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Meet the team


  • Dr Becky Houghton, Clinical Health Psychology Service
  • Dr Esther Davis, ICU Consultant
  • Service User representation (TBD)
  • Other representation from ICU and CHPS (TBD)

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.

How you can contribute

  • Shared learning from similar projects. If this has been developed elsewhere it would be very helpful to understand what happened, how and the impact it had.
  • Critical friends welcome - any suggestions on how to refine this project would be greatly appreciated.

Plan timeline

26 Oct 2020 Project Board is formed
30 Nov 2020 Review of literature commences
1 Mar 2021 Project Team identified and formed
1 Mar 2021 Service Users identified and contacted
15 Mar 2021 Feedback to group regarding resources required
15 Mar 2021 First collaborative meeting take place
29 Mar 2021 Development of resources commences
10 May 2021 Resources trialled
8 Nov 2021 Review of trial
22 Nov 2021 Approval of resources - begin wider rollout


  1. Really interested to see how this project progresses! Would be good to share learning through the national critical care networks too.

    1. Hi Kujan, sorry for late reply.  Thanks for this, I will absolutely add this into my communication strategy.  It would be good to keep in touch with you over the next while, given our projects.  Congratulations again and all the best with your project!

  2. Great project idea - good luck!

  3. There could not be a better time for this project. Psychological support and early intervention for trauma in ICU - great idea and very scalable too. Well done.  Interested to see this progress

    1. Thanks Gill, this seems to be new ground.  Whilst Psychological input is identified as valuable for patients who experience trauma/ PTSD following a stay in ICU, there is little guidance as to what extent.  Looking forward to exploring this further and supporting the development of something more tangible to support staff and service users, particularly during a time where trauma is more likely, unfortunately, to come out of time spent in ICU


  4. Hi. Good to hear about your interesting proposal. I'm working with the Health Foundation to support connections and collaborations amongst Q members for Q Exchange. To help with gaining a bit more support and the critical friends you need, it might be worth having a look at the other critical care proposals that have been submitted to date - both of which focus on rehab from ICU. You might also find it helpful to connect in with the special interest group on QI in mental health which could be another form of support. Good luck with your idea. Best wishes, Emma

    1. Thanks Emma! I will do.

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