Use of Attend Anywhere during COVID-19 pandemic
In mid 2018 the Medical Psychology service identified a need to be able to provide virtual clinics for some patients and although other organisations had been willing to share their experiences and practices of these types of clinics, these were not able to be taken forward, predominately due to Information Governance and IT barriers. Due to the COVID-19 pandemic it was not possible to continue to provide face to face psychological support. However, the psychological needs of unwell patients was quickly identified as a priority, given that for many patients, their medical treatment plan had to be altered and many patients were shielding, adding to their sense of isolation. Support for End of Life patients was a priority.
NHS England offered NHS organisations a 12 month free licence for Attend Anywhere video clinic and/or telephone support. The Medical Psychology Department at South Tees took up this opportunity for outpatients, and where appropriate and necessary, in patients to enable ongoing assessment and treatment of patients with psychological problems linked to their physical health.
Initially a protocol was developed to prioritise the patients who needed ongoing support during the first wave of COVID-19; a team was identified to provide this support and training on the Attend Anywhere platform.
For staff members who were based at home a Home Working Standard Operating Procedure (SOP) was developed to ensure safe access to and storage of notes and appropriate governance.
From July 2020, a protocol was developed to determine which patients required face to face support. Most patients have continued to access support by video or telephone.
Access to IT to support use of Attend Anywhere was initially a challenge and at some sites access to appropriate clinic space to use the IT continues to be a challenge.
Using Attend Anywhere has:
- Enabled patients to continue to receive psychological assessment and treatment as inpatients and outpatients throughout the COVID-19 Pandemic and beyond
- Enabled staff to continue to offer clinics remotely when access to NHS facilities was limited
- Enabled carers and families to be involved in treatment planning when access to Hospital and care planning was limited
- Enabled multidisciplinary team (MDT) clinics to run, with staff based in different venues
- Enabled staff greater flexibility to provide the Staff Support component of their work.
- Reduced travel time and costs when staff travel from their base to the MDT base which can be extensive in rural North Yorkshire. It has reduced travel time between venues, which allows additional appointment slots to be allocated where appropriate.
- Reduced need for patients to travel to appointments and associated patient transport costs. Patients also commented that they are at times dependent upon others for transport to appointments, and that not having to ask for help to get to Psychology appointments has given them a greater sense of privacy over this aspect of their care. Not having to travel is clearly an advantage for patients who may be in pain, suffering from fatigue or nausea and other side effects of treatment or their illness. Parking at hospitals is an increasing problem, and this does cause patients and their carers anxiety.
The benefits included:
- Allows access to psychological assessment and therapy during the COVID-19 Pandemic and in longer term for those who may struggle to travel
- Enables use of visual aids, downloads and interactive materials as part of therapy (although further training is needed for some)
- Enables carers and family to be involved in assessment and treatment planning
- Enables observation of behavioural cues, carer interaction, to connect to people’s homes where domiciliary visits are not commissioned or possible
- Enables MDT clinics, without need for all to be on site
- Enables greater privacy for patients, who may otherwise rely upon others for access to Hospital
- Enables shadowing/supervision for Trainees
- Enables clinics to continue when there are staff working from home due to isolation
- Enables clinics to continue remotely when access to NHS facilities is limited
- Enables staff to work more flexibly, to provide Staff Support.
The AHSN NENC Innovation Manager provided support by advising of a local Trust who had already been utilising Attend Anywhere. He connected us with this Trust who were happy to share their experiences which sped up our implementation of Attend Anywhere.
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