QUiPP app improving outcomes for women in threatened preterm labour

Creating a toolkit for effective implementation of the QUiPP app

‘Better care for women at risk of pre-term labour 


The QUiPP app @theQUIPPapp (Quantitative Innovation in Predicting Preterm birth) determines the risk of pre-term labour more accurately, helping to improve care for women at risk. Funded by the HIN Innovation Awards, this project tested the app in selected maternity wards in south London and created a toolkit to support wider adoption across other sites.

QUiPP at-a-glance


Key achievements

  • “This project was successfully funded by the HIN Innovation Awards which allowed the QUiPP app to be rolled out in selected maternity wards in south London and create a toolkit to support wider adoption across other sites.”
  • QUiPP Toolkit is now been recommended both locally and nationally by NHS England and the British Association of Perinatal Medicine.
  • Version one of this toolkit was rapidly rolled out during Covid-19 in April 2020 as it helps decrease unnecessary admissions and transfers.

The app is an innovative and evidence-based diagnostic tool that uses analytics to help clinicians understand the risk of pre-term labour more accurately. This improves the lives of women and babies by identifying those who truly need medical intervention and reassuring those who don’t.

The app was tested across 20 UK sites and the QUiPP Toolkit has now been recommended both locally and nationally by NHS England and the British Association of Perinatal Medicine.

Pre-term labour is a clinical conundrum: it’s very common for women to be at-risk of pre-term labour, but the actual number of women who go on to deliver early is very low. To be safe, this means that many women are currently over-managed: they are treated as though they will deliver early even if the risk is low in reality. Because it is very dangerous to move an early baby once it is delivered, women at risk of pre-term labour are often moved to specialist hospitals further from home with specialist cots for early babies and are given more invasive care.

"Your idea is a good idea!"Naomi Carlisle, NIHR Clinical Doctoral Research Fellow

This tool has the potential to make a big difference and to improve care for these women. Whereas currently women are simply either ‘high’ or ‘low’ risk, the app calculates a percentage score so that clinicians can understand risk to a much higher degree of accuracy. This reduces the need for women at lower risk to move far from home and frees up the cots for the women who genuinely need them, so that people receive the care that is most appropriate to their risk and are not moved from their family and familiar midwife team if it is not necessary.

How does it work? 

It’s a clinical decision support tool based on a validated algorithm that incorporates existing point-of-care tests and risk factors. A clinician enters information about a number of biomarkers, such as the scan that measures the cervical length and the swab on quantitative fetal fibronectin. QUiPP uses all the data across risk range for each variable and provides a user-friendly clinical interface. This is more useful for making management decisions and women find it very useful to see and discuss their risk as a percentage, with a highly visual aid to support discussions and decisions around treatment. The QUiPP app is free and has significant cost-savings associated with reducing unnecessary admissions and interventions. By freeing up NHS capacity for patients in the most need of care (eg maternal beds, neonatal cots), this intervention can save money and transform maternity pathways beyond the preterm birth setting. Qualitative findings suggest that the majority of clinicians involved in triaging threatened preterm labour found using the QUiPP app time-saving, simple and that it increased confidence in decision-making.

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Innovator Spotlight

Professor Andrew Shennan, Professor of Obstetrics at King’s College London and Guy’s and St Thomas’ NHS Foundation Trust, said:

“This is a great example of the way that technology doesn’t replace clinicians, it makes our lives easier and helps us to care more effectively for our patients. QUiPP calculates the risk in a quick and visual way, giving women reassurance at a worrying time in their lives. What you really want is an exact chance of what’s going to happen. That way women and clinicians can make the most informed choices.

“These kinds of real-world testing are so important for scaling innovation. We hope that through this work, we can show the value of a tool like this and support others to use it in their practice.”

We also spoke to Naomi Carlile about the project one year on…

Tell us what has happened since the Innovation Grants:
I recently co-develop a toolkit to enable hospital sites across England to implement a best care pathway (the QUiPP Toolkit) for women who arrive in threatened preterm labour. I am now working on my NIHR Clinical Doctoral Fellowship, which is looking at how the Preterm Birth Surveillance Pathway is implemented across England (the IMPART study).

What has been your proudest moment so far:
I am proud that our QUiPP Toolkit has now been recommended both locally and nationally (by NHS England and the British Association of Perinatal Medicine), ensuring that more mothers and babies are receiving optimum care.

What your advice for future innovators:
Your good idea is a good idea! Get in touch with organisations like HIN south London to help advise on how to get it off the ground!

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The digital transformation agenda and the changes in 2021

Denis Duignan, Health Innovation Network’s Head of Digital Transformation reflects on what’s been happening recently in the world of digital transformation and technology.

NHS Digital and NHSx merging into NHS England

The government announced that NHS Digital and NHSx are to be merged into NHS England, forming part of the new Transformation Directorate within NHSE alongside Improvement, and Innovation, Research and Life Sciences. This move has come about following the publication of the much-anticipated Laura Wade-Gery Review.  It’s been driven in part by a desire to build on the progress made in digital transformation throughout the pandemic and to create greater alignment and co-operation between the ‘digital’ policy and strategy people and the delivery agents across the organisations.

What might this mean?

We will have to wait and see how much it’ll practically affect the merging arm’s length bodies and what this means for patients and staff on the ground, but I suspect due to the recent injection of funding for digital and technology in the Autumn Budget (£2.3 billion for increased diagnostic capacity and £2.1 billion to support the innovative use of digital technology) that we (digital health enthusiasts) have reason to be optimistic.

“Within the Digital Transformation & Technology team, we are kicking off a number of exciting projects…”

The other reason for optimism around the digital transformation agenda comes as a result of some clarity given in recent NHSx publications describing what good looks like (WGLL), who pays for what and the unified tech fund which has set out to simplify and consolidate the many funding pots for digital. WGLL has set the goalposts for Integrated Care Systems (ICS) and already we are seeing digital strategies emerging across the country, with south west London Health and Care Partnership recently approving its, signifying a real step-change in ICS maturity.

What’s the HIN’s Transformation & Technology team up to?

Within the Digital Transformation & Technology team, we are kicking off a number of exciting projects which will see us explore automation in primary care, address elective recovery and improve outpatient services through technology.

On a personal note, the highlight of my last few weeks was trying our Office Manager’s Oculus Quest two virtual reality system which she set up in the office for a few of us to try. This tech absolutely blew my mind and although I’ve been hearing about how VR will change healthcare for quite a while, seeing is believing.

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KCL graduate with 30 years’ experience in private and public sectors supporting innovation appointed chair for the Health Innovation Network.

Hitesh Thakrar has a wide knowledge of the life sciences, information technology and innovation sectors and considerable experience serving on several Boards. This includes the Alan Turing Institute, the national institute for data science and AI and KQ Labs which is an Accelerator set up by the Francis Crick Institute to support next generation businesses in data science and life sciences.

He is also a partner at Syncona, a Wellcome Trust backed early stage venture fund and the Chair of the Investment Committee for Newable Ventures (a pre-Series A deep tech fund) and an Advisory Committee Member for UK Innovation and Science Seed Fund which supports nine publicly funded research bodies, including the Science and Technology Facilities Council, a part of UK Research and Innovation (UKRI). Most recently he has become a member of the Board of Trustees for Royal National Orthopaedic Hospital Charity, his local hospital.

Hitesh started his career in the public sector working with local authorities, before moving into the City as an investment manager specialising in technology, life science and innovation companies in the public markets, and more recently in venture capital private markets with a focus on building UK based innovation led start-ups.

