cCBT TEC

2016: Scottish Government, cCBT TEC PROGRESSION of cCBT IN SCOTLAND 2007: 2 territorial services 2014: EU, MasterMind Project 2016: Scottish Government, cCBT TEC

MASTERMIND IN SCOTLAND

WHAT MASTERMIND MEANT FOR SCOTLAND Opportunity Understanding Experience

MASTERMIND IN SCOTLAND GRAMPIAN FIFE LANARKSHIRE SHETLAND BOARDS POPULATION NHS Lanarkshire 652,580 NHS Fife 366,910 NHS Grampian 579,220 NHS Shetland 23,200 MasterMind Total 1,621,910 TAYSIDE FORTH VALLEY

This was achieved in month 7 of 24 SUCCESS OF MASTERMIND RECRUITMENT NUMBER TARGET +/- Patients 6,107 800 + 5,307 Target of 800 patients commencing treatment was required by MasterMind. This was achieved in month 7 of 24

ACROSS EUROPE

THE RIGHT SERVICE MODEL

Service model built around trust in technology and referrers RIGHT SERVICE MODEL Patients complete treatment in their homes or community locations such as Libraries Co-ordinator arranges initial appointments across all locations and deals with initial patient issues Central Coordination of service from within psychology Co-ordinator supports home and community users All referrals come to one central point using same process Run with minimal clinical input but support is there when needed Referrers maintain clinical responsibility and respond to suicide alerts Service model built around trust in technology and referrers

KEY ELEMENTS OF IMPLEMENTATION Service costs are limited to software licence and administration Service are fully integrated into stepped or matched care models Multiple referral routes are created across a number of disciplines Selection of the right workforce is vital A strategic approach to marketing High level support, commitment and effort in participating boards

IMPLEMENTATION APPROACH

NATIONALLY SUPPORTED IMPLEMENTATION Existing services feed into national expertise and directly into implementing boards Expertise and support offered to Health Boards includes policies, key documentation advice and guidance Implementing Boards in MasterMind able to pass on knowledge and experience to other remaining Health Boards 4 Health Boards Nationally supported implementation reduced set-up time from 2 years to 5 months

PHASED IMPLEMENTATION 1st Phase: service development, integration into psychology service model, service opens to psychology, early engagement GPs 2nd Phase: continued development, service opens to GPs 3rd Phase: implement marketing strategy 4th Phase: marketing strategy, service improvement 5th Phase: sustainability of service

DIFFERENT REGIONAL APPROACHES, SAME OUTCOMES National Model of Implementation Different Implementation Models Service Localised and Embedded in Local Structures Maintains Fundamentals of Original National Model Same Outcome for Patients and Quality of Service

CLINICAL ENGAGEMENT

Marketing creates expectations that needed to be met WHAT DO WE MEAN BY MARKETING Marketing is simply structured, co-ordinated communication Marketing was used to shape opinion and address negative perceptions Marketing delivered consistent messages preventing confusion and creating clarity Marketing strategies aimed to create 7 points of varying contact Marketing creates expectations that needed to be met

It is also the most complex and subtle of tasks GOOD COMMUNICATION AND MARKETING IS VITAL - WHY? SUSTAINABILITY REFERRALS IMPACT Single most important activity in the development of a sustained cCBT service. It is also the most complex and subtle of tasks Do it well and the service can have a genuine impact on patients, referrers and those services surrounding it

NEED FOR STRATEGY Co-ordinates activities and message Define and understanding of objectives Creates targets that define successful outcome Identify assets, resources and man power Focuses and targets approach Develops understanding about what can and cannot be achieved

Services becomes more efficient and cost effective with increased use WHEN IT WORKS Use increases dramatically and continues to increase inline with marketing activity Average cost per patient = £60 Services becomes more efficient and cost effective with increased use

PLAN EARLY FOR LONG TERM SUCCESS

PLAN EARLY IN THE PROCESS SUSTAINABILITY PLANNING MARKETING STRATEGY Mid 2014 Early 2015 Mid 2015 Mid 2016 End 2016 2017 Services Running Milestones of Development Completed Organisational Structures in Place Referrals received and patients commencing treatment Continued Service Development Marketing of Service MasterMind Targets Achieved Service Improvement MasterMind Commencers Target Achieved MasterMind Project Ends Continued Marketing of Service Sustainability Planning

PROGRESS THROUGH cCBT TEC

PROGRESSION OF cCBT IN SCOTLAND DUMFRIES & GALLOWAY BORDERS HIGHLAND WESTERN ISLES AYRSHIRE & ARRAN LOTHIAN ORKNEY GLASGOW & CLYDE GRAMPIAN FIFE LANARKSHIRE SHETLAND 2007: 11% of national population TAYSIDE FORTH VALLEY 2015: 44% of national population, funded EU MasterMind Project 2018: 100% of national population, funded by TEC

REFERRAL NUMBERS YEARS TOTAL REFERRALS 2013 1,340 2014 1,370 2015 5,529 2016 7,050 2017 10,553 In 2016 – Shetland is the highest referring Boards per head of population showing the value of technology to overcome barriers of traditional therapy approaches During the implementation programme cCBT received over 22,000 referrals, this estimated to raise to 30,000 by the end of the process in July All service continue to grow with Forth Valley and Tayside recording increases in referral

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