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Applications open for HIN and My Home Life’s Care Home Pioneer Programme 2023 Cohort 5

Published and last updated by Michael Mbanunu

The Health Innovation Network (HIN) and My Home Life England are delighted to announce the fifth South London Care Home Pioneer Programme – 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 now open for applications from care home managers, deputies, and senior nurses, working in the following settings: older person’s residential homes, older person’s nursing homes, learning disability and mental health care settings, and supported living settings, in south London.

Did you know?

  • Since 2017, 84 managers from 77 care homes in South London have participated in the programme.
  • The Pioneer programme has had representatives from all the South London boroughs.

The Pioneers programme is a collaboration between My Home Life England and the Health Innovation Network, which has delivered leadership development to 84 care home managers across South London, over 4 cohorts since 2017.

The Care Home Pioneer Programme uses Action Learning techniques, involving experiential learning through a continuous process of action, learning and reflection, supported by colleagues, with an intention of improving practice. The Pioneers will work alongside mentors from the HIN to deliver a real-world service improvement project in their care home. Previous Pioneer projects have led to significant improvements in local priority areas such as falls reduction or oral health.

The free programme is jointly funded by care home commissioners and the NHS and will consist of a combination of four face-to-face workshops and nine monthly action learning sets, both virtual and in-person. At the end of the programme, there will be a celebration day to celebrate all that has been achieved.

If you are interested and want to know more about the programme, click the link here to read the flyer and apply.

This infographic highlights key feedback from Pioneers who took part in the programme in 2022.

Table Reads; 2022 Pioneer Programme post-programme survey Cohort 4’s Pioneer Care Home Leader’s completed surveys following their Celebration Event. This infographic details high level overview of their feedback. *, 92% of respondents stated that… Their sense of achievement had improved 92% of respondents stated that… Their understanding of how to improve the culture of care had improved, 92% of respondents stated that… Their quality of management and leadership had improved, 92% of respondents stated that… Their confidence as professionals had improved, 92% of respondents state that… The quality of their engagement with staff had improved, My Home Life England and HIN logos, *Based on 12 respondents

Pioneer, Cohort 4, Care Home Pioneers, said: “The Health Innovation Network and the support from My Home Life England team has boosted my confidence, skills, and knowledge in working jointly with the multidisciplinary team. The forum that was held has empowered me to exercise the duty of care and leadership while supporting a positive professional working relationship. I aim to maintain the good practice and to continue to grow and develop together with my team..”

Andrea Carter, Programme Director, Healthy Ageing Team, Health Innovation Network, said: “The resilience and kindness of this particular group shone through and will stay with me for a long time, even after 27 years working in health and social care.”

You can find some great examples of Pioneer projects that have been carried out by clicking on the following here or alternatively watching the video below.

Further information

Find out more about the programme and how to apply.

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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/.

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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.

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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.