Throughout these experiences, he has developed a passion for supporting innovation and an ability to understand the factors behind why some new technologies would succeed quickly, some would take time, and some would not succeed at all.

“It’s clear to me that there is a convergence happening between life sciences and technology. This is going to accelerate in the next 20 years and the HIN is a pivotal place to bring these together.”Hitesh Thakrar

He said: “I’ve seen how AI and x-rays can be used to predict arthritis, how data and AI can improve biopsies for prostate cancer and am really interested in the ethics and governance around it.

“It’s clear to me that there is a convergence happening between life sciences and technology. This is going to accelerate in the next 20 years and the HIN is a pivotal place to bring these together.

“I’m keen to bring my experience in the public and private sectors to the HIN to find innovations that make a difference for patients, public and health professionals in south London.”

He was appointed following an open process that included HIN Board members from south west London and south east London.

Dr Rishi Das-Gupta, HIN Chief Executive said: “Hitesh’s drive and passion for innovation make him a great fit for the HIN. I’m looking forward to working with him to accelerate innovation in south London.”

Hitesh has been appointed for a term of four years and will replace Professor Richard Barker, whose term as chair ends on December 31, 2021.

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The value of simulation labs in supporting the adoption of health technology in nhs services

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Nicola Reynold, deputy Clinical Director for Mental Health at the Health Innovation Network (HIN), shares her experience of using the HIN Innovation Grant funded simulation lab. Nicola is also a Principal Clinical Psychologist at Oxleas NHS Foundation Trust and Clinical Lead for the Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD) pathway.

I was recently invited to participate in a digital simulation lab by my colleague, Dr James Woollard, Consultant Child and Adolescent Psychiatrist, Chief Clinical Information Officer at Oxleas and National Specialty Advisor in Digital at NHS England. The NHS has used simulation in clinical training for several years to provide a safe and controlled learning environment where clinicians can make mistakes and learn in real time without compromising patient safety, but whilst simulation labs are well evidenced in contexts such as medical training, they have not been used to support clinicians to develop skills in prescribing digital interventions to service users. This specific pilot was part of a project funded by a HIN innovation grant in 2019, and run by partners Oxleas NHS Foundation Trust, St George’s Advanced Patient Simulator, St George’s University Hospitals NHS FT and mHabitat – a digital health innovation team operating as a self-funding business unit within Leeds and York Partnership NHS Foundation Trust. The aims of the project are to explore the value of simulation labs in supporting the adoption and spread of digital technologies within the NHS.

The experience

The simulation lab involved professional actors and clinicians simulating a clinical scenario in a mocked-up emergency department, in this case, the assessment of a 17 year old girl who had presented to A&E with her stepfather following an episode of self-harm. It took place at the simulation labs in St George’s Hospital and a simulation team were present to guide us through the process. Our task was to undertake a clinical assessment of the girl, played by an actor, and prescribe the “Calm Harm” app to her. We also had to discuss a care plan with both her and the actor playing her stepfather.

After an initial briefing, we spent some time preparing for the simulation. We thought about the concerns that might be raised and how we would address them. The developer of the App was also present to address any questions we might have and we were provided with a checklist of the areas that were important to address, such as the young person’s IT literacy and the functionality, efficacy and safety of the app. Following the group preparation and discussion, one clinician simulated the scenario with the actors, whilst the rest of us observed via screen and took notes. After we held a debrief where we reflected on what had gone well and areas we could improve on. Finally, the actors came out of character and gave feedback on their experience as the patient.

You would be forgiven for thinking that this all sounds like elaborate role play and, to be honest, that was my first thought. However, no roleplay I have ever done in my clinical training has ever come close to the same level of authenticity or richness of learning that the simulation lab did. It provided a real opportunity to safely practise new skills in an environment that was as close as possible to a real-life clinical setting, and as such felt much more valid than role play.

“Simulation labs provide a valuable learning opportunity for all clinicians to develop their knowledge, skills, and confidence in health technology.”

The value of simulation

But simulation has a role beyond patient scenarios. The NHS Long Term Plan emphasises the need for digital transformation in the NHS and invests millions in new technology every year, with a view to supporting clinicians to deliver more efficient and safe care in a timely way. Unfortunately, rollouts of new technology are complex and there is often a disconnect between user testing at the development stage and the application of the technology in a real-world clinical setting. Simulation labs provide an opportunity to bridge this gap by making it possible to identify, mitigate and manage problems early on. This could save

In addition, the Topol review rightly emphasised the need for clinicians to develop the knowledge and skills to prescribe apps and digital products. I was previously a Fellow on the Digital Pioneer Fellowship, but many clinicians lack knowledge or confidence to prescribe apps to service users and since there is currently no mandatory training provided to achieve this it is down to individual clinicians having an interest in digital technology to find training opportunities. This not only acts as a barrier to adoption and spread but creates inequalities in services. Simulation labs provide a valuable learning opportunity for all clinicians to develop their knowledge, skills, and confidence in health technology.

As a learning experience, the simulation lab has stayed with me and I have continued to reflect on what I learned in the weeks since participating. I have found that I am discussing apps more readily and confidently than before but am also more mindful about when to do this. One thing I learned from the simulation lab is that the service users are unlikely to be receptive to a conversation about new apps when they are in crisis or preoccupied with other concerns and could feel that their concerns are not being taken seriously. I look forward to attending further simulation labs and would hope to see these becoming more widely applied to digital health contexts in the future.

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HIN Patient safety team and AHSN network win at the prestigious HSJ Awards

The Health Innovation Network (HIN) Patient Safety and Experience’s Covid Oximetry @home work was announced as the winner in the patient safety category for the significant support Patient Safety Collaboratives and AHSNs provided to implement COVID Oximetry @home and virtual wards. The programme was delivered in partnership with NHS England and NHS Improvement, NHS Digital and NHSX, and helped thousands of people most at risk from Covid-19 to be safely supported at home, through remote self-monitoring of their oxygen saturation levels.

The judges said, “This was an outstanding example of a true system wide collaboration. This project not only touched the UK but positively impacted people’s lives across the world. The outcomes were positively overwhelming in relation to lives saved, bed day reduction and early admissions which improved mortality and morbidity rates. It was clear that this approach contributed heavily to the prevention of the NHS becoming overwhelmed during the pandemic. The patient testimonial demonstrated the real impact to individuals and added value to the presentation coupled with the passion and authenticity of the presenters.”

Catherine Dale, HIN Programme Director for Patient Safety and Experience, said, “I am delighted that this project that demonstrates how many partners and stakeholders, came together to respond to the pandemic and keep patients safe has received such wonderful recognition.”

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ESCAPE Pain wins Self Care Innovation Award

ESCAPE pain, a project that has helped thousands of people around the UK to manage common types of musculoskeletal pain has been named as the winner of this year’s Self Care Innovation Award by the Self Care Forum.

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ESCAPE-pain (Enabling Self-management and Coping with Arthritic Pain using Exercise), is designed for those with chronic osteoarthritis of the knee or hip, or with lower back pain.

It combines education about self-management and coping strategies with an exercise regime tailored to suit the needs of each participant.

Originally developed in London by Professor Mike Hurley, it has since been adopted by the Health Innovation Network and is now run by Orthopaedic Research UK. It is delivered by specially-trained facilitators in over 300 locations including hospital outpatient departments, gyms and community halls. It has been used by around 20,000 people and is estimated to have saved some £30 million in health and social care costs.

