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£1.3m research grant awarded for three year study to evaluate effectiveness of digital weight management

Published and last updated by Michael Mbanunu

A three-year study to determine how well a digital weight management tool helps people with obesity in south east London lose weight has won a £1.3m grant from the National Institute for Health and Care Research (NIHR).

The funding is via the NIHR Invention for Innovation (i4i) Programme, which is aimed at medical devices, in vitro diagnostic devices and digital health technologies addressing an existing or emerging health or social care need.

The Health Innovation Network (HIN) South London, Guy’s and St Thomas’ NHS Foundation Trust and King’s College London (KCL) have been awarded the grant to undertake a three-year study to determine the clinical and cost-effectiveness and implementation of a digitally enabled tier 3 weight management platform Roczen in south east London. The project will start in November 2024. HIN SL and KCL will be the analytical partners jointly leading the study working alongside clinical staff in Guy’s and St Thomas’ Centre for Obesity and Roczen. The study will be supported by three lived experience partners, who will be embedded in the study team.

Andrew Walker, Head of Insights at the HIN SL said: “Obesity is a major issue for our local community in south London. We are very excited to test if digital innovation can help address this and see if our work could potentially be scaled up to help people with obesity across the country.”

Dr Laura Falvey, Executive Clinical Director for Reset Health & Roczen, said: “This groundbreaking study puts Roczen and our partners at the forefront of exploring the future of obesity care in the UK. With a focus on the patient experience, we aim to answer key questions about how the NHS can improve and sustain weight management services through tech-enabled clinical care. Over the next three years, we’re excited to set a high standard for what’s possible in improving the lives of people living with obesity.”

Professor Emma Duncan, from King’s College London, said: “Our study exemplifies translational research as we take novel digital innovations into the clinical space. We hope this project will show that proven interventions can be delivered virtually to help people living with obesity, whoever they are, wherever they are and whenever they want, cost-effectively and sustainably. This grant also highlights what we can achieve when we work as a team: individuals with lived experience, academics, clinicians, digital experts, and health economists – a true partnership to deliver better health care.”

Professor Mike Lewis, NIHR’s Scientific Director for Innovation, said: “The UK is a hotbed of innovation but the NHS sometimes misses out on the opportunity to adopt new digital technologies at scale. This competition gives seven organisations the chance to gather the real-world evidence to show impact and support their adoption at scale."

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’Considering what?’ Lessons from the Paralympics on the power of the Social Model of Disability

Published by Michael Mbanunu

Our understanding of disability has changed significantly in the past few decades. Nowadays, people tend to avoid concentrating on a person's condition or disability and instead focus on challenging societal attitudes and creating inclusive environments. However, this wasn't always the case.  

A key driver of this change has been the involvement of people with lived experiences in shaping policies and practices related to disability or illness—something we’ve championed in our organisation through our Involvement Strategy. This blog, written by HIN Lived Experience Partner Aurora Todisco, explores the development of the Social Model of Disability, how attitudes toward disabilities continue to evolve, and how its principles helped shape Channel 4's recent Paralympics campaign. 

The medical model was once the standard approach for framing disability, defining people with disabilities primarily by their medical conditions. Instead of addressing their needs, this model focused on 'fixing' individuals rather than addressing societal barriers.  

This approach often portrayed people with disabilities as 'having something wrong' with them needing to be fixed to function in a 'normal' society. Such views created negative perceptions and deepened insecurity for disabled people, heightening the challenges they faced for many years.  

 Today, we are working to redefine disability by emphasising the external circumstances that contribute to it, rather than viewing it as a personal shortcoming or asking, 'What's wrong with them?'. While there's much more progress to be made, we’re at least raising the necessary questions: How did we get to a place where change is commencing? And where do we go next? 

Transitioning to the Social Model of Disability 

The Social Model of Disability, shaped by academics, those with firsthand experiences, and the disability rights movement, has redefined the outdated views of disability stated earlier. This model shifts the focus from the impairment itself to the societal barriers, inaccessible environments, and prejudiced attitudes that truly disable people. It highlights the need for inclusive settings that provide equal opportunities for all, regardless of impairment. 

In developing the social model, persons with disabilities played a crucial role. By including those directly affected, we’ve gained a clearer understanding of the challenges they face. In shaping policies and practices, we have fostered a deeper understanding of the challenges faced and developed a more accurate perspective on disability.  

Since we launched our Involvement Strategy in 2022, we’ve had the privilege of working closely with two Lived Experience Partners who have supported our co-production and engagement work. Their involvement ensures that policies genuinely reflect the general needs of patients rather than just their condition, promoting true inclusivity. This approach emphasises the importance of creating environments where everyone, regardless of disability or illness, has equal access and opportunity.

The Paralympics and Challenging Perceptions 

These principles are still persistent today, recently showcased in Channel 4’s ‘Considering What?’ campaign during the Paralympics. Channel 4 recently released the film project ‘Considering What?’ by 4Creative, timed with the launch of the Paralympic Games in Paris. Research revealed that viewers watch the Paralympic Games to see athletes 'overcome their disabilities'. By confronting this perception, the ad encourages viewers to question their subconscious biases and recognise athletes for their abilities. 

This approach resonates with what the Social Model of Disability stands for—challenging societal attitudes towards disabilities rather than 'curing' or 'overcoming' them. Notably, this is the first Channel 4 Paralympics ad to avoid the term 'superhumans’ and was developed with direct input from people with disabilities and their communities, emphasising inclusivity and authenticity. It challenges viewers' perceptions, prompting them to reconsider any unknowing biases they may hold. 

Where next? 

As society steadily embraces this refined understanding of disabilities, we move closer to a world where disabled people are recognised as equal and where we celebrate differences in all aspects of life. Channel 4’s campaign represents a highly visible step in the right direction, reflecting the legacy of the Social Model of Disability. It addresses the challenges people face in understanding disability, encouraging a shift away from focusing on the disability itself and instead on combating negative stereotypes and biases. 

Just as the Paralympics challenge societal views on disability, we in healthcare must continuously evolve our understanding to ensure that our systems and attitudes enable everyone to thrive. This can be achieved through inclusive training for healthcare providers and implementing ongoing education programmes centred on disability awareness. Additionally, we must continue to challenge stigma and invest in research and development to leverage assistive technologies and digital health solutions, improving healthcare access and outcomes for people with disabilities. 

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Mindset XR: Introducing Round 2 Companies for the Programme

Published and last updated by Michael Mbanunu

The Health Innovation Network (HIN) South London and UKRI recently announced a multi-year innovator support programme focused on immersive therapeutics for mental health. We are excited to introduce the second round of companies joining the Mindset-XR Innovation Support Programme. These projects will receive our support as part of this initiative.

Below you can find out more about the companies we're supporting for this round:

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Mindset XR: Introducing Round 1 Companies for the Programme

Published and last updated by Michael Mbanunu

The Health Innovation Network (HIN) South London and UKRI recently announced a multi-year innovator support programme focused on immersive therapeutics for mental health. As part of this initiative, we're supporting 29 projects that are seeking to revolutionise mental health care in the UK through immersive digital mental health therapeutic innovations.

These companies are part of the first strand of the programme. Additionally, you can learn about the companies we're supporting in the second strand. Below you can find out more about the companies we're supporting for this round:

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Reflections on Lord Darzi’s Report and the Role of Technology in Healthcare Transformation

Published by Michael Mbanunu

Lord Darzi’s report into the State of the NHS in England (published 12th Sept) outlines the current parlous state of NHS services, and deterioration over the previous decade and proposes several areas of focus. It has garnered headlines around the need for reform, with the Secretary of State already responding saying three key shifts are needed: a move from hospital to community care; from analogue to digital; and from treating sickness to preventing it. What hasn’t been focused on is the many mentions of innovation and opportunities to use technology to improve care spread throughout the report. Here HIN South London CEO Dr Rishi Das-Gupta outlines why the report supports our work in health innovation because of the difference it makes to patients.

For anyone who works in the health service, or has loved ones who do and/or cared for by the service, I do not think the content of Lord Darzi’s report provided any massive surprises. However, it is sobering to see the progressive decline across a variety of performance and quality metrics presented in one document. Particularly, worrying is that these declines have impacted those from disadvantaged socioeconomic backgrounds and ethnic minorities more than others. This raises choices about how we design services accessible for all and whether we provide or target services to narrow this gap.

For me the key is the ‘what next’ and while it is no doubt upsetting to see where the NHS is, I was find a reason for hope and optimism from our experience supporting innovation and tech-driven service change in the NHS. Innovation to address these challenges is possible, and indeed can be fulfilling for staff and patients alike.

The report emphasizes the role of innovation in improving the sustainability and performance of the NHS, highlighting four key areas.

Medium-Term Sustainability

Lord Darzi’s report argues that, despite short-term pressures like long waiting lists and tight finances, innovation is essential for the NHS’s long-term sustainability. It recognizes that while research and innovation are universally seen as important, they have often been deprioritised. Investing in innovative solutions, however, can help the NHS become more sustainable in the medium term. We have a proven track record of helping innovations that can make a difference – our award-winning DigitalHealth.London Accelerator has supported 160 companies to date and one cohort resulted in 181 contracts secured. We also run programmes helping NHS innovators, as well as founders from diverse backgrounds, and areas which need more focus; this is why we are running the second cohort of the national Accelerating FemTech programme, aimed at solutions for women’s health, and the national Mindset programme which is looking at how immersive technology can address mental health and wellbeing.


Virtual Wards and Digital Models

Examples of positive innovation already visible are mentioned in the report including general practice, where some GPs have shifted towards a digital care model and in some innovations such as virtual wards. We have supported London’s virtual wards with procurement specifications, pathway mapping and evaluations. Four key areas of benefit identified from our work for NHSE London and London ICBS on virtual wards:

  • Improved patient experience and satisfaction;
  • Staff benefits including releasing time for more personalised care;
  • Clinical benefits such as reduced infection risk and deconditioning;
  • System benefits including reduced avoidable non-elective admissions and re-admissions.

In primary care, the pan-London Primary Care AI and Automation Grants Scheme we ran found approximately 18,000 online new patient GP registrations were validated and automatically uploaded while approx. 20,000 ‘normal’ pathology results were automatically reviewed and filed.

Innovations such as these have the potential to improve access to care, reduce hospital pressures, and offer alternative ways to manage patients outside of traditional hospital settings.

Technology and AI

The report identifies that technology, particularly artificial intelligence (AI) and digital systems, holds great promise for transforming healthcare delivery. However, the NHS has not yet fully embraced technology’s potential. While there are examples of impactful innovations, many remain small-scale. The report calls for a significant "tilt towards technology" to unlock productivity, reduce administrative burdens, and enable predictive and preventive care. We are already working in AI, having spotted its potential which was why we brought 22 experts together for our roundtable on Ambient Voice Technology which has led to a London-wide pilot taking place now, looking at the productivity benefits it could bring to staff.

The remaining challenge to use data to improve care

Although the NHS has invested in data platforms like the Federated Data Platform and developed apps to improve care, the report points out that much of the NHS’s potential for innovation remains untapped, particularly in areas like data-sharing and AI. There is also a noted gap in IT investments for non-hospital services, which could benefit from technologies to enhance care quality and efficiency. London has engaged the public to establish the best mechanism to share data across our health system and the uses to which we each consent to data sharing. Alongside this, we have the OneLondon programme which, when complete, will position us as a leader in data-driven care. Completing this work and sharing what we learn while doing it should be an ongoing priority.

In summary, while the NHS is making strides in digital transformation, much more can be done to fully realize the potential of innovation to make the service sustainable and efficient in the long run. ‘Fixing’ the service and being able to provide better care to patients can be really satisfying for staff and will help address many of the issues highlighted. We have an established track record in supporting our ICSs, GPs, hospitals, care homes and community providers to introduce, test and spread adoptions. This includes national programmes which we have spread and adapted across south London, such as the national hypertension and lipids programme which has prevented 350 heart attacks and 282 strokes in south London alone, to south London innovations which we have supported to spread nationally such the FREED early intervention eating disorder programme which concluded with 2,722 patients receiving treatment, with £12.1m NHS cost savings.

Innovation is the way to move the NHS forward. Lord Darzi’s report has clearly spelt out why doing the same things in the same ways is no longer an option for our NHS. Innovation is the vehicle for transforming it, and our expertise can help drive this.

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Reflections on Experience-Based Co-Design (EBCD) at the HIN

Published by Michael Mbanunu

Involvement is at the heart of the HIN’s work, enabling us to innovate and improve through the valuable insights of those with lived experience in health and social care.

Recently, we embraced the Experience-Based Co-Design (EBCD) methodology, developed by the Point of Care Foundation. This approach places co-design at the centre of service development, ensuring all perspectives are included. To date, two EBCD projects have been completed here at the HIN, supported by our Involvement team. Through these projects we have gained a wealth of knowledge and valuable insights, and we are eager to share our reflections to provide guidance and support to others on their own journeys

What is involved?

Experience-based co-design (EBCD) is a multi-step process involving deep engagement with both patients and staff to improve how we provide care. Here’s how it unfolds:

  • Gathering Experiences: We conduct in-depth interviews with patients and staff to collect rich, emotional insights.
  • Feedback Events: Separate and joint sessions for patients and staff to view the impact film and discuss findings.
  • Co-Design Workshops: Collaborative sessions to devise and prioritise how we improve services and the care provided to patients.
  • Celebration Events: A final gathering to reflect on achievements and share outcomes

How have we used the EBCD approach?

Our first project was facilitated by the Patient Safety and Experience team aiming to improve the experience of people living with chronic pain by leveraging existing service improvement in south London. This was in response to the nationally commissioned Medicines Safety Improvement Programme (MedSIP), and findings that living with chronic pain can leave people feeling alone, isolated, and not being aware of how to access support that does not come in the form of pain medicines e.g. opioids.

More recently, the HIN Long-Term Conditions team completed an EBCD project commissioned by King’s Health Partners focusing on improving access to mental health and wellbeing support for patients with long-term conditions. This project specifically focused on patients who were eligible to attend pulmonary rehabilitation, which is an exercise and education programme designed for people with lung disease or respiratory conditions, who experience symptoms of breathlessness.

What did we learn from the process?

From our projects, we found that the EBCD methodology can provide rich insights into the experience of patients and staff. Through the in-depth interviews and group discussions, we were able build understanding and mutual respect between participants, gather their honest reflections and emotions, and use this to identify opportunities for improvement.

We found that in both cases, being a participant in itself had significant benefits for patients, as they developed connections with the HIN team and other participants, evoking feelings of belonging to a team and working together to make positive change. Feedback forms were collected after the process to capture these views.

Some of our patients and staff who took part in our project said:

‘I enjoyed participating as it makes me feel like I am helping to make a difference for the better.’ Patient
‘I felt like part of a thought engine. The fuel of what we were to think about was put in, and as a team we all helped push it forwards.’ Patient

Positive feedback from staff was also collected, which highlighted the value of hearing patient voices, understanding their experiences, and working with them to make something meaningful. Staff also viewed the experience as a growth opportunity, having not experienced EBCD methodology before.

‘It was a good opportunity to hear service users' voices. I took it as an opportunity to reflect on why we do what we do and whether this truly reflects what our service users want and need.’ Staff
‘Personally, experiencing the process of experience-based co-design was good for my personal development.’Staff

Whilst the Point of Care Foundation recommends a clear structure and timeline, the methodology is adaptable and can be tailored to different situations. Both HIN projects followed a shortened timeline and therefore omitted some elements, and held all events online.

Completing the project entirely online can work very well as we have demonstrated, providing flexibility to participants, and enabling attendance from those who may not be able to travel due to busy schedules, their health condition, or other reasons. However it does require a different approach and it was noted that, if possible, it would have been advantageous to hold certain events in person such as the joint patient and staff feedback event, or the celebration event to close the project to help further build relationships. We also learnt some tips around online facilitation, making sure that each breakout room has a facilitator and using a round-robin technique to offer all participants an equal opportunity to comment. We gathered feedback after each event, allowing us to adapt our approach as we went.

What are some of the challenges of EBCD and how did we address them?

One of the greatest challenges in a smaller timeframe is likely to be recruitment, and ensuring a diverse cohort is assembled. We recommend trying to establish links with clinicians before starting recruitment, as having these existing contacts will help make this stage more efficient. It is also a good idea to give staff and patients flexibility when it comes to scheduling interviews and workshops so they can plan ahead, and always allow alternative methods of feedback if a participant cannot attend an event (i.e. via email or phone call).

An adaptation suggested by the Point of Care Foundation is using a pre-made video instead of developing your own impact film due to the time and resource requirement associated with this part of the process. However, in both projects, we found the video stage to be incredibly valuable in terms of building trust and relationships with patients. Having an in-house communications team who could support the editing and video production also greatly supported this process. We found the end result to be a very powerful resource and we therefore believe the impact film is important to incorporate wherever possible.

Undertaking an EBCD project requires dedicated resources and time to deliver well, and this should not be underestimated when planning a project. There is however no doubt that the end result will be worth it, as these two projects have demonstrated. As we continue to build expertise in this area, we hope EBCD projects become a more significant part of our HIN offer, and that more HIN teams will consider using this worthwhile and rewarding approach to involving people in their improvement projects.

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Automation in primary care: how technology is helping the workforce

Published by Michael Mbanunu

The growing elective backlog and day-to-day pressures are overwhelming administrative workers, leading to low staff morale and high turnovers. This blog discusses how automation is alleviating some of these pressures by handling low-risk tasks, allowing administrators to focus on more complex duties, and ultimately enhancing both staff and patient satisfaction.

The health and social care workforce remains under enormous pressure, with the long-term challenge of reducing the elective backlog alongside busy day-to-day operations placing strain on almost every part of the system.

Inevitably, these pressures have taken their toll on many staff. The rate of nurses leaving the profession has spiked since the pandemic, and up to a third of UK-based doctors report that they would consider going abroad to practice in the near future.

In primary care, the impact of these challenges on administrative staff is often overlooked. Administrative staff make up more than half of the primary care workforce; without their work organising appointments, registering new patients and acting as the link between clinical staff and the public, the NHS’s “front door” would quickly slam shut.

The same issues affecting other staff groups also apply to administrators, practice managers and reception staff working in primary care – and the resulting low morale and high staff turnover rates pose a real risk to the operations of GP surgeries and Primary Care Networks across the country.

So – how can innovation help?

Automation in primary care

Many of the tasks administrative staff currently need to complete are highly repetitive, often involving transcribing data from forms into IT systems, or from one system to another.

