Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Nuffield Department of Population Health, University of Oxford, Oxford, UK.
J Health Organ Manag. 2022 Feb 1;36(9):66-78. doi: 10.1108/JHOM-06-2021-0205.
As part of an evaluation of the nationally mandated Child and Adolescent Mental Health Services (CAMHS) "transformation" in one foundation NHS trust, the authors explored the experiences of mental health staff involved in the transformation.
DESIGN/METHODOLOGY/APPROACH: The authors employed a qualitative methodology and followed an ethnographic approach. This included observation of mental health staff involved in the transformation and informal interviews (80 h). The authors also undertook semi-structured interviews with key staff members ( = 16). Data were analysed thematically.
The findings fall into three thematic areas around the transformation, namely (1) rationale; (2) implementation; and (3) maintenance. Staff members were supportive of the rationale for the changes, but implementation was affected by perceived poor communication, resulting in experiences of unpreparedness and de-stabilisation. Staff members lacked time to set up the necessary processes, meaning that changes were not always implemented smoothly. Recruiting and retaining the right staff, a consistent challenge throughout the transformation, was crucial for maintaining the service changes.
ORIGINALITY/VALUE: There is little published on the perceptions and experiences of mental health workforces around the CAMHS transformations across the UK. This paper presents the perceptions of mental health staff, whose organisation underwent significant "transformational" change. Staff demonstrated considerable resilience in the change process, but better recognition of their needs might have improved retention and satisfaction. Time for planning and training would enable staff members to better develop the processes and resources necessary in the context of significant service change. Developing ways for services to compare changes they are implementing and sharing good practice around implementation with each other are also vital.
作为对全国强制性儿童和青少年心理健康服务 (CAMHS)“转型”在一个基础 NHS 信托基金中的评估的一部分，作者探讨了参与转型的心理健康工作人员的经验。
设计/方法/方法：作者采用了定性方法，并遵循了民族志方法。这包括观察参与转型的心理健康工作人员和非正式访谈（80 小时）。作者还对关键工作人员进行了半结构化访谈（= 16）。数据进行了主题分析。
研究结果分为三个主题领域，即（1）基本原理；（2）实施；（3）维护。工作人员对变革的基本原理表示支持，但实施受到沟通不畅的影响，导致准备不足和不稳定的体验。工作人员缺乏时间来建立必要的流程，这意味着变革并非总是顺利实施。在整个转型过程中，招募和留住合适的员工一直是一个挑战，对于维持服务变革至关重要。
原创性/价值：关于英国各地 CAMHS 转型过程中心理健康工作者的看法和经验，发表的内容很少。本文介绍了心理健康工作人员的看法，他们所在的组织经历了重大的“转型”变革。工作人员在变革过程中表现出了相当的适应力，但更好地认识到他们的需求可能会提高留用率和满意度。有时间进行规划和培训将使工作人员能够更好地发展在重大服务变革背景下所需的流程和资源。开发服务比较他们正在实施的变革的方法，并相互分享实施方面的良好做法也至关重要。
