Using an AI chatbot to streamline mental health referrals
Mind Matters (Surrey and Borders Partnership NHS Foundation Trust) provides talking therapies to adults registered with GPs in Surrey.
With increasing numbers of referrals and a complex recruitment situation, Mind Matters was faced with a heavy administrative workload - slowing down the referral system for patients and affecting staff wellbeing.
The NHS Long Term Plan has increased the IAPT (Improving Access to Psychological Therapies) accessibility targets by 380,000 people, meaning that by 2023/24, 1.88 million adults must be accessing IAPT services. (NHS Mental Health Implementation Plan 2019/20-2023/24)
A heavy administrative burden of the previous referral system meant less time spent by clinicians on value added tasks during assessments, and a reduced staff and patient experience.
There was a need within the service to:
- Develop a more engaging user experience for the referral process
- Support clinical staff to reduce time spent on admin, allowing them to focus on clinical assessments
- Improve service accessibility
Digitalise the referral process to create a user-friendly system for patients, reduce administrative burden and boost staff capacity and wellbeing.
Solution and impact
Mind Matters Surrey NHS deployed the Limbic Access chatbot that supports e-triage and assessments at the front end of the care pathway, acting as the first point of contact for the patient.
It aims to help reduce the heavy administrative workload, and provide an alternative to traditional longer referral forms that are considered off-putting by patients.
Using conversational AI, the platform aligns with the conversational nature of talk therapy and engages with patients as soon as they visit the service’s website, guiding patients through the referral process. The chatbot can be used 24/7 and patients have the choice of seeing it appear as an embedded chatbot window or on a full screen chat window.
Limbic Access offers the following enhancements to the referral process to benefit patients and staff:
- A self referral tool that guides patients through the referral questions, replacing the longer, static form previously used, therefore offering a smoother transition into the service.
- Collection of routine outcome measures, consistent with the IAPT manual and NICE guidelines.
- The chance to free up clinician time spent on initial data collection.
- The gathering of patient information in a more ‘friendly’ way, omitting unnecessary questions based on information from previous answers, for example the system won’t continue asking smoking related questions to non-smokers.
- Screening of patients, enabling them to be re-directed if necessary to a different, more appropriate service.
- Help in alerting services to high risk patients, who can be prioritised by duty of care teams.
Mind Matters Surrey NHS achieved the following results after the introduction of Limbic Access:
- 98.72% of patients that left feedback said that Limbic was helpful.
- The service has seen a 30% increase in referrals and initial evidence indicates that Limbic improved out of hours access.
- On average, 15 minutes of time has been saved per referral, equivalent to 2000 hours to date.
- On a pro-rata basis, this would equate to a saving of 3000 hours - the equivalent clinical time of 4 psychological wellbeing practitioners.
- Nearly 20% of referrals were identified as ineligible and signposted to a more appropriate service, creating additional capacity for the service.
The referral system:
- Works online (computers or smartphones).
- Is available in multiple languages.
- Is optimised for the visually impared.
- Leads patients through the referral process in a user-friendly manner.
- Integrates with the NHS Spine which contributes to further efficiency savings.
- Screens patients for eligibility, signposting to other services where necessary.
- Provides online assessment questions to be completed by the patient.
- Shares data with the clinician to support subsequent clinical contact.
Scope of capacity
The system can be used in a wide range of referral settings.
Key learning points
- As the first Trust to implement this system, there was a lot of groundwork to be done to refine the questions and user journey. However, this would be expected to be lighter should the system be rolled out to other trusts as the current iteration works well and could be replicated.
- The service reports that it took a little longer than expected for some staff to start using the platform. In hindsight, Limbic and the Trust could have done a little more to train staff on how to use the software early on. As a result, Limbic is engaging an external consultant to create implementation documentation to support clinicians with behaviour change internally.
Paper, email and phone services are offered to ensure that advice can be provided for all patients who need support who may not be able to use or access digital services.
Key figures/ quotes
Adam Ottley-Porter, Psychological Wellbeing Practitioner at Mind Matters:
I complete most assessments in 30 minutes instead of 45 minutes. Limbic means I can focus on how best to support the client without worrying too much about missed information, but can still use the referral to clarify details such as primary presenting problems, medication, risk, etc. It is a richer discussion with the patient around goals and next steps, rather than feeling rushed.
A kind and gentle process. I was anxious about seeking help but it was easier than I thought, thank you.
Being able to seek a referral about something I feel ashamed to admit without having to explain on the phone was helpful
Easy instructions, chat function felt like I was being listened to even though it was AI
The service reports a 30% increase in referrals due to Limbic’s usability and ability to keep patients engaged, meaning the platform is supporting the Trust to deliver against NHS accessibility targets.
Nearly 20% of referrals have been signposted elsewhere, enabling patients to reach the appropriate service sooner.
Find out more
Limbic is the most widely used mental health triage chatbot within the NHS and is available in 17 regions in the UK. It's currently accessible to 9 million people around the UK, and has released over 20,000 clinical hours for IAPT services so far.
Dr Gisela Unsworth, IAPT Clinical Services Manager - IAPT - Mind Matters
Jacqueline Rose, IAPT Clinical Services Manager - Mind Matters
Ross Harper, Co-Founder, Limbic
Syed Abrar, Client Director, Limbic
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Page last updated: October 2022