This makes some low-risk tasks (such as rostering of staff) ideal use cases for automation – freeing up administrators to work on more complex tasks while also improving accuracy, speeding up processes, and boosting staff and patient satisfaction.

Last year, the Health Innovation Network South London and the NHS England (London) Digital First team partnered for an Automation Grants programme, trialling automation and AI-based innovations in primary care. The results of these local pilots showed the potential of automation – with more than 18,000 automated patient registrations recorded, 20,000 pathology results reviewed and filed, and many other positive outcomes.

In-depth: Healthtech-1

One of the innovations successfully tested during the Automation Grants programme was Healthtech-1, a solution focused on automating the patient registration process for GPs.

During their pilot in Lambeth, the Healthtech-1 solution achieved impressive results. Some of the results highlighted during Healthtech-1’s presentation at the recent Health Tech and South London Innovation Event included:

  • Automation of 90% of new patient registrations
  • Estimated savings of more than 4,200 hours of administrator time over a one-year period (equivalent to two full-time staff)
  • 100% retention rate to the paid platform among GP surgeries following the trial

Healthtech-1’s tools have now gained significant momentum across south London and the wider region thanks to their real-world impact. The innovation has rolled out to almost 800 GP practices across the country, and now powers about 1 in 10 new patient registrations in England.

As co-founder Raj Kohli explains, much of their success has stemmed from establishing a deep understanding of the problems faced by primary care teams before starting to build a solution:

“It’s become a bit of a cliché for technology companies to say that they live and breathe the world of their customers, but I think we can justify that statement.

“As well as family connections to working in GP-land, we’ve chosen office space which we share with a practice. Myself and my co-founder did thousands of patient registrations by hand when we first got set up – so I think we can appreciate the reality of what teams are facing.

“We’d like to think our innovations are the things that practice teams would build themselves if they had the time, space and resources to do so.”

Now being used by 13% of practices nationally, the Healthtech-1 team have also benefited from support from programmes such as DigitalHealth.London’s Accelerator:

“DigitalHealth.London was invaluable to our journey. They introduced us to some of our first customers (Dr Annie Murphy), helped us get our first funded ICB pilot (South West London ICB), and networked us with other innovators (Andrew Bailey at Convenet) - who introduced us to our 2nd hire and founding clinician (Dr Lydia van Hamel Parsons)."

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Delivering change in healthcare is simple, but our leadership needs to be more “Buddhist”

Published by Michael Mbanunu

The new government has put change at the top of their agenda for health and care. In this blog, our Chief Executive, Rishi-Das Gupta, suggests that to make the changes needed effectively and efficiently, we first need to shift our leadership style, moving from a top-down "one way is the right way" mentality to a more "Buddhist" approach. This ethos emphasises flexibility, allows for diverse paths to a common goal, and embraces the strengths of local systems. 

In an era where the healthcare landscape is ever-evolving, the new government’s commitment to change is a glimmer of hope for the National Health Service (NHS). It’s no secret that the NHS is grappling with a multifaceted crisis, driven by an aging population with increasingly complex health needs coupled with a progressively fatigued workforce. There is a broad consensus that the solution lies in involving people and communities more deeply in their care and encouraging healthcare providers to innovate… but it continues to be hard to spread innovation, we’ll explore why below.

Clinicians tend to cherish autonomy and the ability to adapt their practice to the patient in front of them. Hence, there is a vast diversity in practice and organisation driven by the preferences of both care providers and patients. This diversity is at odds with a leadership style that mandates uniform changes. In October 2022, Malte Haring, Felix Freigang, Volker Amelung and Martin Gersch conducted a systematic review of 29 papers outlining the tensions in healthcare innovation. They mapped these on a single, wonderfully complex page, highlighting why change often leads to conflict. However, understanding and navigating these tensions is critical for effective transformation.

 Figure 1: Classification of identified tensions in healthcare innovation based on Mini and Widjaja

The Stanford professors Bob Sutton and Huggy Rao, provide a simpler framework for this discussion (which I love) in their 2014 book “Scaling Up Excellence”. They describe two styles of transformation: the “Catholic” approach, characterised by a single, common method, perfected and then applied uniformly, and the “Buddhist” approach, which sets a defined endpoint but allows for multiple paths and paces to reach it. The NHS’s major change programmes have traditionally leaned towards the Catholic approach, aiming to mandate change and spread “best practices” uniformly. This approach, however, often overlooks the autonomy and diversity of service providers, leading to resistance and inconsistency in implementation.

The NHS is unusual in that the vast majority of care (around 90%) is provided by government-run organisations with similar values and employment practices. This leaves staff with relatively few options to work in healthcare outside the NHS and so creates resistance to change. Relatively small groups in a workforce can derail a change programme if they see it as a threat to their current preferred way of working, even if it is of benefit to other staff or patients. Furthermore, implementing significant changes in such a complex system usually requires lengthy public consultations which take a minimum of 14 months and are often costly.

To address these challenges, we need a shift in leadership style towards a more Buddhist approach. Policymakers must recognise that their ability to drive change is linked to incentives based on outcomes that matter to patients. Meaningful change does not need to be uniformly implemented; local systems should have the flexibility to tailor changes to their specific needs. The recent move towards Integrated Care Boards (ICBs) is a significant positive development in this direction. ICBs facilitate collaboration across health and care organisations, ensuring that local needs and circumstances are prioritised.

An example in south London has been the implementation of a national programme to improve medicines safety and reduce harm from prescribing opiates. Both ICBs in south London had identified reducing opiate use as a priority in advance of the national programme and worked with us at the Health Innovation Network to build a good understanding of what was needed for their systems.

South East London made extensive use of nationally developed approaches which focused on while South West London adapted the materials to reflect additional complexities in their local healthcare system. Both ICBs are now amongst the best nationally in terms of using opiates safely despite the differences in approach and have embedded this change locally through a sense of ownership by the local clinicians.

Additionally, developing varied, locally accountable innovation support structures like Health Innovation Networks is crucial. These networks provide the support and resources necessary to drive local innovation and improvement. Crucially HINs use implementation science. The implementation of lasting change or of spreading innovation across complex healthcare systems is a collective social process. In such complex adaptive systems negotiating the local context needs is crucial for implementation to be successful (this approach was outlined by my colleagues in a BMJ article (from 2020).

In conclusion, delivering change in healthcare can indeed be simple if our leadership embraces a more flexible approach. By allowing for diverse paths to a common goal and leveraging structures like Integrated Care Boards (ICBs) and developing locally tailored innovation support (including Health Innovation Networks), we can foster innovation and adaptability in our healthcare system. It’s time to move away from a one-size-fits-all mentality and towards a model that respects and harnesses the unique strengths of our healthcare providers and communities and empowers and supports them to change. Only then can we hope to build a resilient and responsive NHS capable of meeting the challenges of today and tomorrow.

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Meet the Innovator: Conor McGinn

Published and last updated by Michael Mbanunu

In this edition, we catch up with Conor McGinn, Co-Founder and CEO at Akara AI. This healthcare automation company offers AI systems to operating rooms and other healthcare facilities to increase their workflow efficiency.

Current job role: Co-Founder & CEO

Name of innovation: Akara AI


Tell us about your innovation in a sentence.

Akara develops cutting-edge AI technologies, including robots and smart room sensors, to help hospitals free up time in operating rooms so they can perform more procedures.


What was the ‘lightbulb’ moment?

We realised that operating rooms and other critical parts of the hospital are regularly out of action for hours each day and that much of this downtime could be reclaimed through efficiency improvements that are possible with automation.


What three pieces of advice would you give budding innovators?

1. Make it easy to use: Spend time understanding how your innovation would impact clinical workflow when introduced.

2. Demonstrate a compelling ROI: Identify commercial KPIs early and collect data, where possible, to support the business case for the technology.

3. Get on a procurement framework immediately: Even if a hospital loves your technology, it’s very hard for them to purchase it if you aren’t an approved vendor.


What’s been your toughest obstacle?

- Learning how to get support from the different stakeholders inside a hospital.

- Getting someone to champion our technology is just the beginning.

- We’ve needed to learn how to navigate procurement, infection control, hospital IT, estates and facilities, and labour unions, among others.


What’s been your innovator journey highlight?

Getting to see our technology in real use in hospitals and delivering impact to the lives of staff and patients.


What is the best part of your job now?

Getting to work with an amazingly talented group of people who share the same vision and ambition as I have for transforming healthcare.


If you were in charge of the NHS and care system, what’s the one thing you’d do to speed up health innovation?

Introduce more direct incentives (i.e. access to funding, creation of new pathways for career advancement, time carve-outs)  for both clinical and operational staff to work with startups and support health innovation.


A typical day for you would include…

I usually start my day at around 6 am. The first thing I do is review my tasks for the day and identify the 2–3 most important tasks. At 8 am., I attend a standup meeting with the rest of the team to touch base and share our respective plans for the day. I’m usually in back-to-back meetings for most of the day, speaking with partners, advisors, prospective customers, and investors.

When I’m not in meetings, I’m usually responding to emails or checking in on the hospitals where our technology is deployed, which is now in three countries (Ireland, the UK, and the US). A few days each week, I carve out 2-3 hours to complete dedicated tasks, like preparing materials for upcoming pitches, presentations, and strategic initiatives.

At the end of the day, before I leave the office, I review my task list, crossing off things I’ve achieved and adding any new tasks that may have arisen.

You can find Akara AI on its website, Twitter, and LinkedIn.

Using patient insights to transform NHS 111 services

Published by Michael Mbanunu

London's NHS 111 is being transformed to meet service demand sustainably for the future. The changes aim to shift patients who access the 111 services by phone onto digital pathways and online services, which enables them to access appropriate care in a timely way.  The Health Innovation Network (HIN) South London is supporting NHS England London engage with patients to ensure that the changes reflect their needs and benefit patients and the system as a whole. 

During May the Health Innovation Network (HIN) South London organised two workshops with people who had recently used the NHS 111 service. In total, 21 patients took part in activities to help us understand their views of the changes and learn how to achieve the aim of encouraging service users to switch to digital options when using 111. Feedback from those who participated in the workshops was positive. Participants enjoyed the format and welcomed the opportunity to contribute.

Recommendations identified through the workshops will be discussed with the NHS England London team working on the digital transformation of 111 later in June. Following verification with a cohort of patients who did not attend the workshops, necessary changes will be made. Patients will be brought back in September to review how their input has been picked up in the changes to the service.

Patients were recruited through the networks of London’s Healthwatch and information about the patient insights project resulted in over 150 Londoners volunteering to support the work. With their consent, we have created a list of people we can involve in the different activities we are undertaking, including helping us develop surveys and other feedback approaches.

For more information about the work please contact kate.lambe1@nhs.net or helen.sheldon3@nhs.net

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How “closing the loop” empowers Lived Experience Partners and ensures project success

Published by Michael Mbanunu

Just over a year after joining the HIN, Lived Experience Partners (LEPs) Faith Smith and Aurora Todisco reflect on one vital step of involving people and communities in health and care projects that is often neglected: ‘closing the loop’. The concept of 'closing the loop' refers to informing people who have contributed to projects about the outcomes and future of the work they have been part of.

Healthcare innovations can be greatly improved by involving the voices of patients at all stages, through true co-production openly and transparently. This is a great step towards tackling the various health inequalities that are still too present in our systems.

Our role as Lived Experience Partners (LEPs) serves to drive the work of the HIN and their partners towards equity in accessing health and social care services, while championing the voices of the people who live, work and access services in south London.

Over the past year, we seen that (alongside project managers) we have a pivotal role to play in how we 'close the loop' as projects reach important milestones or draw to a close. Closing the loop is essential for building trust with lived experience contributors and wider communities, demonstrating that the voice of experience has informed and guided the final outcomes of the work in question. Ensuring a summary of the difference their involvement has made and any outputs are shared with Experts by Experience is a key step that is often forgotten.

Many of the insights we've gained will also be valuable to other stakeholders seeking to maintain relationships with the people and communities who have contributed to their work.

The power of plain speaking

To ensure that project outcomes and learnings are accessible to all, we work very hard to remove jargon as much as possible in our external communications. NHS projects can often be acronym heavy. These tend to mean something to health professionals but very little to most patients or service users. The complex language of the NHS can often be a real barrier to engaging communities in projects – especially those groups with lower health literacy who often face the largest health inequalities.

Our role is to help provide a bridge between NHS jargon and normal language. Over the past year, we have achieved this by assisting with creating easy-to-read versions of project outcomes to ensure accessibility of the content for public sharing. Recently we helped to create a “plain English” summary for our website of a large, complex report looking at patient perspectives of digital-first primary care – helping to 'close the loop' for the thousands of patients across London who had contributed to the work.

Additionally, we can support project leads in meetings and make sure things are said more clearly and straightforwardly so that lived experience contributors understand and can participate in relevant discussions. Being staff members means we can tackle power imbalances with more confidence – being able to challenge our colleagues if we feel something is not being communicated in a clear way.

Planning to succeed

One of the benefits of being part of the HIN is that we can advise on the design of projects at their earliest stage – when a project is being planned or scoped out.

This means that 'closing the loop' can be built into projects effectively, and that we can make sure the people and communities who contribute to the project are being communicated with fairly and effectively.

Making use of our networks

Finally, our own individual networks can help us to connect the work of the HIN with the communities it serves. We both have extensive experience with involvement activities across health and care, and this has helped us to establish a network of community groups, patients and professionals who can help us spread the word about the outcomes of our work.

Social and digital media also offer important avenues for sharing updates on projects. We’ve been heavily involved in setting up the HIN’s involvement newsletter – Partners with People – and we’ve seen great engagement with it from people from a wide range of backgrounds. Once again, these all show people and communities how much our work is valued and the ongoing impact of our contributions to projects.

Finally, LEPs can champion the HIN South London’s approach to involvement and relevant projects in external spaces. As LEPs, we have been invited to several external conferences either to speak or attend, such as the International Forum on Quality and Safety in Healthcare. We’ve also written for publications such as the HSJ – stressing just how important we feel involvement is for the future of health and care.

Conclusion

Respect for the people we involve in our work is a fundamental requirement of sustainable involvement activities. Being able to show patients, carers and communities the value of their contributions to projects is especially vital if we want to encourage underserved communities to work with us to tackle longstanding and complex health inequalities.

Nurturing relationships with non-professionals takes time and effort. While our role as LEPs is often to play an important part in building these relationships, it should be a priority for any project manager who is involving people or communities in their work. Our ask is that we collectively make sure we don’t 'fall at the last hurdle' – let’s focus on closing the loop and making sure we finish projects with the same spirit of involvement that they often start with.

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Understanding the Potential of Immersive Technology in Mental Health: Insights from the Digital Healthcare Show

Published and last updated by Michael Mbanunu

The COVID-19 pandemic has led to more people experiencing mental health issues and contributed to the immense pressure on mental health support services. One emerging field that holds promise for transforming mental health provision is immersive technology, which offers therapeutic experiences, enhancing access to interventions like virtual reality therapy.

Our Executive Director of Digital and Transformation Dr Amanda Begley and Head of Mental Health Aileen Jackson recently spoke on panels at the Digital Healthcare Show, shedding light on and discussing the role of immersive technology in revolutionising mental health care. In this blog they reflect on key takeaways from their panel discussions, speak on how the Mindset-XR Innovation Support Programme will empower innovators to navigate the complex healthcare landscape and discuss how we can overcome the barriers leading to widespread adoption.

The Mindset-XR Innovation Support programme, which the Health Innovation Network (HIN) South London is leading, plays a central role in advancing immersive technology for mental health by guiding project developers navigating this relatively nascent world and actively stimulating interest for it across the UK. A recurring theme in the discussion at the event was the transformative potential of immersive technology in mental health and its application in diverse areas, examples include, promoting well-being through mindfulness experiences, facilitating exposure therapy for phobias and immersive training tools for healthcare professionals to improve empathy and reduce stigma using the lived experience of people with psychosis and schizophrenia.

Key Takeaways from the Panel Discussion

Not many people are familiar with immersive technology, so having expert Ross O'Brien, Co-Founder of XHRA, on our panel was valuable. His explanation of different immersive technologies in layman's terms helped clarify the topic and develop an understanding amongst audiences.

The importance of having diverse perspectives when discussing how to navigate the complexities of immersive technology adoption was key. From technical expertise to service user and clinical insights, the panels brought together stakeholders from various domains to explore the opportunities and challenges inherent in this growing field.

Notably, Deputy Clinical Director for Mental Health at the HIN South London, Dr Nicola Reynolds perspective as a clinician highlighted the potential of immersive technology in enhancing understanding and support for conditions like ADHD, bridging gaps in education and awareness.

We heard from Sean Carroll of We Are Anagram, a company that received funding from Innovate UK’s Mindset XR strand 1 funding. Their innovative virtual reality training solution is for medical students, nurses, and mental health professionals. This immersive training tool allows users to step into the shoes of a person diagnosed with schizophrenia, following their journey from early childhood to diagnosis through treatment and their recovery journey. The experience is co-designed from the person’s perspective, using a trauma-informed approach, which aims to help healthcare professionals better understand and empathise with people living with these conditions.

Despite the promise of immersive technology, several challenges were highlighted by Jamie Foster from Hill Dickinson our legal representative on the panel and Emily Wheeler from MQ Mental Health Research who gave the lived experience perspective. Regulatory uncertainties, resource constraints, and cultural barriers require a concerted effort to address and overcome these obstacles. We heard there is still a need for ongoing education and awareness initiatives to clarify immersive technology and foster a culture of collaboration both within healthcare settings and with people who experience mental health issues. However, when asked if the UK is ready for immersive tech in mental health the answer was a resounding yes from all panellists.

Empowering Innovators and Ensuring Collaboration: The Mindset XR Innovation Support Programme's Impact

For innovators embarking on the journey of integrating immersive technology into mental health care, the Mindset XR Innovation Support programme offers a comprehensive support system. The programme's commitment is to provide tailored guidance, resources, and mentorship to facilitate the realisation of each project's full potential. By addressing key areas such as regulatory compliance, user involvement, and clinical research, the programme aims to empower innovators, to navigate the complex landscape of healthcare innovation with confidence.

