One in four children referred to NHS mental health services are turned away because the referral paperwork was wrong. Nearly 500,000 children and young people were referred to CAMHS in 2021/2022 alone, and the number has been climbing since 1999. Services are overwhelmed, and families who wait months for an appointment can be rejected without being told where else to go. This project will develop a national digital referral tool that catches errors before a referral is submitted, flags the right service, and includes features like translation support and text-to-speech to reduce digital exclusion. The team will test the tool in five to eight CAMHS providers with different local setups, then produce a blueprint for rolling it out across England. If successful, the system could cut wasted clinician time spent reviewing invalid referrals, reduce distress for families, and help children get the right support faster. The tool and standards will be co-designed with GPs, schools, young people, and family groups to ensure they work in practice, not just on paper.
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Background Nearly 500,000 children and young people (CYP) were referred to CAMHS in 2021/2022, and this number has risen steadily since 1999. CAMHS providers are overwhelmed by the number of referrals. About one quarter of children referred to CAMHS are rejected for treatment by the service because the correct referral process has not been followed. This is distressing for children and families who may wait a long time for an appointment at CAMHS and are turned away without necessarily being signposted elsewhere. The process is also costly to services because time is wasted reviewing referral documents and following up with referrers about children who should have been referred for alternative help. Aim Our overarching aim is to improve the CAMHS referral process for CYP, their families/carers, as well as for health, education and CAMHS professionals who make referrals so that CYP receive the help they need as quickly as possible. Research Questions 1. Using the findings from our NIHR HS&DR funded ENCAMHS 1 project, can we develop a set of national standards for digital CAMHS referral processes? 2. Can we translate the prioritised features from ENCAMHS 1 of a digitally-led, intelligent CAMHS referral process into a usable, acceptable and widely accessible platform that is nationally standardised, locally adaptable and sustainable? 3. Can we address concerns about digital exclusion and other identified health inequalities through the newly developed CAMHS referral mechanisms? Design and Objectives The project has a set up phase, 4 key work packages (WP), and a write up phase. Key objectives are: 1. To develop national standards for digital referrals into CAMHS that have sufficient flexibility to support the diversity of CAMHS configurations locally and regionally (WP1, Months 3-12) 2. To co-develop with key stakeholders a standards-compliant digital CAMHS referral tool that maximises the use of digital technologies to support inclusion (e.g. translation support, text to speech, culturally-relevant service information and imagery) (WP2, Months 3-12) 3. To implement, test and refine the newly developed standards and digital tool in 5-8 CAMHS providers, with CAMHS sites purposively selected for diverse contextual characteristics (WP3, Months 12-24) 4. To develop a blueprint for implementation of the new referral process at CAMHS (WP3, Months 12-24) 5. To develop a robust sustainability plan so that the platforms developed through the funding remain relevant, usable and useful beyond the lifetime of this grant funding (WP4, Months 6-30) Anticipated impact and dissemination We shall develop a standardised, evaluated and flexible CAMHS referral tool, associated technical standards and an implementation blueprint for CAMHS that can enhance the referral process for diverse CAMHS configurations. All of the outputs will be extensively co-developed with key CAMHS stakeholders, including young people and their families. Our confirmed collaborators, including our key referrers (GPs, schools), YP partners (CAMHS.Digital), parents/families partners (CALM Connections), third sector collaborators (MQ Mental Health; 42nd Street), CAMHS providers, and national/regional strategic leads for CYP mental health will ensure our outputs are shared widely.
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