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Understanding and evaluating new models of Child and Adolescent Mental Health Services in South-East England: a study protocol for an observational mixed-methods study
  1. Stephen Rocks1,
  2. Melissa Stepney2,
  3. Margaret Glogowska2,
  4. Mina Fazel3,
  5. Apostolos Tsiachristas1
  1. 1 Nuffield Department of Population Health, Health Economics Research Centre, University of Oxford, Oxford, UK
  2. 2 Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
  3. 3 Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK
  1. Correspondence to Dr Mina Fazel; mina.fazel{at}


Introduction Increased demand for Child and Adolescent Mental Health Services (CAMHS), alongside concerns that services should be better commissioned to meet the needs of the most vulnerable, has contributed to a requirement to transform services to improve accessibility, quality of care and health outcomes. Following the submission of government-mandated transformation plans for CAMHS, services in England are changing in how, where and by whom they are delivered. This protocol describes the research methods to be applied to understand CAMHS transformations and evaluate the impact on the use of mental health services, patient care, satisfaction, health outcomes and health resource utilisation costs.

Methods and analysis A mixed-methods approach will be taken in an observational retrospective study of CAMHS provided by a large National Health Service (NHS) mental health trust in South-East England (Oxford Health NHS Foundation Trust). Quantitative research will include descriptive analysis of routinely collected data, with difference-in-differences analysis supplemented with propensity score matching performed to assess the impact of CAMHS transformations from 2015 onwards. An economic evaluation will be conducted from a healthcare perspective to provide commissioners with indications of value for money. Qualitative research will include observations of services and interviews with key stakeholders including CAMHS staff, service users and guardians, to help identify mechanisms leading to changes in service delivery, as well as barriers and enabling factors in this phase of transformation.

Ethics and dissemination This project has been registered with NHS Oxford Health Foundation Trust as a service evaluation. Informed consent will be sought from all stakeholders partaking in interviews according to good clinical practice. A local data sharing protocol will govern the transfer of quantitative data. Study findings will be published in professional journals for NHS managers and peer-reviewed scientific journals. They will be discussed in seminars targeting CAMHS providers, managers and commissioners and presented at scientific conferences.

  • mental health
  • health economics
  • change management
  • organisation of health services

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  • Contributors MF and AT conceived the study. SR and AT drafted the manuscript. MF and MS contributed to the manuscript and its refinement. MG helped critically review the manuscript. All authors have read and approved the final version.

  • Funding This research was funded by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care Oxford at Oxford Health NHS Foundation Trust. Additional funding came from the Oxfordshire and Buckinghamshire NHS Clinical Commissioning Groups.

  • Disclaimer The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval Oxford Health NHS Foundation Trust.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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