We're able to make connections for them [innovators], so they can receive feedback and learn where they need to adapt. We enable innovators to get some traction by demonstrating their products and getting vital advice on how they need to develop so that they're able to enter the market. To know we may be improving the lives of the one in four people who experience mental health issues in their lifetime through immersive technology is a highlight, and to get that feedback when innovators on the programme say “thank you”, it's why we're in the job.Aileen Jackson, Head of Mental Health

Overcoming Barriers to Implementation

As we navigate the complexities of modern healthcare, embracing innovation becomes imperative. The Mindset-XR Innovation Support Programme stands as a beacon of hope, guiding innovators on a journey to harness the power of immersive technology for the betterment of mental health care in the UK.

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If you're interested in learning more about the Mindset programme or getting involved in this exciting field, please get in touch. Additionally, consider signing up to our newsletter to stay updated on future developments and the launch of our shared learning community.

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Meet the innovator: Will Gao

Published and last updated by Michael Mbanunu

In this edition, we catch up with Will Gao, Chief Commercial Officer and Co-Founder of Suvera a CQC-registered digital healthcare provider that works with general practitioners to support individuals in taking proactive care of their chronic illnesses.


Current job role:

Chief Commercial Officer, Co-Founder


Tell us about your innovation in a sentence:

Supporting general practice with a virtual clinic to proactively care for patients living with long-term conditions!


What was the ‘lightbulb’ moment?  

Working in General Practice as a final-year medical student and realised how stretched the system was and how much we need to think more proactively about our patients. Prevention is the direction of travel, but it requires both the platform and clinical workflows to ensure it’s feasible.


What three pieces of advice would you give budding innovators?

  1. Ask plenty of questions
  2. Don’t be fixated on your solution
  3. Don’t expect anything to happen without trying.


What’s been your toughest obstacle?

Keeping the momentum going despite numerous challenges. Ensuring that we grow sustainably and that we're focused on solving the right problems.


What’s been your innovator journey highlight?

Thanks to the Health Innovation Network (HIN) South London, we were supported by South East London ICB to look at patients in Lewisham who were having poor outcomes for their cardiovascular health, which is a core NHS priority.

In a short space of a few months, we are now managing several thousand Lewisham patients and the data indicates we have prevented hundreds of strokes and heart attacks.

These patients would have otherwise turned up to local emergency departments which increased pressures on the system. We always remind our team that these patients could be friends or family and to never forget that when building our service.


What is the best part of your job now?

Now that we are slightly more established and have more long-term partners – we are learning every day and it feels like we have momentum and the ability to truly make an impact on the health service and for patients.


If you were in charge of the NHS and care system, what’s the one thing you’d do to speed up health innovation?

Provide more resources for innovation but ensure that these resources are recurring. Stop and starts aren’t beneficial for innovators or the system.


A typical day for you would include:

Meeting with several existing and potential partners in the system and translating those insights to the Suvera team to ensure we are building towards something valuable for the system and its patients.

You can find Suvera on Twitter and LinkedIn.

Coggi: involving children in tackling complex health and care challenges

Published by Michael Mbanunu
Parent supervising children using tablet

Working in partnership with people and communities is a tried and tested approach for meaningfully improving health and care and a foundation of the Health Innovation Network (HIN) South London’s approach to innovation.

While most involvement activities focus on working with adult populations, children and young people (CYP) can also make a valuable contribution to projects.

In this blog, we hear from co-founders Pepita Stonor and Yvonne Biggins about how they have involved CYP in the development of their groundbreaking mental health innovation, Coggi. Coggi is also a part of the DigitalHealth.London Launchpad programme.

Childhood is a crucial period for mental health and wellbeing. A commonly cited statistic is that 50% of mental health problems are established by the time someone turns 14; in turn, this means that the potential for preventative interventions for younger people is enormous.

Our app – Coggi – is a versatile Positive Psychology platform which helps children understand their strengths and overcome feelings of anxiety.

Recently, we’ve used Coggi to support children who need to undergo an MRI scan in feeling confident to be scanned without sedation. Currently, up to half of all children who undergo an MRI need sedation to do so; this adds complexity to the procedure, can cause unpleasant side effects, and significantly increases the cost of the procedure to the NHS.

In our opinion, involving CYP in the development of our platform has always seemed like a no-brainer. Anybody who has spent any time around CYP knows how quickly and intuitively they pick up anything to do with digital technology, which makes them exceptionally well-suited to being development partners for digital innovation!

Whilst there isn’t a huge amount of documentation out there about involving CYP in health and care change work, we’ve found that many of the same principles and approaches we use with adults translate well to younger groups.

For example, focus groups still work well for ideation. In fact, we’ve found that the diversity and creativity of ideas that CYP bring is often much greater than what you might expect from adults.

The same goes for feedback. If CYP likes something, they’ll tell you. If they think it’s boring, they’ll tell you that, too! Sometimes the directness that CYP tend to have makes it much easier to address issues with your product than the politely veiled “constructive criticism” that adults seem to prefer.

Having CYP involved at every stage of our work has helped us develop a better product more quickly. We’ve learned about a range of ways to improve our product; from the type of information we should include about MRI scans, to the devices the platform should be available on, and the role of the platform in providing emotional reassurance. Even our in-app buddy ‘Coggi the Chameleon’ was an idea originally devised by CYP!

One potential challenge around involving CYP in innovation is access. Understandably, safeguarding and related concerns can make the practicalities of working with CYP seem quite daunting.

In practice, though, we’ve found there are lots of groups that can help to facilitate meaningful connections between innovators and CYP.

In particular, we’ve had some amazing support from the team at Great Ormond Street Hospital (GOSH) during our pilot of the MRI-focused version of Coggi. Working with their Young Persons’ Advisory Group (YPAG) for research has been brilliant – and similar YPAGs exist across the country under the GenerationR Alliance

Through our work with DigitalHealth.London and the Health Innovation Network South London, it has been great to hear about what other innovators are doing to involve people and communities in their work. We hope that our blog helps give more confidence to other innovators who might be thinking about extending those activities to working with CYP as well.

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Applications open for the South London Care Home Pioneer Programme 2024 Cohort 6

Published and last updated by Michael Mbanunu

The Health Innovation Network (HIN) South London and My Home Life England are delighted to announce that applications are now open for the South London Care Home Pioneer Programme Cohort 6 – a leadership support and professional development programme delivered free of charge to Care Home Managers, Deputies and Senior Nurses to advance their skills, facilitate personal growth and enable them to effectively manage the complex everyday issues that impact on the quality of their service.

The programme is aimed at staff working in the following settings in south London:

  • Older person’s residential homes
  • Older person’s nursing homes
  • Learning disability and mental health care settings,
  • Supported living settings

Did you know?

  • The Pioneer Programme has supported more than 120 Pioneers, over five cohorts from all 12 boroughs of South London.

The programme offers support to care home managers to:

  • Advance their leadership skills and strategies.
  • Design and deliver a quality improvement project.

The programme runs over ten months from June 2024 to March 2025 where Pioneers are guided and supported by skilled coaches and facilitators. Pioneers learn from and support each other to consider new ways to approach some of the complex issues which are part of the job.

The programme begins with four face-to-face workshops, followed by a series of six action learning sets, some delivered virtually and some face-to-face. The celebration day on Wednesday 5 March 2025 showcases the achievements of the Pioneers to the funders and other stakeholders.

‘Action learning’ recognises that individuals learn best when they learn with and from each other, by working on real problems and drawing on their own experiences. Three of the six action learning sets will provide additional support for the quality improvement project.

To apply:

  1. Read the flyer here
  2. Complete and submit the application here by Wednesday 15 May, 9 am.

This infographic highlights key feedback from Pioneers who took part in the programme in 2023.

"The programme has boosted my self-belief. I am so grateful to have been offered the opportunity, and the impact it will have for me and the home. It really made me feel valued."Pioneer, Cohort 5, Care Home Pioneers
The Pioneer Programme has allowed me to grow and reflect on my leadership style, it has provided me with the courage to take steps and face challenges and to not let my own limitations hold me back. It has helped me to embrace my uniqueness and shown me that it is the differences in me that effectively make me the leader I am and has taught me how I can use these qualities when working with my team to improve our service. Pioneer, Cohort 5, Care Home Pioneers

You can find some great examples of Pioneer projects that have been carried out by clicking on the following here. Find out more about the celebration day for last year’s cohort here .

Further information

Find out more about the programme and how to apply.

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Understanding investor attitudes to immersive technology for mental health: a look behind the curtain

Published and last updated by Michael Mbanunu

Hitesh Thakrar is Chair of the Health Innovation Network, South London and an experienced investor in the technology sector, having spent over 25 years investing in public equities in the life sciences, information technology and innovation sectors.

Since 2015, he has moved into early stage venture investing, and is currently a Partner at Syncona Limited (a Wellcome Trust backed early stage venture fund), a Governance Board Member of KQ Labs at the Francis Crick Institute, an accelerator with the Turing supporting next generation businesses in data science and life sciences, and the Chair of the Investment Committee for Newable Ventures (a pre-Series A deep tech fund).

As someone who has led investment into immersive technology myself, I was delighted to chair a recent roundtable event bringing together investors with an interest in immersive technology in mental health.

In the competitive world of investing, these types of open and honest conversations between experts can be few and far between. I would like to extend my thanks to all our attendees for their candour and enthusiasm – and I look forward to their contributions to the project in the future.

The event was an important early milestone for the Innovate UK Mindset-XR Support Programme which the Health Innovation Network South London (HIN) is delivering. My colleague Amanda, HIN Director of Digital Transformation and Technology, recently wrote an excellent blog giving some of the background on the Mindset programme and the pressing need for transformative change in mental health. If you haven’t already, it is well worth a read to learn about the programme and why we are placing such importance on this work.

What was clear right from the outset of our event is that investors are very much on the same page as Amanda and the Mindset team when it comes to embracing the potential of technology to tackle the nation’s mental health crisis.

The fact though, is that virtual, augmented and extended reality aren’t the only games in town when it comes to MedTech for mental health. And, indeed, mental health is far from the simplest potential application for the next generation of immersive technologies.

So – what are the barriers and opportunities for investment in this area?

Some good news is that immersive technology and mental health are both areas where passion, excitement and personal interest play a role in decision making for investors. Investors are humans rather than robots; some of those who joined us at our roundtable spoke bravely of their desire to improve mental health following lived experiences of mental illness, others of the exciting vision that they saw for technology used in computer games making a difference to society.

Those passion points might be enough to pique initial interest among fund managers and sway the odd marginal decision, but sustainable funding inevitably depends on being able to build confidence around return on investment (ROI).

While the consensus in the room was that reliably realising ROI in this area is far from a given today, the mood was optimistic about prospects for the future. To that end, we identified a number of development areas which will help to shape the commercial counsel we provide to the innovators on our Mindset-XR programme.

Those priorities were:

Helping innovators, clinicians and investors to pull in the same direction

Immersive technology brings together experts from a wide spectrum of different fields; medicine, gaming, visual arts, engineering and artificial intelligence to name but a few. Regardless of their background, for innovators to thrive they need to be confident navigating the complex world of health and care.

Finding a common language and understanding the cornerstones which must be in place for healthcare success in terms of patient safety, clinical oversight and regulatory approvals are key. Given our experience delivering the award-winning DigitalHealth.London innovator support programmes, this upskilling feels like exactly the sort of challenge we are particularly well-suited to rise to.

Prioritising innovation based on clinical need

At a time where mental health services are universally stretched, there are no end of possible problems to try and tackle. However, the scale, complexity and urgency to solve these problems varies enormously.

To be successful, innovators need a clear view of the condition(s) they are targeting, current approaches to treatment, and how their innovation might fit into existing clinical pathways. This makes early clinical and commissioner engagement essential to avoid building “white elephant” innovations – technically impressive but out-of-sync with what the system really needs.

Having attendees at the roundtable representing local and national mental health systems felt like a great start to this work, and we look forward to forging meaningful partnerships between innovators and clinicians throughout the course of the programme.

Exploring different funding models and mechanisms

One of the areas we explored during the roundtable was the disparity in progress between work happening in immersive mental health technology on either side of the Atlantic, and what could be learned from our American cousins about supporting innovation through different funding models.

Understandably, many innovators are focused on the NHS as the primary buyers for immersive mental health innovations. While the NHS is a huge market, access is complex and for nascent and potentially expensive technologies such as VR, AR and XR for mental health there may be other options worth exploring. These include working with insurers, targeting the self-funding market and developing innovative partnerships with pharmaceutical companies.

I left the roundtable discussion full of ideas and enthusiasm for the work that we are leading. While we are in the early stages – both of our programme and of realising the potential of immersive technology for mental health – we are already developing a formidable alliance of innovators, clinicians and investors determined to make a difference.

We want to send a special thanks to the following for their support and attendance:

I look forward to our next events. Please do get in touch with the team if you would be interested in joining us.

To find our more, visit our Mindset-XR Innovator Support Programme webpage.

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For more information about Innovate UK's Mindset-XR Innovation Support programme, delivered by the Health Innovation Network, South London, please get in touch.

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Meet the innovator: James Townsend

Published by Michael Mbanunu

In this edition, we catch up with James Townsend, Co-Founder and CEO of Mobilise, an online service that harnesses the collective knowledge, wisdom and expertise of unpaid carers and empowers those that care to thrive.

Tell us about your innovation in a sentence.

Providing online support to unpaid carers (of which there are 11 million in the UK), on behalf of local authorities and health bodies

What was the ‘lightbulb’ moment?

I’m not sure there’s ever been a lightbulb, but joining the Zinc venture builder prompted me to draw on some of my own life experiences:

  1. My years as a Maths teacher in a disadvantaged school in Manchester (via Teach First) taught me that learning and picking up new skills was best done by learning from peers rather than just reading textbooks - and that’s particularly true in stressful situations, as caring can often be.
  2. My mum was diagnosed with Multiple Sclerosis (MS) when I was about six, so learning how to care for a family member has been a big feature of my life.

Those two things really came together and motivated me to build Mobilise not just as a website with lots of information, but as a community where we can learn from and support each other.

What three pieces of advice would you give budding innovators?

  • Really focus on who the client is, and how to solve their problem. Nobody really cares that much about the whizziest AI features you’ve built if it doesn’t solve an everyday, tedious issue that’s causing them pain.
  • Think intentionally about where you get support from, whether it's family or friends just make sure you just make sure you tee them up to provide the support that makes a difference for you. Things will get really difficult and leading innovations can be lonely.
  • Keep on going! Back when we started, the idea of providing support to carers online was a pretty fringe concept, but we’re now seeing local authorities commissioning digital services quite regularly. Even if it feels like you’re hitting a brick wall, it’s worth persevering.

What’s been your toughest obstacle?

The biggest challenge for anybody providing carer support - either online or in person - has always been the identification of carers. Most people don’t realise they have a caring role until they’ve been doing it for about two years. We usually think of it as just doing what any other child, parent or spouse would do.

So it was a major breakthrough when we finally managed to crack how to entice people onto the platform to receive support without them necessarily having to think of themselves as a ‘carer’.

What’s been your innovator journey highlight?

Meeting my Co-Founder - Suzanne. She’s such a great combination of wisdom, passion, and energy. We’re very different in many ways - her affinity for detail and process complements my more impulsive character. However, we really align on the things that matter, like making a difference for carers, and always finding something to giggle about when stuff goes wrong.

What is the best part of your job now?

Every Monday morning we send out an email to the largest community of unpaid carers in the country. A hangover from back when it was just me and Suzanne is that it still goes out from my email address (though I don’t write the email itself any more). So every Monday morning I get a shed load of responses from carers - some telling me just how tough the weekend has been, others thanking me for the work Mobilise is doing and how much it means to them.

I can’t think of a better way to start the week than to be reminded about why the work we do is so important.

If you were in charge of the NHS and care system, what’s the one thing you’d do to speed up health innovation?

This is a really big question we put to leaders in social care on our podcast, Carer Catalysts - hosted by me and my Co-Founder Suzanne. There are two big themes coming out of those conversations:

  • Co-Production with a much broader group of users/patients than has previously been possible. Technology has a key role to play here, opening up decision-making processes to use data from a wider range of sources and allowing direct user input into shaping services.
  • The power of sharing our own individual stories. If we talk openly about the difficult things, it starts to show how common these challenges can be. Be it providing care for someone, or going through a health challenge such as cancer or a miscarriage, so many people struggle in silence. If we all understood how many people were impacted by these things, we might get more momentum to encourage the decision-makers to create better policies for support.

A typical day for you would include…

With so many carers in the team, it makes sense for us to work remotely most of the time so I’m mostly based at home in Brixton. I’ll start fairly early, and try to get most of the regular internal ‘CEO’ stuff out the way early doors.

Then I’ll spend as much time as I can either with our local authority partners, as there’s always so much to learn about the complexities of local government, or with the impressive team building out our products.

We’re growing quite quickly at the moment, so I’m spending a lot time interviewing people. I absolutely love doing interviews - learning about different people, their journey to where they are today, and where they dream of going next. It’s probably the most important thing a Co-Founder can dedicate their time to because the people who come on board shape the company so much. That’s why we put values (particularly ‘empathy’) so firmly into the recruitment process.

Developing collective leadership skills to navigate ‘wicked problems’ in health and care

Published and last updated by Michael Mbanunu

Overview:

For several years at the Health Innovation Network South London, we have run national Communities of Practice (CoP) Leadership Development Programmes in partnership with the Health Foundation’s Q Network,  focusing on supporting participants to develop collective leadership skills that are essential for effective cross-system change and improvement.

CoPs include a wide mix of participants from across health and social care, as well as people with lived experience. These communities and networks have proven inspirational and effective in addressing “wicked” challenges that are typically beyond the scope of any individual, profession, or organisation, through collective wisdom and shared learning.

In January, we held an in-person celebration event to mark the end of the third programme we have delivered. This event was designed and organised by the CoP Leadership programme’s participants and was attended by our Health Foundation colleagues and a range of stakeholders, including some of the participants’ organisational sponsors. It offered participants an opportunity to share key successes and learnings acquired from the programme.

A report has been written, to share insights about the participant experience of this year’s programme. It provides a summary of the key learning emerging from the programme and highlights some recommendations for future programmes.

Report Summary:

The outcomes of the report reflect a predominantly positive sentiment from those who participated in the communities of practice leadership development programme. The feedback highlights how much the participants benefited from the knowledge, networks, and resources shared, leading to a significant increase in their confidence to work collaboratively with others.

Participants particularly enjoyed the interactivity of the programme, which allowed for the sharing of ideas and the formation of connections with peers in similar roles. This aspect of the programme was frequently mentioned as a highlight, offering a valuable space for like-minded individuals to learn with and from each other. Furthermore, they appreciated the diversity of both expert speakers and learning styles, that enabled them to not only develop new ideas but also to practically apply them at their place of work.

