
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Discharge Management: Defines standard criteria and care pathway stages for planned completions, early agreed endings, non-engagement, or unsuitability.
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Discharge Rationales & Letters: Details when formal non-recovery rationales and supervisory tasks are required, as well as mandatory contents for final discharge summaries.
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Onward Referrals: Governs procedures for stepped care referrals back to NHS Talking Therapies or secondary care services.
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