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

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.

Download

We're here to help

Get in touch for more information about Cohort 6 of the Care Home Pioneers programme.

Get in touch

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

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.

Find out more

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

Contact us

Meet the innovator: James Townsend

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

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.

Download the report

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

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

Download

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

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.

We're here to help

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

Get in touch

Meet the innovator: Dr Patrick Hart

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

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.


We're here to help

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

Get in touch

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

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

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.

We're here to help

If you have any questions or would like more information about Communities of Practice please contact us.

Get in touch

Patient Safety Collaboratives continue to support improvement across the healthcare system

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.

We're here to help

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

Get in touch

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

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.

We're here to help

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

Get in touch

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

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.

We're here to help

Want to learn more about our Accelerator programme?

Get in touch

Health economist welcomed to Health Innovation Network

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.”

We're here to help

Need support with evaluating innovation or data analytics?

Get in touch

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

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.

We're here to help

Want to learn more about our mental health projects?

Get in touch

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

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.

We're here to help

Find out more about our work in Communities & Care Homes.

Get in touch

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

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!


Find out more

Get in touch to find out more about the Mental Health Safety Improvement Programme and our work to help reduce the use of restrictive practice.

Contact us

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

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

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 a minimum of 15 ICS, 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:

  • 30,000 fewer people were prescribed oral or transdermal opioids (of any dose) for more than 3 months.
  • Of the 30,000 above 4,500 patients will have been prescribed a high dose (≥120mg day oral morphine equivalent) at baseline and have now stopped opioids.
“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 delivered a CPD-accredited Opioid Stewardship Quality Improvement Collaborative for clinicians across south London from October 2022 to March 2023. Please click here to find out more.


Opioid Action Learning Set workshops

The Health Innovation Network South London invites primary and secondary care clinicians to join our online Opioid Action Learning Sets (ALS) to build their understanding of the complex issues surrounding initiating, de-escalating opioids and effectively supporting patients living with pain. Sessions will occur on 18, 30 January and 27 February 2024 from 12.00- 13-00. Registrations are now closed.


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

We facilitated an experience-based co-design (EBCD) project using the Point of Care Foundation methodology. The aim of the EBCD 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.


Recommendations for whole systems working to improve opioid stewardship

  1. Pain clinic referrals are often seen as the next step once other options have been explored in primary care however onward referral to for example talking therapies, physiotherapy and exercise should be considered.
  2. Where possible it is important that the same clinician and prescriber who commence the opioid prescription are also responsible for ongoing monitoring and reviewing. Clinicians should have the opportunity to discuss complex cases at team meetings.
  3. Primary and secondary care clinicians should have an awareness of the breadth of services in their locality that can assist with supporting patients to adjust to the impact of living with persistent pain on their daily life e.g., social prescribing link workers.
  4. Joint consultations for complex pain management in adults across primary care networks e.g., clinic appointments with colleagues across several disciplines with specialist input from hospital pain clinics should be considered. GP appointments tend to be short, therefore making it challenging for clinicians to have sufficient time to support patients living with persistent pain as much as they would like to.
  5. Maximising digital prescribing systems e.g., creating alerts, issuing weekly prescriptions, and communicating plans to reduce high-risk opioid prescribing to other multidisciplinary team colleagues.
  6. Sharing decisions with patients about how to improve persistent pain management and agreeing on reductions when tapering opioids through regularly scheduled regular follow-ups.
  7. Introducing the idea of changes to the ways persistent pain is managed and informing patients of the risk of harm for long-term and high-dose opioid prescribing at an initial appointment and scheduling follow-ups to explore alternatives to pain medicines.

You can read more about developments with our local programme throughout 2022/23 here in our blogs:

Find out more

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

Contact us

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

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.

Interested in how digital technology can be used for mental health?

Speak to our expert team about how digital technology can be used to help mental health and wellbeing.

Get in touch

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

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.

Find out more

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

Get in touch

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

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

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

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.

Download here

Using Virtual Reality to Help People with Acute Mental Health Conditions

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

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.

Find Out More

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

Contact Us

Partnering with People at the HIN: HEAL-D

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.

View our strategy

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

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 KyratsisHarry 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

Get in touch

Making mental health a priority starts with our workforce

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

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

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).

This work is one of at least 15 Patient Safety Coalitions collaboratives (PCS) established at ICS level across the country. By March 2024, the aim is to have 30,000 fewer people prescribed oral or transdermal opioids (of any dose) for more than 3 months preventing ~484 deaths.

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.

Image

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.

This masterclass was co-delivered with Dr Cathy Standard, Consultant in Complex Pain and Pain Transformation Programme Clinical Lead for NHS Gloucestershire ICB who provided an overview of complex pain management and Clare Howard, Wessex AHSN. Clinical Lead for the Wessex Medicine Optimisation Programme who provided an overview of the NHS BSA Opioid Prescribing Comparators dashboard.

Key learning

  • Persistent pain is complex and has strong links with mood, emotional well-being, mental health, adverse childhood experiences, patient expectations, fears, and previous experience of pain.
  • There is not a strong association between the perception of persistent pain and the extent of tissue injury at the pain site.
  • Clinicians must work as a team to support the management of complex cases, acknowledge the complexity of persistent pain and assess appropriately with consideration of patients’ preferences and recognise high dose opioid prescribing is a sensitive marker of complexity.

Evidence-based audit and feedback

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).

This work is one of at least 15 Patient Safety Coalitions collaboratives (PCS) established at ICS level across the country. By March 2024, the aim is to have 30,000 fewer people prescribed oral or transdermal opioids (of any dose) for more than 3 months preventing ~484 deaths.

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

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).

This work is one of at least 15 Patient Safety Coalitions collaboratives (PCS) established at ICS level across the country. By March 2024, the aim is to have 30,000 fewer people prescribed oral or transdermal opioids (of any dose) for more than 3 months preventing ~484 deaths.

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 being 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.

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.

You can access the outputs of this project below:

We've recently worked on a resource pack, which accompanies our Opioid Stewardship Action Learning Set 2023–24. This is a collection of resources that supported us in meeting the Medicines Safety Improvement Programme's (MedSIP) aim to minimise opioid prescriptions to reduce harm for people with chronic (non-cancer) pain.

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.

Below is a series of videos filmed during pain awareness month in September 2023. These were interviews of participants of the EBCD project and highlighted key outputs: