Key Findings

Using PAVES and early intervention pathway can avoid referrals to CAMHS and so is likely to be a cost-effective intervention. In a cohort of 100 patients, 78 became eligible for PAVES over 3 years. Twenty-six referrals to CAMHS were avoided, most in the first year of providing PAVES. The additional cost to the NHS of providing PAVES was £718 for every avoided referral to CAMHS.

Uncertainties include:

• the proportion of people in the standard of care (comparator) pathway that would be referred to CAMHS. This affects the circumstances under which PAVES could be both cheaper than current care in addition to avoiding CAMHS referrals
• the longer-term impact of the PAVES pathway, making the level of recurring costs, savings or benefits unclear
• the clinical effectiveness of PAVES in terms of improving patients’ mental health has not been formally quantified in the evaluation. The model can be assumed to be conservative in that is does not capture any expected patient benefits
• whether PAVES is suitable for spread and scale up beyond local paediatric neurology services, to help ease pressure on CAMHS services across other long-term conditions for children.

What were we asked to look at? 

Psychology Adding Value – Epilepsy Screening (PAVES) project for children and young people with epilepsy (CYPwE) who experience mental health issues.

SHTG conducted an economic evaluation - that compares the costs and consequences of early intervention provided with PAVES compared with the standard of care which is an onward referral to CAMHS (for patients screened as being high risk) or no intervention (for patients screened as being at lower risk).

Referred by 

NHS Lothian: Royal Hospital for Children and Young People (RHCYP), Psychologists from Pediatrics Psychology and Liaison Services (PPALS)