The leadership development programme has been highly successful in achieving its goals, effectively providing valuable knowledge on how to develop and grow communities of practice, fostering meaningful connections between participants, and facilitating an environment where innovative ideas and open conversations can thrive.

“I'm delighted by the overwhelmingly positive responses from our participants. It's heartening to see the significant impact the programme has made on them, empowering them to do things differently within their Communities of Practice.” Cleo Butterworth, Associate Clinical Director, Patient Safety and Experience

Download the report

Access the Communities of Practice Leadership Development Programme final report.

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One year on: how can working in partnership with people living with chronic (persistent) pain improve care?

Published and last updated by Michael Mbanunu

One year on from the launch of our Chronic Pain Experience-Based Co-Design (EBCD) project, Natasha Callender, Senior Project Manager at the Health Innovation Network South London (HIN), and Natasha Curran, HIN Medical Director and Consultant in Pain Medicine share reflections on their learnings from working with people living with chronic pain. The EBCD project provided an opportunity to gather views about participants’ lived and learnt experience. From getting a diagnosis to practical daily challenges which informed the approach to co-designing improvements for chronic pain management.

In modern healthcare we conceptualise treatment as a linear pathway, starting from diagnosis to treatment. In our EBCD project we found that some patients waited more than 10 years to have a diagnosis for their chronic pain. However, chronic primary pain may be the diagnosis - pain lasting more than 12 weeks with no clear underlying cause, or pain (or its impact) that is out of proportion to any observable injury or disease (NICE 2021). Thus, pain management should not be dictated by needing another diagnosis, as chronic pain is a diagnosis itself. In the NHS only a small proportion of the 15.5 million people living with chronic pain will see a specialist about their pain.

Patients often present to their GP when they initially experience pain and, in some instances, acute pain transitions to chronic pain. After ruling out sinister causes of pain, the same principles of good-supported self-management apply whether patients are managed in primary or secondary care (see below). As clinicians, it is important to acknowledge the impact that living with chronic pain has on every aspect of wellbeing. Clinicians should be aware of the range of services available in the locality (often in the voluntary, community, or social enterprise (VCSE) sectors) and how to refer patients. A learning point from the EBCD project was that patients and staff felt that bringing people together was the best solution for improving chronic pain management in south London.

“For me personally, feeling that things may change to assist others has been a big mental boost for me. I have since signed up to become a volunteer with Mind and am seeking more support for my own mental health. Having the opportunity to be part of this project meant I have more knowledge in my volunteer roles.” Project participant living with chronic pain.

Secondly, systems partners recognised the need to leverage existing services to establish peer support and group education alongside input from health and social care teams to support people living with chronic pain. With our project participants, the following recommendations for peer support and group education were developed:

Co-designed recommendations for peer support and group education 

  • Support every aspect of wellbeing

    Focus on treating people as a whole person including chronic pain and on all aspects of wellbeing.

  • Multidisciplinary

    Involve a variety of health and care staff.

  • Accessible

    Hold sessions online or in locations that are easily accessible by public transport and held at times that avoid peak travel.

  • Guided

    Sessions should be facilitated by health and care professionals who have experience supporting people living with chronic pain.

  • Funded

    Peer support and group education for people living with chronic pain should be funded.

Many participants in the project said they benefited from hearing the experiences of others who live with chronic pain as well as from healthcare staff involved in managing chronic pain:

“During the course of the past year we have learnt what is important to people living with pain and begun to understand the array of different services available in south London. We look forward to continually working with those in pain and those in different sectors so that people do more of the things which are important to them and live with less interference from pain.”Natasha Curran, the HIN Medical Director and Consultant in Pain Medicine

Chronic pain supported self-management resources

For further information about the HIN chronic pain EBCD project, please click here.

Listen to the national Health Innovation Network podcast on engaging patients as partners in patient safety on the HIN chronic pain EBCD project here.

Read a pan London blog on reducing harm for people with chronic pain by reducing harm from opioids here.

Read More

View the resource pack on Reducing harm from opioids by reducing prescribing in chronic pain

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The importance of evidence-based data in supporting services for wound care and the potential for Innovation.

Published and last updated by Michael Mbanunu

The DigitalHealth.London Accelerator and Health Innovation Network South London held a roundtable discussion on the current challenges facing wound care services. Our Senior Project Manager for Innovation Karla Richards shares her thoughts and reflections from this roundtable and how data and innovation can lead the way in transforming wound care services.

In December 2023 a group of professionals including tissue viability nurses and clinical nurse specialists, consultants in vascular surgery and plastic surgery, podiatrists, representatives from the health tech industry, and other professionals came together to discuss the challenges they face in providing wound care.

Participants highlighted multiple significant factors in the growing burden of wound management including unnecessary and unwarranted variation in the delivery of services, poor documentation, inconsistent information, lack of clear diagnosis, differences in evidence-based clinical practice and lack of continuity of care. People working within systems worry that the current ways of working are disjointed, and there is often a lack of communication across pathways, meaning clinicians may miss valuable information about their patients. In addition to the challenges and potential improvement opportunities in wound care, several key points were discussed, including using data to demonstrate demand and improve business cases for services and dressing budgets, improving communications about patient needs across services, and opportunities for new technology. A common thread across all these areas was data, or a lack thereof, and the ability to effectively demonstrate need.

The need for data sharing across systems is vital to transforming wound care. Data provides clinicians with information about the patient’s journey. This can be previous medical history, referrals, types of wounds and treatments, clinical concerns, and patient progress. Decisions driven by this data can be used as a guide for clinicians to provide accurate, solution-based care focussed on the needs of each patient. However, with clinicians operating on separate systems it can be challenging to collect and share information as a patient moves across care settings.

One key point made in the discussion is that there are no metrics for counting the actual number of patients receiving wound care in a particular geographical area or ICS. Anecdotally, there is huge unmet need for high quality wound care, but without standardised reporting, it is difficult to gather data for business cases or to justify increased spending on care.  One clinician explained that when looking at amputations, it is impossible to identify how many patients were also diabetic as this information is not captured on admission as standard. Coding is erratic and does not always translate from primary to community and secondary care. There is also no standardised way of capturing physical information about a wound. Some teams still use a tape measure to document wound size, with others taking photographs and often it is impossible to track the full history of a wound from first origins to current status, even in cases leading to amputation.

“It is clear from this discussion that there are passionate, talented and committed people working in wound care but they have to fight against the system to deliver high quality care to their patients. I hope this discussion can be a mini catalyst to bringing services and people together to improve wound care for everyone.”Mr. Saahil Mehta MD FRCS (Plast), Founder, Plexaa

Clinicians are missing crucial data on dressings too. There is a wide range of dressing types available, with a wide range of costs, from simple bandages to specialist materials which are indicated for particular types of wounds. Some teams are reluctant to use the most expensive dressings, whilst others may use them more frequently than is clinically required. Without a standard way to track dressing selection and use in relation to healing progress, there is no evidence to justify spending on these consumables and to support business cases.  Currently some providers of dressings can provide platforms that show quantity and type of dressing at a team level, but this data is rarely recorded and linked to outcomes for individual patients. The gold standard would include tracking patient progress from first engagement with health care services thorough treatments, dressings used, and outcomes all with standard coding in order to demonstrate how many people are getting evidence-based care.

One participant in the discussion, from an independent social enterprise running a wound care clinic, shared how they collect data on their own system. As a social enterprise, they are a smaller organisation and able to control their own record keeping very closely, and they are also held to a very high standard by their commissioners. They take pride in their systems creating a “story” about each patient which ultimately shapes the care they receive, and whilst being cared for by them this works well. However, this data remains in their system if the patient changes to another provider, as the digital record doesn’t follow patients from independent providers to the NHS. Conversely, the clinic doesn’t have access to the full NHS record on their patients and may not be able to see their full referral history. This highlights the need for patients to own their own data, whatever provider they use.

The Roundtable participants also expressed concerns around relationships and staffing. Changes to immigration rules have seen a drop in the number of EU professionals working in the NHS, and one team mentioned that they have listed jobs and had no one apply. Covid-19 has also affected staffing and it has affected patients, who seem to be presenting much later than previously or calling about their concerns rather than going for face-to-face appointments. The specialist teams report that when they are finally seeing patients in clinic, many of them have a much higher level of wound acuity than would have been seen in initial appointments in the past.

So what are the solutions to these issues? The overarching priority for the professionals was improved data sharing and consistency in recording care and outcomes. New technology was also discussed – but as a tool to facilitate the gold standard of care and not just a “shiny new thing” to distract.

Two health tech innovators were in the room - Healthy.io with their wound care product Minuteful for Wound and a consultant in plastic surgery from Plexaa. These two innovations address wound care from opposite ends of the problem; Plexaa is a smart wearable which preconditions the skin pre-operatively to improve blood supply to the skin. This has been shown to prevent wound healing complications following surgery in clinical trials. Minuteful for Wound allows for better, more accurate decision making and wound care management with consistent documentation through 3D scanning and colour imaging. This medical device uses a smartphone to track wounds over time, identify tissue types, and to provide recommendations on dressings and treatment. The data for each patient can sit within the app and be transferred across providers and along the patient care pathway.

“Innovation is the idea, clinicians, patients, carers, and the voluntary sector coming together to think creatively about how wound services can be improved and sustainable. Our aim as industry partners is for our technology to provide the platform to underpin this change."Thariea Whisker, Director of Minuteful for Wound Services U.K., Healthy.io

The use of technology across multiple settings would mean that professionals have access to the full history of a wound, can see previous treatment plans, and get AI-generated decision support for care. Supporting the use of these types of technology to become part of the existing pathways of care would not only help clinicians, but patients could also see their own progress and begin to understand their own journey better. By empowering patients to participate in their own care, compliance to medication and treatments is improved. Engaged patients may also be interested in participating in peer support, which some of the clinicians agreed could be a valuable tool for patients on similar treatment journeys.

The key conclusions from this event were around the importance of the whole story of the patient’s wound moving with them across different care settings, and finding a clear, unified method to share data, coding and decision making. Technology does have a place in supporting care for patients in both the preparation of skin for surgery and with digital measurement standardising the tracking of wounds and their improvement, or the flagging of decline.  More work is needed to address the perception of innovation and how it can reinforce the sharing of good data-driven decision making and support the workforce to understand existing care pathways. However, effective change also requires personal connections, strong networks, standardisation, and enthusiasm for meaningful transformation.

Thank you to all those who took part in this roundtable, for your honest thoughts and experiences and to Sara Nelson, Programme Director, DigitalHealth.London, for chairing this discussion.

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If you have any questions or would like more information about The DigitalHealth.London Accelerator programme please contact us.

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Meet the innovator: Dr Patrick Hart

Published and last updated by Michael Mbanunu

In this edition, we catch up with Dr. Patrick Hart, Clinical Operations Lead of Concentric. Concentric Health is a digital healthcare company leading the UK market in digital consent to treatment applications.

Current job role

Clinical Operations Lead

Tell us about your innovation in a sentence.

Concentric is the market-leading digital consent to treatment application, with remote consent functionality, which makes it easy for clinicians to share personalised information with patients, and leads to informed, shared decisions.

What three pieces of advice would you give budding innovators?

  1. Identify a problem you're passionate about and start working on a solution.
  2. You’ll go further with a team than on your own.
  3. Double down on what you’re good at, and find other people who are good at the rest.

What’s been your toughest obstacle?

The most formidable challenge we encounter revolves around persuading seasoned clinicians, often deeply ingrained in status quo practices of their entire professional careers, to embrace a transformative shift in their methodology.

Navigating this requires a delicate balance of respect for their accumulated expertise, and a compelling presentation of the merits inherent in the proposed innovation.

What’s been your innovator journey highlight?

When friends & family tell me that they have used (or someone they know has used) Concentric as a patient or as a relative, and the utilisation of Concentric has had a positive impact on their healthcare experience.

This has helped me to realise that innovation transcends technological advancement; it can foster meaningful connections and transform healthcare interactions into more human, compassionate exchanges

What is the best part of your job now?

The most rewarding aspect of my current role is being able to witness the immense scale of impact that our work has achieved. In 2023, more than 240,000 patients used Concentric to record decisions regarding their healthcare.

Another rewarding aspect is that our innovation has played a pivotal role in assisting and empowering such a substantial number of people, which is not just professionally gratifying but genuinely mind-blowing.

If you were in charge of the NHS and care system, what’s the one thing you’d do to speed up health innovation?

My primary initiative to accelerate health and care innovation would be to systematically streamline adoption processes across organisations.

By establishing a unified and efficient adoption framework, we can eliminate the redundancy of duplicative procedures, ensuring that valuable time and resources are not expended repeatedly.

A typical day for you would include…

Calls with teams deploying Concentric, testing new product features and reviewing clinical content on our application.

You can find Concentric Health on Twitter and LinkedIn.

Developing the Social Care workforce in south London

Published and last updated by Michael Mbanunu
Group photo from South London Care Home Pioneer Programme 2023 Celebration event

In December 2023, the South London Care Home Pioneer Programme reached its conclusion with a joyful Celebration Day held at Governor’s Hall at St Thomas’ Hospital. This marked the end of a 9-month period of support for the Pioneers, who are care home leaders drawn from all types of care homes in south London.

The Pioneer programme is run by the Health Innovation Network South London (HIN) and My Home Life England. It leads Pioneers on a journey of personal and professional growth through face-to-face workshops, action learning sets, mentor support and service improvement projects, to enable them to make lasting improvements in care homes across South London. Now running for five years, the Programme has supported more than 120 Pioneers across all 12 south London boroughs.

The Celebration event gave the Pioneers the opportunity to feed back their experience of the programme to funders, and other invited guests. Their heartfelt testimonials described the impact the programme has had on their professional growth, working lives and wellbeing.

Group Photo of pioneers at the Celebration Day Event
“The programme has boosted my self-belief. I am so grateful to have been offered the opportunity, and the impact it will have for me and the home. It really made me feel valued.”Care Home Pioneer 2023
“Attending the programme is possibly the best thing I have ever done! It has built my confidence so much.”Care Home Pioneer 2023
“Being part of the programme has made me feel accepted, bold and seen.”Care Home Pioneer 2023

Pioneers emphasised the applicability of the programme in their day-to-day roles. They also spoke of achieving newfound confidence, making improvements in care via their service improvement projects, and gaining a deeper understanding of leadership dynamics.

Posters describing over 30 service improvement projects were unveiled at the event. These projects demonstrated the commitment and creativity of the Pioneers and showcased the positive impact of the projects on the lives of care home residents and staff.

For example:

  • Education sessions were introduced to help improve knowledge about good nutrition and hydration for people with learning disabilities and autism living in supported living settings
  • Improvements were made in documentation for residents nearing the end of their lives, enabling staff to provide the best possible care
  • Additional activities were introduced to improve the quality of life for residents
  • Electronic record keeping systems were introduced
  • Improvements were made to staff supervision meetings to build confidence and provide additional support

Please find the posters and booklet here.

Representatives from organisations who had funded the programme were also present. Their commitment to positive change in the care home sector was palpable, as they engaged with both Pioneers and alumni, demonstrating a shared commitment to enhancing the quality of care for residents.

“I’m in the really lucky position of visiting the older people care homes in our borough, to see first-hand the impact the course has on those attending, and also the effect of sharing these ideas with other staff, as well as often delivering better communication between the home and relatives and improving outcomes for residents. It is one of the best aspects of my job. A real joy.”A local authority Quality monitoring officer
“Listening to the other graduates and alumni, I was inspired by the benefits they described from attending the course and being part of the network and impressed by the ideas they had for improving the experience of residents and staff. Indeed, I have acted on the idea from one of [the] alumni.”A local authority Director of Commissioning

Pioneer Alumni, who completed the programme in 2022, spoke about the way they had been supported to develop further via the new Pioneer Alumni programme, and encouraged the 2023 Pioneers to join their Network, describing the value of being able to continue to have a space for peer support and discuss challenges in social care.

December’s Celebration event marked the end of the nine-month journey for the 2023 cohort. We feel confident that the programme has equipped our Pioneers to better manage the challenges in social care.

We've made a short video summarising the day. Watch it below.

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To learn more about the South London Care Home Pioneer Programme, and enquire about the 2024 Programme, please contact us.

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Bridging the Digital Divide in NHS Transformation: Ensuring Inclusivity and Equity

Published and last updated by Michael Mbanunu

The Health and Social Care Committee’s report into digital transformation in the NHS, provides a comprehensive assessment of the challenges facing the healthcare sector and the imperative for transformation. While the report acknowledges the potential of digital initiatives to revolutionise the NHS, it also sheds light on the significant difficulties some individuals face in accessing digital services. In this blog post, Dr Rishi Das-Gupta, CEO of the Health Innovation Network (HIN), and Kerry Beadling-Barron, Director of Communications at the HIN, look into the critical issue of digital access disparities, as highlighted in the report, and explore strategies to ensure inclusivity and equity as the NHS undergoes its transformative journey.

Technology offers the opportunity to both support whole populations and personalise care for individuals. Hence, the digital divide, characterised by unequal access to and use of digital technologies, is a growing concern across various sectors, including healthcare. As the NHS embarks on its digital transformation, it must confront the reality that not everyone has the same level of access to digital tools and services. The report emphasises the need to address these disparities and ensure that the benefits of digital initiatives are accessible to all, regardless of their socio-economic status, age, or geographical location.

Equity in Access to Care

A cornerstone of the NHS is its commitment to providing quality healthcare to every individual in the UK. To uphold this commitment, it is essential to recognise and mitigate the barriers that hinder equitable access to digital services. The report rightly underscores the potential risk of exacerbating existing health inequalities if digital initiatives are not implemented thoughtfully. Vulnerable populations, such as the elderly, those with limited digital literacy, and people in remote areas, are at particular risk of being left behind in the digital transformation process. At the HIN we have recognised this need in our projects, and implemented an involvement strategy to ensure we are working in partnership with the communities we serve. We also employed two lived experience partners (LEPs) who are a crucial part of our organisation, to advise on involvement activities within our projects, expand our community networks and support other experts by experience and service users who work with us. Their role is fundamental in supporting us to embed involvement within our organisation.