Announcing ESCAPE-pain as the winner of this year’s Self Care Innovation Award in the run-up to Self Care Week, which begins on 15 November, Self Care Forum Chair Helen Donovan said: “The ESCAPE-pain programme is an effective, scalable way to support people to self-manage osteoarthritis of the knee or hip, or lower back pain. The judges were hugely impressed both by its achievements and by its potential to help people tackle this hugely debilitating condition; we hope it continues to expand as a valuable self care tool for those living with musculoskeletal pain.”

Self Care Forum President, Dr Pete Smith added “Musculoskeletal pain affects millions of people in the UK and can be intensely debilitating.

“It accounts for 20-30% of all GP consultations, second only to minor ailments such as colds and coughs and leads to an enormous number of lost working days.”

The pathway to transformation and acceleration: The vital role of AHSNs from the viewpoint of Jonathan Abraham, CEO & Founder of Healum

Academic Health Science Networks (AHSNs) across England work to spread innovation at pace and scale – improving health and generating economic growth. Here, Jonathan Abraham, CEO & Founder of Healum shares his experiences with the network.

This week Healum had the pleasure of joining CitizenUK and Sweatcoin as part of the Health Innovation Network’s showcase. We were demonstrating the vital role that AHSNs, like the Health Innovation Network (HIN), play in driving digital change in healthcare in local health economies to Dr Tim Ferris, Director of Transformation, NHS England and Improvement, Matthew Whitty, Director of Innovation, Research & Life Sciences at NHS England and Professor Gary Ford, Chief Executive of the Oxford AHSN.

The showcase was a chance to explain our work in providing care planning software and patient facing digital services for people with type 2 diabetes to show how essential this is in helping to recover services and address health inequalities in the system. Our work with the HIN, our local Academic and Health Science Network, has provided Healum with the opportunity to serve people with type 2 diabetes in the local community.

Developing and releasing digital products alone is not enough to transform health services in the NHS. Making full use of data, insights and digital remote methods for supporting the delivery of care requires collaboration with patients and NHS staff to listen, iterate, observe service redesign, skilful implementation, and understand the impacts.

Since Healum started trading four years ago, the HIN has been a vital partner in providing us with access and the opportunity to innovate and serve. They helped us to drive the pace of innovation faster and more effectively alongside other clinical academic and SME tech partners.

“The project’s focus, later branded You & Type 2, was about making it easier for people living with type 2 diabetes to get the most from health and social care systems.”

The pathway to transformation and acceleration: Getting started with HIN

We first started working with the HIN four years ago to address an issue in the adoption of the nine diabetes care processes, particularly in South West and South East London. They pulled together a consortium of clinical leads and project managers working on the provision of diabetes care in primary care settings across the 12 Clinical Commissioning Groups (CCGs). This work was crucial to identifying the opportunity to deploy new models of digitally enabled, personalised care and support planning so that more patients from a range of communities could take control of managing their diabetes in a way that was important to them.

It was at this stage that the HIN decided to put together a Research and Development consortium to bid for the NHS Diabetes Test Beds Wave 2 competition. The objective of the competition was to evaluate the effectiveness of innovative technologies in transforming health outcomes and quality of care for patients with type 2 diabetes. The HIN was instrumental in managing that process in which a set of industry and academic partners were chosen. Healum were selected alongside Citizen UK, Oviva and NHS Year of Care to work collaboratively on the bid, which we subsequently won. Without HIN’s involvement, this consortium across south London would not have happened.

Implementation and rollout of personalised care planning

The project’s focus, later branded You & Type 2, was about making it easier for people living with type 2 diabetes to get the most from health and social care system. The HIN helped to set up a dialogue with patients from multiple communities, with input from healthcare professionals from across primary care – organising focus groups and events for clinicians to help align innovation needs with academic and technology capability.

Co-Creation sessions helped to map care and support pathways, identifying opportunities to support patients to make choices when managing their care, and to assist the healthcare professionals to implement the Year of Care approach. The approach was geared around helping people to understand their own health information and what mattered to them as captured in the nine diabetes care processes, and suggest their best options for care and support.

Healum was given the important role of providing the care and support planning software to enable primary care healthcare professionals, such as practice nurses, HCAs, GPs and link workers to create digital plans of care and support. We did this by capturing patients’ objectives and goals with daily and weekly actions, and providing them with personalised resources – all of which could be accessed through a mobile app designed to Digital Technology Assessment Criteria (DTAC) standards.

Our technology was developed to improve the health outcomes and quality of life of people living with type 2 diabetes to make personal healthy choices through having access to the care plan when it matters.

The team at HIN have deep connections with stakeholders across GP practices in South London, so when it came to figuring out how to organise the set of resources in our software and connected apps, it was only natural that we turned to them. They were able to quickly assemble the right clinical teams to look through the articles, videos, exercises, recipes and local services to ensure that the software was set up to provide the right resource for the right patient at the right time. The sessions they organised with clinicians and patients guided us on how the content for ethnically diverse communities in South London and they advised how we could make the content more personal by helping to pull together community assets and educational resources for those communities.

“Our biggest learning about working with an AHSN was just how crucial they are in helping a small company like us to drive the adoption, usage and understanding of our innovation.”

Rollout and implementation

Our biggest learning about working with an AHSN was just how crucial they are in helping a small company like us to drive the adoption, usage and understanding of our innovation. The HIN was responsible for training over 30 GP practices on the Year of Care processes for care planning and the use of our technology as part of it. Not only did it work tirelessly to train the teams at practices, but HIN colleagues also helped to communicate key logistics around technical implementation and service evaluation. This has set the whole project team up to measure the long-term impacts of these innovations on outcomes, delivery, quality and patient experience.

HIN’s team also supported us in the project when care planning services were paused during the pandemic in a way that we would have been unable to do. They helped the whole project team to find ways that we could use our technology to support remote care and alleviate some of the worst effects on people with type 2 diabetes from communities that were hardest hit by the effects of Covid-19.

“We have a lot to thank HIN for – it has been one of the most transformational organisations in our company’s journey.”

Understanding the impact

One year on and over 1,000 plans of care and support have been created, with over 700 app downloads with 30% of people setting goals and looking at resources on the app. The personalised videos from Citizen, which were integrated with EMIS test results and delivered through Healum, have had over 70% completion rates. Stay tuned to see the final results on health outcomes from the service evaluation to be published in 2022!

In summary

Navigating the health and care system is complex and implementing new ways of working and technology products in the NHS can be a bit of a mine field when you first start out. Our advice to any other digital health company that wants to have the opportunity to serve people in its local population, is to build relationships with their AHSN and to use the opportunities that they provide to listen, learn, understand, develop and iterate.

We have a lot to thank HIN for – it has been one of the most transformational organisations in our company’s journey. Thanks to their efforts in the You & Type 2 project we are now working with South West London Health and Social Care Partnership for the next three years. Huge thanks go to people working at the HIN including Dr Neel Basudev, the clinical lead for diabetes at HIN, to Nina Pearson, Project Manager Diabetes for the most sterling work in project delivery and to Oliver Brady, Programme Director, Diabetes and Mental Health for his leadership of this project from its inception to its present day. Not to forget the incredible leadership of Chris Gumble at South West London Health and Social Care Partnership who has been driving this project every step of the way.

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HIN Patient Involvement Community of Practice shortlisted for an HSJ 2021 Patient Safety Award

In 2019, the HIN’s Patient Safety and Experience team partnered with the South East London Cancer Alliance to plan and launch this CoP, to develop a vision for patient involvement for SELCA, to initiate projects and to identify gaps in patient involvement as well as patient experience.

