title: A national survey of the infrastructure and IT policies required to deliver computerised cognitive behavioural therapy in the English NHS.
abstract: OBJECTIVE
  This study aimed to identify if patients have adequate access to Computerised Cognitive Behavioural Therapy (cCBT) programmes in all mental health trusts across England.
  
  
  METHODS
  The primary researcher contacted a targeted sample of information technology (IT) leads in each mental health trust in England to complete the survey.
  
  
  METHODS
  Telephone, email and postal mail were used to contact an IT lead or nominated expert from each mental health trust.
  
  
  METHODS
  48 of the 56 IT experts from each mental health trust in England responded. The experts who were chosen had sufficient knowledge of the infrastructure, technology, policies and regulations to answer all survey questions.
  
  
  RESULTS
  77% of trusts provided computers for direct patient use, with computers in all except one trust meeting the specifications to access cCBT. However, 24% of trusts acknowledged that the number of computers provided was insufficient to provide a trust-wide service. 71% stated that the bandwidth available was adequate to provide access to cCBT sites, yet for many trusts, internet speed was identified as unpredictable and variable between locations. IT policies in only 56% of the trusts allowed National Health Service (NHS) staff to directly support patients as they complete cCBT courses via emails to the patients' personal email account. Only 37% allowed support via internet video calls, and only 9% allowed support via instant messaging services.
  
  
  CONCLUSIONS
  Patient access to cCBT in English NHS mental health trusts is limited by the inadequate number of computers provided to patients, unpredictable bandwidth speed and inconsistent IT policies, which restrict patients from receiving the support needed to maximise the success of this therapy. English NHS mental health trusts need to alter IT policy and improve resources to reduce the waiting time for psychological resources required for patients seeking this evidence-based therapy.
authors: Institute of Health and Wellbeing, University of Glasgow, Gartnavel Royal Hospital UK, Glasgow,  UK.
authors: Holly
authors: H
authors: Andrewes
authors: David
authors: D
authors: Kenicer
authors: Carrie-Anne
authors: CA
authors: McClay
authors: Christopher
authors: C
authors: Williams
references: BMC Psychiatry. 2011 Aug 12;11:131
references: 21838902
references: Cogn Behav Ther. 2009;38(2):66-82
references: 20183688
references: Psychol Med. 2007 Sep;37(9):1217-28
references: 17306044
references: Cochrane Database Syst Rev. 2005 Oct 19;(4):CD004690
references: 16235374
references: Br J Psychiatry. 2004 Jul;185:46-54
references: 15231555
references: Br J Psychiatry. 2008 Sep;193(3):181-4
references: 18757972
references: Fam Pract. 2011 Oct;28(5):489-504
references: 21555339
references: Expert Rev Pharmacoecon Outcomes Res. 2007 Jun;7(3):291-7
references: 20528315
references: Cochrane Database Syst Rev. 2009 Oct 07;(4):CD000562
references: 19821271
references: Br J Psychiatry. 2005 Jan;186:11-7
references: 15630118
references: Clin Psychol Rev. 2006 Jan;26(1):17-31
references: 16199119
references: BMC Med Inform Decis Mak. 2012 Sep 08;12:102
references: 22958309
references: J Ment Health. 2011 Dec;20(6):593-603
references: 22126636