Addressing the Challenges

To bridge the digital divide in NHS transformation, several key strategies must be employed:

  • User-Centric Design: Digital initiatives should be designed with the diverse needs of users in mind and through involving the people who will become end users. User-centric design principles ensure that digital tools are intuitive, easy to use, and accommodate varying levels of digital literacy.
  • Assistive Technology and Support: Consideration should be given to individuals with disabilities or special needs who may require assistive technology to access digital services. Providing necessary support, such as screen readers or adaptive devices, can enhance their experience and ensure information is accessible to all.
  • Collaborative Partnerships: Collaboration between the government, private sector, and community organisations can help create innovative solutions to bridge the digital divide. At the HIN we run our own London Accelerator for digital health companies with a product or service that has high potential to meet the current challenges facing the NHS and social care today. So far 160 companies have been supported resulting in over 3,500 pilots in the NHS.

Conclusion

The government report on the NHS serves as a wake-up call to address the digital access disparities that exist within the healthcare sector. As we embrace the potential of digital initiatives to transform the NHS, it is imperative to ensure that no one is left behind. By implementing strategies that prioritise inclusivity, accessible infrastructure, and user-centric design, the NHS can achieve its transformation goals while upholding its core principle of providing equitable healthcare access to all members of society. The journey towards a digitally empowered NHS must be guided by the principle that every individual, regardless of their digital prowess, should have equal access to the benefits of modern healthcare services.

The importance of active listening in heath and care practice

Published and last updated by Michael Mbanunu

Health Innovation Network (HIN) South London has been working alongside the Health Foundation’s Q Network to launch the Communities of Practice Leadership Development Programme. This is an immersive learning course that was launched in January 2019 to offer health and care staff all of the building blocks for effective community practice leadership. Current participant Rona Inniss, a nurse working in a London teaching hospital, shares her reflections from her participation in the last Communities of Practice leadership development programme.

I am a nurse, working in a London teaching hospital. Before studying nursing and gaining my professional registration, I studied and worked in architecture. This year I started an ICA Pre-doctoral Clinical and Practitioner Academic Fellowship (PCAF) focused on hospital environments. I will continue the fellowship part time over the next 18 months with the intention of submitting a PhD proposal through the Doctoral Clinical and Practitioner Academic Fellowship (DCAF) scheme at the end of 2024.

As part of the training plan that I put together, I applied for and was offered a place on the HIN South London Communities of Practice (CoP) Leadership Development Programme running from January 2023. I wanted to do the CoP programme because I was interested in less hierarchical and more collaborative ways of working. I have found the modules, guest speakers and tools, and the group working and reflection incredibly valuable. For me the most important tools have been those that foster an environment of authentic communication and dialogue. Over the years, I’ve done many courses and training that have had elements focused on active listening, but this is the first course that really supports the genuine processes of listening, engaging, and honestly reflecting.

Although each module focuses on a different element and style of leadership, the importance of listening has run through each module and session. The tools are often very simple and tend to boil down to permitting each other to talk openly while others listen with compassion, without judgment, and without the need to immediately react and respond.

One powerful tool asks people to sit in a space together (virtually or face-to-face) and take it in turns to talk while the others listen without interrupting or reacting. Knowing that you will be given the opportunity to speak without having to interject, and that you will be listened to, slowed the conversation, and allowed everyone to have their ideas heard. It stopped the usual voices from dominating and forced us all to reflect on what was really being said before we responded. I found that fleeting thoughts were lost as the dialogue was passed from person to person before I had my chance to speak. By listening fully to what was being articulated without mentally preparing what I was going to say or listening for a gap in the flow to interrupt, the conversation felt richer and more meaningful.

Like all my colleagues in the NHS, we are working under tremendous pressure. When you and your team barely have time to carry out the fundamentals of your role, it feels like taking the time to indulge in listening exercises is an unnecessary luxury. I would argue that exercises are always valuable, but right now, working in near constant crisis mode, the act of listening is more vital than ever. As a result, I am doing what I can to make sure that communication I lead is reflective and allows everyone space to speak. It is easy to forget the power of listening, in the heat of each exhausting and often demoralising day, I struggle to find the time and energy to listen. For me, this course is a reminder to continue to try harder to act with compassion and to really listen to my colleagues and patients.

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Patient Safety Collaboratives continue to support improvement across the healthcare system

Published and last updated by Michael Mbanunu

The Health Innovation Network supports the delivery of the National Patient Safety Improvement Programme through its 15 regional Patient Safety Collaboratives (PSCs). The programme supports the NHS England Patient Safety Strategy. During the first quarter of 2023/24 (April to June 2023) significant progress has been made across all five improvement workstreams. See the highlights below or download the report.

Read more about how patient safety collaboratives are progressing National Patient Safety Improvement Programme work here in the latest activity report.

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If you have any questions or would like more information about medicines safety in care homes, please contact Alison White, Head of Patient Safety.

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MatNeoSIP: collaborating to improve maternity and neonatal outcomes post-pandemic

Published by Michael Mbanunu

The Health Innovation Network held its fifth Maternity and Neonatal Quality Improvement (QI) Series event: ‘Sustain and Share’ in October 2023. The Maternity & Neonatal Safety Improvement (MatNeoSIP) team at the HIN has been working with trusts across south London, improving clinicians’ working knowledge of quality improvement methodologies and facilitating project work. Our newly appointed MatNeoSIP Lead, Hebe Davies-Colley shares key outcomes and reflections from the event.

The Perinatal Optimisation Workstream is a set of 9 interventions that all maternity and neonatal units nationally are aiming to successfully implement. The workstream aims to reduce the rates of neonatal deaths, stillbirths and brain injuries that occur during or soon after birth by 50% by 2025 and to reduce the national rate of preterm births from 8% to 6% by 2025.

We were delighted to host colleagues from trusts across south London who came together to share their progress towards reducing maternal and neonatal harm ambitions, learn from the last year of collaboration, and collectively look forward to what the perinatal optimisation workstream will bring next. We heard three local project presentations, a reflective fishbowl discussion, and further presentations from our south east and south west London Local Maternity and Neonatal System (LMNS) leads and the National NHS England MatNeoSIP team.

Since the pandemic, many maternity teams have been running on maintenance mode. This event showed us how the tide is starting to turn; now there is an ever-increasing motivation to start improving outcomes and learn from each other in a collaborative, multi-organisational, multi-disciplinary community. It was inspiring to see great successes in several south London trusts, with notable improvements in rates of delayed cord clamping (DCC) and maintenance of normothermia for preterm babies.

DCC is where clamping of the umbilical cord separates the baby and the placenta is delayed 60 seconds after birth. This allows time for extra blood to flow from the placenta to the baby and evidence shows that DCC reduces death in preterm babies by nearly a third. Normothermia is maintaining the normal body temperature which is important because hypothermia (temperature too low) carries risks including sepsis and respiratory distress. At the same time, hyperthermia (temperature too high) can have significant metabolic consequences. DCC and normothermia are 2 of 9 elements measured as part of the perinatal optimisation workstream in the MatNeoSIP.

Dr. Mirna Krishnan, Neonatal Registrar at King’s College Hospital (KCH), gave an excellent overview of their QI project named ‘Optimum Cord Management: “Hurry-up and Wait"’. In a year, KCH successfully increased the rates of DCC for babies under 34 weeks at the Princess Royal University Hospital site and Denmark Hill site by 12% and 27%, respectively. Both sites are achieving 90% documentation of cord management and the rate of DCC is now sitting just below the average across the patient safety collaborative area.

Dr Yogita Shanmugharaj, Neonatal Clinical Fellow at the Queen Elizabeth Hospital site of Lewisham and Greenwich Trusts (LGT) also gave a presentation on optimal cord management titled ‘Improving compliance with Delayed Cord Clamping (DCC) for preterm babies < 34 weeks’. Yogita reported that after 2 improvement cycles to raise staff awareness and introduce measures where basic newborn life support (NLS) was initiated (stimulation and airway support) to the baby to perform a heart rate assessment at 30 seconds while still attached to the cord, the overall rate of DCC increased from 49% to 83%!

Dr. Drupti Jogia Paediatric Registrar and Dr. Alina Petric Paediatric SHO of Croydon University Hospital (CUH) also presented their successful work. They spoke about their audit project entitled ‘Maintaining normothermia on Admission to the Neonatal Unit.” Through implementing a checklist for admission temperature, rates of hypothermia dropped from 32% in Q1 2022/23 down to 4% in Q3.

We then used a “fishbowl” technique to hold a reflective discussion exploring the experiences of those who had participated in the projects at a trust level with engagement from the HIN.

Looking at the factors which made the process work, it was clear that the dedication of the project team and working group members was key. Challenges discussed included trying to sustain the measures to become ‘business-as-usual’ after QI programmes had ended. The participants also discussed difficulties with juggling clinical responsibilities and project work.

Dr Justin Richards, Consultant Neonatologist at St George’s Hospital and south west London (SWL) Neonatal Network Lead presented clear updates from the SWL LMNS workstream. He reported that the appointment of two Neonatal Quality Leads has incurred drastic improvement in the SWL engagement with the perinatal optimisation interventions and therefore steep improvements in the rate of uptake across SWL trusts.

Mel Howie, Maternity Project Manager from the south east London (SEL) LMNS set out SEL priorities for 2024 including a parent passport, integrating neonatal parents into the maternity voices partnership, and further progressing the preterm birth pathways.

Finally, we were pleased to hear from Charlie Merrick, Senior Improvement Manager in the national MatNeoSIP team at NHS England. Charlie provided clear insight using the Preterm Optimisation Dashboard (available on the MatNeoSIP page on FutureNHS) and displayed outcome data of some huge achievements since the start of MatNeoSIP in 2018. These included the potential lives saved, brain injuries prevented and cost savings to welfare and society in south London. Looking forward, MatNeoSIP will have a new ambition for 2024/25 starting next April, the details of which will be confirmed in due course.

I feel that we had an incredibly positive event. It was brilliant to bring our colleagues together celebrate their successes and collaborate in a positive space. Delegates reported that the ‘energy for improvement was palpable’ and a real appetite for change in the south London region. We at the HIN hope to continue providing practical and facilitative support to improvement teams at the trusts, and we’d like you to watch this space for news of our next round of workshops sharing learning about quality control and sustainability of interventions within QI projects so the improvements in practice are maintained.

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If you have any questions or would like more information about Maternity and Neonatal Safety Improvement Programme, please contact Hebe Davies-Colley, MatNeoSIP Lead.

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Helping patients with long-term conditions access “cool” technology

Published by Michael Mbanunu

Ruth Bradbury, Senior NHS Navigator at DigitalHealth.London, shares her reflections from a recent panel discussion at HETT about the possibilities for patient facing technology.

When I was asked to be part of this panel at HETT I was excited to be able to share the trends I am seeing through my work at DigitalHealth.London. I was fortunate to be joined by clinicians and leaders with years of experience in implementing patient facing technologies.  They have seen it all from the highs to the lows.

Our Chair, Rishi Das Gupta, CEO of the Health Innovation Network South London, brought his enthusiasm for the topic with an opening question around what we have seen that is ‘cool’?  Now, there are lots of ‘cool’ technologies at different stages in development – emerging proof of concepts or established players delivering systemic change, but what makes something cool?  Is it the super-duper AI behind the scenes, the ease and convenience for the user, or the clinical outcomes?

My fellow panellists talked about their work in renal transplant and maternity care and how they have worked with patients and clinicians to improve the clinical pathway for their patients through implementing technology.  They also referenced groundbreaking AI technologies that turn your smartphone into a medical device equipped to measure clinical vital signs. For me though, the ‘cool’ bit about patient facing technology is where it enables the patient to be involved in their care and in an empowered position to take control of their condition and their management.

A current trend that we are seeing at DigitalHealth.London is in Long Term Condition (LTC) management. Patients with LTCs are a high need population for health and care services.  With clinical services that are stretched, risk stratification of patient need becomes even more valuable to ensure patients get clinical input at the right time.

Some examples that I have seen through my work include innovations which allow patients can share photos and videos of themselves; these can support their clinician to better manage their condition through the image record alone or AI analytics which can track change and direct management. Patients who are able to log their daily routines and medication can provide more reliable information to their clinicians to support virtual management or more effective face-to-face appointments. And technologies that support the patient to take control and ownership of their LTC can demonstrate improved clinical outcomes, reductions in secondary care re-admission or reduction in outpatient follow up, and overall improved quality of life. I think those are the impacts that make patient facing technologies cool!

One of the discussion points focused on the role of patients and users in the development and implementation of technology. Sian Thomas, SRO for Digital Maternity Cymru, talked about how her work rolling out a digital maternity record involved collaboration with women and birthing partners. Collaboration could involve co-design and co-production, but involvement of patients and users needs to consider the diversity of the population so that health inequalities are recognised and targeted. For the supplier developing a patient facing technology, understanding health inequality issues and engaging with the right people can be challenging, but there are broad brush actions that can be taken. For example, is the tech accessible in different languages or via mobile and web apps? Is the user interface and experience simple enough to manage differing levels of digital literacy? Beyond this, suppliers and health and care teams have a role to dig deeper into the specific needs of the target population so that implementation does not leave people behind.

So, we know there are many 'cool' patient facing technologies out there, with new ideas and products ready to be launched to the health and care system.  The un-cool part is how to get these ideas and products into the hands of the patients and clinicians; the challenge of navigating the system, finding the champion and ultimately the money.  At DigitalHealth.London we make this un-cool part part of our everyday mission. We work with innovators to help them understand where they should be focusing, where the need is, and who they should be talking to.  And not forgetting supporting innovators to build the evidence base to demonstrate the value of their ‘cool’ innovation.  For me, working with digital health innovators and clinicians to ultimately get technology into the hands of the patient is what makes it all possible.

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Health economist welcomed to Health Innovation Network

Published and last updated by Michael Mbanunu

A passionate health economist with over 10 years’ experience is joining the Health Innovation Network for south London.

Dr Anna Buylova will start in her new role at the HIN in December, moving from the Health Economics Unit. Her experience includes decision modelling, methodologies of study design and conducting health economic evaluations across a range of diseases, settings and population groups, including measuring determinants of socio-economic inequality in access to healthcare services. She is particularly interested in emerging trends in statistical methodology and in making the most of NHS data to improve care for patients.

Before joining the Health Economics Unit, Anna worked on the evaluation of innovative medical technologies (including digital health and artificial intelligence technologies) helping the NHS adopt efficient and cost-effective medical devices and diagnostics more rapidly and consistently. This included cost utility, cost consequence, cost-effectiveness (including building de novo Markov models) and budget impact models; as well as delivery of projects funded through NHS AI Lab and Healthcare awards.

She will be part of the HIN’s successful Insights team offering supporting on evaluation and data analytics. Currently, the team is working on health and care projects including an evaluation of virtual wards in South West London and a national pilot on hearing checks in residential schools for children with additional needs.

Dr Andrew Walker, Head of Insights at the HIN said: “Being able to demonstrate the financial impacts of innovations and new models of care is a crucial part of evaluating public sector programmes so it’s exciting that Anna will be joining our team.”

Dr Buylova said: “I’m looking forward to using my skills to highlight what models of care provide best value for money in the NHS so we can promote the spread and adoption of innovation quickly.”

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Moving past the physical – how tech can help our mental health.

Published and last updated by Michael Mbanunu

Medtech often has a focus on physical health or issues directly related such as wait list management for elective care. So Jill Owens, senior project manager in the mental health team at the Health Innovation Network, the AHSN for south London, was pleasantly surprised to find more companies developing products for the mental health sector. Here she discusses what she found and why it’s important.

I have been attending HETT, the Healthcare Excellence Through Technology conference where innovators and healthcare professionals share the best of themselves in London since its very first show.  This year I was looking forward to seeing colleagues old and new but - with a good deal of focus being on wait list management in elective care - I was prepared not to find radical development in the mental health arena.  I was delighted to be completely wrong and to meet several companies making exciting strides in supporting people with their mental health.

These included well-known companies developing their offer, such as Kooth.  Kooth has been supporting young people’s mental health since 2004 and claims to be the largest mental health platform for young people, working with services across England and the US.  Simeon on the Kooth stand was brimming with ideas for development of Kooth, including how it can be used to tackle the needs of specific groups such as young black men, and how we can have a joined-up approach to mental health crisis.  We had an energetic discussion about how to engage system leaders and get data to support future action.

It was also great to learn how other established companies, such as DrDoctor, are actively looking to expand their offer to mental health services.

There was emerging innovation, such as CareLoop Health, an AI driven tool which has been developed by the University of Manchester and partners to prevent relapse of psychosis and schizophrenia by alerting care teams to its signs, which offers a critical treatment window for delay or prevention. Each year a person with psychosis has a one in four chance of relapse. Studies such as one published in the Lancet in 2022, show a reduction in full relapse with use of CareLoop as well as additional care benefits.  It was exciting to speak to Ben at the CareLoop stand about the team’s ambitions to spread this innovation more widely.

Extended reality (XR) is also becoming big news in health innovation. SynchVR Medical already has established tools to address pain management and anxiety in children and adults. At its HETT stand I was able to have a demo of its technology which has been adapted to include exposure therapy for phobias and anger management. The demo involved popping on the headset and selecting from a variety of examples, including road rage and even an office!  The experience was quite unique and can truly be described as immersive.

We know that since the COVID-19 pandemic there has been an exponential rise in the severity and number of people seeking help for their mental health (NHSconfed, 2022), and an associated rise in wait lists. There still needs to be more discussion around how investment in technology can support mental health.  But speaking to the innovators at 2023 HETT conference I am confident that there is a great deal of energy at hand to develop ways innovation can be used to improve the lives of people with mental health issues.

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Supporting webinar to raise awareness about the use of Urgent Community Response services in south east London

Published and last updated by Michael Mbanunu

Our Community and Care Home Programmes Team has been supporting South East London Integrated Care System (ICS) to increase awareness of Urgent Community Response services amongst care homes and telehealth (pendant alarm) services.

On 10 August 2023, Health Innovation Network supported South East London integrated care system colleagues to bring together over 60 staff drawn from care homes, telehealth services and London Ambulance Service at a webinar chaired by Helen Smith from south east London’s Community Provider Network.

The webinar featured presentations from each of the Urgent Community Response providers in south east London, namely Bromley Healthcare, Lewisham and Greenwich NHS Trust, Oxleas NHS Foundation Trust and Guy’s and St Thomas’ NHS Foundation Trust.

Clinical case studies were used to demonstrate the wide range of conditions that the services can support.

A recording of the webinar and the presentations are available. Another webinar is planned to take place in November 2023.

Please also see here for South East London’s Urgent Community Response services booklet which gives contact details and further service information.

