Overall, the findings suggest that it is possible to train staff from ETCs to deliver effective CBT interventions to peers. The implications of these results are discussed, including suggestions for future research and clinical intervention implementation within this population. The limitations of this research are also addressed.

The Coronavirus (Covid-19) pandemic is exerting unprecedented pressure on NHS Health and Social Care provisions, with frontline staff, such as those of critical care units, encountering vast practical and emotional challenges on a daily basis. Although staff are being supported through organisational provisions, facilitated by those in leadership roles, the emergence of mental health difficulties or the exacerbation of existing ones amongst these members of staff is a cause for concern. Acknowledging this, academics and healthcare professionals alike are calling for psychological support for frontline staff, which not only addresses distress during the initial phases of the outbreak but also over the months, if not years, that follow. Fortunately, mental health services and psychology professional bodies across the United Kingdom have issued guidance to meet these needs. An attempt has been made to translate these sets of guidance into clinical provisions via the recently established Homerton Covid Psychological Support (HCPS) pathway delivered by Talk Changes (Hackney & City IAPT). This article describes the phased, stepped-care and evidence-based approach that has been adopted by the service to support local frontline NHS staff. We wish to share our service design and pathway of care with other Improving Access to Psychological Therapies (IAPT) services who may also seek to support hospital frontline staff within their associated NHS Trusts and in doing so, lay the foundations of a coordinated response. Key learning aims (1) To understand the ways staff can be psychologically and emotionally impacted by working on the frontline of disease outbreaks. (2) To understand the ways in which IAPT services have previously supported populations exposed to crises. (3) To learn ways of delivering psychological support and interventions during a pandemic context based on existing guidance and research.

Background: Following the 2014 Ebola outbreak, South London and Maudsley NHS Foundation Trust (SLAM) were commissioned to provide a "culturally appropriate, effective and sustainable" intervention to address the psychological needs of the Sierra Leonean Ebola Treatment Centre (ETC) staff. Aims:The study evaluated the effectiveness of group Cognitive Behavioural Therapy (CBT) developed to treat anxiety, depression and functional impairment amongst a sample of former ETC staff in Sierra Leone. Group comparisons explored whether the effect of the intervention differed dependent on the facilitators that delivered it, as well as whether it differed between former staff of high-and low-risk ETC roles.Methods: A sample of 253 former ETC staff attended the group CBT intervention comprised of eight sessions over six weeks. Outcome measures were administered upon entry and within two weeks after the intervention.Results: At post-intervention, anxiety, depression and functional impairment significantly reduced.Reading ability (RA) was introduced as a covariate having impacted the outcomes. The intervention effect differed by facilitators delivering the sessions but not by ETC role risk. The implications of these results are discussed.Conclusions: Group CBT is a promising psychological intervention for treating the anxiety, depression and functional impairment of former ETC staff in Sierra Leone. Furthermore, as part of a stepped-care approach, it may provide a model for psychological support for staff that have worked on the frontline during future epidemics.

Mental health support in Sierra Leone is sparse, and qualitative research into the feasibility of implementing psychological interventions is equally underdeveloped. Following the 2014 Ebola virus disease outbreak, South London and Maudsley NHS Trust were commissioned to develop a psychological intervention that UK clinicians could train national staff with minimal psychological experience to deliver to their peers. Following the completion of the stepped care, group-based cognitive–behavioural therapy intervention, qualitative interviews were conducted with the national team to identify key barriers and enablers to implementation of and engagement with this intervention. This article describes the key themes that came out of those interviews, and discusses the implications of these findings for future clinical teams.

ObjectivesResearch registers using Consent for Contact (C4C) can facilitate recruitment into mental health research studies, allowing investigators to contact patients based on clinical records information. We investigated whether such a register was useful for mental health research, seeking the perspectives of patients and research investigators.Setting and designIn 2012, a C4C register was developed in a large secondary mental health provider within the UK; almost 9000 patients have joined. This mixed-method study audited the effectiveness of the register.ParticipantsA ‘mystery shopper’ exercise was conducted, and patients (n=21) were recruited to ask clinicians about the availability of research opportunities. Structured interviews were conducted with patients (n=52) about their experiences of being on the register. Similar interviews were conducted with 18 investigators from 19 studies, who had attempted to use the register to recruit participants.Outcome measuresThe impact of C4C on study recruitment, and whether it helped patients learn about research.ResultsSo far, the register has provided 928 individuals with 1085 research opportunities (in 60% of cases, the individual agreed to participate in the study). Clinicians were willing to link patients to research opportunities, but often lacked information about studies. For patients, the register provided opportunities which they may not otherwise have; 27 of 52 had participated in studies since joining the register (18 participating for the first time). Most investigators used the register to supplement recruitment to their studies, but described problems in prescreening potential participants from a clinical record for complex studies.ConclusionsAlthough the register helped investigators recruit for studies, and provided patients with research opportunities, clinicians' input is still useful for identifying suitable participants. C4C registers should be adapted to provide clinicians with automatically updated information on local studies allowing them to match patients on their caseload with active studies.

