Outcome Measures in Children & Young People’s Mental Health: Weeknotes 1 - 25.01.22

About our project

This project was selected to take place as part of a national NHSEI&X programme, from January to early April, supported by We are Snook and the Child Outcomes Research Consortium. Locally, we’re delivering this between BNSSG CCG, our Children and Young People’s Mental Health provider, AWP, and external supplier Mace & Menter.

We’ve kicked off a rapid discovery-design piece, looking at improving the use of ‘Outcome Measures’ in Children, Adolescent Mental Health Services in BNSSG.

Using routine outcome measures, or ‘ROMs’, are important for several reasons:

• Clinicians use them to inform treatment decisions and effective use of capacity
• They help service users (and parents/carers) to understand their progress and how this might relate to what happens next in their journey
• The data informs service provision and planning at both a national and local level.

In BNSSG, we have some anecdotal understanding of the barriers to ROMs being used more in our Children and Young People’s Mental Health services, such as more staff training around ROMs being required, or the impact of current digital systems used for collection and reporting. Our aim for this piece of work is to understand both the problems contributing to the current low ROMs return rates and set a design direction that will help solve the top issues in a pragmatic and feasible way.

We’ve chosen to focus our scope, so that this phase of work is achievable in the timeline available. This means we’re predominantly looking at ROMs within the ‘Anxiety and Low mood’ pathway, which is a high volume pathway in terms of referrals and users. We’re also planning to include some research with other, quite different, pathways, to understand whether any of our findings might translate more universally across services.

What have we been doing?

We pushed the start of the main project activities w/c to February 7, so that we have a bit more time to find people to participate in research. We kept the original kick-off date of January 25, though, so this week has been a week of prep. We’ve:

• Held a kick-off meeting to talk about scope, hopes and fears for the project, and how we all want to work together.
• Had lots of conversations about participant recruitment. We’ll be doing 27 interviews in the first few weeks of the project, across professionals, children and young people and parents and carers. We’ve been agreeing what criteria we want to use to decide which people to speak to, and how we’ll find them.
• Booked our first handful of stakeholder interviews over the next couple of weeks. These are a chance for us to meet people who have an interest in the project, and learn what we can do to make sure the outcome aligns with their goals. They’re also a chance for us to find out as much as we can about the subject area!

3 things that went well

• Meeting the whole project team across each organisation and having a clearer sense of who’s who and how they will be involved. We’re really excited to be getting underway with this project.
• The kick-off meeting — we ended the meeting with a clear direction, a set of things to avoid, and an understanding of who’ll be signing off key decisions.
• We’re making good progress on recruitment, which is important at this stage in the project. We can’t just leave it until later! We’ve got useful feedback on our recruitment materials from the ‘ROMs Champions’ group, and our clinical stakeholders have identified exactly which roles will give us the variety that we need for our professional interviews.

3 things we’ve learnt

• Parents and carers are a really key integral part of therapy, especially for younger children. This means that they’re often the ones filling in ROMs, and we need to make sure that we hear about their experiences, too.
• Miro (our virtual whiteboard) doesn’t work on Internet Explorer!
• We’re continually learning that cross-organisational collaboration in the NHS creates extra complexity, and this project is no exception! Whether it’s identifying the right stakeholders, recruiting staff for research, clarifying CYP participation requirements (such as DBS checks or safeguarding training) or ensuring each organisation is in agreement around information governance and data protection.

3 challenges we’re working on

• As always, recruitment is the trickiest thing we’re tackling at this stage of the project. We’re having lots of good conversations and our momentum around preparation is good at the moment, but we need to try to keep people interested and engaged in this through the difficult task of finding participants — and get the ‘ask’ out to potential participants quickly!
• It’s been a week of re-planning to fit in interviews, analysis and testing with parents and carers — a user group we hadn’t considered in our original plan. Luckily, We are Snook (supporting the national programme) have offered some of their time to boost our interview capacity. Thanks Snooks!
• We’ve got some formalities to nail in relation to our information governance, safeguarding and CYP participation requirements. We’re working hard to make sure these areas are addressed across both the CCG and AWP — without impacting on our pace for the project!