What is the positive change that has emerged through new collaborations or partnerships during Covid-19 that your project is going to embed?

Best practice guidelines suggest that those experiencing psychological problems during and following admission to Intensive Care Unit (ICU) require assessment and appropriate intervention from qualified psychologists, these only account for <1% of referrals to the Clinical Health Psychology Services (CHPS) despite a systemic review (2019) suggests that 1 in 5 critical care survivors experience Post Traumatic Stress Disorder.

During COVID-19, regional and local collaboration led to new guidelines for Health and Social Care Trusts to provide psychological assessment and support to adults admitted to ICU with COVID-19 regarding identification and response to trauma.  CHPS  now attends monthly ICU follow-up clinics with ICU colleagues to identify and respond to trauma and psychological adjustment during the recovery journey.  Clinical Psychology assessments are now offered to those attending ICU post-COVID 19 as per agreed regional guidelines but this does not allow for follow up for other adults admitted to ICU who are also likely to experience trauma.

What does your project aim to achieve?

This project aims to reduce health inequalities by ensuring all appropriate ICU service users will have access to Clinical Health Psychology services (CHPS) at point of referral, by developing joint review sessions with ICU.

Additional resources will also be developed, including

• A service user forum to provide resources and share experiences with one another
• Training resources for staff within both CHPS and ICU (to be identified)

We aim to marry current best practice guidance with existing literature, and input from experienced staff & post-ICU service users to develop bespoke guidance within the NHSCT.  This will include efficient and effective pathways and processes to support.  Alongside this will be the further development and use of bedside technology to assist early identification of trauma.  This project and collaboration between ICU and CHPS will potentially benefit all those admitted to ICU through embedded processes of prevention, identification and early intervention during admission to ICU.

How will the project be delivered?

By establishing a Service User Reference Group and reviewing research literature, this will inform the scoping exercise to identify key changes required to meet trauma informed standards of care.  The aim is to identify and, where necessary, establish standards and to measure service delivery against these.

The project will be carried out using a combination of Model for Improvement methodologies and PRINCE2 project management.  Team members have and will be identified from existing ICU, Clinical Health Psychology, Innovation and Quality Improvement, and Service User representation.

Impact will be measured by focusing on

• reduction of waiting times,
• number of service users assessed by the Clinical Health Psychology Service,
• staff and service user feedback.

These measures will be monitored closely and inform change ideas throughout the course of the project.  Measures will also consider the implications on cost avoidance by introducing this project.

Clinical risk will be managed through current service provision.

How is your project going to share learning?

The Project will be shared with Q members either  through site visits or online.

This will also be shared regionally on the HSCQI Website and through our local Innovation and Quality Improvement Hub and Annual event.

It will also be shared wider with Healthcare Improvement Alliance Europe, as well as through Regional and National Critical Care Networks.

It is anticipated that this will also be published, based on findings.