The recent Mental Health Act (MHA) Draft Bill marks a landmark change, placing an onus on reform that positions the patient at the heart of legislation. This core objective, drawn from the MHA Review’s four key principles – choice and autonomy, least restriction, therapeutic benefit and the patient as individual – demonstrates a commitment to ensuring that acute mental health care is structured around patient outcomes. Ultimately, the aim is to make acute mental health care more human.
However, through our work digitising the MHA at Thalamos, we have learnt that in practice, there remain obstacles to this being reliably delivered. Ambiguities in how digital health providers should approach prioritising patient outcomes means that for many, it becomes merely a tick-box exercise. What’s needed to ensure that providers can genuinely meet the goals set out by reform to improve patient outcomes is an agreed framework of Responsible Innovation.
At the centre of every MHA detention or treatment is a person usually at a very vulnerable point in their life. So having a shared framework which recognises this and outlines demonstrable measures to ensure that digital development benefits, and never endangers, patient safety, is vital. Mental health providers must be equipped to responsibly digitise services, and provide safer, more effective treatment pathways for their patients.
Whilst digitising the Mental Health Act can greatly reduce treatment delays and ensure that patients can access care as soon as possible, it is crucial to recognise the potential pitfalls that it can present if not done responsibly. Digitising the Act is much more complex than just digitising the words on the forms; it’s about creating safer, swifter and more effective treatment pathways for those entering acute care.
Digitisation affects the entire care pathway and consequently, has a direct impact on the patient undergoing treatment. To ensure this impact is therapeutic, it’s essential that providers strive for a model of Responsible Innovation. This means recognising that every decision made in product design and development will ultimately affect the patient receiving care, and acting to ensure this is always as human as possible.
At Thalamos, we are taking a ‘by-design’ approach to Responsible Innovation; clinical safety, lived experience and ethics are built into every stage of our product design.This ensures that patient outcomes, and the impact of our technology, are considered at every step of digital development.
In practical terms, this involves convening the expertise of a dedicated advisory board. As part of this board, I am responsible for ensuring that clinical safety and ethics are appropriately considered and implemented throughout the digital MHA. This means embedding ethical principles into our clinical safety documents and ensuring that digital regulation is woven into every practical design and implementation decision. My role is to support the wider team to ensure that clinical safety, ethical and regulatory requirements consistently direct the actions taken at every stage of product development.
By maintaining the understanding that digitisation is more than the digital product, and requires a holistic approach to ensure its impact is positive, we have seen very encouraging outcomes. Thalamos has helped reduce the average access to treatment times from 7 days to just 15 hours*. In addition, at one Trust the use of Thalamos saved each ward the equivalent of one nursing shift per month^.
Increasing pathway digitisation across acute mental health care will help uphold the key tenets of MHA reform. But it must be done responsibly. By introducing a shared framework, centred around a by-design approach to clinical safety, lived experience and ethics, providers will be able to reliably compare performance, identify areas for improvement and ensure that positive patient outcomes are at the centre of delivery.
Digitisation is loaded with complexity and we must recognise the gravity of the task. Our by-design approach enables patients to be treated as holistic individuals, rather than just a statistic. By making clinical safety, lived experience and ethics the foundations upon which digital development stands, we can ensure that the patient is always placed, and remains, at the heart of the Mental Health Act.
* The Second Opinion Appointed Doctor (SOAD) Team within the CQC (Care Quality Commission) saw average access to treatment times reduce from 7 days to 15 hours through using Thalamos against a paper-based system.
^Cheshire & Wirral Partnership NHS Foundation Trust demonstrated a time saving of 42 hours of “clinical time” per ward, per month by using Thalamos against a control site.
This article was written by a member of the Thalamos team who no longer works for the organisation, however we haven’t removed it as we still consider the content to be relevant.
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