Table of contentsS1 Using computerized adaptive testingTim CroudaceS2 Well-being: what is it, how does it compare to health and what are the implications of using it to inform health policyJohn BrazierO1 “Am I going to get better?”—Using PROMs to inform patients about the likely benefit of surgeryNils Gutacker, Andrew StreetO2 Identifying Patient Reported Outcome Measures for an electronic Personal Health RecordDan Robotham, Samantha Waterman, Diana Rose, Safarina Satkunanathan, Til WykesO3 Examining the change process over time qualitatively: transformative learning and response shiftNasrin Nasr, Pamela EnderbyO4 Developing a PROM to evaluate self-management in diabetes (HASMID): giving patients a voiceJill Carlton, Donna Rowen, Jackie Elliott, John Brazier, Katherine Stevens, Hasan Basarir, Alex LabeitO5 Development of the Primary Care Outcomes Questionnaire (PCOQ)Mairead Murphy, Sandra Hollinghurst, Chris SalisburyO6 Developing the PKEX score- a multimodal assessment tool for patients with shoulder problemsDominic Marley, James Wilson, Amy Barrat, Bibhas RoyO7 Applying multiple imputation to multi-item patient reported outcome measures: advantages and disadvantages of imputing at the item, sub-scale or score levelInes Rombach, Órlaith Burke, Crispin Jenkinson, Alastair Gray, Oliver Rivero-AriasO8 Integrating Patient Reported Outcome Measures (PROMs) into routine primary care for patients with multimorbidity: a feasibility studyIan Porter, Jaheeda Gangannagaripalli, Charlotte Bramwell, Jose M. ValderasO9 eRAPID: electronic self-report and management of adverse-events for pelvic radiotherapy (RT) patientsPatricia Holch, Susan Davidson, Jacki Routledge, Ann Henry, Kevin Franks, Alex Gilbert, Kate Absolom & Galina VelikovaO10 Patient reported outcomes (PROMs) based recommendation in clinical guidance for the management of chronic conditions in the United KingdomIan Porter, Jose M.ValderasO11 Cross-sectional and longitudinal parameter shifts in epidemiological data: measurement invariance and response shifts in cohort and survey data describing the UK’s Quality of LifeJan R. BoehnkeO12 Patient-reported outcomes within health technology decision making: current status and implications for future policyAndrew Trigg, Ruth HowellsO13 Can social care needs and well-being be explained by the EQ-5D? Analysis of Health Survey for England datasetJeshika Singh, Subhash Pokhrel, Louise LongworthO14 Where patients and policy meet: exploring individual-level use of the Long-Term Conditions Questionnaire (LTCQ)Caroline Potter, Cheryl Hunter, Laura Kelly, Elizabeth Gibbons, Julian Forder, Angela Coulter, Ray Fitzpatrick, Michele Peters

Objective Postural tachycardia syndrome (PoTS) is a disorder of the autonomic nervous system which involves a range of symptoms, worsened when adopting an orthostatic (upright) position. Symptoms can include tachycardia, dizziness, fainting, nausea as well as many others which, as is typical of a syndrome, vary from person to person. Although research is increasing into this condition, the unifying experiences of managing it on a daily basis have not been extensively investigated. This study aimed to capture participants’ experiences of living with PoTS. Method A longitudinal digital ethnographic approach was employed. Eight participants recorded daily video diaries discussing their experiences of PoTS and its impact for 17 days. Interpretative phenomenological analysis was utilised to analyse the data and identify connections across participants’ accounts. Results Four superordinate themes emerged: ‘loss of control and lack of agency over body’, ‘identity changes’, ‘lack of understanding from others’ and ‘adapting to cope with PoTS’. Discussion The findings demonstrated the complex and widespread impact these participants experience from their PoTS symptoms, including the consequent emotional difficulties that result from managing this condition. An overall lack of understanding about PoTS by others was emphasised, suggesting the requirement for better education and support services for this condition.