In the UK, approximately 15 million people have one or more long-term, physical health conditions (LTCs). One in three of these people have a comorbid mental health condition. However, integrated mental and physical healthcare that addresses patients’ experiences is not readily accessible. Patients are less likely to engage with treatment that is not tailored to the challenges they face. This has consequences on an individual level (e.g. quality of life and illness management) and on a service/national level (e.g. increased service use and higher healthcare costs).

COMPASS has been developed to address this need. It is an online program that supports people who are living with long-term conditions and who are experiencing low mood/anxiety. COMPASS uses a blended model of care, combining online cognitive-behavioural therapy (CBT) and self-management with therapist support.  

Aim
COMPASS aims to increase access to online CBT for people with long-term conditions; this is the core of a program that patients can access from home. It also aims to improve the effectiveness of online CBT by targeting specific mechanisms linked to low mood and anxiety in long-term condition populations.

The program is designed as a ‘navigational tool’, comprising of 11 modules organised in four areas of the COMPASS; North, South, East and West. Each area contains two or three modules, for example, ‘Managing uncertainty’, ‘Achieving routine’ and ‘Managing symptoms.’

COMPASS is different to other online talking therapy platforms because: 

  • It is tailored to treat low mood and anxiety in the context of living with one or more long-term conditions . 
  • It uses the latest research evidence to identify mechanisms known to trigger and sustain symptoms of low mood and anxiety in people with long-term conditions. These mechanisms are then targeted in the program.
  • It has been co-developed by people with long-term conditions to improve its acceptability, utility and ease of use.   

The wider COMPASS package
The program includes features that maximise efficiency and flexibility for therapists and healthcare services, e.g. case-management functionality. In addition to the online program, we offer training, an implementation support package and COMPASS-specific supervision.

What is the evidence base for COMPASS?
COMPASS was developed using the UK Medical Research Council (MRC) Complex Intervention Development Framework and is based on research of the literature and extensive user involvement. To read more about the evidence-based development process see the ‘About Compass’ page.

How can my service get involved?
If you would be interested in implementing COMPASS in your service, please email Dr. Katrin Hulme or Dr. Joanna Hudson for more information, at compass-ltc@kcl.ac.uk.

The COMPASS program is currently being piloted in seven NHS healthcare services:

  • The Kidney Clinic (Guy’s and St Thomas’)
  • Xeroderma Pigmentosum (Guy’s and St Thomas’)
  • Neurofibromatosis (Guy’s and St Thomas’)
  • Rheumatology (Guy’s and St Thomas’)
  • Oral Medicine (Guy’s and St Thomas’)
  • Gastroenterology (Guy’s and St Thomas’)
  • Talking Therapies Southwark

We will shortly be partnering with some national charities to launch a COMPASS-hub project – updates to come!

It will also be rolled out in further services during the next phase. 

How to refer to COMPASS
If you would like to refer patients to COMPASS at Talking Therapies Southwark, they must be registered with a Southwark GP. You can refer them using the following link, or ask them to refer themselves: https://slam-iapt.nhs.uk/southwark/welcome-to-southwark-psychological-therapies-service/contact-us/making-an-appointment/

Interoperability and compliance
COMPASS is interoperable with IAPTus, the patient management tool used by 70% of National IAPT services.

COMPASS is hosted and maintained by SPIKA Ltd, the software development company who programmed COMPASS. SPIKA meets NHS Digital standards for privacy, confidentiality and security, and is IG Toolkit approved.

Associated reading
https://www.kingsfund.org.uk/publications/long-term-conditions-and-mental-health

https://www.england.nhs.uk/wp-content/uploads/2014/10/5yfv-web.pdf