Project5 Care Model
This page serves as a proposal for NHS teams seeking to understand the offer, the due diligence and the opportunity to dovetail or embed around existing mental health support Comms to regional staff.
Stepped Care Model
The service is staffed by volunteers from the coaching and mental health practitioner sector, currently over 4,000 are registered. Each providing a minimum of 4 sessions per week for free (the number on offer is now at 80,000+ sessions per month).
These sessions will be provided for a gateway website which will provide 3 Tier options to NHS staff, based on a self-triage approach.
Self-help / Tier 1:
Accessible self-management education videos which are internally hosted with signposting to relevant external resources. A sample video is here - a catalogue of training videos for managers, staff and some for family members will be available at launch. An additional library of video resources, contributed from our volunteers will also be catalogued to increase engagement and accessibility to various methods of support.
Coaching - Tier 2:
Coaching support and intervention constitute Tier 2, where staff members are not in a state of distress but need to stand back and appraise their decision making or have a block as to how they might plan practically for pending dilemmas. These sessions will be provided by qualified coaches or trained mental health professionals who will follow solution focussed coaching guidelines.
The solution focussed coaching will support NHS workers over two sessions to find solutions to professional dilemmas rather than investigate problems. It focusses on building strengths rather than investigating weaknesses, it aims to find positive ways forward, and on overcoming barriers to desired objectives.
Accredited coaches will be offering solution-focused support in 1 hour sessions. This approach will be standardised across the coaching volunteers via guidelines and onboarding CPD.
Wellbeing - Tier 3:
Wellbeing interviews will be accessed by NHS staff when they have experienced high levels of distress which threatens to impede their decision making and clinical practice. These two interviews constitute Tier 2 and will be conducted by experienced Wellbeing Specialists with backgrounds as mental health professionals with knowledge of clinical team and the demands placed on the NHS. The initial wellbeing interview will be crisis intervention focussed, while the second promoting resilience interview will follow-up from the first interview and provide further intervention to foster resilience.
Crisis intervention is an immediate and short-term psychological approach aimed at assisting individuals in dealing with the psychological consequences they face after making critical decisions and actions. This type of intervention initially attempts to restore emotional stability and allow the individual to be able to process the situation, think through their decisions, learn from the experience, and consequently reduce the potential for the individual to become psychologically traumatised.
Promoting resilience becomes possible when the NHS staff member has become stable and better able to reflect on their wellbeing. It aims to maintain and promote capabilities and the use of strategies to reduce the potential to experience high levels of distress should similar crisis events occur in future. The second session will support NHS staff to engage in activities that promote good physical and psychological wellbeing. This might include stress management, exercise, regular sleeping hours, healthy eating, ensuring breaks during the working day, regularly de-briefing with colleagues, and gaining support and advice from identified senior colleagues.
Beyond Tier 3 - signposting will be made to local services via OH, 111 or GP contact, should staff present with resistant episodes of emotional crisis.
A bespoke digital booking system has been developed to rapidly link staff in need to available slots in our database of available sessions. Registration on the website will be followed by an option to select a slot in the desired Tier of support. This will be immediately booked into the diary of the staff member via an email calendar invitation. It is foreseen that out of hours sessions will be available and a potential 24 hour response time for bookings.
Desktop and mobile booking page samples below:
Suicide Risk Intervention
At all points of contact with the website (registration, education and booking) queries will be made relating to the risk to self. Information will be provided to signpost staff to access more immediate services. Our service is collaborating with the charity www.actiontopreventsuicide.org to deliver this support in an evidence-based fashion. A support and signposting page is being designed by this service, for the support of any staff at risk. This charity have specialist experience in suicide prevention in medical staff.
The NHS Wellbeing website will have customised templates providing volunteers with an onboarding process via two pathways.
One pathway will be for Professional Coaches and another for mental health professionals who if successful will become Wellbeing Specialists. Both pathways will require applicants to detail their professional registration, re-registration date, professional insurance liability, current supervision status, length of work experience in different contexts, supervisory training, and confirmation of a willingness to adhere to the practice and supervision requirements of NHS Wellbeing.
Professional Coaches will be specifically required to follow a solution focussed approach in their interviews, whereas Wellbeing Specialists (mental heal professionals) will be expected to undertake crisis intervention and resilience promotion interviews.
All volunteers will be verified via:
- checking their accreditation number on the relevant body website
- verification of ID via passport/driving license
- verification of public liability insurance via the collection of proof
- confirmation that they already receive regular supervision
All coaches will be required to be accredited with one of three reputable bodies (AC, ICF, EMCC). All mental health practitioners will be registered with a professional governance body (e.g. GMC, BABCP, HCPC etc).
Trainees will not be included unless their host training bodies provide permission and agree to provide additional supervision support.
A robust supervision model has been created to provide practice guidelines and oversight of the model, which will be expected to change in response to evidence.
Clinical oversight committee
The current committee consists of 4 Clinical Psychologists, 1 NHS CCG Governance Lead, 1 Occupational Psychologist and 1 Clinical Psychology Research Lead. The team has experience in projects such as the Glenfell Tower intervention and North Staffs team support. The project lead has experience in large scale NHS innovation and is also a member of the DCP Digital Health Subcommittee, who provide national guidelines on digital remote therapy working.
Treatment Model Guidelines
All volunteers will be provided with guidelines on how to work within their allocated Tier. These have been developed from best-practice evidence that relates to the current need, whilst also supporting rapid CPD and standardised working across this model. These guidelines can be provided to CCG teams at request, but are not for dissemination as they are dependent on our supervision model.
700+ supervisors have registered into the service.
Each Professional Coach and Wellbeing Specialist will receive supervision from a qualified supervisor familiar with the approach they will be taking. Supervision will be provided one-to-one and occur no less than once every six-eight weeks. In addition, all professionals volunteering to take part in NHS Wellbeing service will be required to have their own personal supervision and professional liability insurance. Each supervisory session will be isomorphic with the coaching practice and wellbeing interview guidelines, and the supervisor will be expected to model the interviewing approach outlined in the guidelines to provide a template of practice for the practitioner.
Key areas covered in the supervisory sessions will be dealing with high levels of risk and distress in staff, adherence to the practice guidelines, and monitoring outcome of intervention.
Qualified volunteer supervisors will be identified at an early stage in the application process and will be expected to adhere to their profession’s standards, have their own professional liability insurance to be supervisors, and their own supervision of supervision.
Service evaluation and development
The project has allocated two trainee Psychologists under the supervision of the Exeter Clinical Psychology course, to support and accelerate the development of a service evaluation method. This method will be based on rapid learning models common to the delivery team (who already deliver these approaches for Devon CCG in Primary Care). Monthly evidence reviews will be undertaken to analyse feedback from NHS staff and supervision sessions - adapting the model where required to build an intervention that is based on rapidly collected evidence.
All data collected by this project will be confidential, except for booking links shared between staff and wellbeing specialist volunteers. Our data use map will be available on request - being ico registered and GDPR compliant in our methods. This approach is not new to our team - rather replicated at scale for this project.