The average wait for a child to receive support from specialist mental health services in 2020 was more than a year. This average figure masks significant regional variation and has been further exacerbated by the pandemic. In order to better support young people with their mental health, Child and Adolescent Mental Health Services (CAMHS) might be able to deploy digital offers at various points of their pathway – whether this is while they are waiting for an initial assessment, support during treatment or maintaining wellbeing after treatment. Although it is widely acknowledged that digital has a role to play in the future of healthcare delivery, further understanding is required around which products might be the most suitable and safest, how these are to be adopted and how they might best support clinicians, young people and their parents and carers to improve outcomes. the Oxford AHSN has been working with commissioners and providers in the Buckinghamshire, Oxfordshire and Berkshire West (BOB) Integrated Care System (ICS) to support transformation of services for children and young people’s mental health, with a particular focus on scoping digital support.
What is the challenge?
Over the past decade, NHS mental health service providers have adopted digital mental health provision in a piecemeal way, selecting and developing those products that – at a particular point in time – best met the needs of services and were deemed suitable to be commissioned. The advent of integrated care systems has presented an opportunity to review existing offers and explore potential synergies and opportunities for identifying and commissioning innovations that address gaps in provision. The challenges faced across the health system include the sheer variety and number of digital health offers currently available, the absence of a commonly understood system for identifying the safest and most efficacious digital treatments, issues around interoperability and procurement processes and the often limited technical knowledge of clinicians who, primarily, wish to offer the most appropriate treatments to their patients using their expert clinical knowledge.
What did we do?
In November 2021 the Oxford AHSN was approached by the Buckinghamshire, Oxfordshire and Berkshire West (BOB) Integrated Care System (ICS) to support their workstream for transforming services for children and young people’s mental health, driving change and improvement using digital options and solutions. Over the past six months the BOB ICS and NHS trusts providing mental health services in the region have been working together to understand how best to meet the challenge of the growing emotional wellbeing and mental health needs of children and young people. This has included engaging with clinicians from across CAMHS services to seek their input as well as colleagues from across the national AHSN Network. Initially this involved gathering information about digital approaches commonly used or identified as being desirable across the country. Subsequent desk research was undertaken to identify what is available for those aged under 18 years to include current available evidence, details of adoption and commissioning models or approaches and where each offer sits within the i-THRIVE model. Once an initial list was compiled, the Oxford AHSN began a series of online interviews with developers of digital to gather additional insights and information about products and any planned or proposed developments to them over the next 18 months. Subsequent engagement with clinicians and, separately, with young people was conducted in June 2022 to better refine what might be required to make this process acceptable and successful in practice.
What has been achieved?
An initial report including 22 potential digital innovations was presented to BOB ICS colleagues. The information gathered from interviews with the creators of these products has been added to a spreadsheet which allows ICS colleagues to navigate and interrogate this material to identify potential products based on local needs. A webinar delivered by BOB ICS and the Oxford AHSN took place on 30 June 2022 shared learning so far from this project. More than 90 people registered to either attend live or receive a recording of the 90-minute session.
What people said
“Working with Matt and Lauren from the Oxford AHSN has been a positive experience. Engaging the AHSN has allowed us to gather a wealth of information which we will use to develop a coherent strategy for a digital offer to children and young people. Our collaboration has developed and grown in response to our findings and the information gathered, including from clinicians and from local youth boards and events involving young people such as the Oxfordshire Youth Summit.”
Andy Fitton, Head of CAMHs and Eating Disorder Transformation, Oxford Health NHS Foundation Trust
“Presenting our work – together – via a jointly branded webinar allowed us to promote the benefits of collaboration as well as what we’ve discovered so far. Although this work was originally intended to respond to local needs and intelligence, we look forward to Matt and Lauren sharing the collated knowledge – through a report and the spreadsheet that informs it – across the country to benefit the whole health system.”
Mairi Evans, CAMHS Senior Responsible Officer for Buckinghamshire, Oxfordshire and Berkshire West
A report of the findings from this work is due to be published within the next month and engagement with the BOB ICS is ongoing. Key learnings and resources from this work will be spread to other ICS areas within the Oxford AHSN region and further afield.