NHS Scotland is seeking a provider for a national online cognitive behavioural therapy service under a contract worth up to £9m. The existing service has already required additional funding because of rising demand.
NHS Scotland has opened a procurement process for a national online cognitive behavioural therapy service, with the contract estimated to be worth £9m over as long as five years.
The service is not a new treatment programme.
Internet-enabled cognitive behavioural therapy, known as ieCBT, is already provided nationally in Scotland and allows patients to receive live therapy at home through written online conversations with a qualified therapist.
The new tender was published on 14 August by Public Services Delivery Scotland.
It seeks a provider to continue giving patients access to NICE-recommended forms of CBT for common mental health problems, particularly where people face barriers to traditional services.
The initial contract would run for 36 months, with two possible 12-month extensions.
The £9m figure is the estimated value across the maximum five-year period and does not represent an annual cost.
Why NHS Scotland is buying the service
Documents from the existing contract provide a clearer explanation of why NHS Scotland is continuing and potentially expanding the service.
Ieso Digital Health was awarded the current national ieCBT contract in November 2023.
The original contract was formally valued at £3.5m, covering an initial two years with the possibility of a further 12-month extension.
In January this year, NHS Scotland published a formal modification to that contract after demand for the service increased.
The formal procurement figures show the contract value increasing from £3.5m to £4.4m.
NHS Scotland said the increase was necessary because more patients across Scotland were using the service.
It also said ieCBT was playing a significant role in reducing long waits for psychological services.
The modification notice contains a numerical inconsistency in its explanatory text, which refers to £3.6m increasing to £4.5m. The formal contract-value fields in the same notice state £3.5m increasing to £4.4m. Those formal figures are used here.
The new procurement is considerably larger, although a direct comparison requires care.
The current contract covers up to three years. The new £9m procurement could operate for five years if both extensions are used.
It is therefore not evidence by itself that NHS Scotland intends to double annual spending on the service.
What the procurement history does show is that the existing contract required additional money because demand exceeded the level originally anticipated.
Who uses online CBT in Scotland
CBT is one of several forms of psychological therapy used by NHS Scotland.
It is based on the relationship between thoughts, feelings and behaviour and is intended to help people recognise and change patterns that may contribute to psychological distress.
Scottish Government guidance describes CBT as a structured and time-limited form of psychotherapy which is widely used for depression and anxiety as well as other psychological disorders.
Different versions of CBT are used for different conditions.
Scotland’s national guide to psychological therapies identifies CBT-based treatments for conditions including depression, generalised anxiety disorder, panic disorder, social anxiety, obsessive compulsive disorder, phobias, post-traumatic stress disorder, eating disorders, substance use and chronic pain.
That does not mean everyone with one of those conditions will receive CBT.
Clinical treatment depends on the individual, the condition, its severity and the available evidence for different forms of therapy.
The specific national internet-enabled CBT service covered by the current contract is more narrowly defined.
Scottish Government guidance identifies Ieso as the current provider and says the service is available to people aged 16 and over.
The guidance lists uses including anxiety, depression, OCD and phobias. A related ieCBT pathway also includes stress and single-incident PTSD.
Patients use a computer, tablet or mobile phone at an agreed appointment time.
The therapist and patient then communicate in real time through typed messages rather than video or spoken conversation.
Unlike some computerised CBT programmes, where patients work largely through modules themselves, this form of ieCBT involves direct contact with a therapist.
Referral is through a mental health clinician rather than the service simply being opened anonymously by anyone online.
CBT is not mandatory for ordinary NHS patients
There is no general requirement for people receiving NHS mental health care in Scotland to undergo CBT.
Scottish Government guidance on psychological therapies says people should be offered evidence-based treatment appropriate to their needs and, where possible and clinically appropriate, should have access to different ways of receiving treatment, including digital, group and in-person services.
There are separate provisions in Scottish mental health law allowing compulsory treatment in restricted circumstances.
The Mental Health (Care and Treatment) (Scotland) Act 2003 allows compulsory treatment for some people where statutory conditions are met.
The legal definition of medical treatment under the Act includes psychological intervention.
That does not make CBT routinely compulsory.
Scottish Government guidance states that most people using mental health services receive treatment without being subject to a compulsory order or certificate, and that compulsory treatment is permitted only under strict circumstances.
The £9m ieCBT procurement is therefore a service NHS Scotland is making available as part of psychological care, not a programme people across Scotland are required to undertake.
