What’s driving A&E and urgent care use in England?
GOSH's creative problem solving
Advisory Board member Great Ormond Street Hospital for Children (GOSH), a specialist children's hospital in London, has known these facts for some time. However, the hospital's internal demand for psychological consultations can get so high that wait times sometimes prohibited patients and parents from receiving care when they needed it most.
In response, Dr. Isobel Heyman and Professor Roz Shafran sought to provide children already seeking medical care at GOSH with an easily accessible service. With a little ingenuity, they developed the Lucy Booth.
The Lucy Booth is a drop-in centre themed after the Peanuts cartoon character that provides low-intensity, early-intervention services for patients and families concerned about their mental health. It's located in the lobby of the hospital and welcomes both drop-ins and referrals from GOSH clinicians.
The Booth is the product of a research study, funded by Beryl Alexander Trust via Great Ormond Street Children's Charity, and has already helped 100 patients and families to date. It's supported by a team comprised of two full-time staff members (psychological wellbeing practitioners), a PhD student/junior doctor, a 0.2 FTE psychiatrist, administrative support staff, as well as the valued input of volunteers, students, psychologists, and two principle investigators.
What makes the Lucy Booth so successful?
While the project is still being evaluated, there are three key elements that have made the Lucy Booth a noteworthy and—more importantly—sustainable initiative thus far:
- It marries psychiatric and medical care: The Lucy Booth provides services complimentary to GOSH's already existing medical and psychological services. This means that instead of duplicating efforts, the Booth can provide flexible, accessible, and evidence-based interventions that are solely low-intensity.
- It focuses on more than just the patient: Interventions are inclusive of parents and caretakers. While 75% of the participants were patients at the time of evaluation, 19% were parents or carers and 6% were siblings. This approach has a huge impact, considering half of the parents with sick children had anxiety and depression.
- It makes financial sense: Low-intensity interventions are cost-efficient as they require neither specialised clinicians nor significant start-up investment. Moreover, early interventions in mental health avoid the exacerbation of not only psychological disorders, but also of physical conditions that can prolong hospital length of stay.
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