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2173 Developing an integrated care programme for acute paediatric settings
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  1. Vian Rajabzadeh,
  2. Sofia Chantziara,
  3. Michaela Otis,
  4. Susan Barber,
  5. Stuart Green Hofer,
  6. Jean Straus,
  7. Michelle Kay,
  8. Benedict Hayhoe,
  9. Dasha Nicholls
  1. Imperial College London

Abstract

Aims and Objectives The increasing demand for mental healthcare in young people has resulted in limited availability, leading to increased emergency department (ED) visits and subsequent admissions. Individuals with mental illness frequently rely on ED services, overwhelming the demand to address mental and physical care needs. To address this, the ‘Best for You’ integrated care programme was developed in collaboration with NHS Trusts in Northwest London. ‘Best for You’ aims to improve the experience and long-term recovery of young people in mental health crises through tailored care in acute and community settings, along with access to digital resources. However, integrating these interventions into the NHS presents unique challenges. This study sought to gather stakeholder perspectives on the pre-implementation and early planning stages of the ‘Best for You’ programme, focusing specifically on emergency care.

Method and Design Fourteen semi-structured interviews were conducted with stakeholders of the ‘Best for You’ programme, including emergency care specialists, psychiatrists, mental health nurses, and non-clinical staff involved in the planning and delivering services. The Consolidated Framework for Implementation Research informed thematic analysis.

Results and Conclusion Key considerations include the importance of dual-trained staff handling acute and mental health needs. Staff should possess an awareness of the various components of the programme and clear communication strategies to ensure seamless care transitions. Barriers included unanticipated cost changes, and difficulties in securing a physical space within an emergency care setting, which is appropriate, safe, and able to meet young people’s needs. This study highlights challenges in developing a complex mental health programme in the NHS emergency setting. Our findings emphasise the need for shared awareness of programme elements, mental health competency, clear communication throughout care pathways, and staff and system resilience and adaptability. Realistic consideration of space requirements is crucial for successfully implementing integrated emergency care programmes.

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