Cast your mind back to the very start of the pandemic… Millions of workers faced a shift to remote working and new, digital systems overnight – and acute mental health care was no exception.
With restrictions limiting in-person hospital visits, many practitioners were suddenly tasked with completing their roles remotely. Digital alternatives to existing manual and paper-based systems became essential. Working alongside the Second Opinion Appointed Doctor (SOAD) Team at the Care Quality Commission (CQC), Thalamos played a key role in delivering these and helped maintain patient safeguarding for treatment under the Mental Health Act (MHA).
The pandemic catalysed an unparalleled urgency for digitisation. Within existing paper-based systems, the forms underpinning acute mental health care treatment had to be completed and delivered manually. This was further complicated by the fact that a wet-ink signature was required on all forms. But with practitioners suddenly needing to work remotely due to the pandemic, this became infeasible.
Practitioners were obligated to deliver paper forms due to the legislation mandating wet-ink signatures, but were no longer able to visit hospitals due to the pandemic. In order to ensure they could still deliver a second opinion service and continue safeguarding care, a huge collaborative effort emerged to find a solution.
By joining forces, the SOAD and Thalamos teams were able to drive forward the change needed. The pandemic had provided an imperative for digitisation – and we were able to begin opening the doors to greater digital innovation across the mental health care sector.
As part of the CQC’s patient safeguarding, the SOAD Team is responsible for reviewing patient appeals and authorising treatment under the MHA. Due to the pandemic, SOADs could suddenly no longer visit hospitals to perform assessments. As a result, emergency legislation had been drafted which would have lessened the requirement for a second opinion in certain cases – therefore weakening patient safeguarding. A digital solution was desperately needed to prevent this.
So Thalamos teamed up with Principal SOAD Simon Wood and CQC SOAD Operations Manager Craig Jennings, to launch a digital certificate system. Having shared a prototype T3 form, and gained support from the Department for Health and Social Care (DHSC) to begin using electronic signatures, we launched a pilot involving 30 active SOADs. They were able to create and complete assessment certificates digitally and send them to hospitals electronically, bearing electronic signatures. These could then be accessed digitally by the clinician in charge of the patient’s care.
The pilot ultimately helped stop the need for emergency Covid legislation, which would have suspended the need for a second opinion in some cases. Delays inherent to the paper-based system were removed, and the potential for mistakes that could invalidate a certificate were significantly reduced. Care providers received valid certificates much more quickly, reducing wait time for treatment and speeding up delivery of care. The time between SOAD assessment and treatment commencing fell from 7 days to just 15 hours.
“With everybody on board and knowing what they’re doing, it would be moments from the SOAD making their decision and issuing the certificate, to the hospital receiving that certificate and then being able to act upon it – that, for me, is the key.”
The pilot’s success rested on the close collaboration between Thalamos, Simon and Craig. We all shared a common objective and were keen to work together to make it a success. Continuous, open channels of communication and continual feedback helped us to adapt and tweak the system as it was being used, successfully optimising the remote working model.
“The keys to this working were identifying problems before they became problems, having multiple modes of approach and having someone with a proper grasp of each issue.”
“Looking into the future, it’s around creating a much more intuitive system. I think there’ll be the potential for ensuring quality control in terms of the certificates being produced.”
Following the pilot phase, we’re now rolling out SOAD digital certificates more widely and creating additional forms. The increased data being produced will enable practitioners to compare and evaluate standards of working and care. Our collaboration with the CQC has shown just how powerful digitisation can be. In December 2020, legislation was officially changed to support doctors and AMHPs to complete and send forms electronically.
The pandemic may have fast-tracked digital innovation across acute mental health care, but it’s clear there should be no looking back. Digitisation allows us to reduce delays, lessen administrative burdens and speed up access to treatment. Creating a fully digitised Mental Health Act will help us provide swifter, simpler and safer care for all.
Arden spent 12 years working with private equity businesses helping them build best-in-class executive teams, manage company restructures, accelerate growth and prepare management buyout deals. Arden’s dad (also called Arden) is a psychiatrist, which opened his eyes to acute mental health care from a young age. After witnessing a close friend being sectioned first-hand, he founded Thalamos to improve the process and outcome for those in crisis.
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