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Culture is everything: reflections on reducing restrictive practice at Lesney Ward

Published and last updated by Michael Mbanunu

Restrictive practices are techniques such as physical restraint, seclusion and rapid tranquilisation used to limit a person’s liberties, movements or freedom to act independently in potentially dangerous situations.

The inappropriate or overuse of restrictive practice in mental health services has been identified as an area of concern in healthcare since at least 2015.

Beginning in 2021, the Health Innovation Network has been involved in local efforts to reduce restrictive practice based on the findings of a successful pilot led by the National Collaborating Centre for Mental Health.

We speak to HIN Patient Safety Project Manager Ayobola Chike-Michael and Ward Manager James Njoki about the programme team’s recent visit to Lesney Ward, an acute adult mental health ward which is part of Oxleas NHS Foundation Trust. Read reflections from previous visits here.

Ayo

In my role of supporting mental health wards to reduce restrictive practices in south London, I recently had the privilege of visiting Lesney Ward, which is part of Oxleas NHS Foundation Trust.

Lesney is a 20-bed mixed adult mental health inpatient ward, and I was eager to explore the ward’s efforts to create a therapeutic environment with minimal use of restraints.

Upon arrival, I was delighted to find that Lesney Ward had recently undergone refurbishment. The ward now boasts a fully functioning gym, a sensory room and therapeutic garden among other enhancements.

During my visit, I met the ward manager, two other members of staff and a QI lead from the Trust. Engaging in meaningful discussions, we exchanged ideas on how to promote positive change and minimise restrictive practices within the ward.

One remarkable aspect of Lesney ward is its commitment to establishing a culture of no restraint as the default approach. As a result, the ward does not have any seclusion rooms. The primary method used to reduce the use of restrictive practice is the de-escalation method, which was commended at a CQC inspection in February 2023.

I was impressed by the variety of successful de-escalation methods employed by the ward. Apart from the verbal de-escalation methods, there were other successful change ideas the team shared with me:

  • Patient Engagement Time (PET). PET is a 7-day activity timetable with flexibilities where each staff spends 30 minutes with their assigned service user to build rapport and provide reassurance.
  • Daily community meeting. Held Monday to Friday, this meeting involves patients, staff, healthcare assistants, occupational therapists, activity coordinators and others. This could be led by patients or staff.
  • Relational security. The ward makes active use of the ‘See Think Act’ framework.
  • Simplification of language. For example using terms such as ‘physical health check’ instead of ‘vital signs’, which enhances communication between staff and service users.
  • Being proactive about giving information to service users.
  • Diverse activities. Activities on offer include arts and craft, walking group, sensory group, therapeutic garden visit, orientating to ward, gym induction and physical health competency.
  • Appropriate interventions and medications. Ensuring patients receive the right interventions and medications to prevent transfers to psychiatric intensive care units whenever possible.
  • Inclusive safety huddles. These huddles involve all stakeholders including domestic staff
  • Nutritious food. Food is sourced from reputable providers, with careful planning going into making sure that it provides the right nutrition for service users. Taster sessions were organised for both staff and service users, and a variety of fruit is available throughout the week.
  • Promoting decaffeinated beverages while maintaining flexibility
  • De-escalation for smoking demands. Employing de-escalation techniques to address service user requests to smoke, directing them to e-cigarettes.

My visit to Lesney Ward was an inspiring and enlightening experience. The recent refurbishments have enhanced the ward’s facilities and contributed to a more holistic approach to care.

The ward’s commitment to creating a therapeutic environment with minimal use of restraints is truly commendable. By prioritising patient engagement, promoting positive change, and implementing innovative strategies, they show us the possibility of creating a mental health system that values dignity, respect and recovery for all.

James

The culture of doing everything we can to deliver the best care at Lesney Ward is something that is quite special; it is something that predates my time here but which every staff member believes in.

We take a lot of pride in having very low levels of restraint and very rarely needing to refer our service users to Psychiatric Intensive Care Units (PICUs).

Whilst developing a culture takes years, we hope that our service users feel the benefits of our culture as soon as we start caring for them.

We are big believers in starting things off on the right foot. We make sure that all the people entering our care have their medicines reviewed as soon as possible, and we spend time with service users helping them get oriented to the ward and understanding the support we can offer them.

We hope that this helps us build bonds between service users and the staff and helps everyone to understand that we want to do everything possible to support our service users.

In the longer-term, having such a proactive culture has meant that we have been able to improve the environment we provide care within, which in turn has meant better outcomes.

Where it might have been easy for our old gym to have quietly closed when it fell into disrepair, the attitude of the team here meant that we saw it as an opportunity for improvement. Now, the gym is better than ever, and it provides a positive space for our service users.

Likewise, our garden is something that people might dismiss as being a bit of a luxury – in today’s NHS how can you justify spending time and money on greenery?

The reality is that those small things, those moments of going above and beyond the basics, can make a big difference to health outcomes and reduce the need for restrictive practice.

For example, a few weeks ago we had a new service user who was very unwell. It was very difficult for us to safely provide the care he needed as he was distressed about his new surroundings. It would have been an easy option to “escalate” this service user to PICU.

However, through going through the records of the service user, we found that they had an affinity for being outside. We tried moving some of our time with them into our garden, and we saw a huge transformation.

That sort of outcome isn’t something that comes from a moment’s work, or even a month’s work. But it shows that persistence and creating the right culture will pay off in the long term. From the first step to the last step, make sure every one has the right intention!

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Early Intervention Eating Disorders (FREED) National Spread Programme has been shortlisted for an HSJ Award 2023

Published and last updated by Michael Mbanunu

A mental health programme which has benefitted 1000s of young people with eating disorders has been shortlisted for a prestigious national HSJ Award.

An early intervention eating disorder model which originated in south London has helped over 2,000 young people has received national recognition today (Monday, August 14).

It has been announced that the First episode Rapid Early intervention for Eating Disorders (FREED) model aimed at 16 to 25-year-olds developed by South London and Maudsley NHS Foundation Trust (SLaM) and King’s College London (KCL) has been shortlisted for a 2023 HSJ Award.

The model provides swift access to specialised, evidence-based treatments tailored to youth, incorporating developmental considerations with a focus on early intervention. In 2020, it was selected by the Academic Health Science Network as a national programme, with the Health Innovation Network, the AHSN for south London, managing the rollout. To date, the programme has benefited 2,722 young people, leading to full early recovery in approximately 65% and halving the need for costly and disruptive in-patient treatment. The model has now been implemented in over 50 eligible mental health trusts in England, leading to estimated NHS savings of £12.1 million.

Dr Rishi Das-Gupta, the Chief Executive of the Health Innovation Network (HIN) said: "I’m pleased that the HIN has been able to support the spread of FREED. We know that eating disorders impact the lives of many young people and that intervening early is extremely helpful. This programme exemplifies how we can innovate in care delivery to reduce health inequalities and enhance access to services for our local communities - and reaching over 2,000 patients since the start of the programme is a mark of the impact of the teams delivering the service."

Ulrike Schmidt, Professor of Eating Disorders at KCL and Consultant Psychiatrist at SLaM who has led development and evaluation of FREED said: “Adoption of our programme by the AHSN/HIN has turbo-charged our ability to make FREED available to young people in all parts of England. We are now working to spread and improve the evidence-base for FREED further, both nationally and internationally.”

Danielle Glennon, Head of FREED and Head of Psychology & Psychotherapy at SLaM who alongside Professor Schmidt has been part of FREED’s story since the beginning, said: “The AHSN/HIN programme meant that despite the unrivalled challenges clinicians faced through COVID, we could continue to support teams in making FREED a reality for young people in their area. The commitment, creativity, and willingness to share, as the FREED network grew, is inspirational.”

Laura Semple the Director for National Programmes at the AHSN Network said: “Over the last three years, it has been an honour to collaborate with the 15 AHSNs on the FREED Programme. Clinical colleagues have worked diligently with their AHSN partners on the ground to get new FREED services up and running across England and it is excellent to see this achievement recognised. While we know there is much more to do to improve care for young people, the national availability of FREED is vitally important progress and we look forward to seeing the FREED network continue to thrive in the future.”

More than 1,400 entries were received for this year’s HSJ Awards, with 223 projects and individuals reaching the final shortlist, making it the biggest awards programme in the award’s 43-year history. The high volume - and exceptional quality – of applications once again mirrors the impressive levels of innovation and care continually being developed within the UK’s healthcare networks.

The winners will be announced during the awards ceremony at Evolution London on November 16, 2023.

Reducing harm for people with chronic pain by reducing the prescribing of opioids

Published and last updated by Michael Mbanunu

Introduction

At the Health Innovation Network (HIN) South London we developed a local programme across south London in response to the nationally commissioned Medicines Safety Improvement Programme (MedSIP). The Patient Safety Collaboratives (PSCs) are working with at least 50% of Integrated Care Boards (ICBs) across England, and will collectively achieve the ambition to improve care for people with persistent (chronic, non-cancer) pain by reducing opioid analgesic use by the end of March 2025:

- 25,000 fewer people are prescribed oral or transdermal opioids (of any dose) for more than 3 months compared to 31st March 2024.

- 4,500 fewer people are prescribed high-dose opioids (greater than or equal to 120mg oral morphine equivalent/day) compared to 31st March 2024.

The approach to improving the management of chronic non-cancer pain will involve raising awareness, shared learning, testing and scaling models of care that enable personalised care and shared decision-making, biopsychosocial support and supported self-management.

“All too often the complexity of having chronic pain and of helping people and professionals to manage pain are overlooked. High prescriptions of opioids can be a result. I’m delighted that this work has looked at how to manage pain as well as reducing harm from opioids.” Natasha Curran, Consultant in Anaesthesia and Pain Medicine at UCL Hospitals and Medical Director of the Health Innovation Network.
Our local programme covered the following:

Working with staff to drive improvement

We worked with clinicians across South London through our Opioid Stewardship Quality Improvement Collaborative (2022/23) to deliver projects to make local improvements. Please click here to find out more.

We delivered an opioid action learning set series with local and national partners affiliated with the British Pain Society, European Federation of Pain, Royal College of General Practitioners and Royal College of Psychiatrists. The content from the series has been used to create an opioid QI project guide to give clinicians ideas of projects they could deliver locally.

Using opioid prescribing data for system audit-feedback

We shared local opioid prescribing data packs with GP practices across south London based on the Campaign to Reduce Opioid Prescribing . Please click here to find out more.

Working in partnership with people living with chronic pain

At the HIN, we seek to understand, design, and improve the experience of health and care for staff, service users, and patients. We believe that this requires a deeper understanding, using people’s personal experiences to improve things.

We facilitated an experience-based co-design project using the Point of Care Foundation methodology. The aim of the project was to improve chronic pain management by bringing patients and staff lived and learnt experiences together to prioritise and co-design solutions as equal partners. Please click here to find out more.

We are working with King’s Health Partners, Pain: Equality of Care and Support within the Community (PEACS) programme and the University of Warwick, I-WOTCH (Improving the Wellbeing of People With Opioid Treated Chronic Pain) to test out and support scaling biopsychosocial alternatives to opioids and supported self-management programmes.

You can read more about developments with our local programme here in our blogs:

Medication Without Harm: Improving care for people living with chronic pain - Health Innovation Network

Medication Safety: How patients and healthcare professionals make safety work - Health Innovation Network

Working with patients as equal partners to improve chronic pain management - Health Innovation Network

One year on: how can working in partnership with people living with chronic (persistent) pain improve care? - Health Innovation Network

Find out more

To find more about our local programme please contact Natasha Callender, Senior Project Manager and Medicines Workstream Lead.

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My experiences of autism and mental health care: the bad, the good and the future

Published and last updated by Michael Mbanunu
Close up of young person sit on sofa hand holding mobil

There are more than 700,000 autistic people in the UK. Many autistic children and young adults experience a delayed diagnosis, which can have a significant negative impact on their mental health. 

We hear from Freddy Henderson (she/her) about her experiences being diagnosed with Autism Spectrum Disorder (ASD) and her reflections on what mental health services can do to care for autistic people in a more effective and person-centred way. 

Freddy also discusses how innovations such as Tellmi can provide valuable access to safe, anonymous peer support for autistic children and young people, who may often prefer to use digital channels. Tellmi is an innovative digital peer support app which is commissioned by the NHS and has been used by more than 80,000 young people to discuss their mental health.

Please note that this article contains some mentions of self-harm, suicide and eating disorders which some readers may find upsetting. 

I have 2 disabilities, Functional Neurological Disorder (FND) and ASD, although the latter is what I am going to be talking about today. I was diagnosed with autism six years ago, at age 17. That diagnosis came about after I was referred to the integrated neurodevelopmental team by Child & Adolescent Mental Health Services (CAMHS) as they suspected I was autistic. I had originally been referred to CAMHS when I was 15 by my school, as I was suffering a lot with my mental health and was grappling with self harm, depression and anxiety. I later developed anorexia and so was also under Child & Adolescent Eating Disorders Services (CAEDS) for about three months until I turned 18. Later at university I accessed NHS services in conjunction with the university resources to help me balance my mental health needs and medication for it.

I want to highlight that my ASD was not the direct reason I was using these services, but rather that I needed these services because the effects of my late diagnosis had become so catastrophic that it ‘broke’ my ability to cope with the world.

What I hope I can give an insight on in this blog is my own perspective what was helpful, what was not, and how I think services and treatment could be improved.

The bad

Let’s start with the worst of my experiences to get them out of the way.

My first therapist at CAMHS was terrible. They made me feel belittled and patronised, and their complete failure to understand my attempts at communicating what was going on meant that my health got actively worse.

I was very quiet and reserved in sessions and had flashes of anger when my therapist tried to make suggestions; I felt attacked and as though they were accusing me of not trying hard enough. I never shouted or expressed that anger outwardly, but it meant I was defensive and ardently against sharing information that I deemed to be too personal.

At the start of one session my therapist walked in and put a colouring book and pencils on the table and told me to colour. After a few minutes, I asked if we were going to talk. They replied with “well if you’re not willing to talk to me, why should I talk to you?”.

A couple of days later I was held overnight in hospital after a bad self-harm incident, which led to meeting my next therapist.

The next therapist made me feel much better. They were kind and patient with me and gave me practical help with how to formulate sentences expressing my thoughts and feelings. They would ask direct questions rather than open-ended ones, something that helped immensely.

We’ll come back to them later, but first let’s quickly talk about another bad experience.

It is now widely recognised that eating disorders are rife within the autistic community (especially young people) and I was no exception. What started as a desire to get “in shape” quickly morphed into a monster beyond my control.

I won’t describe any of my thoughts, actions or physical consequences as eating disorders are notoriously competitive and I don’t want to trigger other people who might be vulnerable themselves. The only part relevant to this story is that I was very unwell.

I was only in CAEDS treatment for about three months just before I turned 18, and so was transferred to the adult services where I promptly discharged myself after the therapist there criticised me for not making eye-contact with them.

Any readers with a vague understanding of autism may see the issue here. Eye contact is often difficult for autistic people and I don’t look at people’s eyes at any time, let alone when I’m feeling vulnerable. By this time, I had my diagnosis and the sheer disregard for my condition and the traits it presents as meant I rejected all additional treatment for my anorexia.

I am very pleased to say that I no longer have anorexia as I put in a lot of hard work and, with the help of some borrowed ideas from the fat acceptance movement, managed to overhaul the disease that controlled me for 3 years.

The (mostly) good

Now, onto the good experiences!

My second primary therapist was the person who helped me get an autism diagnosis, which turned out to be one of the biggest turning points in my mental health journey.

Up until that point I genuinely believed that I was fundamentally flawed as a human being and there was something intrinsically wrong with me. I considered myself nothing short of a complete waste of space and that my life would forever be spent in pursuit of a goal I would never achieve.

Getting my diagnosis put a stop to most of these thoughts, although it remains difficult to completely dismiss ideas you have held for the majority of your life.

It helped me come to terms with my differences and understand that I was not ineffectual as a human being, but rather I just operate a bit differently.

I was able to recognise my strengths for what they were, rather than consider them some minor penance for my otherwise catastrophic flaws. The diagnosis helped me to separate my brain from my mental health disorders. It helped me understand why I thought the way I thought and act the way I act.

It also helped explain why so much of the therapy I had had had been ineffective. Of course the CBT for panic attacks hadn’t worked; I wasn’t having panic attacks, I was having meltdowns.

Another type of support that helped hugely was when I met other autistic people.

At my university there was an autism support group. Granted, it was run by non-autistic staff members and in my third year it took such a drastic turn for the worse that I left after arguments with said staff, but still. I met a couple of good friends there who I miss dearly as we are no longer in the same city.

Meeting other people like me was amazing. We were able to connect on a level I hadn’t experienced before as we had an innate understanding of each other. That is not to say that my friendships with autistic people are inherently better than those with non-autistic people – they are just different.

Of course, autistic people are not a monolith and so there were some people there who I really disliked. Regardless of the ups and downs – being able to talk about our shared experiences was such a relief.

During my second year at university, the pandemic hit.

Covid-19 impacted every aspect of our lives, including the support services I was in. I got removed from the NHS community mental health service and the university wellbeing service as they wanted to free up capacity for people struggling to adjust to life in such a different world. The irony was not lost on me.

The ASD group was also moved online and let me tell you, trying to do a jigsaw puzzle over zoom presents some complications. I think it’s fair to say that aided in the breakdown of the group dynamic and made it quite difficult for the members who weren’t very confident to get to know the group.

We ended up doing activities such as a name-this-vegetable quiz, organised by one of the staff members. This quiz was later referenced when the whole group was arguing with the mentors that they were treating us like children.

The difference between in person support and digital support was stark. No one was ready for the pandemic and as everyone struggled to adjust, those accessing support services just plain struggled.

However, there was a definite silver lining to the switch to digital content and support: my university was online, which turned out to be an absolute godsend. By my second year I was still struggling with my mental health and processing a suicide attempt a year earlier. I had also started to develop what I now know is FND, although it would take roughly 4 years to get diagnosed.

In short, I was both physically and mentally really ill. Being able to do classes online was bizarre at first, but not having to expend energy getting to and from class and dealing with the sensory nightmare of being in public was amazing.

Lots of the pressure I had felt, both economically struggling at work and socially struggling on nights out, had been lifted. People found ways to socialise online, and jobs offered flexible working where possible. It hugely helped me.

The future

That is why going forward I am such a proponent of a hybrid approach to pretty much anything that can be hybridised. Whether it’s flexible office hours or the option of having therapy online, giving people the option to choose what suits them best hugely helped me and so many of my autistic and otherwise neurodivergent friends.

