Improving cognition and reducing mental health waiting lists

COVID-19 saw a significant rise in the number of people struggling with their mental health. According to the ONS, one in five adults experienced some form of depression in comparison to one in ten pre-pandemic, with many older adults experiencing a rapid decline in their cognitive functioning. During this time, the NHS has continued to be under immense pressure, with nurses firefighting on the front line to meet increased demand and a backlog of referrals.

We’re incredibly lucky to have a national health service, but the system isn’t designed to cope with an ageing society and pressures placed on it by a pandemic. The NHS Long Term Plan and Older Adults Community Mental Health Framework emphasises the importance of the voluntary, community and social enterprise (VCSE) sector in improving health outcomes and tackling inequalities. Like the NHS, we’re keen to ensure services are co-designed with patient experience in mind that provide positive health outcomes and value for money.

Lack of support between referral and appointment

…the gap between referral and appointment leads to further cognitive decline.

Before COVID-19, patients who presented with a memory complaint would be seen on multiple occasions by their GP before being referred for a memory assessment. This referral can sometimes take up to two years, and some patients can then wait a further 18 months for an appointment. During this waiting time, the gap between referral and appointment leads to further cognitive decline.

Before we launched Unforgettable Experiences, there were no services available that GPs could refer patients to, for support that would help them to maintain cognitive functioning. I have witnessed first-hand with my grandmother, the challenges of caring for someone with increasing cognitive decline. It’s heartbreaking and I was determined work in partnership with the NHS to find a solution.

Forward-thinking clinicians at Tees, Esk and Wear Valley NHS Foundation Trust were instrumental in supporting us with this ambition. They helped us to understand need, demands and gaps in service delivery that would help to achieve greater patient outcomes.

Clinicians told us they were finding it difficult to engage with patients digitally during the pandemic.

They shared with us their experiences and ideas of how we could help their patients and them in their day-to-day roles as they responded to the immediate crisis and transitioned to a new digital way of working

Clinicians told us they were finding it difficult to engage with patients digitally during the pandemic. Many patients were trying to access face-to-face services but weren’t confident with technology, lacked access to equipment and needed support.

Nurses explained that their workload meant they struggled to speak to every patient on their case load as often as they would like. All were keen to ensure referral processes were simple, to save time.

Bridging the gap

The online pilot was a success and a clear example of how the NHS can work with the VCSE sector to create innovative, scalable solutions that make a real difference to patient outcomes and deliver cost efficiencies.

With the NHS’s support, we designed a service to provide older adults experiencing memory complaints or cognitive impairments with a bespoke programme of live, creative, and interactive therapeutic activities online in a variety of artistic disciplines. The service was modelled using principles of arts therapies and cognitive stimulation therapy and provided digital support to older adults so they could participate engage online.

As a result of our collaboration with Tees, Esk and Wear Valley NHS Foundation Trust, the pilot received over 134 referrals and supported 71 older adults to achieve 20 per cent improvement in quality of life (QOL-AD). Patients that were referred to us did not require as much time from nurses, giving them greater capacity to see other patients. The online pilot was a success and a clear example of how the NHS can work with the VCSE sector to create innovative, scalable solutions that make a real difference to patient outcomes and deliver cost efficiencies.

I’ve had the pleasure of working with some exceptionally innovative clinicians who understand the value and the role that the VCSE can play in delivering additional support to extend capacity within the system and ensure that our patients receive the care they are entitled to and deserve.

The desire and willingness to collaborate with the VCSE is there. The VCSE is increasingly being invited to decision-making tables with health commissioners to co-design pathways, but more investment is required to sustain services, best practice and support data sharing to facilitate stronger collaboration.

Victoria Burnip is chief executive of social enterprise Unforgettable Experiences. You can follow Victoria on Twitter @victoriaburnip