Pilot implementation of co-designed software for co-production in mental health care planning: a qualitative evaluation of staff perspectives

Abstract

Background: Mental health policies advocate service user participation in care planning. However, service users often feel they’re not fully involved and direct access to users’ own electronic care plans in the community can be an obstacle. To address this, an electronic care pathway tool (CPT) was co-designed by service users, staff and software developers, to facilitate co-production of care and crisis plans.

Aims: To investigate the feasibility and acceptability of the pilot implementation of the CPT in professionals’ practice to co-produce care plans and enable efficient working.

Method: Qualitative interviews with fifteen mental health practitioners, and five service development/management staff. Normalisation process theory, which outlines the social processes involved in implementing technology, and co-production theory, informed interviews and data analysis.

Results: Multiple factors influenced CPT usage, including people’s views of technology, practitioners’ relationships with service users, service users’ mental health needs, and their capacity for reflective thinking. The CPT’s visual and interactive features could enable co-production of care plans. The CPT supported practitioners’ efficiency, but its features did not easily streamline with electronic patient records.

Conclusions: CPT interactive touchpoints supported service users’ therapeutic reflection and facilitated care planning involvement. Information technology system interoperability was an obstacle.

Keywords:

• Co-production
• co-design
• care planning
• care programme approach
• crisis planning
• electronic patient records
• information technology
• normalisation process theory
• mental health services

Acknowledgements

The authors thank the Engagement & Implementation Manager for her co-ordination and communication role within the research. They also thank the service users and carers who were involved in the development of the interview topic guide, and all interviewees who took part in the study.

Disclosure statement

Otsuka Health Solutions (OHS) were paid under contract by Avon and Wiltshire Mental Health Partnership NHS Trust (AWP) to design and develop digital solutions including the Care Pathway Tool described in the publication from April 2015 to December 2016. OHS paid the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC) West a fee for the evaluation project which represented 50% of the costs of the project. OHS own the software referred to in this publication as the 'Care Pathway Tool'.

Ethics approval and consent to participate

The study was reviewed by the NHS Health Research Authority (ID: 199385) and ethically reviewed by the University of Bristol, Faculty of Health Sciences, Research Ethics Committee (Application: 29045). All participants provided recorded verbal consent for their anonymised quotes to be published.

Data availability

The datasets generated during the current study are not publicly available due to the confidential nature of the participant interviews and the data containing information that could compromise research participant privacy/consent.

Additional information

Funding

This study was jointly funded by Otsuka Health Solutions and the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West) at University Hospitals Bristol NHS Foundation Trust and conducted in collaboration with Avon and Wiltshire Mental Health Partnership NHS Trust. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR and the Department of Health and Social Care.