NHSX and Mental Health Update 6

This is an informal update to NHSX’s commitment to:

Digital and data specialists from NHSX will team up with NHS England’s mental health national policy teams to help clinicians and policymakers improve patient experience through technology.

This is a selection of things that happened (other things also happened) from team members working on a discovery into children, young people and mental health…

Team general orders

As part of the inception day, we came up with a list of general orders. General orders are a bunch of rules and standards we all agreed to as team.

1. Be open and honest
2. Be prepared and on time for sessions and meetings
3. Use the agreed tools
4. Google Drive for storing docs
5. Slack is the primary communication channel
6. Trello for planning
7. Google Hangouts for remote meetings
8. Miro for visuals and mapping
9. Provide updates if you can’t attend ceremonies
10. Ask questions - it’s ok if you don’t understand!
11. Ask Sophie about using documents with personal data
12. Before you go on leave, let the team know your tasks
13. Avoid jargon
14. We all have lives (and other work) outside of the project
15. Celebrate even small successes!
16. Team over employer
17. Say when you are experiencing problems
18. Be a good ambassador for the project
19. Prioritise learning over outputs
20. Make sure to involve anyone working remotely

Rabbit holes

During the inception day, we ran an activity to uncover any “rabbit holes” - things that we could uncover as part of the discovery but could be significant time drags if we went too deep into them.

Mostly these would be things that others are already tackling or are just too big to bite off with the time we have. We recognised that they were still important and we should document them, but we needed to make sure they didn’t distract us from the main problem statement.

Following voting, the top 3 we identified were:

1. Appointment booking systems
2. Issues around interoperability
3. How well the treatment solves the problem

The rest:

• Quality of data
• How the parents/whole families are supported
• All the different ways CYPMHS are managed locally
• Awareness of mental health services
• Lots of work in school-based interventions
• What happens after treatment

As we have been learning more we are compiling an even bigger list… new ones added include:

• People owning their own health record
• Regulation/quality control of services that are available online
• workforce issues

We continue to learn.

Agile lunch and learn

A bunch of the team + wider colleagues signed up to give a lunch and learn to NHS England colleagues about culture and practices in “digital” teams.

We rattled through opinions about agile not Agile, plain English descriptions of ceremonies, principles that people in our small team typically have (e.g. embrace feedback early and often) and took some questions.

Was fun, we have been talking about the importance of exposing new ways of working and building capability since week 1. More will come.

Updates trying to find participants

This week we agreed our research goals for discovery and a rough plan of who we will need to involve and when.

We’ve been working closely with Subject Matter Experts in our team to reach out to CYPMHS services to take part. We are targeting regions with the highest and lowest waiting times and trying to learn more about initiatives that have been introduced locally to prepare children and young people. We’ve engaged with Young Minds, The Children’s Sleep Charity and Children and Young People’s Mental Health Coalition this week, to tell them about our work and help to reach out to parent and young person’s networks.

In Round 1 we’ll be doing a series of site visits to CYPMHS locations and interviews with healthcare professionals to understand the context of how the service is delivered. If you can help, please get in touch at digitalresearch@nhsx.nhs.uk

Award winning

Congrats to Hugh who won an award this week.

Congrats to the #Barbers4Health team with Jacqueline Sin, Mariana Pinto da Costa, Hugh Hathaway and Jan Smeddinck who won the best project #DIMH2019 focusing on the mental health needs in LMIC. Well done to all teams! pic.twitter.com/6lRUZgGsaH

— Social Psychiatry (@QMULSocialPsych) August 14, 2019

Rumour has it that Hugh is an A grade barber now.

UCL visit

A couple of the team visited the UCL centre for Artificial Intelligence. Learned a bit more about work relating to predicting people that would not attend appointments and interventions to encourage people to turn up or cancel if appropriate.

Interesting chat with people targeting a not dissimilar outcome.

Reading

It’s good to become deeply knowledgeable about the space you are working in. If an ambition of discovery phases is to know enough to make recommendations (that we have confidence in) then we need to dedicate time to learn.

Not all of this has to be “new”. There is plenty to learn from previous research/reports and to this end we have been finding time in our calendars to go through our folder of existing research. We have a lot. There is much more to do. It can be hard to find time in the office to get through what we have collected but it is fabulously valuable. The more we learn, the better we’ll design and we can avoid duplication of research. More to do.

An important reflection from reading this week: We should not talk solely about “Did Not Attend rates”. Must not forget to reference Was Not Brought rates. Especially as children and young people are likely not solely responsible for turning up or not being brought.

First research sharing session

In tandem with reading and learning we have setup a weekly time to share all the things we are finding out. Instead of learning being trapped in each team members skull we are trying to encourage the sharing of knowledge by having gatherings each Friday to share anything interesting learned in the past week. This could be from reading or otherwise.

A lot of value is not just sharing but also in the conversation around the topics. This is now in the calendar for the rest of the discovery.

Discovery is done objectives

The team has collectively set some goals/acceptance criteria that we want to have checked off before officially saying the discovery is over. Here is a list that we came up during the first few days of being a team. Discovery is done when…

• We understand the types of users most affected by waiting times
• We understand the problems that arise due to long waiting times
• We understand why CYP do not attend/not brought to appointments
• We have evidence that backs up our recommendations
• We have all learned something new
• We understand what widely used digital interventions are available in the marketplace
• We understand the major technology innovations emerging for mental health
• We understand the best practice for designing digital mental health services/tools/products
• We have a good idea of what has been tried/tested before in tackling waiting times/preparing for care and do not attend rates
• We have reviewed a sample of artefacts that people encounter (e.g. appointment booking letters or assessment forms)
• We have a good understanding of the research out there on the effect of waiting times and DNA rates
• We have used a range of research methods to gather insights about users in a holistic way- we have different perspectives/angles
• We have actively involved external groups and actively made sure they understand about our work
• We understand why there are variations in waiting times between services in different areas
• We understand what parents do to support their children while they are preparing for mental health services
• We understand more about constraints that might affect delivery
• We have thought about the consequences of our recommendations

Find out more

If you want to stay informed about wider NHSX work then check out @NHSX on Twitter.

If you want to give us feedback or get in touch with the team then you can do so using this form!