Shaping virtual reality to fit in NHS mental health care
Summary
A team at Oxford University created a psychological treatment delivered by virtual reality, but needed to know how it could be optimised to fit NHS services and meet the wider needs of patients and staff. Our remit at MindTech was to bridge this gap! Along with the McPin Foundation, we carried out workshops with staff and patients (separately) to identify needs and shape its delivery so that it could feasibly fit. We identified important factors such as which staff would be available (bearing in mind busy workloads), which services would most welcome it, that it needed to be mobile (mirroring those services) and core expectations around accessibility and design to fit the needs of the specific end users it was aimed at.
Workshops to explore context, needs and feasibility
I led the initial design of the study and co-ran the staff workshops with two colleagues (alongside two colleagues from McPin Foundation who ran the patient workshops).
● 10 workshops in total: one with staff and one with patients at each of the five sites (Bristol, Manchester, Newcastle, Nottingham, Oxford)
● Stakeholder feedback meeting to present findings and make final design decisions
● Timescale 2 months, including planning, recruiting and delivery
Iterative workshops were held in the five cities where it was going to be trialled, giving staff and patients a chance to look at VR kits and discuss practicalities, barriers and opportunities in those specific contexts. Workshops were also used to map services at each site, and iteratively identify core challenges and issues, enabling the solving of problems from one workshop to the next.
Workshop participants tried out a demo VR programme and gave feedback, with post-its used to capture core ideas. Group discussions were then held with the whole group, with note takers.
● Findings from each workshop were immediately sent to the design team for consideration, enabling some decisions to be made very early (plus identification of queries, which we used subsequent workshops to answer).
● A final feedback meeting was held where main findings were presented so final decisions could be discussed and made.
● This meant final design decisions were made within 2.5 months of starting, to meet the deadlines of the trial (which would then build and test it)
A treatment that fitted in
We identified core user needs and engaged users in shaping design decisions about how the technology would be used. This meant that alongside what the technology was doing therapeutically, we identified how to make it fit smoothly into its context of use. A key aspect was flexibility of staffing to deliver it, so different sites could adapt it to their resources, a core factor in its success. Findings included:
● Identifying the type and level of staff that would have capacity in their workload and; they were at a more junior staff grade so this dictated the supervision and training needed
● Which services would welcome it and have patients who would be ready to try it (and which services might not have capacity, or patients at an appropriate stage in their journey). This meant patients could easily be referred to try it
● By identifying it would need to be mobile and usable in patients’ homes (and other settings), designers had to plan for smaller-sized venues in the spatial dimensions of the VR world, and it determined what kit would be appropriate
● Common accessibility issues were identified, particularly mobility and vision, but other inclusion issues were also raised (e.g. wearing headscarves), and built into the training
With quick relay of findings to the wider trial team, we relayed key ideas, findings and challenges so they could consider and triangulate with other sources of data. Key strengths in this project were flexibility and communication – we had to remain open to new challenges emerging and solving them iteratively as workshops progressed. Ultimately the technology fitted well into services by aligning with core user needs, and it was demonstrated to be a viable therapy in terms of fitting within in the NHS. The subsequent trial was a success!
To find out more, you can see the industry partner’s website here: www.oxfordvr.co
Or feel free to contact me to discuss our role in the study in more depth!