HIN Patient Involvement Community of Practice was shortlisted for an HSJ 2021 Patient Safety Award. Out of hundreds of applicants, they have been shortlisted for this year’s Service User Engagement and Co-production Award, recognising their outstanding contribution to healthcare. We are delighted for the team on this well-earned accomplishment! The award winners will be announced in September.

West of England AHSN submitted, on behalf of the AHSN Network, an application for PReCePT work, which has also been shortlisted for a Quality Improvement Initiative of the Year award.

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HIN shortlisted for two NHS Communicate Awards

Two projects have been shortlisted for the first-ever NHS Communicate Awards.

The ongoing You & Type 2 diabetes work in the “Use of Data and Insight for Innovation” category and for the Patient Safety and Experience #OnlyHuman campaign in the “Best Behaviour Change or Public Health Campaign” category. The winners will be announced on 16 September.

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Two HIN projects have been shortlisted for the 2021 HSJ Awards

The Health Innovation Network Patient Safety and Experience’s Covid Oximetry @home work and DigitalHealth.London’s Digital Pioneer Fellowship have both been shortlisted this week for HSJ Awards 2021.

The Covid Oximetry @home project has been shortlisted for the Patient safety award and the DigitalHealth.London’s Digital Pioneer Fellowship is a finalist for the Workforce initiative of the year award.

Winners will be announced during the awards ceremony at Evolution, London on 18 November 2021.

Congratulations to these teams on the recognition for these impactful projects improving outcomes for patients and empowering the workforce.

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Kingston Council Mental Health and Wellbeing Training Programme for Care Workers

In order to safeguard the wellbeing of the care workforce, Kingston Council launched a wellbeing training programme, alongside a package of support, in September 2020.

In brief

  • Increased the number of mental health first aiders in the care workforce by 110 per cent.
  • 78 per cent of attendees found the mental health first aid course useful.
  • All the participants would recommend the programme to others.

Covid-19 has taken its toll on us all and we’re yet to know the full impact it’s had on our workforce, particularly those working on the frontline in the health and care sector. From the physical exhaustion of maintaining capacity when sickness levels were high to the emotional effects of managing own fears and anxieties whilst coping with mass bereavement and loss. The trauma our care workers have faced over the past year cannot be underestimated and their mental and physical health has never been more of a priority.

In order to safeguard the wellbeing of the care workforce, Kingston Council launched a wellbeing training programme, alongside a package of support, in September 2020. The aims of the programme were to raise mental health awareness and understanding amongst the workforce, build resilience and increase their ability to cope with day to day stressors. Through the programme, a network of wellbeing champions was created to provide peer support and deliver wellbeing workshops throughout their organisations and communities.

“The course was absolutely wonderful and I enjoyed my experience in the mental health for first hand. I would recommend everyone to have the course”Course participant

Our Healthy Ageing team were asked to evaluate the wellbeing programme that Kingston council provided for their care workers. You can read the results of the evaluation here.

The pilot programme has been a huge success and increased the number of mental health first aiders in the care workforce by 110 per cent. It’s worth noting, although stress levels were reported as higher post the course, this coincided with the second wave of Covid, lockdown and a very difficult winter. The programme may have made people more aware of the actual stress they were working under – which is a positive outcome as, once recognised, steps can be taken to address the issues.

After the programme participants felt that they understood how to look after their own wellbeing and spot signs of anxiety, stress and other related mental health conditions. The team, plan to continue rolling out this programme throughout 2021.

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Pulmonary Rehab – the COVID effect

The latest Innovation Exchange podcast is out – ‘Pulmonary Rehab – the COVID effect’, following on from the national Innovation Exchange webinar focusing on the same subject.


In this episode, Dr Hasan Chowhan explores the challenges facing pulmonary rehab services, which have been heavily impacted by the COVID-19 pandemic. Greater strain will continue on these services as we support COVID patients with longer term respiratory problems. So what can innovators do to help? Listen and find out…

Dr Chowhan interviews Kelly Redden-Rowley, a Respiratory Physiotherapist and Head of Community Respiratory Service at Sandwell and West Birmingham Hospitals Trust. We also hear about exciting innovations from: Jan Van Aken from Spirit Digital; Kevin Auton from Aseptika, Simon Taylor from Rehab Guru and Farhan Amin from Concept Health.

 

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Enjoyed this podcast? You can catch up on the previous ones on the Innovation Exchange website.

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Sitekit and Health Innovation Network launch the Liberate to Innovate report today

The speed and ingenuity of the NHS’s response to the Covid-19 pandemic presents a unique opportunity to understand how successful digital transformation can be delivered quickly and at scale. In partnership with Sitekit, we published a report to capture the behaviours, values and decisions which made rapid digital innovation during the covid-19 pandemic possible.

As infections increased and the country went into lockdown, every part of the health service began the rapid adoption of digital tools, but there was no certainty of success. The NHS’s ability to repurpose services and buildings, establish new virtual teams, find new ways of delivering care and even improve services depended on liberating countless individual acts of leadership, collaboration, problem solving and empathy.

“The past 12 months have seen extraordinary changes in health and social care. As south London’s AHSN, we have been involved in a wide variety of transformative projects helping local and national NHS partners use innovative digital technologies and approaches to respond to the intense pressures of the pandemic.”Anna King, Commercial Director, Health Innovation Network

In collaboration with Sitekit, we listened to the stories of NHS staff who have been making this extraordinary acceleration in digital transformation a reality, to help us all learn from 2020 about how to deliver innovation in the years to come.

“It is vital that the sometimes hard-learned lessons of this period are recorded, and that we use these insights to inform the future of digital transformation in healthcare.”Anna King, Commercial Director, Health Innovation Network

We have also reflected on how digital transformation during the pandemic has enhanced NHS culture. We believe there are vital lessons to be learned from the pandemic about what drives success in digital transformation. We hope that chief information officers and other technology leaders and senior managers will use this unique opportunity for learning to maximise the chances of success as the healthcare digital revolution accelerates.

Find out more

To view the full report visit the Sitekit website.

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Ensuring women at risk of pre-term labour in England receive the best care through Quipp App

Over 18 months after winning a Health Innovation Network (HIN) Innovation Grant, we catch up with Naomi Carlisle, NIHR Clinical Doctoral Research Fellow Department of Women and Children’s Health, King’s College London to tell us about her team’s project and what’s happened since then.

In brief

  • In England and Wales, eight per cent of babies are born prematurely.
  • Due to the increased interest in the toolkit owing to Covid-19, the team rapidly rolled out the first version five months ahead of schedule.
  • So far, the team have helped over 20 sites across England embed the toolkit.

In England and Wales, eight per cent of babies are born premature (before 37 completed weeks of pregnancy). Babies who are born preterm are more likely to be unwell or die.

Often, the first time clinicians can assess risk of preterm birth is when a woman presents to hospital with threatened preterm labour symptoms (such as period-like pain, tightening, or backache). However, threatened preterm labour symptoms are not very good at predicting with women will deliver their baby early. Research tells us that only three to five per cent of women who have symptoms will deliver within seven days.

Therefore, clinicians have to consider the best plan of care, being mindful of the potential consequences of a woman having a preterm birth alongside the risk of overmedicalizing women and offering them unnecessary treatments and interventions.

