1. Using video consultation in a mental health setting
Dr Laura Stevenson
Dr Rebecca Chubb

2. Serves 470,000 people of all ages in Stoke-on-Trent and across North Staffordshire
Recognised limited use of technology to engage patients
Vision: pilot scheme for video consultation to determine what worked, evaluate, and identify barriers
Based in neuropsychiatry and older peoples services directorate

3. What did we do? Pilot and survey
Devised SOP and governance policies for using ‘Skype’ for patient consultations
Identified vascular wellbeing team and older persons OP clinic as pilot areas
1 lead medic, 1 lead nurse
3 months duration, commenced Sept 2017
Promoted to relevant teams via discussion and s
Away day to explain and encourage staff participation

4. Who used it? VWB arm – all appropriate patients asked
Tended to be younger
Have memory impairment plus vascular risk factors, often a mood component also
OP Clinic arm – nurses identified suitable patients
Generally over 65 years
Memory and /or other mental health issues
At home or in care home setting
Nurse present with them to facilitate consultation

5. Evaluation

6. Patient and carer feedback - supportive
Carer felt this was a useful way to speak with a Dr
Written information helpful and pitched at correct level
Satisfied re: confidentiality
Indications that would consider using again in future

7. Patient and carer feedback - challenges
All suitable patients in vascular wellbeing team asked about participation - overwhelming message for not wanting to was not having access to or not feeling confident in using technology
Technical issues for those that did participate affecting satisfaction
Challenge with visual/ hearing impairments

8. Staff feedback - supportive
“ was very useful to have flexibility with patients that would be difficult to attend a formal clinic setting
had care home manager in appointment
the consultation was considered to be very successful
I had a home visit with him already planned so I called in as normal and the video-consultation was possible ”

9. Staff Feedback - challenges
“I’m not sure we would have a big uptake to use this consultation method given the client group to access independently
The connection could be difficult
The appointment time probably makes this a longer contact than normal due to setting up and gaining contact but if the patient had to attend an appointment it would be even longer given travel arrangements ”

10. Survey
Questionnaire compiled and disseminated to patients on all IP wards and 4 CMHTs
Some general adult (18 – 65yrs), some old age (> 65yrs) participants
Scoping exercise to determine attitudes, thoughts and practicalities around using technology to see a mental health professional

11. Survey Findings Overall 81% access to internet
66% knew what skype/ video consultation
35% knew how to use it
In OA cohort 64% access to internet
41% knew what skype was
9% knew how to use it
Overall 65% , 60% use FB, 13% twitter
30% willing to use it to see a MH professional- majority indicated preference for standard face to face appt

12. Reflections Use of video consultation within healthcare is increasing
Ideally all patients should have this available as an option, whilst recognising the perceived benefit of accessing services in person for some
In terms of a future work, evidence suggests focus within general adult population may aid uptake
? Focus in CAMHS - linked to use greater use of technology, patient expectations etc

13. Future thoughts Skype for business
Address training needs - both patients and staff
Encourage wider use within the trust generally to increase staff confidence
Ideally offer as an option for clinic appointments and for relatives to skype into important consultations – practicalities would need to be considered
Expand use within care home settings