Driving digital adoption in child mental healthcare

A ‘transactional’ approach to implementing digital health tools is bound to fail, writes Hayley Payne, associate director, children, young people and maternity at NHS Gloucestershire Integrated Care Board

Commissioners agree that technology has a central role to play in how we respond to rising demand for child mental health support.

The good news is that innovation is flourishing: new digital tools are emerging to support young people with everything from anxiety to disordered eating. However, getting this technology into service users’ hands is increasingly challenging.

While technology is advancing rapidly, the system responsible for adopting it is under significant strain. Integrated care boards (ICBs) are navigating structural reform, cost reduction measures, and rising complexity in patient need.

Meanwhile, providers face fragmented procurement processes, multiple commissioning priorities but shrinking funding envelopes of limited duration. The result is a disconnect between promising innovation and practical delivery at scale.

For both sides, it can feel like ‘commission impossible’.

Digital initiatives such as On Your Mind Glos – and our work with organisations like MyHappyMind and BFB Labs – show that it is possible to implement digital initiatives that deliver tangible benefits for clinicians, practitioners and families alike.

In my experience commissioning children and young people’s services across the NHS, there is a common denominator in successful implementations: a strong, transparent and collaborative partnership between the NHS, provider, and local authority stakeholders from the outset.

Below are three core principles that have consistently made these partnerships a success.

1. Have the hard conversations early

Obstacles are to be expected when implementing new technologies in the healthcare system, particularly in complex, cross-service areas such as child mental health. It’s never as simple as parachuting in new technology and expecting immediate results.

Challenges on both sides – including funding constraints, workforce shortages, system change, governance requirements and procurement timelines – can derail even the most promising initiatives.

This means having candid conversations early is critical. It can be tempting to focus on the ambition of a new solution and the positive impact it is going to deliver.

It is harder, but more important, to be explicit about the obstacles that may stand in the way.

It’s never as simple as parachuting in new technology and expecting immediate results

Commissioners should clearly articulate procurement processes, approval timelines and any financial limitations that might affect long-term adoption.

Providers must present a realistic delivery roadmap and be transparent about product maturity, regulatory position and development plans.

Transformation is built on trust, and trust is built on honesty.

2. Share the risk – and reward

Too often, commissioning is treated as a transaction: the NHS holds the purse strings and providers make the pitch. But this dynamic rarely translates into sustainable change.

Digital adoption is a shared endeavour. Both parties enter with the same ambition – better outcomes for young people – and neither side should shoulder the risk alone. Whether it’s the financial risk assumed through funding, or the regulatory and reputational risks tied to service delivery, accountability should be equal.

When all stakeholders have skin in the game, commitment deepens and problems are solved collaboratively

When all stakeholders have skin in the game, commitment deepens and problems are solved collaboratively. Without this, it can be easy for the buck to be passed and for projects to stall.

If there’s no shared risk, it’s rare to see sustained reward.

3. Keep the KPIs flexible 

Clear objectives are always essential. However, in child mental health, rigidity can undermine impact.

Young people’s needs evolve, systems change and service pressures fluctuate. What worked at one time and in one place may not serve a different community in a different operational context in the same way.

Metrics should be collaboratively agreed upfront and flex to reflect the realities of service delivery as well as the ambition.

Successful partnerships build in structured review points to evaluate impact and adapt KPIs in response to the realities services and patients are facing.

We’ve seen this first-hand through our work with child mental health tech innovators and providers at NHS Gloucestershire ICB.

By creating robust evaluation frameworks — including sharing regular professional feedback, monitoring service user data, and working together to implement learnings and drive through change — we’ve been able to effectively adapt solutions in response to evolving needs, ensuring they stay relevant and deliver long-term impact.

4. Overcome obstacles

The NHS is operating in one of the most challenging environments in its history.

Commissioning complexity, financial constraint and workforce pressures are real. But allowing these pressures to get in the way of implementing innovative, evidence-based solutions is a disservice to the young people we serve.

We must move beyond transactional procurement and towards genuine collaboration, sharing risk and giving equal commitment to delivery.

Only by building closer, more mature and longer-term partnerships between innovators and the NHS can we translate promising technology into practical, equitable support for children and young people.

The technology exists and the need is irrefutable. The task now is to commission in a way that makes impact not just possible, but inevitable.