Jonathon Burton, web and digital services manager at Berkshire Healthcare NHS Foundation Trust, talks about the trust’s Support Hope and Recovery Online Network (SHaRON), initially designed for people with eating disorders.
Mental health issues are 24/7, 365 days a year, but unless you are acutely ill in hospital, support services tend to be 9 to 5 with crisis services providing out-of-hours care. In 2009, mental health services for eating disorders weren’t as readily available as they are today and there was less in the way of support from professionals or peers. One of our clinicians at Berkshire Healthcare was frustrated that eating disorders services tended to finish at 5pm and nothing was available over the weekend. This led us to design and create our own Support Hope and Recovery Online Network (SHaRON),1 a social networking e-health system, initially created for people with eating disorders but now being rolled out to support other mental health services.
Carelink2 provided the infrastructure with the highest level of security and privacy of data and SHaRON became the first of its kind, providing an always available 24/7 solution, connecting individuals to each other and to their care providers.
The online therapeutic and social networking platform, similar to Facebook but with very high levels of security, is easy to use for individuals with eating disorders and their clinicians.
Building blocks to recovery
From a user perspective, the Support Hope and Recovery Online Network is like a building. You need a key to get in, and once you’re in that building, your key will let you into specific rooms. As a clinician or moderator, you have access to every room. As a patient, you have access to the rooms or information directly related to your illness. For example, it would not be appropriate to have those with anorexia in the same room as those with bulimia, so they are in separate rooms.
Within the building, there is a ‘living room’ where patients can talk in real time to others undergoing treatment and those who have recovered. They will also find a ‘library’ where they can view relevant accredited documentation about their illness and a ‘television’ where they can view video content on self-support and home therapies.
The Support Hope and Recovery Online Network is invaluable in providing support to its users who might struggle in the evenings, during the night and at weekends, and relieves the pressure on crisis mental healthcare services. Digital support also helps avoid appointment cancellations and helps patients who live more remotely in rural communities or who are reliant on public transport to stay connected.
Safe networking environment
Mental health can cause both physical and perceived social isolation as many people don’t want to go out and engage with anybody. With SHaRON we are creating a safe networking environment for our users; they can access it when they want to, in addition to attending appointments.
Our service users are anonymous to each other, with their own nicknames, so they don’t feel judged about anything they might say to anyone else. This is so much easier for mental health patients than face-to-face networking, which involves all the social skills they might really struggle with. Even if they haven’t been able to get out of bed and wash their hair or have a shower, they can still access the support they need with a digital service.
Security providing peace of mind
The SHaRON application is provided and supported by Carelink. It’s a robust, mission-critical, secure platform, holding hugely sensitive data related to its patients and clinicians. Carelink manages the platform on its in-house cloud platform which includes connectivity to the internet and the recently launched Health and Social Care Network (HSCN), which replaces the N3 network.
We think of the infrastructure as being like our bank vault. The high level of security required for SHaRON is implemented in various layers and backups are performed daily, the data is deduplicated, encrypted, compressed and stored in a secure offsite location.
In a recent survey we carried out, over 80% of SHaRON users agree that it has been helpful in their recovery.
We’ve widened the e-health system over the past seven years to support talking therapies, perinatal and child mental health services. As of June 2018, the service was supporting more than 2,500 members.
The Support Hope and Recovery Online Network also alleviates the pressure on mental health staffing; they can now be online and responsive to clients whilst completing other administrative work. We’ve also empowered peer moderators, recovered service users, who are trained and supervised to work for us at no extra cost. This also has huge benefits to their own ongoing recovery.
Digital driving innovation
Some NHS organisations are so busy doing their day jobs, they just don’t have the time or capacity to think about digital adoption. Building a system from scratch might not be right for everybody, but having the breathing space to innovate and to find the right digital solution is key.
People often think that it will cost thousands to move towards digital, but a lot of digital solutions are low cost, yet have the potential to transform trusts. Unless the NHS gives people the ability to take time out from delivering to allow time for rethinking services then innovation will stagnate.
SHaRON started with a clinician who noticed limitations to patient services. Clinicians need people within the NHS that they can approach that are willing to take a risk and give a new idea a go – that is how you will transform services. The NHS needs transformation and digital is one way to make that happen quickly.
Web and Digital Services Manager
Berkshire Healthcare NHS Foundation Trust
This article will appear in issue 6 of Health Europa Quarterly, which will be published in August.