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

The closure of schools and the reduction in outpatient clinics made access to therapeutic support for children an immediate challenge. Without regular support many children on our caseloads would suffer long-lasting impacts.

The setting up of a teletherapy service was an obvious solution requiring creativity, collaborations and partnerships.

We formed a working group who collated existing research and resources, liaised with IT and IG, trialled online platforms and developed training for our team. Our therapeutic interventions rely on interaction so it was necessary to find innovative solutions such as online games and quizzes, interactive screen-sharing and the use of props.  Challenges with digital access for more disadvantaged families had to be overcome but some groups saw increased attendance and improved feedback

The teletherapy service has meant that our support for families has continued throughout the pandemic and opportunities for rolling our service across traditional geographical boundaries is being explored.

What does your project aim to achieve?

This project aims to comprehensively evaluate changes made during COVID-19 using a Quality Improvement approach.

Anecdotally , teletherapy has shown benefits in ease of access, time efficiency and improved attendance for families but we would like to investigate data, processes and stakeholder feedback more extensively to determine exactly when/how/why/what is effective.

We hope that this will enable us to plan an effective telehealth offer more strategically in the future. National reports have shown that access to therapy services across the country is variable and often inadequate. Diverse funding streams are available to support therapy provision (charitable funding, education-focussed, grants, research)  but not all NHS services are able to maximise these opportunities. Longer term, a robust and quality-assured teletherapy service within a sustainable business model, could be offered more widely, reducing inequalities of access and meeting an identified need for children and families.

How will the project be delivered?

At present, a small group of ‘telehealth’ champions have been supporting the digital developments across our team in a voluntary capacity. This project will strengthen and enhance their role, allowing them dedicated time to take a QI approach to trial and evauate teletherapy models, gain skills, make partnerships, and provide training to the whole therapy team.

The funding will allow us to backfill time for a senior manager to steer and coordinate this project, with a small group of  therapists working in diffrerent service areas (early years, adolescents, special schools, hospital) to deliver and support. A cross-therapy steering group will be set up to monitor and drive the work over the year.

Existing links both within our own organisation (e.g. with IT, information governance and across other services) as well as externally (e.g. with Therapy Box, a therapy tech company and current research partner with us) will be made.

How is your project going to share learning?

COVID-19 instigated a rush  towards adopting Telehealth as an occasional or default option for therapy and healthcare with children and families. Adopting changes in a crisis and at speed has led to enormous benefits – solutions found quickly and long-time barriers overcome.

However, this project aims to take a step back and use data and feedback to reflect on the effectiveness and true improvement value of these changes. This learning will be relevant across healthcare and can be applied to any setting where telehealth practices are being adopted.

We hope that a key outcome will be practical recommendations and toolkits for anyone currently or thinking of adopting telehealth in their service so that evaluation and outcomes measures can be incorporated from the outset, and so that the right children and families recieve the right sorts of telehealth options at the right time.

How you can contribute

  • Regular communication with members working on similar projects
  • Support connecting with relevant services who are using telehealth
  • ideas and support to enagage users in feedback in creative ways
  • Support to develop tools for co-production of telehealth services now and going forward

Plan timeline

6 Dec 2020 End of Phase 2 - data collection and feedback & steering group meeting
13 Dec 2020 Evaluation and reflection - adopt / adapt / abandon - plan phase 3
4 Jan 2021 Digital project delivery - phase 3 & steering group meeting
14 Feb 2021 mid phase 2 reflection and re-evaluation - consider project sustainability
14 Mar 2021 End of Phase 3 - data collection and feedback & steering group meeting
29 Mar 2021 End of project - begin roll out - sustain and spread
1 Apr 2021 Project Start: key stakeholders steering group launch
5 Apr 2021 Gathering of baseline data
18 Apr 2021 Digital project delivery - Phase 1
11 Jul 2021 End of Phase 1 - data collection and feedback & steering group meeting
18 Jul 2021 Evaluation and reflection - adopt / adapt / abandon - plan phase 2
1 Sep 2021 Digital project delivery - phase 2 & steering group meeting
17 Oct 2021 mid phase 2 reflection and re-evaluation - look at data and feedback

Comments

  1. Hi Annabelle,

    I've been meaning to comment on your idea, apologies it's taken me so long, nothing like a deadline to focus the mind! Thanks for your comments on my project.

    Sounds like you have done some great groundwork and achieved a huge amount already, I like the sound of your 'telehealth champions', and also your create approach - games and quizzes to engage the children sounds excellent.

    It will be good to hear more about the inequalities you address as your project progresses and you gather more data. Language is a big issue for us (possibly not so much with your younger families) and we think most non English speaking patients are not even currently being offered a video call, which we are planning to address! I know Homerton have been really proactive with translation of materials so you have access to that.

    'Specialist children's and community services' is also one of our biggest users of video consultations at Barts Health so if you would like me to connect you up with anyone from there just let me know (if you don't know them already!)

    Anyhow, best of luck with your idea and will be interested to hear more in due course.

    Best wishes, Jo

  2. We would be really interested in this. We have rapidly deployed video consultation across our care group but using a very generic and therefore adult focussed platform. We'd love to enhance it with more 'child friendly' interface and interactivity and as a Trust currently scoping other products available. One of our SLTs has experience working for 'Mable' who have a well developed SLT online offer.  We are also using video consultation across CAMHS, Paediatric O.T, Physio, Podiatry, SLT and Dietetics to name but a few.

    1. Thanks for the encouragement Lyse. I saw that you have put an idea on here about webinars too. There is so much digital innovation going on - particularly in the independent sector (like Mable you mentioned) - we relaly need to pool leanring and share. I'm particulalry interested in stopping and reflecting on what actually works for families too, and what will work long term. I think we are in danger of falling into lots of web-based input that may feel good but not actually help.

  3. Hi Annabelle,

    Myself and my colleague Emma Adams (Health Transformation Partnership) are supporting the Health Foundation this year by fostering conversations between Q members and encouraging collaboration. We were Exchange applicants last year, so we’re hoping that our experience will help us to help others, as their ideas take shape.

    I imagine the idea you've presented will be of huge importance to Post-Covid service delivery. I also imagine - but I guess we'll see- that others will be posting projects relating to virtual service delivery, so I look forward to helping you make connections as you build up the details of your idea. I'm also working with another Trust who deliver a range of remote services, including those designed for children. They have undertaken a Trust-wide remote working Quality Improvement project, gathering feedback from users and staff. They are shortly going to be collating their learning - I'll check how widely they are happy to disseminate that. If they are happy to do it, I'll share the results with you, should this be of interest.

    Best of luck with your Q Exchange idea!

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