As a team of clinicians (two obstetricians and a midwife) with specialist preterm birth knowledge, we were aware of the complexities of triaging women in threatened preterm labour. Our aim was to produce a toolkit to promote a best practice pathway for affected women and help accurately predict the risk of preterm birth. This 12-month project begun in September 2019, with the aim of producing a completed toolkit by September 2020.

We decided to apply for a HIN Innovation Grant which would enable us to develop this toolkit. We found the process straightforward. Any questions that we had were quickly answered by the team at the HIN.

The QUiPP app was developed by our group and is available for free. It identifies those who truly need medical intervention, offers reassurance to those who do not and has been shown to reduce unnecessary hospital admissions and transfers.

Six months after starting the project, the first Covid-19 lockdown occurred. Concerns were raised that the pandemic would increase strain on hospital beds and ambulances. As the QUiPP App reduces inappropriate hospital admissions and transfers, interest in the toolkit grew.

Our plans for the toolkit had to be adapted. Luckily our two stakeholder engagement events had already occurred, and we managed to complete our patient and public engagement via email through local Maternity Voice Partnership groups. Due to the increased interest in the toolkit owing to Covid-19, we rapidly rolled out our first version in April 2020 (five months ahead of schedule).

“ We are proud to have developed a toolkit that is now recommended nationally and helps ensure that women and their babies are receiving the best care. ”

The team at the HIN were invaluable during this process. They put us in touch with their contacts who aided in both the design and hosting of the toolkit. The team also helped disseminate the toolkit on their social media sites.  A few months later we updated the toolkit to a second version based on iterative feedback. This second version went live in August 2020 and you can access it for free here.

Since the toolkit has gone live, we have helped over 20 sites across England embed the toolkit. This has included email support, telephone support and delivering online training sessions to aid toolkit implementation The toolkit has been included as part of the West and South West of England PERIPrem care bundle, and it has been recommended by the Pan-London Maternity Clinical Network. Nationally, NHS England recommended the app and toolkit in its Covid-19 update to the Saving Babies Lives Care Bundle and in the British Association of Perinatal Medicine Antenatal Optimisation Toolkit.

We are proud to have developed a toolkit that is now recommended nationally and helps ensure that women and their babies are receiving the best care. Development of this would not have been possible without being awarded the HIN Innovation Grant, and its subsequent advice and support.

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My experience transitioning from frontline nursing to a digital role

Gemma Dakin is a project support officer for the Digital Transformation and Technology team at the Health Innovation Network (HIN) which she combines with one day a week as a nurse at The London Clinic. For International Nurses Day 2021 she shares her experience so far and how she was inspired to become a Digital Pioneer Fellow.

Working on the wards after graduating

I was eager to graduate and start my first job as a Registered Nurse in Major Trauma and Orthopaedics at Leeds General Infirmary (LGI). Every day, patients came in with severe and traumatic injuries and my small team of healthcare professionals had the responsibility of caring for them. This job required me to be efficient at wound care management, pain control and medication administration. I learnt to operate in high pressured and critical situations, which demanded professional competency, excellent communication skills and strong teamwork.

It was during my time on the ward that eMEDs (electronic medications) and eObs (electronic observations) were rolled out. eMEDS allowed clinical teams to prescribe and issue medications to a patient through an electronic system. Similarly, eObs allowed clinical observations (Pulse, Blood Pressure, Temperature, Respiratory Rate, Oxygen saturations – all part of NEWS2) to be recorded via an iPad by a healthcare practitioner and the results to be fed back into the Electronic Patient Record (EPR). These systems helped the clinical teams to improve patient safety and reduce medication errors in different ways:

  • eMEDs flags drug interactions or patient allergies when a new medication is prescribed, acting as a safety net that was non-existent with written medication charts.
  • eMEDS removes the challenges of illegible hand-written medicines and associated errors.
  • eObs requires a double signature if a patient is above a certain NEWS2 threshold, meaning that the nurse is always informed if a patient reads to be unwell.
  • The integration of eObs with the EPR allows visibility to other healthcare professionals to track the patient, even if they are not on the ward (e.g. a doctor on the other side of the hospital can login, see the patient’s observations over time and intervene if necessary).
  • eMEDS allows a Doctor or Nurse Prescriber to login and prescribe medication from another ward permitting faster treatment and interventions.
  • eCharts were also rolled out during my time at the LGI, helping to more accurately assess, plan and record patient care.
“ It was this transformation of care from paper to digital that made me keen to pursue a role that could have an impact on transforming the way the NHS works.”

Big changes with better patient outcomes

I felt really lucky to see such big changes happening that simplified how we cared for patients. Moving some processes to digital made a real difference to their health outcomes while in hospital.  It was this transformation of care from paper to digital that made me keen to pursue a role that could have an impact on transforming the way the NHS works.

Today I work four days a week as Project Support Officer at the Health Innovation Network (HIN), Academic Health Science Network for South London. My fifth day of the week is spent nursing on a day surgical ward, which I think really helps me to understand the opportunities that might make the biggest difference to patients.

At the HIN, I support the Digital Transformation and Technology team in health technology projects to drive the adoption and spread of innovative ideas and technologies across large populations. It occurred to me that, this combined with my nursing, put me in a position where I could capitalise on my clinical experience to help drive digital transformations for patients, clinicians and other stakeholders.

To further enhance my digital learning, I applied to join the digital pioneer fellowship in September 2020. This was with the ambition of applying my learning from the fellowship to support the Dermatology Improvement Collaborative programme. The programme aims to provide NHS Trusts with a framework to improve their dermatology services.

Research drives meaningful change

Research is very important to implement change and transformation in the NHS. I have seen firsthand how proving a new process works can accelerate the uptake and eventual benefits to patients. I learnt that whilst the rollout of eMEDS and eObs had a large technological component to the project, for it to be successful, it required strong clinical and senior managerial engagement to drive the service transformation forward. This links to a few of the learning modules that I have studied as part of the fellowship. The psychological aspect of change management to properly engage stakeholders and how strategic influencing can impact the success of a project, are elements of the digital pioneer fellowship which I have found extremely beneficial to study and which I will be able to apply to my projects time and time again.

“As a nurse, something that is always emphasised to you is the importance of evidence and evaluation. It’s important to understand what the evidence base is for treatments, and clinical research is of course vital for innovation. That is something that I think can be applied to my work at the HIN as well – a lot of the work we do is about real-world evaluation and there are definitely parallels in the mindset and approaches required”.

“ …the network of like-minded people and senior NHS mentors taking part in the Digital Pioneer fellowship, willing to share their experience, has been invaluable…”

The benefit of networks

Equally, the network of like-minded people and senior NHS mentors taking part in the Digital Pioneer fellowship, willing to share their experience, has been invaluable in understanding what is going on in the system, helping to link up projects and share common problems with a group who all have similar goals, all involved in digital transformation and innovation programmes.

Finally, each digital pioneer fellow choses a mentor from a pre-selected list at the start of the fellowship. I have been linked up with a digital nurse consultant at Oxford University Hospital, who has helped me to revisit the day-to-day life of technology projects being rolled out in hospital, looking at both the challenges but also the direct benefits this can have on staff and patients.

I hope to continue using my learning, research and understanding of the evolving landscape to be involved in both the digital and clinical world. I am proud to be a nurse driving digital health projects forward focusing on the improvement and redesign of NHS services to best impact patient care and staff satisfaction.

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A light bulb moment into a fantastic reality!

