Consultant Connect is featured in the latest IMPHS report: ‘Learning from the Integrating our Mental and Physical Healthcare Systems (IMPHS) Project – delivered as part of the King’s Health Partners Mind & Body Programme.’
IMPHS have kindly shared the full report, which you can read in full here.
We have also replicated pages 16-20 of the report in the following article:
Providing physical health advice and guidance
‘Consultant Connect is amazing… It reduced the number of patients I sent to hospital/ambulatory care and improved the appropriateness of care and referrals.’ Junior Doctor, South London and Maudsley NHS FT
Despite the existing relationships between South London and Maudsley NHS FT and its acute hospital partners, communication delays and access to specialist acute advice and guidance has frequently been cited as a barrier to providing mind and body care. The IMPHS team engaged with over 150 South London and Maudsley NHS FT staff and 50 in-patients at the start of the project to understand the problems faced.
Clinicians reported that time used to access advice and guidance from acute specialist colleagues detracted from their time available to provide direct care for service users; they felt current pathways for obtaining advice and guidance increased the likelihood of having to transfer in-patients with non-emergency physical health issues to emergency departments, which also led to worsening patient experience. The perception was that current systems created unnecessary additional pressures on resourcing.
In-patients reported that, during an admission to a mental health hospital, it was preferable to have physical healthcare provided in mental health settings, where possible and appropriate. Their main reason was that transfers to busy, acute hospital environments, which are not set-up for the needs of people experiencing acute mental illness, would likely add to and become a cause of additional distress. The views of in-patients also aligned with the findings of Right Care, Right Place (2015) which are that there is an expectation that hospital stays should not be disrupted by unnecessary transfers.
What we did
Consultant Connect offered a ready-made solution for improving communication, saving clinicians’ time, and improving patient experience and outcomes. The service provides an app-based communication platform that connects clinicians with experts, directly and in ‘real time’, without the need for a referral and bypassing hospital switchboards, so they can access specialist advice and guidance.
Consultant Connect was already operating and commissioner funded at population level in south east London, to support GPs to access advice from local secondary care, acute hospitals; as a result, no further costs were incurred by expanding access to South London and Maudsley NHS FT. However, this would be the first time a mental health Trust had used Consultant Connect in this way, in the UK.
We planned to pilot Consultant Connect on one older adult mental health ward, commencing in March 2020. However, the emergence of the COVID-19 pandemic led to an increased, NHS-wide, need to avoid inappropriate inter-hospital transfers and admissions. In response, we sought permissions from senior leaders at the South East London CCG, King’s Health Partners Chief Executive’s committee and relevant Clinical and Information Governance leads to open access to all South London and Maudsley NHS FT in-patient services.
In June 2020 all South London and Maudsley NHS FT in-patient clinicians were given access to the platform, which connected them with colleagues in local acute partner Trusts. Based on early evaluation findings, the pilot was extended to all community based staff in 2021.
Main impact and findings
Consultant Connect is now embedded into routine practice at South London and Maudsley NHS FT. Our evaluation found that, two years post launch:
- Over 500 South London and Maudsley NHS FT staff registered for Consultant Connect, from 16 distinct professional groups.
- Over half of all physical heath calls placed were for Cardiology, Diabetes & Endocrinology, Haematology
- A broad range of acute specialties have given advice and guidance: 61/80+ specialties have been contacted
- >70% of queries resulted in the service user receiving physical health care from mental health clinicians, avoiding referrals or transfers based on outcomes left at the end of calls.
As part of our service evaluation, call data analysis helped to identify training needs for psychiatry trainee doctors. We produced four bespoke physical health educational webinars based on the most common call topics.
We also identified that approximately half of all calls to Cardiology related to ECG trace queries. Existing functionality on the Consultant Connect App enables secure transfer of picture and messages, that we are planning to switch on for South London and Maudsley NHS FT clinicians, and we believe further time saving will be made as a result.
In addition to physical health lines, South London and Maudsley NHS FT clinicians can also set up their own ‘internal’ lines. This has supported remote working practices and has been used to good effect with Staff Vaccination Advice Line.
The value of Consultant Connect and the difference it has made to support staff in routine practice to be able to provide more effective and responsive care for their patients was recognised in multiple ways throughout the life of the project.
Our highlights include:
- ‘Best Mental Health Partnership with the NHS’ – Award Finalist at the Health Sciences Journal (HSJ) Partnership Awards 2022
- ‘The Future NHS’ – Award Nominee at the NHS Parliamentary Awards 2022
- ‘Best Oral Presentation’ – Runner Up Award at 4th UK
- Implementation Science Research Conference 2021
The introduction of new systems, ways of working and interventions can be difficult to deliver and implementing change during a global pandemic increased that challenge. However, the existing infrastructure that Consultant Connect had already established in south east London, and many other areas, helped make rollout in South London and Maudsley NHS FT more feasible.
Successful implementation was supported by:
- Speaking to a broad range of service users, carers and staff to identify the need and use case for Consultant Connect.
- Securing high-level approvals and buy-in from senior leadership at all organisations early on to raise awareness and send a clear message of support to service managers and clinical staff.
- Sending targeted and consistent communications about how to use Consultant Connect and its benefits. We developed a detailed communications plan including all available channels including engaging with early adopters/influencers to spread the word, and junior doctor WhatsApp groups (junior doctors are the largest user group).
Choosing to rollout the platform trust wide rather than small scale, which enabled us to collect enough usage and impact data to build the case for further developments such as adding more specialities to the directory, or widening access to include community mental health services.
Regularly reviewing usage data to identify opportunities for improvement with the intervention, as well as potential education and training.
Considering sustainability and resourcing; even small-scale implementation could take more than several months.
If you have any questions or would like more information, please email us at firstname.lastname@example.org or call us on 01865 261 467.