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Bridging the Care Gap: Exploring the Stepped Care Model and Digital Interventions in the NHS

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    April 15, 2024

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    NHS, mental health gap, secondary care, stepped care model, waiting lists

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The resources available to fulfil a growing demand for accessible and appropriate mental healthcare are often limited. It is estimated that only one in four people with a mental health condition in the UK receives appropriate treatment. This statistic suggests that the NHS goal of providing talking therapy services to 1.9 million individuals in the current year is only a fraction of the total number of people who require such services.

The Stepped Care Model framework acknowledges that people's mental health needs are becoming increasingly complex, and as a result, it is necessary to provide appropriate treatment at each level of complexity. The Stepped Care Model comprises three steps, each offering a distinct level of intervention, ranging from self-help resources to specialist therapies.

The NHS Talking Therapies is an essential part of the Stepped Care Model, which offers evidence-based psychological therapies to people who suffer from common mental health conditions such as anxiety and depression. These therapies, which include cognitive-behavioral therapy (CBT) provided by trained professionals, have been proven effective in improving mental well-being. According to the National Audit Office, the percentage of people receiving talking therapy over the phone increased from 21% to 60% between 2019 and 2022. 

Challenges in Mental Healthcare Services

Due to the high demand for these services, resources are limited, resulting in lengthy waiting times and restricted access. The mental healthcare system is also  facing numerous challenges, one of which is the scarcity of trained professionals. As of quarter 4 of 2022/23, the whole NHS had 112,497 full-time-equivalent job vacancies, and 23.9% of them (26,837 vacancies) were in the mental health sector. These challenges have resulted in a care gap, leaving many individuals without adequate support. Moreover, the COVID-19 pandemic has exacerbated these issues, with a surge in demand for mental health services and limitations on in-person consultations.

Digital Interventions: Bridging the Gap

The digital transformation of the healthcare industry is happening at a rapid pace. According to a report by NHS Confederation and Google Health, 72% of people across all age groups are willing to use technology to avoid hospital admissions and monitor their health. They are also willing to share information and data with their doctors. By integrating digital tools into the Stepped Care Model, mental healthcare services can increase their capacity and provide timely support to more individuals.

Interestingly, individuals are increasingly preferring digital support as a stepping stone to gaining confidence before opting for traditional talking therapies. Laura Rodger, the lead senior health practitioner for the work and health programme at Ingeus, shared the story of a young woman who was unable to meet a therapist in person due to anxiety but eventually enrolled in a digital program offered by SilverCloud® by Amwell®  and was able to receive prompt, digital treatment.

Since 2015, SilverCloud® by Amwell® has stood as a proud partner of the Midlands Partnership NHS Foundation Trust (MPFT). Together, they have addressed the escalating demands for mental health support, leading to significant clinical and operational advantages. 15,000 accounts were activated over a variety of services including; Talking Therapies, Community Services, Drug & Alcohol Service, Criminal Justice and Dental.

MPFT has seen the impact of SilverCloud programmes by accessing platform data, showing quantifiable improvements and recovery rates. The impact of these programs allows individuals with less complex needs to access lower-level interventions swiftly, therefore alleviating pressure on waiting lists and streamlining the management of more complex cases within the system.

The SilverCloud platform empowers MPFT Psychological Practitioners to enhance their flexibility within their working week, enabling them to support more patients than they could with face-to-face therapy alone. Over 90% of MPFT users report experiencing tangible, positive benefits from the SilverCloud programs.


Agarwal R., Gao G., DesRoches C., Jha A.K. Research commentary—The digital transformation of healthcare: Current status and the road ahead. Inf. Syst. Res. 2010;21:796–809. doi: 10.1287/isre.1100.0327. [CrossRef] [Google Scholar


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