The Q Lab and Mind are working with four organisations (‘test teams’) to generate and test ideas to improve care for people with mental health problems and persistent back and neck pain.

• Health Innovation Network
• Keele University, working with Midlands Partnership NHS Foundation Trust
• Powys Teaching Health Board
• Robert Jones & Agnes Hunt Orthopaedic Hospital NHS Foundation Trust

In a recent blog Dominic Burton outlined the design process the teams are following over the next 6 months.

Over the next couple of weeks we’ll be publishing a short series of blogs to share the test teams’ journey’s so far, and more details on the ideas they hope to develop and test.

In this blog Amy Semple from the Health Innovation Network (HIN) introduces their work and the changes they hope to see.

At the HIN, we play a key role in encouraging and supporting the spread and adoption of evidence-based good practice, so developing solutions which have potential to scale across networks is something we have in common with the Q Lab.

This opportunity has enabled us to build upon existing relationships we have with Pain Services across South West London and develop a new partnership with a local recovery organisation across the two projects that we’ll be working on with the Lab. We will be testing ideas across a range of sites, which we hope will have a positive impact for people living with mental health problems and persistent back and neck pain.

Project one: Bespoke training and mentoring for physios to better support patients with their health and wellbeing

We have identified that the psychological needs of people using our physiotherapy services are not identified early enough, and that there is a gap in physios confidence and training to discuss and support people’s mental health needs.

We will be testing ideas across a range of sites, which we hope will have a positive impact for people living with mental health problems and persistent back and neck pain.

Working with outpatient physio teams at Kingston Hospital and St George’s Hospital in Tooting, we are looking to embed a training and mentoring package for physio’s so they can have conversations about mental health wellbeing with their patients. We will be working across the two clinical settings so are able to work with a range of physios to explore how they can be best supported to have conversations on mental health, to help them appropriately signpost and refer patients to further supporting services if a need is identified. Strengthening the focus on emotional wellbeing will create opportunities for patients to reflect on their wider health (beyond just physiotherapy) within a physio setting and to access psychological support earlier if needed.

Project two: Adapting joint pain advice to mental health services

We know that many people living with mental health problems also experience back and neck pain. This can lead to people reducing their activity and can increase social isolation – which in turn will impact their mental and physical health. We are working with Sydenham Garden – a wellbeing centre which uses its gardens and activities to help people in their recovery from mental health problems and chronic pain – to try and address this issue. There, we will be looking to implement our Joint Pain Advice (JPA) approach developed to support people managing chronic pain, based on NICE guidelines.

We are aiming to adapt the JPA programme so Sydenham Garden staff can deliver JPA to their co-workers (people with mental health problems) who use the centre. We will be balancing fidelity (the original concept at the heart the intervention) and quality, while also allowing flexibility for an intervention like JPA to succeed in a different setting (such as Sydenham Garden), so our approach needs to be flexible and iterative.

Sydenham Garden is the current setting for this Q Lab testing work, but the hypothesis is that the JPA can potentially be adapted for other mental health settings, or with other services where people also experience persistent pain. Therefore, what is key for us in this project is identifying the core components of the JPA that are essential for impact (and what aspects of the JPA need be adapted).

At Sydenham Garden we’ll be focusing on the following potential ‘customisable’ elements of the JPA:

• Content – what adjustments to language and content do we need to make this a useful intervention for people with both mental health problems and persistent pain?
• Delivery – fitting in with Sydenham Gardens existing operational delivery is important for staff and co-workers.
• Outcomes – what outcomes do we need to capture and how can we make it easy for staff?

The importance of collaborating with the right partners – who can help shape how interventions can be adopted and adapted – is key to each project’s success and will allow us to improve care for people living with mental health problems and persistent pain.

Get in touch

Over the next month we’ll be doing some focus groups at Kingston and St Georges to work with physio teams to identify what their needs are. At Sydenham Garden, we’ll be training the team on how to support co-workers to manage their pain along with motivational interviewing techniques, so they can confidently deliver JPA with their co-workers, as well as working with mental health colleagues and teams at Sydenham Garden to strengthen the mental health focus of JPA content.

The Lab is a collaborative process and we’ve drawn on helpful learning and insights from Lab participants already. We want to continue to connect with Lab participants and Q members working in mental health services supporting people with persistent pain. If that is you, please do get in touch – we’d really value picking your brains.

We’ll continue to share with the Q community our learning from our testing journey with the Q Lab, but of course feel free to get in touch via the Q website – or join the online group to stay connected.