I still like going out with my friends, and having workplace banter is fun, but having seen the real benefits that digital services offer makes me very reluctant to go back to how things were.

And this is a key concept that I want to convey: when the world changed it was because it had to, but the effect was more surprising than anyone anticipated. All manner of people benefitted in unforeseen ways and thus having an open, flexible approach to resources and services is, in my humble opinion, the way forward.

Peer support does not have to be in person. Digital channels can be just as useful as in-person, and possibly more so when you consider factors such as geographical isolation, physical disability or time restrictions. Apps like Tellmi allow users to connect with others like them. Just as meeting my autistic friends was hugely helpful, having access to other people who may be experiencing similar issues is hugely helpful.

I’ve had the chance recently to speak with and work alongside the creators of the Tellmi app, and it seems clear that a lot of the reason why their service works for autistic people is because they put an emphasis on listening to and learning from autistic people to make their app better. Having people involved in the day-to-day running and development of the app who are neurodiverse is undoubtedly a good thing.

Consulting, engaging and co-producing with diverse groups of people will help build better solutions that work for all people. Just as neurodiverse people should be consulted about improving services for neurodiverse people, changes which have the potential to affect any group should be decided with the involvement of people who are representative of that population.

An underlying cause of the lack of effectiveness for many of the treatments I experienced was that they did not account for my autism. Autism is a fundamental part of me – and something I am very proud of – yet I was being funnelled through services not designed for people like me. As such, is it not surprising that they did not help me, and in some cases caused me harm?

Any support for autistic people needs the input of autistic people. And any services that might support autistic people also need the input of autistic people. You can have the best intentions in the world and be the brightest person alive, but if you haven’t lived as an autistic person, you will never build services which truly support autistic people alone.

Almost all the solutions I have found that have got me to where I am now have been of my own creation.

And where I am now is pretty darn great. I am happy, I am optimistic, and I am enjoying my life – which is much more than I could say when I was 15.

You might look at me, in my wheelchair with my headphones on and sunglasses blocking out external stimuli and think my existence is something which requires improvement. But I am at my best. Imposing one’s own ideas of how someone else should live is an issue for the ages, and that is precisely why it is imperative that we remove assumption and prejudice from the equation when we are trying to make services better for people.

I mostly don’t read work on autism by non-autistic authors. It is often derogatory, wrong or just plain offensive and I have no time for it.

My autism is a condition of which I take pride in and use to my advantage. I don’t have to be a genius like Einstein or a world changing advocate like Greta Thunberg in order to deserve the right to live as my authentic self.

I have no interest in support that hasn’t been developed by someone like me because it will be inherently steeped in presumptions and expectations that I don’t ascribe to. I will only ever be happy when I accept that I am not fundamentally flawed because of my condition and work alongside it to shape my life in the best way for me.

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“We are ‘done unto’ by health” – how do we help care home providers get an equal voice in integrated care?

Published by Michael Mbanunu

Here the Health Innovation Network’s Clinical Director Carrie Chill reflects on the learnings from a recent event focusing on how to ensure social care can have a louder voice in integrated care systems, and how those in the health system can support them.

Have we unlocked the full potential of integration?

I joined colleagues recently at a London-wide event to explore the potential of increased involvement from care providers at a more strategic level in the health and care system.

The Health Innovation Network supported a number of organisations at the event, which was hosted at City University London. These included My Home Life England, a charity working to improve the quality of life for those living, visiting, and working in all care settings, and Care Providers’ Voice, an organisation aiming to create strong networks of providers and maximise the benefits of collaboration across local geographies.

Attendees included care professionals in leadership roles from London nursing homes, residential homes and domiciliary care providers. They were joined by system leaders from local authorities and at a London level to explore how care providers can contribute to strategic development of Integrated Care Systems and Integrated Care Partnerships.

One of the early themes which emerged from the discussion was that care colleagues felt they needed a better understanding of the way health and care systems operate at a strategic level. They also felt they needed confidence, support, and resource to become more involved. There was a feeling among care providers of sometimes being required to undertake training or activity which had been done before or was of little value to the care setting. I felt many of these feelings were summed up by the comment that “we are ‘done unto’ by health”, with very little power to influence such situations.

We heard from Mike Armstrong and Tay Nagendran from Care Providers’ Voice on what has worked well in north east London. They explained how they have supported providers with recruitment and training and how “having a seat at the table” has helped local authorities deliver services more effectively.

I was struck by the consensus that the involvement of care providers would be both valuable and welcomed, but also by the hurdles to be jumped before it could become a reality. Care providers felt mentoring and ongoing support would be beneficial and there was much debate about exactly where and how their involvement would be most impactful.

It is so positive that My Home Life and Care Providers’ Voice have raised the profile of this important issue in London, and continue to do so. I feel we at the HIN are well placed to support these discussions through our networks including our Care Home Leads Forum, our Pioneer Alumni, through strengthening partnerships, and by exploring the potential of a London Care Network.

I believe we are just starting on the road to full integration. Great work has been done to configure the system, but we now need to work from the bottom up, to engage and include not just health, but also care and the voluntary sector.

It may not be quick, it may not be easy, but it will certainly be worthwhile.

The HIN and MHL are in the fifth year of working together to deliver the South London Care Home Pioneer programme to develop the leadership skills of senior care home staff.

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To learn more about this programme, contact us via the email below.

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Accelerating FemTech: How can FemTech help reduce inequalities in maternity care?

Published by Michael Mbanunu

The final webinar in the Accelerating FemTech: Inspire series was hosted by West of England Academic Health Science Network (AHSN) and was on the topic of inequalities in maternal and neonatal care.

Anna King, Commercial Director at the Health Innovation Network, began the webinar by introducing the Accelerating FemTech initiative and the Accelerate programme which is currently open for applications.

Alex Leach, Director for Innovation and Growth (acting), provided a short introduction to West of England AHSN and the work the organisation has being doing across Bristol, Gloucestershire and Wiltshire, leading the way on multiple maternity and neonatal care programmes.

The first presentation was delivered by Ann Remmers, Maternity and Neonatal Clinical Lead for West of England AHSN, on the topic of health inequalities and the impact they have on outcomes and experiences in maternity care. Ann provided insight into what is meant by inequalities in health and what these mean in maternity care, sighting shocking statistics such as the MBRACE-UK Report finding that black women were 3.7 times more likely to die than white women during maternity care. Ann concluded by emphasising the power of collaboration when looking at innovation in this space.

Sonah Paton, Founder and Director of Black Mothers Matter, spoke next about the lived experiences of black mothers, the evidence available and the context which led to the founding of Black Mothers Matter, encouraging innovators to remember the real people behind the statistics. She provided an overview of the support which the organisation provides including an online resource library and shop, antenatal support boxes and taught sessions in a community group including with pelvic health specialists and baby yoga instructors. Sonah also discussed the Black Maternity Matters initiative, co-produced with multiple partners including West of England AHSN, and currently being piloted in Bristol Trusts, involving training and QI projects.

Finally, the Founder & CEO at Anya, Dr Chen Mao Davies, gave an inspiring presentation on the multi-award winning FemTech start-up which is leveraging AI, 3D technology and access to world-class specialists to support parents with breastfeeding. This was born out of Chen’s personal experiences of breastfeeding and aims to help the 90% of mothers who are reported to give up breastfeeding before they wanted to. She shared the company’s co-production approach and patient involvement strategy, and the resultant improvements that they were able to make to the Anya product as a result.

If you found these clips interesting, you can now express an interested in attending our in-person Accelerating FemTech events happening in Manchester, London and East Midlands.

Applications are also open to Accelerating FemTech: Accelerate, a 10-week support programme is for small / medium-sized companies (SMEs) from across the UK, that have early-stage innovations addressing current challenges in women’s health.

Relicensing of AHSNs confirmed

Published by Michael Mbanunu

Today the Government has confirmed that that Academic Health Science Networks (AHSNs) are being relicensed for a further five year period as part of a broader commitment to science, research and innovation.

Set up in 2013 by NHS England to act as innovation arms of the NHS, AHSNs work locally and nationally to support the spread of all types of innovation within the NHS, from new technologies to ways of working and service improvements. Under the Department of Health and Social Care and the Department of Science, Innovation and Technologies’ joint commission - the Office for Life Sciences (OLS) - AHSNs also provide bespoke support to innovators to accelerate promising innovations from development to adoption, and boost economic growth.

The Health Innovation Network (HIN) is the AHSN for south London. In the last year we have supported over 70,000 patients to benefit from new treatment and diagnostics in south London. In addition, we have supported national programmes such as FREED which had resulted in all 54 mental health Trusts adopting this innovative programme, developed in south London, to support people with eating disorders.

Dr Rishi Das-Gupta, HIN Chief Executive and Hitesh Thakrar, HIN Chair said: “Today’s announcement is very welcome and re-iterates the importance of AHSNs as part of the research, innovation and health and care infrastructure.

“It also builds on statements by NHSE over the last year and the Hewitt Review last month which highlighted AHSNs as an essential function. It provides a renewed mandate to continue our AHSN work across south London, which forms a core part of the support we provide to the local health system as part of our work to support the spread and adoption of innovation across London and nationally and to innovators locally, nationally and internationally.”

Professor Gary Ford, Chair of the AHSN Network said: “It is a testament to the collective impact of the AHSNs over the past 10 years that our commissioners have issued a further licence. We welcome the opportunity and challenge this provides for our teams to identify, develop and spread innovations that meet the priorities of the NHS over the next five years.

“The challenges facing the NHS will only be met by widespread adoption of innovation in digital and diagnostic technology and in data to transform clinical pathways and empower patients.”

The new license will come into effect from 1 October 2023 with the option of a review after two years.  As part of the new licence, AHSNs will be renamed health innovation networks. Each organisation will continue to support local innovation and transformation, working with their local integrated care boards (ICBs) while continuing to come together as a national network to spread promising solutions at scale.

The real impact remote monitoring has on care home residents and those who care for them

Published and last updated by Michael Mbanunu

Project Manager at the Health Innovation Network Andrew Scott-Lee reflects on the learnings from an evaluation of more than 170 London care homes using remote monitoring.

The use of Remote Monitoring (RM) technology to monitor physical health conditions outside of hospital has increased rapidly in recent years, and in particular since the Covid pandemic. This growth in use has also been seen in care homes where the technology has been introduced to enable monitoring of residents’ health at home and to improve the chances of identifying deterioration quicker.

Our evaluation of the implementation of remote monitoring in 173 care homes across four London Integrated Care Systems in 2021 found that 73% of homes continued to use the equipment months after implementation. Many care home staff reported benefits to them, residents, and the wider healthcare system.

The report highlights the confidence that RM instils in care home staff, who are often not trained to the same level of nurses or doctors. Utilising the physical health monitoring kit, baseline health data is collected, and guidance is available so that appropriate action can be taken when readings change. Training in use of the technology empowers staff to interpret observation readings and communicate effectively, confidently and in a clinically appropriate way with GPs, urgent care, and ambulance services.

I was able to explore in detail the approach that South West London (SWL) Integrated Care System took to implement RM in care homes, by undertaking a series of interviews with staff who led the digital transformation, and care home managers. The experience of these staff is described in this report.

You can see from the report that SWL’s Integrated Care System has made impressive progress in implementing digital transformation in care homes. My conversations with staff also highlighted the challenges faced by the care home sector in general in making the transition to digital ways of working.

Prior to the pandemic, many care homes predominantly used paper-based approaches for tracking and monitoring resident care, so the transition to digital monitoring requires - for some - a change in mindset. Care homes continue to experience high staff turnover rates, making it difficult to embed change. The amount of training and on-going support for digital transition may vary across different geographies, which impacts a home’s ability to sustain a digital transition once they have begun the journey.

Despite challenges, the commitment of care home staff to do what is best for their residents dominates. Although RM remains in its early stages of adoption in care homes overall, care home staff and GPs recognise its value.

Further evaluation may demonstrate that more consistent early identification of deterioration could result in fewer 999 calls and ambulance conveyances from care homes, and shorter, more appropriate hospital attendances and admissions.

Technological advances offer the potential for health and care services to work even better together to ensure that care home residents receive the right care, in the right place and at the right time, and services are used as efficiently as possible.

This can only be good news for care home residents, and the people who support them.

Download the report

Find out more about the impact of remote monitoring in care homes in our full evaluation report.

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Using Virtual Reality to Help People with Acute Mental Health Conditions

Published and last updated by Michael Mbanunu

Aileen Jackson, Head of Mental Health at the HIN, writes about the promising results from a pilot of virtual reality (VR) relaxation technology on mental health wards.

A scuba diving experience with wild dolphins. A sunny meadow in the Alps. A coral reef. A sunny mountain meadow with animals. A guided mindfulness meditation on the beach. A session of Tibetan sound bowls. These are some of the images and sounds that have helped to reduce stress for people with acute mental health issues.

Learning about how a cutting-edge virtual reality (VR) relaxation innovation has supported people with acute mental health conditions has been truly inspirational and uplifting. After being made available on an acute in-patient mental health ward, the VR headset was, perhaps unsurprisingly, well received by service users and staff. So why is this intervention not routinely offered on all mental health wards?

Background

The project was made possible through a Health Innovation Network innovation grant back in 2019. It was developed by virtual reality pioneer Dr Simon Riches, Highly Specialist Clinical Psychologist, in partnership with Kings College London and VRelax.

The pilot involved 42 service users at South London and Maudsley NHS Foundation Trust, of which 28 were inpatients and 14 were attending outpatients. The most common diagnoses for those who participated were schizophrenia, schizotypal and delusional disorders. All service users had one session of virtual reality relaxation.

How did VR help?

Positive outcomes were reported by all 42 participants, including significant reductions in stress, anxiety, and sadness, and significant increases in relaxation, happiness, and connection to nature.

A particularly interesting learning for me was how the virtual reality experience translated into the real world. Just one session resulted in participants being more open to trying new things and getting out into real world nature. There are also really promising indications that providing a calming VR experience can lead to a reduction in violence and aggression on the wards.

As with all new innovations there are some lessons to learn. Some practical issues were encountered around navigating the VR devices both for clinicians and service users, and some clinicians reported disconnect with participants as they were unable to see and experience the VR at the same time. However, in general clinicians were enthusiastic about the benefits of the intervention.

The main conclusion is that virtual reality relaxation can be a powerful tool in the context of often-stressful psychiatric wards, enabling service users to have a virtual break to visit beaches or mountains. This is especially pertinent to service users in south London and in any populated urban area, who don’t have ready access to peaceful, natural environments.

Given these promising results, I would encourage mental health wards to consider how they can offer this low-cost and potentially highly beneficial option to service uses.

Read the Full Evaluation Report

Find out more about the impact of virtual reality relaxtion for acute mental health conditions in the evaluation report.

Read the evaluation report

Delivering holistic care for physical health conditions through digital talking therapies

Published and last updated by Michael Mbanunu

Could digital talking therapies tools help to provide more well-rounded care to people with physical health conditions? Health Innovation Network project manager Gemma Dakin discusses the potential benefits of these digital tools and work being done to increase their usage.

The links between physical and mental health are well-established. About one in three people with a long-term physical health condition also has a mental health problem (most often depression or anxiety), and people with mental health conditions may also have a long term physical health condition such as diabetes or cardiovascular disease.

Despite this, approaches to treatment often remain segregated. Looking specifically at treatments primarily for physical health conditions, access to high-quality mental health support or “joined-up” physical and mental health interventions is limited.

However, in recent years, innovations have started to emerge which provide tailored support to help people manage the mental health implications of physical health conditions. Many of these innovations are based around providing digital access to talking therapies (sometimes known as Improving Access to Psychological Therapies or IAPT).

Talking therapies use techniques such as guided self-help or cognitive behavioural therapy (CBT) to help people self-manage their symptoms and find improve their wellbeing. They are most suited to treating mental health problems of relatively low severity; there is a growing nationally-recognised evidence base suggesting they can improve the quality of life for people with physical health conditions ranging from diabetes to lower back pain.

Improving access to talking therapies in south London

Through the Health Innovation Network’s activities in mental health, the work of DigitalHealth.London and the work of our colleagues at King’s Health Partners (KHP), we have a well-developed network of promising innovators providing solutions to support mental wellbeing for people with physical health conditions.

In late 2022, the HIN co-hosted a webinar with the Healthy London Partnership showcasing some of these solutions to an audience of NHS commissioners, clinicians and other interested parties.

Presenting at the webinar were:

  • Limbic: a chatbot-based solution designed to speed up the patient journey between assessment and treatment and offering tailored psychoeducation and CBT.
  • Silvercloud: a system providing digital access to therapy and therapeutic tools, currently being used across four long-term condition areas.
  • Minddistrict: a versatile online mental health platform providing access to services such as Acceptance and Commitment Therapy (ACT), CBT and psychoeducation.
  • Mahana: a specialist digital treatment for people living with Irritable Bowel Syndrome (IBS).

Each of these innovations presented evidence for the potential benefits of their solution to support people with physical health conditions – not only through improving outcomes for patients directly, but also through reduced administrative burden on services. You can find the slides presented at the event here.

With 1.9 million people with depression or anxiety disorders expected to be using talking therapies services by 2024, digital services will have an increasing role to play in managing demand and enabling convenient access to effective care. New innovations embracing person-centred co-design will help to provide more different ways for patients to access tailored support. Waiting lists for many forms of treatment will continue to be a challenge across the mental and physical health sectors; evidence-based digital solutions which help people manage and improve their mental health and wellbeing will undoubtedly grow to be an important element of providing truly integrated care.

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Interested in using digital talking therapies to support patients? Get in touch with the team to find out how we can help

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Partnering with People at the HIN: HEAL-D

Published and last updated by Michael Mbanunu

In the UK, Type 2 diabetes affects African and Caribbean communities at a higher rate than white European communities. To address this disparity, a type 2 diabetes self-management, and education programme called Healthy Eating and Active Lifestyles for Diabetes (HEAL-D) was developed.

We hear HIN Involvement and Implementation Manager Sophie Lowry and Project Manager Sally Irwin talk about how HEAL-D was formed, pivoting to virtual delivery and the potential of a national scale-up.

The project has recently become the subject of a protocol paper in BMJ Open, which can be found here.

African & Caribbean communities in the UK are disproportionately affected by diabetes, with evidence that African & Caribbean communities are three times more likely to be affected than white Europeans. Additionally, there’s poorer control at diagnosis, where onset is 10 years younger. To help tackle this inequity, Healthy Eating and Active Lifestyles for Diabetes (HEAL-D), a type 2 diabetes self-management and education programme for people of African and Caribbean heritage, was launched in south London.

