Acacium Group’s Digital Innovations Think Tank: Children and Young People’s mental health

Introduction

Acacium Group’s Digital Innovations Think Tank seeks to bring together experts to advise on how best to apply digital innovation to existing care pathways.

The inaugural meeting of the Think Tank was held on Tuesday 6 July 2021, and focused on the digital delivery of children and young people’s mental health services. The Think Tank was attended by representatives from across the clinical community.

This note:

• Provides a short background on children and young people’s mental health services
• Summarises the presentation on the digital delivery of an innovative therapeutic model of care for children and young people’s mental health, developed by Acacium Group’s Xyla business
• Outlines the points of note arising from the Q&A session on the presentation
• Summarises key themes in the wider discussion which followed

Background

The demand for children and young people’s mental health services continues to grow, with NHS leaders reporting increasing difficulty in meeting demands on their services. Digital innovation presents one possible solution to reduce strain on NHS capacity through delivering improved efficiencies, whilst also improving outcomes. The momentum generated by the increased use of digital innovation throughout the COVID-19 pandemic presents an opportunity to explore digital delivery models in further detail, including how they can be embedded within service recovery and redesign.

The digital delivery of a therapeutic model of care for children and young people’s mental health.

Since 2019, Xyla has been providing digital solutions to local NHS and higher education bodies for the care and treatment of adults with mental health conditions. Around 3,000 patients are currently registered with the service, which has been consistently judged to deliver above-average clinical outcomes for the Improving Access to Psychological Therapies (IAPT) programme. The service reports higher accessibility, and adopts a flexible approach towards integration with NHS and partner services to enable the delivery of local requirements and value for money.

Building on this experience, Xyla has constructed a new therapeutic model for the digital delivery of care for children and young people’s mental health which will be launched in early 2022. The model manages the triage, assessment, and treatment of people aged 11-18, offering a range of low and high intensity therapies. Complementing existing local NHS services, the model employs high data system interoperability standards to enable frictionless referrals throughout the patient pathway. It is designed to integrate with local services, not to simply ‘bolt-on’. Recognising that younger patients have unique communication preferences and needs, the model has been co-designed by a children and young person’s advisory group (the ‘Acacium Group Mental Health Super Heroes’).

Q&A on the therapeutic model

The Think Tank explored the following issues in the Q&A

• Recording patient outcomes and progress throughout the clinical pathway will be instrumental in demonstrating the effectiveness of the digital service model, and would support a culture of capturing outcome measurements routinely within NHS and partner services
• Parental/Carer oversight has been factored into the model, which allows an appropriate adult to input into patient-clinician engagement through the digital platform. The extent to which parents/carers are involved will be dependent upon, and guided by, individual patient circumstances
• Partnering with schools could help to improve accessibility and interaction with the mental health digital service model. In addition, there are opportunities to expand upon and enhance mental health provision commissioned by education providers
• Routes of entry will be dependent upon the specific requirements and preferences of local partner services, thus allowing flexibility with respect to the point at which children and young people are referred into the model for treatment
• Urgent referrals can be initiated at any point in the digital service model given the high level of integration envisaged with NHS and partner services, with protocols decided locally
• Comorbidities are an important consideration in the development of the model, and attendees felt that set shared prescribing responsibilities should be agreed locally and incorporated into the digital pathway
• Communication has been styled specifically to maximise children and young people’s engagement, such as through the use of live chat functionality and traditional SMS services which may be preferred over traditional forms of communication
• Child protection and safeguarding is a core feature of the digital service model, and is designed to work around local protocols to enable seamless and secure interaction with NHS and partner colleagues

Points from the wider discussion

The Think Tank noted that:

• There is a window of opportunity to embed new digital delivery models. As patient and clinician attitudes begin to favour a return to “pre-COVID normality”, it will become important to demonstrate the model’s benefits over traditional services, such as in enhancing multidisciplinary coordination and user accessibility
• A ‘schools-first’ approach could improve the attractiveness of the digital delivery model and help address digital exclusion, allowing children and young people access to services within a familiar and secure environment with guaranteed availability of data and computing resources
• Services should continue to be provided through both digital and non-digital channels
  • Digital exclusion among children and young people can exacerbate existing health inequalities and needs to be factored into how services are commissioned locally
  • Face-to-face services are more appropriate in some circumstances than digital services, and by achieving full integration between Xyla and NHS services from the outset, appropriate mechanisms can help guarantee seamless patient transition between digital and in-person services when required
  • Increased patient choice of channels can help to address exclusion while improving accessibility for other groups. Choice also plays an important part in securing the confidence and buy-in of children and young people, and will lead to improved patient outcomes and service satisfaction
  • Service integration and data interoperability is a priority for the NHS and a requirement for many providers. Further national guidance is needed to unlock barriers to better data sharing and interoperability.
    

Contact information

We hope this short briefing is helpful. If you are interested in knowing more, please get in touch via info@acaciumgroup.com.