Introducing telehealth in children's therapy services v1

• Research type

  Research Study

• Full title

  Introducing telehealth in children’s therapy services: learning from Covid-19 innovations to inform future practice

• IRAS ID

  286203

• Contact name

  S Armitage

• Contact email

  samarmitage@nhs.net

• Sponsor organisation

  Sheffield Children's NHS Foundation Trust

• Duration of Study in the UK

  0 years, 8 months, 15 days

• Research summary

  Research Summary:
  Introducing telehealth in children’s therapy services: learning from Covid-19 to inform future practice

  Web-based information and communication technology, for example WhatsApp and Skype, has been used by children’s occupational therapists, physiotherapists and speech and language therapists to continue to provide care during COVID-19. This is called telehealth. There is currently limited evidence about telehealth in children’s therapy services to guide clinical practice and service re-design.

  To generate evidence, this study will:

  1) describe the use of telehealth in children’s therapy services (with whom, for what ends, and in what situations)
  2) identify the consequences of telehealth on therapy services, children and parents
  3) map the role of telehealth in children’s therapy (rationale, process, expected outcomes by families, therapists and service managers).

  A two-part qualitative study will be conducted over 7 months:
  
  Part 1): a) therapists (n=3), service managers (n=1-3), children aged 0-16 years with neurodisability and receiving therapy, and the children's parent (n=3) will be sampled from three NHS Trusts. Online individual interviews will collect data on participants’ experiences of telehealth and consequences to its use. Samples of telehealth therapy interventions (e.g. videos) will be collected. Data will be analysed using framework analysis; b) scoping review of the telehealth literature.

  Part 2) an online Community of Practice with children’s therapists and therapy service managers (n=3-8). Online meetings (n=2-3) will collect data on the wider role of telehealth in children’s therapy services. Data will be analysed using thematic analysis. The Community will feedback and comment on practice guidelines, materials, and recommendations as they develop from interview data (part 1 above) and group meetings.

  The outputs of the study will be a full report about the drivers, facilitators, barriers and expected outcomes to telehealth. The report will include recommendations for practice and research.

  Lay summary of study results:
  Our study provides a detailed description of telehealth in children’s therapy services, as implemented during COVID-19. Contextual factors that support and optimise children’s therapy using telehealth have also been identified, alongside outcomes and impacts of telehealth for children with neurodisability, parents and therapists. During COVID-19, telehealth was a valuable mode of delivering current therapy interventions and huge amounts of time, resources and financial investment supported the transition of care to telehealth delivery. Telehealth promotes children’s self-care not only by being a platform through which therapists can teach, and children can learn, self-care skills such as dressing, eating, using a knife-and fork, and making and expressing their choices, but also supports a broader concept of self-care whereby children can lead and direct their care. Children can also improve physical skills such as posture, strength and balance from telehealth therapy. Telehealth has the potential to support children’s therapy services to move towards addressing wider determinants of children’s health and broader health outcomes, specifically, family empowerment, family leadership, and self-management. However, attitudes and perceptions of telehealth being an inferior service to face-to-face care and only suited to the delivery of specific ‘hands-off’ therapy interventions may limit telehealth in practice and lead to missed opportunities. Developing recommendations for telehealth practice in children’s therapy services, targeted at all key stakeholders, and continuing conversations about telehealth in children’s therapy are important next steps to progress towards high-quality, modernised hybrid therapy services that meet the changing needs and priorities of children with neurodisability and their families.

• REC name

  London - West London & GTAC Research Ethics Committee

• REC reference

  20/PR/0483

• Date of REC Opinion

  21 Oct 2020

• REC opinion

  Further Information Favourable Opinion