Over two weeks in March 2020 Sussex Partnership NHS Foundation Trust rolled out a new and safe virtual consultation platform to keep supporting young people in its inpatient and community mental health services. In the first month of the COVID-19 response, over 5,000 virtual consultations with patients were carried out.
The chosen digital platform, Attend Anywhere, made it easier to offer booked appointments and drop in clinics at the start of the COVID-19 response. The trust’s ambition was to adopt the platform across its wide range of mental health services, including forensic mental health, learning difficulty services, dementia care and services for children and young people.
From the start, the Trust weaved user experience and the voice of experts by experience into the project plan for the roll out.
This project also benefitted from strong clinical leadership in the digital team and an endorsement from the executive team. By having a dedicated project team with clinical and digital members who took a flexible approach to supporting services, adoption was fast. Staff were supported with virtual training offered three times a day.
The costs of deploying the virtual platform were minimal. The Trusted need to purchase extra web-cams, laptops and speakers to support ward rounds and easy-to-use tablets for use in urgent care lounges, inpatient units and residential homes. The trust also developed local training sessions for patients, and user manuals based on the materials provided by the company.
I found Attend Anywhere really simple and easy to use. Another good thing is that unlike other platforms, I wasn’t forced to look at a picture of my own face during the call (which can be really off-putting). I also liked the fact that if something is too difficult to say, there is always the option of typing a few words into the chat box.
A young service user
Our digital offer presents a great opportunity to make family and friend carers part of our multi-disciplinary, team discussions, ward rounds and decisions during theCOVID-19 pandemic and part of business as usual going forward.
Jacqueline Clarke-Mapp, Carer leader
The platform allows the conversation to take place in a more familiar, safer-feeling setting than a clinic consulting room. It has been welcomed by several of my regular clients – especially those with neurodiversity. There are challenges both technically and clinically, but it’s an additional tool that we are keen to continue using together.
Alex Christie, a nurse in the Basingstoke Children and Young People’s Mental Health (CAMHS) team
Rotherham, Doncaster and South Humber NHS Foundation Trust – e-clinics app for children and young people
Rotherham, Doncaster and South Humber (RDaSH) NHS Foundation Trust expanded use of its e-Clinics app, to enable young people to self-refer and talk to a children and young people’s mental health services (CYPMH; also referred to as CAMHS) practitioner on their mobile device. As of June 26 2020, Doncaster had registered 730 young people on the app, in addition to offering them support from CYPMH (CAMHS) school nursing and sexual health and drug support services. As part of the COVID-19 response, professionals were offered the app to access advice.
Given the success of the e-Clinics app in Doncaster and the need to adopt creative ways to enable young people to access support at this time, the Trust has made the app available across six children’s services, all of which manage and support young people with low mood, anxiety and other health issues. This gives all young people aged 11-19, not just those who are already in contact with CYPMH, across Doncaster, Rotherham and North Lincolnshire access to support.
The app has been rolled out across CYPMH, school nursing and sexual health services. Staff were given extensive virtual training in its use.
The e-Clinic app is easily downloaded from the Apple or Google play store. A young person can then use it to book a virtual appointment and ‘live’ chat to a CYPMH practitioner via instant messaging. It is available to anyone in the secondary school age group.
E-clinics are generally used by young people as a first contact route into the service. Feedback demonstrate that young people get the support they need via the app and do not need follow-up support.
Thank you for talking to me. I was worried what it might be like. But I’d definitely recommend this to my friends.
A young service user
The online chats can typically last between five and 30 minutes, depending on what help and advice is required, and appointments can be booked Monday to Saturday dependant on the pathway.
“Consultations could focus on topics such as bullying, low mood or anxiety, body image, bereavement, self-harm or anger or any other matter that is causing concern or affecting a young person’s physical or mental health. Once the young person has registered their details and downloaded the app, every consultation they make is anonymous.
