Affiliation:
1. Cambridgeshire and Peterborough NHS Foundation Trust Cambridge UK
2. Department of Psychiatry University of Cambridge Cambridge UK
3. Department of Psychology University of Bath Bath UK
4. Department of Public Health and Primary Care University of Cambridge Cambridge UK
Abstract
Accessible summaryWhat Is Known on the Subject?
Mental health care can be delivered remotely through video and telephone consultations.
Remote consultations may be cheaper and more efficient than in person consultations.
What the Paper Adds to Existing Knowledge
Accessing community mental health care through remote consultations is perceived as not possible or beneficial for all service users.
Delivering remote consultations may not be practical or appropriate for all clinicians or community mental health teams.
What are the Implications for Practice?
Remote consultation cannot be a ‘one‐size‐fits‐all’ model of community mental health care.
A flexible approach is needed to offering remote consultation that considers its suitability for the service‐user, service and clinician.
AbstractIntroductionResponding to COVID‐19, community mental health teams in the UK NHS abruptly adopted remote consultations. Whilst they have demonstrable effectiveness, efficiency, and economic benefits, questions remain around the acceptability, feasibility and medicolegal implications of delivering community mental health care remotely.AimTo explore perceived advantages, challenges, and practice adaptations of delivering community mental health care remotely.MethodsTen community mental health teams in an NHS trust participated in a service evaluation about remote consultation. Fifty team discussions about remote consultation were recorded April–December 2020. Data analysis used a framework approach with themes being coded within a matrix.ResultsThree major horizontal themes of operations and team functioning, clinical pathways, and impact on staff were generated, with vertical themes of advantages, challenges, equity and adaptations.DiscussionRemote consultation is an attractive model of community mental healthcare. Clinical staff note benefits at individual (staff and service‐user), team, and service levels. However, it is not perceived as a universally beneficial or practical approach, and there are concerns relating to access equality.Implications for PracticeThe suitability of remote consultation needs to be considered for each service‐user, clinical population and clinical role. This requires a flexible and hybrid approach, attuned to safeguarding equality.
Funder
NIHR Cambridge Biomedical Research Centre