Transforming the way vulnerable service users, and young people in particular, can access NHS healthcare is the key driver for the Clinical Lead of ChatHealth, Caroline Palmer. Granted the title of Queen’s Nurse in 2015 for her role in delivering innovative in the NHS, Caroline now leads the NHS-based digital development team at Leicestershire Partnership NHS Trust, who are behind the award-winning healthcare messaging platform, ChatHealth.

I began my ChatHealth journey back in 2012 when I was working in School Nursing and was involved in piloting ChatHealth in a school I was supporting at the time. Fast forward to today and I now lead the ChatHealth digital development team and oversee the ongoing product development of ChatHealth alongside our complementary digital healthcare platforms, including age-appropriate health information websites and online health and wellbeing questionnaires. To date, we have nurtured and trained over 2,000 innovative healthcare professionals across the UK to ensure they can safely and securely offer digital platforms to reach vulnerable service users and offer choice in access to services.

ChatHealth’s journey so far

Back in 2012, my colleagues and I recognised that we needed to change the way we interacted with young people. At the same time, NHS England was encouraging services to move towards easier access to online healthcare. Smartphone usage was growing significantly at this time and continues to do so. Nowadays, half of all 10-year-olds in the UK own a smartphone and 94 per cent of children own one by the age of 15, as reported by Ofcom (2020).

After considering several off-the-shelf solutions, we went ahead with developing our own bespoke secure web-based messaging tool to receive and respond to mobile phone messages. As a result ChatHealth was born – offering a safe and secure messaging service that puts patients directly in touch with healthcare professionals.

Students at our local schools in Leicestershire helped to co-design ChatHealth and were the first to benefit from being able to send a message to their school nurse. These young people told us they felt more comfortable and confident talking about sensitive issues via their mobile phone; they talked about ‘hiding behind the screen’ and not feeling ‘judged’. They were more likely to ask for advice than before, particularly as they had the option to ask questions anonymously. We found that more adolescent boys were seeking advice, who have been traditionally less likely to.

Following the successful launch, public healthcare teams from across the country were keen to learn how they could replicate the same successful model to offer safe and secure messaging in their own local areas. Again, fast forward to today and nearly 2 million teenagers now live in areas where ChatHealth is available and also available to the parents and carers of over 1.6 million children and young people, including 111,000 new-borns. In recent feedback (March 2020) collected from service users after having a ChatHealth conversation, over 99% said that it had helped them.

AHSN support

East Midlands AHSN has supported ChatHealth as an innovation project from the very start, enabling it to be set up in other areas and providing funding and mentoring advice to help achieve ongoing and sustainable growth. In 2019, ChatHealth was chosen for the NHS Innovation Accelerator (NIA) following a rigorous, multi-stage selection process. There has been ongoing support and uptake from across the AHSN Network, helping ChatHealth to reach 100% coverage in the East Midlands and Eastern England and wide-spread adoption in the West Midlands and Kent, Surrey and Sussex.

ChatHealth has now been adopted by 50% of school nursing teams who offer confidential and non-judgemental messaging helplines to support 11-19 year olds and trusted help and advice to parents and carers of school-aged children. We are now working more closely with young people’s mental health teams. Many of them are interested in using ChatHealth to offer service users access to professional advice whilst on waiting lists or already using mental health services.

In recent years, the number of health visiting teams setting up messaging services has risen and around 20% of them have launched ChatHealth to support new parents. First-time parents during the early years appreciate the convenience of having immediate access to professional healthcare advice about their babies. To support perinatal mental health, Leicestershire Partnership NHS Trust were the first to set up a ChatHealth messaging helpline to offer expert mental health advice to expectant and new mothers.

We are looking forward to continue working with the AHSN Network to support further national spread and adoption of ChatHealth messaging helplines in public health, young people’s mental health, perinatal mental health as well as adult mental health services.

Digital provision during COVID-19

During the COVID-19 pandemic, ChatHealth has proven to be an extremely useful service for young people and parents alike. As a virtual service, ChatHealth has enabled healthcare professionals to reach vulnerable people dealing with issues exacerbated by COVID-19. Nationally, incoming messages to ChatHealth have increased by 50% and the range of reasons why young people are wanting mental health support has also increased with service users expressing worries or concerns relating to COVID-19. A healthcare professional said, “Resources like ChatHealth are vital for helping to support our young people during this time.” Feedback from a service user was that that the service “has been extremely helpful and has put me at ease”.

ChatHealth services throughout the country are working hard to remind and reassure service users that they are still here to help and can be easily reached via ChatHealth for trusted health advice. Over 85 ChatHealth messaging helplines are available across different areas throughout England and Wales. All ChatHealth services are listed on the website, where mobile phone users can tap on a service and send a text message to ask any health questions.

I am proud of the many innovative healthcare professionals embracing these new ways of working with children, young people and families, to bring healthcare into the digital world of technology and inspiring others to follow.

Enabling service users to access healthcare in ways that are easy and age appropriate encourages them to take ownership of their health, seek support from services in a timely way and engage through their own choice. This increases the likelihood of more positive and long lasting improvements for their health.

Using digital technology within healthcare can sometimes feel scary for professionals and potentially push them out of their comfort zone, however when implemented in a safe way like ChatHealth, it is proven that healthcare professionals engage really well and can see the benefits for their service users.