Our Innovation Grants support pilots that make a real difference to the lives of people in south London. Here one of our alumni Chris Gumble, Project Manager for Long term conditions at the South West London Health and Care Partnership shares his experiences of the scheme.

Key achievements

  • There was an 87% completion rate for the programme.
  • In the group of 24 people, the average weight loss per person was 1.8kg.
  • There was a 77% uptake from people who identified as not white for ethnicity.
  • There were over 1,000,000 steps walked in a single week.

How do we prevent people from developing Type 2 diabetes who are at risk? How can we make improving your health and wellbeing fun? How do we embed knowledge in an engaging way? How do we encourage physical activity and make this a normal part of everyday life? Should we incentivise people to take care of their health?

These were all questions that needed answering due to the fact that there are over 200,000 new diagnosis of Type 2 diabetes each year. Type 2 diabetes is largely preventable through lifestyle change, so my answer to these questions was to create the ‘Diabetes Prevention Decathlon’.

The Diabetes Prevention Decathlon is a ten-week structured education prevention programme. Decathletes attend weekly and within their teams collaborate to discover how to best reduce the risks through theory sessions, games, discussion and a weekly 45-minute physical activity session including a variety of sports. They compete in teams to increase activity levels in between sessions to win “Sweatcoins” which can be redeemed in exchange for prizes, and they can also be ‘earned’ by watching learning recap videos and participating in weekly quizzes. Participants are also signposted to relevant local initiatives. South West London Health and Care partnership (SWLHCP), Sweatcoin, Harlequins Foundation and Health Innovation Network (HIN) partner to deliver the Decathlon.

The Innovation Grant afforded us the ability to make the Decathlon a reality. Many minds make light work and the minds in my team, I believe are the best. We applied for the funding, which as a process was extremely easy to do but hard work, research and a credible product are the essential ingredients for success.

The project was clinically lead and coproduced across multiple organisations with input from our local patient user groups and was well supported by directors and senior leaders within my organisation.

“ The great minds at the HIN have supported with direction, creative ideas, afforded me platforms to speak and present our findings on the programme and help form connections…”

The support I have received from the HIN prior to application, during the award and consistent support since the Decathlons inception has been phenomenal. The great minds at the HIN have supported with direction, creative ideas, afforded me platforms to speak and present our findings on the programme and help form connections with one of our partners, Sweatcoin who were an SME on the Digital Health. London accelarator.

With a number of programmes completed (we are currently planning to expand the areas), the Decathlon is offered in both in our adapted virtual edition as well as planning for a future world where we can run the Decathlon in person. Currently being delivered across two boroughs, we hope to deliver across all of south London in the coming year. We are also working with the Wandsworth Community Empowerment Network to redevelop the curriculum and resources to support the uptake and retention to reduce inequalities and improve the experience of our very diverse South London population.

There have been many proud moments on this journey, the formation of our partnerships, the creation of the programme, the adoption of innovative technology, the weight loss, retention and completion rates of Decathletes, the millions of steps walked in between sessions but mainly, what I am most proud of is that our Decathletes turned up for week two of the programme. This was proof that what we had worked so hard to create, was liked by people who would benefit the most from attending.

The Decathlon has an abstract and poster submitted to the DUK conference 2021 and been nominated for a patient education award and also been nominated for an HSJ Value award 2021 for Diabetes care initiative (how awesome is that)!

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You can find out more about our Innovation Grants here, our other work with diabetes here or if you want support with an innovation of your own you can contact our Innovation team.

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Innovative programme for chronic joint pain given a sustainable future thanks to new partnership

A new partnership between the Health Innovation Network (HIN) and Orthopaedic Research UK (ORUK) has secured the future of an award-winning programme that helps people with knee, hip and back pain.

The ESCAPE-pain programme, which stands for Enabling Self-Management and Coping with Arthritic Pain using Exercise (ESCAPE), was developed by Professor Mike Hurley at St George’s University of London and Kingston University to help people with knee, hip and back pain. In 2013 it was identified as a local innovation that was ready for adoption by the Health Innovation Network (HIN), the Academic Health Science Network for south London. It has since been supported by Versus Arthritis, Sport England, the NHS Innovation Accelerator (NIA), the AHSN Network.  In 2020 it was named Musculoskeletal (MSK) Initiative of the Year by Health Service Journal.

During the last eight years the HIN has worked with partners to support the scale-up of ESCAPE-pain to over 300 locations across the UK.  It has been used by around 20,000 participants, saving £30million in the costs of health and social care. Participants frequently report that their pain improves, they take fewer medications and find they are more able to get back to doing the things they enjoy.

The longer-term future of the programme has now been secured through a partnership between HIN and national medical charity Orthopaedic Research UK (ORUK). From April 20th, the charity, which works to improve bone, joint and muscle wellbeing through education, training and research, will be operating and developing ESCAPE-pain under licence from the HIN. Key members of the ESCAPE-pain team will continue to run ESCAPE-pain at Orthopaedic Research UK, ensuring a seamless transfer.

“It has been rewarding for all those involved to see the success of ESCAPE-pain in the last eight years. The HIN has supported the development and spread of the programme and we’re delighted to have identified a sustainable future for the programme which will ensure its continued national delivery, so that many more people with chronic joint pain can benefit from this evidence-based approach.”Rishi Das-Gupta, Chief Executive, HIN

Rishi Das-Gupta, Chief Executive, HIN said: “It has been rewarding for all those involved to see the success of ESCAPE-pain in the last eight years. The HIN has supported the development and spread of the programme and we’re delighted to have identified a sustainable future for the programme which will ensure its continued national delivery, so that many more people with chronic joint pain can benefit from this evidence-based approach.”

Adrian Downing, chair of ORUK said: “The difference ESCAPE-pain makes to people with arthritic pain is clear. As one of the few charities devoted to bone, joint and muscle wellbeing, we have a critical role to play in enabling pain-free movement for all. The stark reality is that poor musculoskeletal health is a major and debilitating drain on society.  It is the third largest area of expenditure for the NHS. Tragically, it is also linked to rising levels of obesity, anxiety, isolation and depression.  With such a huge societal impact, we must never accept the inevitability of pain, or indeed its cost.  This is why we are so excited about this partnership with HIN, which gives us a proven and practical way to help the many thousands of people suffering from poor musculoskeletal health. Weare looking forward to working with all the providers who currently deliver ESCAPE-pain services.”

Professor Gary Ford, Chair, The AHSN Network said: “The AHSN Network works to support the adoption and spread of innovations with a strong evidence base addressing significant population health needs. Collectively the AHSNs have supported the adoption of ESCAPE – pain across the country. We are pleased that this partnership will mean that people will continue to benefit from access to ESCAPE-pain in health and leisure facilities local to them.”

Further information

Queries regarding the ESCAPE-pain programme can now be sent to the Orthopaedic Research UK (ORUK) team.

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Join us at the Intelligent Health AI Conference for free

An interactive session on AI in social care and care homes will be the focus for a joint HIN/NIHR session at the Intelligent Health 2021, Artificial Intelligence (AI) conference. Along with DigitalHealth.London and AHSN Innovation Exchange, the HIN will be delivering a Challenge session at this virtual conference.

Our challenge session is jointly led between ourselves and the NIHR, and features Head of Healthy Ageing Fay Sibley:

How do we integrate AI based technologies into social care and care homes?

  • Understand the challenges to help care homes become AI ready.
  • Learn from case studies on how they addressed barriers and came up with solutions.
  • Identify the key challenges around gathering data between multiple partners.
  • Understand where learnings from care homes can be translated into other opportunities to support independent living for other patient groups.

