NHS England has published eight principles for the “appropriate use” of digital technologies in mental health settings, aiming to provide a guide for procurement, implementation, data protection, policy, staff training and recording in patient care and treatment plans.
Designed to help clinicians decide whether using digital technology is the “most appropriate, effective and least restrictive” way of treating patients in mental health settings, the principles focus on: a human rights approach, consent and capacity, equity of access, co-production, therapeutic and personalised care, safety planning, evidence base, and treatment outcomes.
The guidance covers digital technologies such as those intended to support direct care and support patient safety, monitoring tools, and devices used to enhance communication. However, they do not cover EPRs, e-prescribing, core information systems or “tools that support administrative tasks and record-keeping”.
A key theme throughout is the need to balance patient care with human rights. Principle one tackles this overarching message, noting that “any digital technology must be used in accordance with the Human Rights Act (1998)” which includes the right to life; liberty and security; respect for private and family life; and to be free from inhuman or degrading treatment. Importantly, it highlights how “digital technology may be used to protect a patient’s human rights” but should not be used to interfere with them.
One of the other key focus areas lies within principle two, which details the correct approach for gaining consent over the collection and storing of patient data. It stresses the need to get consent directly from the patient and to communicate in a way that meets their needs without taking a “blanket approach”. In the case of a patient being unable to give consent, the guidance notes how this should instead come from a parent, lasting power of attorney or court-appointed health and welfare deputy. Details on the chosen technology, such as purpose and decision-making process, should also be communicated clearly to the patient, to ensure they understand why the technology is being used.
An “ongoing partnership and collaboration” between patients, clinicians and those developing the technology also takes priority, with principle four stating how this should occur during procurement, testing, implementation and evaluation. An emphasis is put on involving those with “varying views, backgrounds, and characteristics” which aligns well with principle three, focusing on ensuring safeguards against the “discrimination of patients” when using digital technology for care and treatment.
When it comes to using digital technologies more effectively for mental healthcare, there’s a distinct focus on using digital technology alongside a “relational approach”, in order to “enhance” therapeutic relationships, rather than replace them. Principles five and six both stress how meaningful engagement and building a rapport with patients are considered more effective when improving outcomes and managing safety risks.
Finally, principles seven and eight focus on assessing evidence base before the procurement of digital technology and measuring the impact of using digital technologies for care and treatment. Both are centred around adopting robust processes, clear record keeping, patient outcomes and regular reviews.
All eight principles were put together to align with the 12 core commitments outlined in the NHS’s culture of care standards published last year, with a particular focus on commitment 2: Safety. Offering further guidance on staff training, data protection, policies and the lawful use of digital technologies, the document aims to deliver all-encompassing guidance for NHS-funded mental health in-patient services.
Dr Lade Smith CBE, president of the Royal College of Psychiatrists, has penned a response to the principles, commenting: “We have seen examples where these principles have not necessarily been adopted and the impact has been not only to affect the ability of that particular initiative, but to also affect longer term use in the confidence of digital and technology based models in the treatment and care of those with mental illness.”
Read the full guide on the NHS’s principles for using digital technologies in mental health inpatient treatment and care.
Digital mental healthcare: the wider trend
Earlier this month, the Medicines and Healthcare products Regulatory Agency published new guidance on developing safeguards, regulation and evaluation for UK digital mental health technologies including mental health apps, AI-powered assessments, and virtual reality therapy.
To provide instant access to more detailed mental health information, Cambridgeshire & Peterborough ICS recently announced that its shared care record now shares five types of key mental health documents. This includes: care plans; crisis plans; diagnosis extracts; risk assessment; and mental health act notices.
In a recent interview, we caught up with James Reed, consultant forensic psychiatrist and physician executive at InterSystems, to discuss key opportunities for digital transformation and technology in the mental health space.
