Sally Eason, Associate Director of Digital Transformation and Service Redesign at Arden & GEM, shares how the Shine programme is improving the mental health and wellbeing of primary care staff and patients in Bedfordshire, Luton and Milton Keynes in this case study for Mental Health Today.
It is no secret that primary care is under pressure. Even before COVID-19, demand for primary care services was on the rise, thanks in part to an ageing population and increasing number of people living with multiple long-term conditions. But the added pressure of the pandemic has caused a backlog in healthcare delivery combined with additional health needs arising from the pandemic itself, particularly in relation to mental health.
A perfect storm
When faced with such significant challenges, there is no choice but to innovate. What can we do differently? How can we achieve more? For Bedfordshire, Luton and Milton Keynes (BLMK) Integrated Care Board (ICB), this started with recognising that patients and staff were experiencing similar health and wellbeing needs and looking at opportunities to support both groups with a similar initiative.
This led to Arden & GEM’s digital transformation team working in collaboration with BLMK and evidence-based mental health platform developers, ShinyMind, to design a programme that would support the immediate mental health needs of staff and patients. But we also wanted a solution that could support longstanding ambitions to enable self-care, reduce hospital admissions and widen access to primary care services.
The Shine programme
The result is the Shine programme which puts tailored mental health support directly into the hands of both staff and patients through a mobile app with supporting training. The programme consists of three customised parts: The ShinyMind app, a supporting training programme and a prescribing portal.
The ShinyMind app was originally developed for and co-created with NHS staff and is at the heart of this programme. It offers users interactive exercises, advice and resources that improve wellbeing and resilience based on science and research. But like any digital project, providing the 'tool' in isolation limits its potential. The training helps staff understand how to make the most of the resources available to support their own wellbeing, and develop the skills needed to 'prescribe' the app for patients.
Practices select ‘prescribers’ to attend a series of virtual training sessions, then, using a 'train the trainer' model, trainees share the programme and its materials with their colleagues, improving the resilience and wellbeing of the whole staff group.
Research conducted among staff involved in the pilot found that wellbeing had improved by 91%, nearly three quarters of participants (73%) cited an improvement in job satisfaction and over 60% felt there was a greater likelihood they would continue working in primary care.
“It is exciting to see the interest being generated among our colleagues, who are feeling the benefit of the programme at a personal level for wellbeing and job satisfaction as relationships strengthen across teams. They are also seeing patients benefit from the app as they feel more empowered and motivated in their daily lives and early data suggests that, in some cases, this is translating to reduced demand for appointments. I feel we are on the edge of a new way of working towards workforce and patient wellbeing.”
Janet Thornley, General Practice Nurse Strategic Lead at BLMK ICB
Delivering personalised care for patients
The programme has been designed to benefit patients over 18, focusing on those experiencing anxiety and depression, living with long-term conditions and facing the greatest health inequalities.
Staff can use the prescribing portal to provide access to specific 'LifePacks' which are matched to the needs of patients to personalise support and enable better self-management of health conditions such as coping with anxiety and mental wellness, diabetes and menopause.
A confidential patient questionnaire assessing the impact of the pilot programme found that 60% of respondents thought the app helped them to feel better and would like to keep it. Life satisfaction scores improved within six weeks for 28% of respondents and 17% saw an improvement anxiety scores (GAD) after six weeks. One patient commented, “Using this anywhere is helpful, it has made me feel less alone in dealing with stuff, and when I’m stressed it’s like a go to [in] dealing with it. I have been surprised how much it has helped me”.
A growing impact
This programme is making it easier for patients to access care and advice, and reducing waiting times by expanding the number of staff and range of roles able to prescribe support to those with poor mental health.
Crucially, the programme is enabling stretched primary care services to provide preventative care. Following the success of phase one, BLMK ICB has just extended the programme to an additional 30 GP practices and 15,000 patients.
This project combines NHS and private sector expertise to tackle some of the priorities set out in the Fuller Stocktake report. The lessons from this programme go beyond the specifics of the service provided though. It serves as a reminder to us all that the health needs of NHS staff and patients often overlap. In seeking to address some of the causes of poor mental health for our communities, we should look close to home, both for inspiration and for opportunities to help those we rely on so heavily to deliver patient care.
This article is taken from a case study originally written for Mental Health Today.