“Secondary school years are when many young people find it difficult to understand and manage their emotions and often feel alone. Whatever the issue, we all need help from others from time to time. Talking to someone we know, like parents, carers or a teacher is a good place to start, but we also recognise that it can sometimes be difficult to share our thoughts with the people closest to us.
“We’ve carried out a lot of research with young people and found they like this virtual way of contacting us. They can discreetly share personal issues openly from a distance, which they may feel uncomfortable discussing with someone in front of them, or on the telephone.
Karen Smith, Transformation and Integration lead in children’s services at RDaSH
Liverpool Children and Adolescent Mental Health Services (CAMHS) Partnership – Adaptations to COVID-19
The Liverpool CAMHS Partnership has adapted to remote working to support children and young people with a wide range of needs during the response to COVID-19, including by establishing an all-age dedicated 24/7 access and crisis care line for children and young people up to the age of 18 years. The service has received 818 calls since April from children, young people, parents/carers and professionals.
The Trust has been working hard to ensure children, young people and families get the support they need during these difficult times. Teams have mobilised quickly to deliver remote support safely, and to ensure access and pathways are simple.
Their services can now be accessed easily and young people are put in direct contact with a practitioner or administrator for advice or to make a referral for more support. Practitioners from across the different organisations are in close contact with each other, which ensures children, young people and families get the right support from the right service. Contact has included virtual multidisciplinary and agency meetings that include representatives from primary care.
Across the CAMHS partnership, the NHS and third sector have been taking a collaborative approach to deliver support remotely, including:
- Establishing a dedicated 24/7 access and crisis care service for children and young people up to the age of 18 years, meaning that any child or young person, parent or carer in crisis can access a mental health clinician directly, at any time, seven days a week via a freephone number or an email address. If they need it, they will receive a more detailed mental health assessment via a video link on the same or the next day.
- Individual and group support for children and young people, including therapeutic interventions through telephone and video (eg online counselling).
- Targeted individual and group support for vulnerable groups through telephone and video consultation, including advice on sleep from sleep practitioners.
- Eating disorder service delivering care remotely through telephone, video and face-to-face when required (fully risk assessed for COVID-19). This service is now piloting telemedicine with children and young people and families, using digital equipment to reduce the need for face-to-face contact and to enable young people to do their own physical checks in their home environment, which are then registered with the team for monitoring.
- Psychosocial education and courses for children and young people, parents and carers through telephone and video.
- Individual and group support for parents and carers, including specific courses delivered online.
- Development of resources and information for children, young people, families and professionals on mental health and building resilience during this time.
- Dedicated web page outlining details of the support available from each partner, and how to access it. This has been widely promoted, including by the local media.
The involvement of children and young people has been important to the development and adaptation of services. As well as increasing social media activity to promote the services, give advice and share links to support, services have engaged with children and young people through Instagram live sessions. Coffee mornings with parent/carer forums to understand their needs and provide support, and courses designed to support parents and carers, have all been adapted for video call delivery.
In addition, a series of bite-size training opportunities have been adapted, covering common issues such as managing trauma, social media and mental health, embracing uncertainty and dealing with eating disorders. The courses are being delivered from May to September and over 4,200 bookings have already been made.
In general, families have welcomed the virtual way of working; virtual courses, coffee mornings, and individual support and groups have been well attended. Some of these may continue in this format post COVID-19. Liverpool has also strengthened collaborative working through weekly virtual multidisciplinary team meetings; given their success these are also likely to continue post COVID-19.
I’m finding that phone support is helping a lot, it might not be a counselling session but it at least gives support and gives me a chance to vent anything out. I find my counsellor really easy to talk to and we get along well, I’ve really felt my mental health improve. The times of my appointments were really practical and the times of my phone appointments are also really easy to handle. All together I’m really happy with the service I’ve received from the provider and my counsellor especially, I can’t thank them enough.
A young service user
My son has been having sessions in school and then via the telephone with the counsellor. I have seen a huge improvement in him and it makes me feel happy in the knowledge that the provider is still there should we need them again.