Health Innovation Network, the Academic Health Science Network (AHSN) for South London, has released a new report into remote mental consultations.
The report, produced by the Health Innovation Network, along with NIHR Applied Research Collaboration South London and King’s Improvement Science, also included input from experts at South London and Maudsley NHS Foundation Trust, South West London and St George’s Mental Health NHS Trust and Oxleas NHS Foundation Trust.
In a foreword to the publication, Professor Fiona Gaughran, a lead consultant psychiatrist and an applied informatics research lead at NIHR ARC South London, said: “This local-level learning has the potential to be captured, synthesised and shared across organisations; to identify evidence gaps, create positive change within services and improve experiences and outcomes for patients, carers and staff. This report shares our methods, findings and tools developed and highlights the gaps in evidence and future research opportunities.”
The report itself found that remote consultations do ‘make care more accessible’ but that they are also ‘not the right solution for all patients’. The shift to consultations being held by telephone or video, rather than face-to-face because of the COVID-19 pandemic, also led to ‘improved access, reduced missed appointments, and reduced travel stress’.
However, the report also found challenges, which included access to technology, as well as issues around broadband connectivity and data packages, in addition to other barriers such as patients or clinicians being unable to find a private space where they would not be interrupted.
The report also makes a number of recommendations to ‘inform clinical practice’ and ‘determine ongoing gaps in knowledge’.
Natasha Curran, the Health Innovation Network Medical Director, said: “Access to mental health services during COVID-19 has been disrupted as patients were isolated and clinicians were unable to hold face-to-face consultations. Technology has allowed clinicians to provide consultations remotely, and this has been well received by many patients who say it is more convenient and saves the time and stress of having to travel to appointments.
“This study also shows that remote consultations don’t work for everyone for a variety of reasons: the nature of some patients’ condition, technological barriers, or privacy, for both clinicians and patients. This comprehensive report points to the benefits of a hybrid system, the importance of patient choice, where some consultations can be carried out remotely and others face-to-face, that could support vital ongoing mental health treatment both during COVID-19 and beyond.”
Key findings from the 6,030 patients who responded to NHS trust surveys on remote consultations in mental health settings were that they allowed the ‘flexibility of varying levels of support’ during the pandemic, ‘care was more accessible to populations’ who may have previously found travel challenging and that ‘some patients felt more relaxed in their own home’ during consultation.
From the 554 clinicians that responded to the surveys, including psychologists, psychiatrists, psychotherapists and nurses, ‘training to use technology’ was raised as a need for both clinicians and patients.
Patients, carers and clinicians, meanwhile, said that remote consultations were ‘more convenient, reduced travel time, saved travel costs’ and ‘meant family members were readily able to attend family sessions’.
However, the Health Innovation Network notes that there is no ‘one size fits all’ approach and highlights that an ‘individualised approach’ will ‘always remain the gold standard’, especially for new patients, children, and those with a psychosis diagnosis, learning difficulties or the digitally excluded.
The report, which is available to view here, provides three evaluations, including evidence reviews of research both prior and during COVID-19, as well as thematic analysis of surveys from across the three trusts and of an e-survey on 32 projects.
