Abstract

Background: Telehealth is the use of technology to support distanced health care, patient and professional health-related education, public health and administration. It is an approach to health and mental health care that is both patient-centred and has been put forward as a tool for increasing access to care for people who experience difficult accessing face-to-face services. Despite these advantages it should not be considered a panacea for the challenges with accessing and delivering healthcare in rural and remote settings. It is likely that underserved rural communities might require additional support to participate and engage effectively with telehealth.

Aims: To explore staff experiences of Telehealth during the Covid-19 pandemic within the Improving Access to Psychological Therapies (IAPT) service at a mental health NHS trust in a rural UK county.

Methods: An online survey was administered to staff within the IAPT service in Lincolnshire, between April-June 2021. The survey comprised items that asked about participants use of telehealth before and after Covid-19 enforced service changes, their own experiences using telehealth, their perceptions of the level of satisfaction of their clients and any perceived impact on the quality and quantity of service provided.

Outcome: Sixty-two individuals completed the questionnaire (response rate 74%). Both the delivery of telehealth via telephone and online video conferencing had significantly increased since the pandemic (66% vs 98%, p<.001 for telephone and 10% vs 89%, p<0.001 for online video). The majority of respondents (77%) believed that telehealth service delivery required different skills to traditional in-person consultations, however; more than half (58%) reported that they had not received any formal training. None of the respondents indicated preference to return to fully face-to-face and most (86%) preferred to deliver psychological therapies fully or mostly via telehealth. Respondents perceived significant improvement in patient’s attendance rate (68%) when compared to conventional face-to-face offerings. They also identified groups they believed had increased challenge engaging with telehealth services. These included older adults, people with learning and sensory disabilities as well as those who reside in rural and remote areas with poorer mobile/internet connectivity.