Psychology service model redesign: direct to psychology and stepped care in the multidisciplinary sleep service

This commentary outlines a rationale for Model of Care redesign using implementation science methodology in an example service (Sleep Psychology within a Public Hospital multidisciplinary service) incorporating Stepped Care and "Direct to" Psychology pathways. Sleep disorders are common and costly to society, with insomnia being the most common sleep disorder. We can improve access to Psychological care for this highly prevalent condition within existing resources through strategic service model redesign. In our service, model of care redesign was necessitated by the escalating demand for Psychology services in the context of finite resourcing in our public hospital context (Queensland Health). However, redesign of Psychology models of care is necessary across the public and private sector Nationally, particularly with the ongoing impacts and aftermath of the COVID-19 pandemic. These pressures have necessitated rapid changes in Psychology service delivery, with implementation of systematised models of care, practicing at full scope, delegation to junior staff, and utilisation of time efficient (e.g., group delivery) and technological solutions designed to improve service efficiencies, effectiveness of care, and to maintain or improve patient reported experience and outcomes. Given the evidence-base for direct access and stepped care models, appropriately tailored to the individual service context, it is imperative that we disseminate and share processes and skills for service model redesign with our colleagues across service areas and service delivery contexts. Implementation of similar/comparable service models to improve efficient and effective Psychology service delivery is a matter of priority Nationwide.