Speakers:

  • Fay Sibley, Head of Healthy Ageing, Health Innovation Network
  • Elina Naydenova, CEO & Co-Founder, DigitalHealth.London Accelerator company Feebris
  • Guy Gross, COO of Teladoc in the UK
  • Daniel Casson, digital adviser at Care England, and part of the Digital Social Care Team
  • Darren Crombie, CEO of Upstream Health
  • Jose-Luis Fernandez , Deputy Director of the NIHR School for Social Care

It takes place on 11 May between 10:20 – 11:20.

Another session is being led by DH.L and the Innovation Exchange:

Can AI help the NHS recover from the pandemic – a focus on cancer services

  • How has the use of digital and AI technology helped to speed up current pathways during the pandemic?
  • Exploring the patient journey: Diagnosis, treatment, rehabilitation
  • How can we use digital and AI technology to create new pathways?

Speakers:

  • Professor Fiona Gilbert, Professor of Radiology, Head of Department, University of Cambridge School of Clinical Medicine
  • Danny Ruta, Clinical Artificial Intelligence Lead, Guy’s Cancer Centre, Guy’s & St Thomas’ NHS Foundation Trust
  • Rayna Patel, Medical Doctor, Co-Founder and CEO, DigitalHealth.London Accelerator alumnus, Vinehealth
  • Peter Mountney, CEO, Odin Vision, currently on the 2020/21 DigitalHealth.London Accelerator
  • Liz O’Riordan, Speaker, Broadcaster and Author of ‘The Complete Guide to Breast Cancer’

As a partner we have been offered a limited number of free tickets to the virtual conference, available on a first come, first served basis. To join us at the conference simply apply the following Discount Code: AHSN200 (select Add Discount Code at the bottom right-hand side of the screen) once you have selected your ticket on the booking form.

Find out more

To view the full programme visit the Intelligent Health AI Conference website.

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Innovation Grants 2021

The winners of five Innovation Grants awards have been announced today (31 March) by the Health Innovation Network, working in partnership with Health Education England (HEE). In all there were 32 applications for the awards.

At a glance

  • Five Health Innovation Network Innovation Grants packages of £10,000 to £30,000 have been awarded to help kickstart innovative health and care projects.
  • Winning projects include artificial intelligence rehab for musculoskeletal disorders, a self-care app for patients with inflammatory bowel illness and digital urine screening for chronic kidney disease.
  • Scheme links NHS teams and local boroughs with commercial innovators and guidance from technology experts.
  • Funding means winners can gather real world evidence of impact ahead of wider roll-out.

All of the chosen innovations align to key NHS priorities by addressing major health challenges such as managing musculoskeletal pain, mental health and supporting people with long term conditions. Each project has been given between £10,000 – £30,000 to help them deliver the initial results needed to justify wider-roll out. Many projects are working with local boroughs and a wide range of commercial partners.

This year’s grant winners are:

Dr Joel Parker, Consultant Clinical Psychologist, OXLEAS NHS Foundation Trust: Fun and Fitness is a community sports development programme to support adults with learning disabilities to increase physical exercise and improve physical and mental health outcomes. The project is a bespoke community sports development programme within the Royal Borough of Greenwich that will be formalised into a manual to be shared with services across south London.

Evaluation

The projects have now been completed. Project evaluations are available here:

The remaining project evaluations will be added when completed.

Rishi Goel, Consultant Gastroenterologist and Lead for IBD Services, Kingston Hospital NHS Foundation Trust: For the first time in South West London, Inflammatory Bowel Disease (IBD) patients will be able to self-manage their care and communications with clinical teams via a digital patient portal. This project will trial the use of self-monitoring tools through ‘Zesty’ that is integrated with their electronic patient record allowing patients to become empowered with direct involvement in their care.

Kate Bramham, Consultant Nephrologist and Clinical Senior Lecturer, King’s College Hospital NHS Foundation Trust: Improving the health of individuals living with diabetes and other long-term conditions using digital urine screening tool Healthy IO for early identification of chronic kidney disease (CKD). This condition is increasingly common and there is growing recognition that early identification and management is critical in delaying progression of the condition as well as related complications. In addition, CKD is can easily go undetected until it’s at the advanced stages.

Professor Heather Jarman, Consultant Nurse in Emergency Care, St George’s University Hospitals NHS Foundation Trust and Ben Wanless, Consultant MSK Physiotherapist, St George’s University Hospitals NHS Foundation Trust: Transforming management of musculoskeletal acute back and leg pain in the Emergency Department through the digital self-management app ‘getUBetter’. This project will pilot prescribing the app to patients discharged from St George’s University Hospitals NHS Foundation Trust Emergency Department with lower back and leg pain.

Nimalini Ajith, Joint and Bone Health Physiotherapist, Public Health, Royal Borough of Kingston and Nicky Wilson, Consultant Physiotherapist, King’s College Hospital NHS Foundation Trust: Delivering personalised exercise rehabilitation in Kingston and Southwark using artificial intelligence (AI) provided via a co-designed accessible app. This project aims to improve musculoskeletal health outcomes, promote healthy ageing and reduce demand on the NHS. It will pilot an AI-rehabilitation programme called ‘Good Boost’ in people’s home’s, local community venues and in public swimming pools, leveraging community assets to support people.

The winners were chosen after a rigorous selection process by expert panels. The five teams will be funded and supported by the Health Innovation Network over a 12-month period to pilot their projects in south London and generate vital evidence of impact.

Lesley Soden, Programme Director for Innovation, at the Health Innovation Network, said:

“The impact of Covid-19 on our NHS services means that we need to look at different ways of working to improve health and care for people in south London. This funding is crucial to kick-start innovation projects to test out different innovations and new ways of partnership working.

“NHS teams often struggle to find substantial funding to pilot new ideas in real-world settings to demonstrate the kind of results they need for support for wider roll out across regions and potentially nationally.

“The quality of all this year’s applications was very high and the 2021 Innovation Grants projects we have selected are going to test novel ways of using evidence-based innovations and digital solutions. We are so pleased that our previous grant winners in 2020 have gone on to deliver innovative health and care projects, with a handful being nominated for national awards this year.

“For the 2021 winners we’re looking forward to working with these teams to prove their concepts and demonstrate real world application to enable greater adoption across the health and social care system.”

See more information on the HIN Innovation Grants here.

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Every contact counts when it comes to Covid-19 vaccine hesitancy

Cleo meeting Sir David Sloman, NHS Regional Director for London at a recent visit to the North Lewisham and Alliance PCN Covid Vaccination Hub at the Waldron Health Centre, to talk about her experiences of talking to people who are vaccine hesitant

There is no “silver bullet” to tackle vaccine hesitancy. However, every one of us has an opportunity to use personal relationships to make a difference to Covid-19 vaccine uptake rates.

We hear from Cleo Butterworth, Associate Clinical Director for Patient Safety and Experience at the HIN (pictured with Sir David Sloman, NHS Regional Director for London at a recent visit to the North Lewisham and Alliance PCN Covid Vaccination Hub at the Waldron Health Centre) as she talks about her experiences with the south London community.

Pictured above: Cleo meeting Sir David Sloman, NHS Regional Director for London at a recent visit to the North Lewisham and Alliance PCN Covid Vaccination Hub at the Waldron Health Centre, to talk about her experiences of talking to people who are vaccine hesitant

Alongside my work as an Associate Clinical Director at the Health Innovation Network, I have recently been volunteering as part of the Covid-19 vaccination efforts in my local area, North Lewisham. Figures from early February put south east London as a region where rates of vaccine uptake have so far been worryingly low, and I hoped I might be able to use my and experience as a pharmacist to reassure those with concerns about the vaccine.

