What is the challenge your project is going to address and how does it connect to the theme of 'How can improvement be used to reduce delays accessing health and care services'?

Context:

Surrey mental health services are currently experiencing high volumes of referrals with limited resources.  ADHD is a mental health condition that people experience throughout their lives.  ADHD undiagnosed can directly affect ability to work and lead enabled lives.

Surrey and National NHS ADHD waiting lists are very long or closing. There could be years waiting to be seen by an ADHD expert.  GP’s will not assess, diagnose or treat.  NHS Business Services Authority confirm demand for ADHD is soaring.

Need being assessed:
Would citizens benefit from an on-line first ADHD service?

That empowers people to:

– self-assess ADHD and better manage own care

– receive a first line of treatment that is safe, quick and effective
– including self-directed CBT and first-line prescribing of non-controlled medication

-better quality of life
– early identification of cases requiring a ‘complex case’ treatment pathway if required

-Surrey the area of focus with national scale and spread.

What does your project aim to achieve?

Aims for patients: 
Empowerment for patients to self-assess ADHD (neurodevelopmental condition)
Significantly shorter waiting times
Welcome offer of intervention and support for those on waiting list
Earlier identification of ‘complex cases’ that require more intense resource
Offer of medication while waiting
Possibility of coming off waiting list if no service required
Less stigma surrounding ADHD

Systemic Outputs: 
Managing demand through the system
Numbers treated
Impact on standard waiting list
Citizen’s empowerment
Better use of resources and filing workforce shortage gap
Clear data on assessment and treatment of ADHD used to further improve and align services to need
User champions of the system
Improved access to healthcare reducing current inequity
Clear numbers of people requiring to continue as per referral to ADHD wait list
Explore cost-benefits of non-controlled medication which, on first exploration, is significantly less expensive – short-term and long-term prescribing
Potential to apply this online pathway to other conditions

How will the project be delivered?

Using agile methodology: 

– Explore and review what other relevant online treatment pathways exist and learn from these;
e.g., smoking cessation pathway with medic review and online prescribing
– Further build on technology assessments already started
– Bring together partners within the SABP organisation and expertise across our ICS and identify early pain points, barriers and potential solutions with an ADHD CO-Design Hackathon e.g. patient groups, Pharmacies/GP’s/Nursing Teams
– Involve digital services and potential for utilising the shared record system across the ICS

– Development of pathway
– Scoping Online questionnaires/clinical assessment tools
– Clinical review and buy-in across partners of questionnaires
– Scope shared decision-making tools for ADHD
– Scoping of an online ADHD Therapy/Coaching programme
– Clinical and pharmacology partners review of prescribing
– Scope safety mechanisms required
– Development of a clinical risk assessment of this pathway
– Risk assessment of Information Governance issues
– Development of outcomes and impact dashboard

How is your project going to share learning?

We will use our Surrey Health Tech Accelerator (Partnership across the ICS with AHSN and Surrey University) as to create a working group across NHS Trusts experiencing similar problems.

An evaluation of the project for publication which will allow other trusts and organisations to build on our learning and scale up.

Thought leadership and webinars will be used as a way of sharing learning as well as developing a space on the NHS Futures platform.

Updates will be published through our online corporate channels at intervals.
– Reports and outputs will be shared on Q Exchange for the benefit of other members

Significant findings will be shared by hosting a webinar that will be recorded for YouTube/Socail Media for the general public