Initially, this course was designed using co-production methodology by Kings College London (using National Institute for Health and Care Research) funding. As well as working with people with lived experience of type 2 diabetes, the project engaged community leaders and healthcare professionals. Often, the process involved building trust with community “gatekeepers” such as faith leaders, and then engaging with individuals once credibility within the community had been established.

Through this engagement work, the project team identified barriers and facilitators to motivate lifestyle behaviour change, improve healthcare access, foster engagement amongst local communities, and identify appropriate cultural adaptations.

At present, we at the HIN are supporting HEAL-D through the National Insights Prioritisation Programme (NIPP). This is an initiative by the Accelerated Access Collaborative (AAC) and the National Institute for Health and Care Research (NIHR) to accelerate the evaluation and the implementation of innovation that supports post-pandemic ways of working, builds service resilience, and delivers benefits to patients. Through this programme, we‘re evaluating the delivery of HEAL-D online (led by Sophie) while preparing for national scale-up (led by Sally).

When planning our NIPP project, we were keen to continue with the co-production ethos and ensure that people with lived experience of type 2 diabetes helped to shape the project. To do this, we wanted to collaborate with people throughout, not just gather views as part of the qualitative evaluation.

This all sounded great in theory, but then we had to do it!

We believe that our lived experience collaborators should be fairly compensated for their time, given their contribution as equal partners to our projects. Therefore, we first prioritised building involvement in the project budget when sending our NIPP proposal. Once approved, recruiting people became easier as the developer of HEAL-D, Dr. Louise Goff, had the details of several enthusiastic people who had previously offered to support any further HEAL-D projects. After getting permission for their details to be passed on, we contacted everyone individually to explain more about the project and what we were asking them to do. We then had an introductory session where everyone got to know each other and shared their experiences of HEAL-D.

The group have supported us/the project offline by doing various tasks.  These included:

  • Reviewing existing learning resources
  • Suggesting questions to be used in the post-course questionnaire
  • Conducting interviews as part of the evaluation
  • Reviewing evaluation materials such as information sheets and consent forms

Additionally, the group has stayed connected via a WhatsApp group, which has enabled us to get quick input into the project through questions such as, "Would you prefer HEAL-D to be known as a ‘programme’ or a ‘course’?" Likewise, the group has served as a place for people to share advice, tips, and information on local diabetes initiatives.

As the project develops, we will ask for people's input in further activities, including the analysis of data collected for the evaluation and reviewing an updated HEAL-D website.

We are also involving people in other ways including conducting interviews with HEAL-D service users to gather their experience of HEAL-D online and seeking input from people who are not aware of or engaged with HEAL-D about their attitudes towards remote delivery and digital exclusion.

To recruit people for these activities, we reached out through creating a poster and then sharing it with local community organisations to share through their social media, newsletters, and other communication channels. We have also attended community events, to speak with people, get their input and invite them to join us.

Through building strong relationships with our group and reaching out to broader audiences to hear a range of voices, we have received valuable input and made sure that HEAL-D continues to be focused on the needs of those that use the service. We are pleased that we have been able to continue the HEAL-D involvement ethos and look forward to seeing the outputs that would not have been possible without involving people with lived experience.

If you would like to read more, check out this blog by Lorraine, a member of the group who recently shared her experience of the HEAL-D course to help spread the message about HEAL-D, or check out our webpage about the NIPP project: https://healthinnovationnetwork.com/projects/heal-d/.

This project is featured in our Annual Report 2022/23.

Read the Health Innovation Network Involvement Strategy 2022-25

Learn about how we are involving people and communities to change health and care for the better.

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“Let’s embrace the complexity and apply what we know”

Published and last updated by Michael Mbanunu
Head Shot of Amanda Begley

Digital health adoption is the focus of a newly published set of journal papers, jointly curated by the HIN’s executive director of digital transformation Amanda Begley. Here she reflects on the role of complexity and evidence on digital health adoption and the practical steps available.

With thanks to Frontiers, my co-editors Yiannis Kyratsis, Harry Scarbrough and Jean-Louis Denis and our 74 authors, we have just completed the editorial for our Research Topic Digital Health Adoption: Looking Beyond the Role of Technology | Frontiers Research Topic (frontiersin.org).

With 50,000 views already and the research topic being in the top three in the journal section, digital health adoption is clearly a hot topic. So, I thought it important to let you know about the open-access articles available to read.

Do read our short editorial – it provides brief summaries of all the articles and has embedded links to help you navigate to which of the 10 in the research topic are of most relevance to your work and thinking.

The editorial also describes four key non-technology related aspects of digital health adoption (co-creation, stakeholder management, ethical and social factors and the need for transparency), and five key levers to adoption:

  1. Understanding and responding to the needs and preferences of diverse individuals and communities
  2. Early and active stakeholder engagement in both design and technology use
  3. Building the capability and confidence of all actors to acknowledge and raise quality, privacy, security and safety concerns
  4. Adopting a holistic, rather than a piecemeal approach to build a supportive ecosystem
  5. Considering seriously the wider ethical implications.

I don’t want to repeat the content of the editorial here, so am instead sharing a couple of reflections:

  • Let’s embrace the complexity: We are increasingly realising the breadth of considerations and capabilities required to implement digital health technologies ethically, equitably, efficaciously, and economically. Although this may feel at times overwhelming, one of the many things I love about the health and care system is that it’s complex, requires careful thought and partnerships – change can be unpredictable, hard won, and takes time. With the growing research and practical insights accumulating, we are now better informed about how to enable technology adoption. Also, national policy work continues, like NHS England and National Institute for Health and Care Excellence’s (NICE) current work on a policy framework for defining the assurance pathway for digital health technologies and NICE’s Early Value Assessment
  • Let’s apply what we know. As an assistant and trainee clinical psychologist and when completing my PhD, reviewing the evidence-base was second nature to me. However, as I moved into commissioning and operational management, I got so busy fire-fighting that I forgot to draw on the evidence (like implementation-, complexity- and behavioural sciences) to inform my efforts to implement innovation and transform care. It’s only been in the last 15 years that I’ve drawn on the rigorously captured findings of the authors included in this series and utilised the vast knowledge that sits in our open access journals like Frontiers, BMJ Open and Implementation Science to name but a few. I know how hard it is to make time for this but doing so gives greater rigour to our efforts.

So digital transformation is not easy, quick or straightforward – but perhaps I’d be bored if it were… 

However, if we continue listening to our users and staff, openly sharing and actively learning from others, and working with colleagues across care settings and sectors then anything’s possible – including digital health adoption at scale for our patients, populations and staff.

Find out more

Speak to our team to understand how the HIN could support your organisation with digital transformation projects

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Making mental health a priority starts with our workforce

Published and last updated by Michael Mbanunu

Andy Scott-Lee recently joined our Mental Health team, having spent most of his career with front-line mental health roles. We speak to him about his reflections on his first few months at the Health Innovation Network and what his experiences have made him think about how we could protect and improve the mental health of our nation.

Every week, so it seems, a new worry is added to the list of issues affecting society. Between the housing crisis, the climate crisis, and the cost-of-living crisis, there seem to be more factors than ever making life difficult for ordinary people.

In a world where everyone is affected by these issues differently, where do we start when it comes to finding common ground for improving our nation’s mental health and wellbeing?

In my opinion, it all begins with looking out for the people looking after our mental health.

Most clinical teams working in mental health are under significant pressure at the moment. I think awareness of those stresses probably peaked during Covid-19, where we saw a significant increase in mental health issues experienced by NHS staff, but it’s so important that we don’t slip into thinking those operational pressures have gone away.

People working in the NHS need to feel they are valued and that they and their services are supported by their organisation to do the job they were trained to do. I've worked on the front lines of mental health, and so often have found that the times where I delivered the best care were when I felt my health and wellbeing were being prioritised.

To be authentic and consistent in my care for others, I needed to first feel good about myself.

Making time to change our culture

Improving the way we look after our workforce is a responsibility for everyone working in mental health. 

Many mental health professionals already take a mindful approach to their own wellbeing, and I feel this is something we should continue to encourage. Certainly, the mantra of "be gentle on yourself" was something that I repeated to myself when treating many of my patients with trauma, and there is a wealth of insight and guidance on effective self-compassion dating back as far as Buddha. But self-help is only a part of the solution. 

One of the biggest things I’ve noticed since joining the HIN is that wellbeing isn’t just listed as an “organisational priority” – it is something that everyone actually invests time and effort into. 

Finding everyone represented in health and wellbeing conversations has been a relieving and refreshing experience. At all levels, it is acknowledged that the time and effort that goes into improving our wellbeing is reflected in the quality of the work that we do. Dedicated wellbeing champions lead the way, and it is great to see staff from all backgrounds and seniorities consistently taking advantage of activities designed to improve our physical and mental health. 

Of course, the HIN does have significant organisational differences to a Trust providing clinical care. But I think the essence of what we have here – senior leadership buy-in, dedicated champions and advocacy across the organisation for wellbeing as a priority – could be applied anywhere. 

Practical action, not policies 

Health and wellbeing isn’t a new topic within the NHS; NHS England’s People Plan from 2020 is full of sound thinking on the issue. 

But despite “islands of improvement” we haven’t made enough progress as a system, and perhaps we’ve fallen into the trap of talking too much and acting too little. 

So my challenge to people working in mental health is this – what can you do to improve the wellbeing of our workforce, and in turn improve the care that we provide? 

Can you find a way to reduce the workload of someone so that their “wellbeing champion” objective becomes part of their core responsibilities rather than an add-on to do in their personal time? 

Can you be the senior leader who always makes time to attend a wellbeing walk or other activity? 

Can you be the person who takes the initiative to learn from what’s working elsewhere? 

I believe you can. 

Evaluating remote consultations in mental health: creating a positive legacy from the pandemic

Published and last updated by Michael Mbanunu

Covid-19 catalysed huge changes for mental health services, with many appointments switched from face-to-face to video or telephone consultations almost overnight. More than two years on from the start of the pandemic Dr Stuart Adams (Consultant Psychiatrist and Chief Clinical Information Officer at South West London & St. George’s Mental Health NHS Trust) discusses the lasting legacy of these changes – and how a new evaluation tool will be a vital enabler for further improvements to the service user experience.

The pandemic has been exceptionally difficult for everyone involved in mental health – service users, clinicians and managers have all had to deal with situations that I think most of us hoped we would never experience.

Whilst nobody will look back on the past two years fondly, I think it is important that we do what we can to ensure that we learn from such testing times, and maintain momentum on some of the accelerated transformation work enforced by the pandemic. One of the areas where I think we have a real opportunity to create a positive legacy is the use of remote consultations in mental health.

Starting in 2021, we partnered with the Health Innovation Network, experts by experience, and other local stakeholders on a large-scale evaluation of the rapid adoption of remote consultation technologies. Over the course of that evaluation we spoke to thousands of mental health service users and staff about what the switch from face-to-face to telephone or video consultations had meant for them.

Whilst the evaluation identified some complex challenges around the adoption of remote consultations by mental health services – not least ensuring digitally excluded people were not “left behind” – there were also many positive themes in our final report.

People we spoke to in our evaluation often talked about the convenience of remote consultations, saving time and money on travel to appointments. Writing at a time of an emerging cost of living crisis and a renewed focus on making the NHS as environmentally sustainable as possible, the convenience factor seems more relevant than ever.

Managing the transition from transformation to business-as-usual

Two years on from the start of the pandemic, it has been positive to see that people are continuing to make the most of remote consultations as an option for accessing care. About 12% of all our consultations at South West London and St George’s are now conducted remotely, with much higher take-up in some services such as CAMHS.

So – with a robust evaluation in the books and uptake seemingly in a steady state, is this “mission accomplished” for remote consultations?

Not from where I’m standing, if we want to really make the most of the potential of these innovations.

We’ve come a long way in terms of technology from those first days of the pandemic, from shaky connections and clunky interfaces, through to more dependable solutions with functionality that helps rather than hinders the therapeutic alliance. But – anybody who has been a part of a remote consultation knows there’s still room for technological improvement.

We’re also still understanding the answers to some big questions around implementation – for example the benefits and drawbacks of phone versus video-based remote consultations.

And finally, as with any service, we must commit to interrogating our delivery of remote consultations to ensure we are providing service users with the best (and most effective) choices and services. This brave new world contains many exciting opportunities for Quality Improvement, and we have only just scratched the surface of what might be possible.

Meaningful evaluation underpins progress in all of those areas, which is why I am pleased that our partnership has produced a new appointment survey, designed to help Trusts understand service user experiences of remote consultations on an ongoing basis.

The free tool can be easily adopted by any NHS service and delivered through a variety of platforms. Along with other project resources from the partnership, we hope it will be useful for clinicians and managers hoping to further develop remote consultations as an option for their service users.

Here’s to continuing to drive progress that benefits services users, clinicians and systems – with robust evaluation illuminating the road ahead for all of us.

Opioid Stewardship QI Collaborative

Published and last updated by Michael Mbanunu

In response to the nationally commissioned Medicines Safety Improvement Programme (MedSIP), the Health Innovation Network has developed a local programme aiming to reduce opioid-related harm to patients experiencing chronic pain (non-cancer related).

The Patient Safety Collaboratives (PSCs) are working with at least 50% of Integrated Care Boards (ICBs) across England, and will collectively achieve the ambition to improve care for people with persistent (chronic, non-cancer) pain by reducing opioid analgesic use by the end of March 2025

The Health Innovation Network (HIN) delivered a CPD-accredited Opioid Stewardship Quality Improvement Collaborative for clinicians across south London from October 2022 to March 2023.

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If you would like to see examples of how participants improved chronic pain management by reducing harm from opioids, please click here.

The collaborative combined masterclasses from local and clinical specialists with QI workshops. Participants were supported to develop an improvement project linked to one of the focus areas in their own practice. You can read more about the QI collaborative in our blog here. Below you can see a summary of the key learning from the masterclasses and QI workshops.

Evidence-based audit and feedback

Published and last updated by Michael Mbanunu

In response to the nationally commissioned Medicines Safety Improvement Programme (MedSIP), the Health Innovation Network has developed a local programme aiming to reduce opioid-related harm to patients experiencing chronic pain (non-cancer related).

The Patient Safety Collaboratives (PSCs) are working with at least 50% of Integrated Care Boards (ICBs) across England, will collectively achieve the ambition to improve care for people with persistent (chronic, non-cancer) pain by reducing opioid analgesic use by the end of March 2025.

To support practices, they were provided with a resource pack signposting resources to support staff in general practice to review patients prescribed high-risk opioids (e.g. patients on opioids for more than 12 weeks for chronic pain and those prescribed high doses). The approach was modelled on a successful campaign undertaken by the West Yorkshire Research and Development team and their support enabled the production of opioid prescribing reports. 

Monthly reports were cascaded through medicines optimisation leads to general practices between November 2022 to March 2023. The reports were based on NHS BSA Opioid Prescribing Comparators dashboard, to help practices understand their own opioid prescribing trends and to increase awareness of the dashboard. The objective was to encourage a reduction in inappropriate prescribing of high-risk opioid prescribing in chronic pain.

The graph below highlights the impact of both the QI collaborative and evidence-based audit and feedback across general practices in south London.

Experience-based co-design

Published and last updated by Michael Mbanunu

In response to the nationally commissioned Medicines Safety Improvement Programme (MedSIP), the Health Innovation Network has developed a local programme aiming to reduce opioid-related harm to patients experiencing chronic pain (non-cancer related).

The Patient Safety Collaboratives (PSCs) are working with at least 50% of Integrated Care Boards (ICBs) across England, will collectively achieve the ambition to improve care for people with persistent (chronic, non-cancer) pain by reducing opioid analgesic use by the end of March 2025.

It is widely known that living with chronic pain can impact all areas of life, and at times can be stressful and challenging. Living with chronic pain can leave people feeling alone, isolated, and not aware of how to access support that does not come in the form of pain medicines e.g., opioids. To ensure patients were involved in our programme of work, the HIN Involvement and Patient Safety and Experience teams facilitated an experience-based co-design (EBCD) project using the Point of Care Foundation methodology. The project aimed to improve the experience of people living with chronic pain by leveraging existing service improvement in south London.

You can access the outputs of this project below:

We have developed a resource pack, to support clinicians in identifying alternatives to pain-relieving medicines for people prescribed opioids who are living with chronic non-cancer.

The EBCD poster provides guidance on how social prescribing link workers can support you in dealing with persistent (chronic) pain. While also providing you with a link to find support in your area.

Our chronic pain experience-based co-design project provided a great space for service users to share their personal experiences across the integrated care pathway. By taking part in the project, I felt that patients were listened to and empowered to speak up to ensure services providing care and support to people living with chronic (persistent) pain were improved based on their needs and preferences.Aurora Todisco, Lived Experience Partner, Health Innovation Network

The stages of our chronic pain experience-based co-design project

The project used all the standard elements of EBCD: filmed interviews with people living with chronic pain, staff interviews and feedback events. The catalyst film summarised patients collective experience providing insights into getting a diagnosis, the role of medicines, the role of alternatives to medicines, relationships with health and care professionals, follow-up with health and care professionals, self-management and adjusting to living with chronic pain.

In this project, the approach moved away from traditional EBCD in two important ways.  We did not observe any chronic pain consultations as they vary significantly, and we had a large co-design group that we split into two to explore a range of options during the co-design meetings. The co-design groups focused on deciding and refining co-design group outputs.

Who was involved?

The majority of project participants were from south East London and included the following:

Our implementation considerations

1. Treat people living with chronic pain as a whole person. Appreciate that everyone will be at a different stage of living with chronic pain and are still processing and adapting to living with chronic pain.

2. Build relationships with staff members delivering services to support chronic pain in your integrated care systems.

3. Ensure participants are aware of what the project can deliver in the time allocated from the outset and they have collective ownership of the co-design group outputs.

4. Map the chronic pain services in your integrated care systems.

5. Identify services that offer alternatives to medicines for chronic pain management in your integrated care systems.

The joint priority chosen by participants was bringing people together. The project outputs intend to raise awareness of how people living with chronic pain can connect to activities, groups and support that improve health and well-being.

Related Pages

Working with patients as equal partners to improve chronic pain management

“We want to work in partnership” – World Patient Safety Day and MedSIP

AHSN Network Health Innovation Podcast - Engaging the patient in patient safety