Waiting times remain below the national standard
The expansion of digital psychological treatment is taking place while NHS Scotland continues to miss its national waiting-time standard for psychological therapies.
The Scottish Government standard is that 90% of people referred for psychological therapy should begin treatment within 18 weeks.
The latest Public Health Scotland statistics, covering the quarter ending March 2026, show 79.4% started treatment within 18 weeks.
A total of 19,285 people began psychological therapy during the quarter, while 31,179 people were referred.
Half of those who did begin treatment started within three weeks.
The figures cover psychological therapies generally and should not be treated as statistics for ieCBT alone.
They do, however, provide the wider context for NHS Scotland’s statement that the online service is being used to help reduce longer psychology waiting times.
Digital treatment across every health board
Digital CBT is now well established within Scotland’s mental health system.
Scottish Government guidance says computerised CBT has been available across all territorial NHS boards since 2018.
It lists 35 CBT-based digital treatments, covering mental health, wellbeing and some long-term physical health conditions.
Examples include programmes addressing depression, anxiety, panic, OCD, insomnia, social anxiety and phobias.
There are also CBT-based programmes designed to help people experiencing psychological difficulties alongside conditions including chronic pain, diabetes, coronary heart disease and rheumatoid arthritis.
Digital services vary considerably in how they operate.
Some allow people to work through structured material independently.
Others provide regular support.
The ieCBT service covered by the £9m procurement involves a therapist working directly with the patient through live written communication.
The Scottish Government has specifically identified the ability of ieCBT to overcome geographical barriers.
That is particularly relevant in a health system covering remote, rural and island communities as well as Scotland’s major cities.
It can also provide an alternative for patients who find travelling to regular appointments difficult or who encounter other barriers to conventional psychological services.
The new tender does not state how many patients are expected to use the service during the next contract.
It also does not provide a projected cost per patient.
Quality will account for 85% of the assessment of bids, with price accounting for 15%.
Companies must meet information-security requirements including ISO 27001 and provide evidence of relevant experience.
The tender closes at 17:00 on 14 September 2026.
The procurement documents describe the purpose simply as continuing a national service.
The history of the existing contract provides the reason behind that continuation: NHS Scotland has already had to increase its spending because more people used the service than originally anticipated, while the wider psychological therapy system continues to fall short of Scotland’s 18-week access standard.
Sources
Public Contracts Scotland — Internet Enabled Cognitive Behavioural Therapy (ieCBT), new contract notice, published 14 August 2026
https://www.publiccontractsscotland.gov.uk/search/show/search_view.aspx?ID=AUG562357
Public Contracts Scotland — Internet Enabled Cognitive Behavioural Therapy Extension, contract modification, published 13 January 2026
https://www.publiccontractsscotland.gov.uk/search/show/search_view.aspx?ID=JAN547054
Public Contracts Scotland — NHS Internet Enabled Cognitive Behavioural Therapy, contract award to Ieso Digital Health, published 1 December 2023
https://www.publiccontractsscotland.gov.uk/search/show/search_view.aspx?ID=DEC493947
Scottish Government — Resources for Mental Health and Wellbeing in Primary Care Services
https://www.gov.scot/publications/resources-mental-health-wellbeing-primary-care-services-2/
Scottish Government — Digital services and national CBT provision in Scotland
https://www.gov.scot/publications/resources-mental-health-wellbeing-primary-care-services/pages/3/
Scottish Government — National Implementation Guide: Digital Evidence Based Psychological Treatments
https://www.gov.scot/publications/national-specification-delivery-psychological-therapies-interventions-scotland-national-implementation-guide-1-digital-evidence-based-psychological-treatments/
NHS Education for Scotland — The Matrix: A Guide to Delivering Evidence Based Psychological Therapies and Interventions in Scotland
https://www.matrix.nhs.scot/
Public Health Scotland — Psychological Therapies Waiting Times, quarter ending March 2026
https://www.publichealthscotland.scot/publications/psychological-therapies-waiting-times/psychological-therapies-waiting-times-quarter-ending-march-2026/
NHS Inform — What is psychological therapy?
https://www.nhsinform.scot/tests-and-treatments/counselling-and-therapies/what-is-psychological-therapy/
Mental Health (Care and Treatment) (Scotland) Act 2003 — definition of medical treatment
https://www.legislation.gov.uk/asp/2003/13/section/329
Scottish Government — Resources for Mental Health and Wellbeing in Primary Care Services: mental health legislation guidance
https://www.gov.scot/publications/resources-mental-health-wellbeing-primary-care-services-2/
