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01.12.2012 | Research article | Ausgabe 1/2012 Open Access

BMC Medical Informatics and Decision Making 1/2012

A national survey of health service infrastructure and policy impacts on access to computerised CBT in Scotland

BMC Medical Informatics and Decision Making > Ausgabe 1/2012
David Kenicer, Carrie-Anne McClay, Christopher Williams
Wichtige Hinweise
David Kenicer, Carrie-Anne McClay contributed equally to this work.

Competing interests

CW is an author of a variety of written and cCBT resources. These are licenced through Five Areas Ltd, a company that delivers free and licensed online life skills resources based on a CBT model in a variety of settings including the NHS in Scotland. CW was involved in the design of the study, but he was not involved in the data collection or analysis. CAM is registered for a PhD with the University of Glasgow and was employed by both the University of Glasgow and Five Areas Ltd during the course of this research. The authors declare that they have no competing interest. CW and CAM have declared competing interests. DW declares that he has no competing interests.

Authors’ contributions

DK designed the study, collected and analysed the data and contributed to the writing of the paper. CW was the primary investigator of the project and made a substantial contribution to the study design and writing of the paper. CM was responsible for the interpretation of the data and had a key role in writing the paper. All authors read and approved the final manuscript.



NICE recommends computerised cognitive behavioural therapy (cCBT) for the treatment of several mental health problems such as anxiety and depression. cCBT may be one way that services can reduce waiting lists and improve capacity and efficiency. However, there is some doubt about the extent to which the National Health Service (NHS) in the UK is embracing this new health technology in practice. This study aimed to investigate Scottish health service infrastructure and policies that promote or impede the implementation of cCBT in the NHS.


A telephone survey of lead IT staff at all health board areas across Scotland to systematically enquire about the ability of local IT infrastructure and IT policies to support delivery of cCBT.


Overall, most of the health boards possess the required software to use cCBT programmes. However, the majority of NHS health boards reported that they lack dedicated computers for patient use, hence access to cCBT at NHS sites is limited. Additionally, local policy in the majority of boards prevent staff from routinely contacting patients via email, skype or instant messenger, making the delivery of short, efficient support sessions difficult.


Conclusions: Overall most of the infrastructure is in place but is not utilised in ways that allow effective delivery. For cCBT to be successfully delivered within a guided support model, as recommended by national guidelines, dedicated patient computers should be provided to allow access to online interventions. Additionally, policy should allow staff to support patients in convenient ways such as via email or live chat. These measures would increase the likelihood of achieving Scottish health service targets to reduce waiting time for psychological therapies to 18 weeks.
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