For any pharmacist, providing reliable and accessible information about medicines to the public is a fundamental skill. When I volunteered to contact individuals, who had declined their Covid-19 vaccination and see if I could change their mind, I anticipated I might be able to make a difference quite quickly. Surely, I thought, most of the issues I encountered could be tackled by reassurance about safety or side effects, correcting misinterpretations of the (admittedly very complex) science around these new vaccines, or debunking far-fetched myths propagated by “anti-vaccination” news sources.

The reality I encountered, however, was much more complex. It soon became apparent that decisions about getting the Covid-19 vaccine were based far more on emotion than just medical fact.

I did have many very productive conversations about fear of side-effects, worries about catching the virus from the vaccine and other more challenging or complex questions to do with the medical science behind the vaccine. For example, many people appreciated me taking the time to explain how these vaccines have been delivered so quickly without compromising safety or efficacy. However, I felt I had little power to significantly change the position of the majority of the individuals that I talked to.

“ The key missing ingredient was trust, a factor I had perhaps underestimated in my interactions with the fearful, worried, yet proudly self-determined people I spoke to about the Covid-19 vaccine. ”

I was surprised at how entrenched peoples’ views were about opposing the vaccine; many seemed angry that I was trying to change their mind about a conscious decision they had made about their own bodies. They did not want to discuss their concerns with me. In many cases, they did not want to share with me what those concerns were.

The majority of the people I spoke to were from BAME communities – communities with higher rates of serious illness and death from the coronavirus. The communities that have felt the impact of health inequalities for decades; the communities where adults are more likely to work in public-facing occupations such as social care or public transport, increasing exposure to the virus; the communities which tend to have larger multi-generational households where the virus can spread easily if it is brought in by family members unable to work from home.

On reflection, this defensive mindset should not have been unexpected. The key missing ingredient was trust, a factor I had perhaps underestimated in my interactions with the fearful, worried, yet proudly self-determined people I spoke to about the Covid-19 vaccine.

Trust is not something given lightly or conferred on the basis of a short telephone call. Trust is the years of seeing the same friendly face at a community pharmacy; trust is the practice nurse who helped you overcome a fear of needles and take a blood test; trust is the GP who went above and beyond to give an elderly relative dignity in death. But trust is also your kind neighbour; your friend; your colleague – and that is why every contact count when it comes to addressing vaccine hesitancy.

“ Whatever your background, healthcare professional or otherwise, understand that you might well be the trusted “medical expert” that someone turns to for guidance on the vaccine. ”

With the importance of trust in mind, it is understandable that a call out of the blue from a well-meaning but otherwise unknown voice representing the same system that people might feel had let them down could have been unwelcome.

All this is not to say that we should give up on engaging with vaccine hesitant individuals, or that these groups are a “lost cause”. Quite the opposite, in fact. Whatever your background, healthcare professional or otherwise, understand that you might well be the trusted “medical expert” that someone turns to for guidance on the vaccine. Whether it turns out to be a mumbled half-question from a colleague or a bemusing WhatsApp from your Auntie, my advice would be to prepare yourself to make sure you can seize the opportunities when they are presented.

You can help equip yourself for those conversations by reading about the vaccine on the NHS website as well as more detailed “FAQ” information on vaccine safety and effectiveness from SEL CCG, and learn about the best tactics to explain vaccination science to the general public or this FAQ site made by experts.

Above all though, my advice is to be prepared to listen, empathise and reassure. In the face of a frightening pandemic and a seemingly uncaring system, you might be the only voice with the sufficient level of trust to make a difference.

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Find out more about our work responding to the challenges of Covid-19.

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Remote monitoring and the potential benefits for patients with long term conditions

Dr Annette Pautz has been a GP at Holmwood Corner Surgery in South West London for 16 years. She is Deputy Chair for the Borough Committee in Kingston, Chair of the Council of Members for Kingston (a group representing Kingston GPs) and is also the clinical lead for community, care homes and respiratory in Kingston for SWL CCG. She believes introducing remote monitoring systems into care homes can have huge benefits both for primary care clinicians and care home residents. More than that, she believes it could be a first step to unlocking better care for larger portions of the population too.

Remote monitoring provides a way for us to effectively and actively monitor our patients in care homes, identify early deteriorating patients and get a much better idea of who needs a home visit urgently. This is particularly important when care homes are understandably trying to reduce the amount of people visiting because of the pandemic. It should also give GPs more certainty around their decision making – it can be difficult for a non-clinical person to describe why they are concerned over someone’s health, whereas the data provided by remote monitoring is in the ‘same language’ the GP uses.

In addition, if general practice has all this data, we can potentially link up with hospital consultants more easily and quickly to discuss a patient’s care. This will provide better and more responsive clinical care for care home patients without them having to wait for GPs or Community Healthcare Staff to do a home visit and then come back and prescribe. I think sometimes the system is a little slow for care home residents and this will provide a much more interactive, responsive service for them which will be better for patients and the care home staff who worry about them. That has to be a real selling point.

Listen to Dr Pautz talking about the benefits for primary care

I know primary care colleagues have concerns about whether these systems will integrate with their existing clinical systems or increase their workloads. That’s why we’ve made sure in South West London that the software which we have chosen will integrate with EMIS, the system which the majority of our GPs use. And rather than roll this out to all GPs at once, we will pilot it with a couple of our GP care home leads first. We’ve had good engagement from them through their PCNs and our hope will be that through the pilot we can identify a good process for monitoring and using the data.

Excitingly, if we can make a success of this in care homes then it opens up the possibilities for how we can look after people who are still in their own homes and move more care out of hospitals and into the community. It would definitely be useful for people with long-term conditions – patients will be able to learn more about their condition and take more control, reducing the need to go to a doctor’s surgery or hospital. It could also help with discharging patients earlier if they can be monitored at home.

Listen to Dr Pautz talking about the benefits for primary care

We have an opportunity now with the pandemic to see if we can roll this out and find a way to share this way of working with colleagues in secondary care. We’re already having virtual MDT meetings and there’s the possibility that the vital signs that are recorded on devices could be expanded to include spirometry, ECGs and ultrasounds. With these it will be vital to have the view of secondary care consultants and allied health professionals like radiographers where we can all see the same data in real time to give advice.

It is clear what we are looking to do with care home is the first step on what has exciting possibilities for how we care for large numbers of people in the near future.

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If you’re interested in finding out more you can contact the London Innovation Collaborative programme lead Fay Sibley.

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Using Whzan to help monitor the wellbeing of care home residents

Rick Mayne is the Registered Home Manager for Sherwood Grange Care Home in Kingston, South West London which is home to more than 50 residents with varying care needs and abilities. He’s worked in the sector for 30 years, five of which have been at Sherwood Grange. Last year his home implemented Whzan to help monitor the wellbeing of his residents during the pandemic. Here, he tells us why he believes it’s been a game changer.

I’ve always been inquisitive and thought if there was more we could do.  Being a residential home our residents tend to be more stable medically, so we don’t have clinical staff like a nursing home would. However I’ve always prioritised wellbeing lifestyle and so we would do regular observations but these were kept on a closed IT system, with no automated analysis.

Listen to Rick talking about Whzan

In 2020 when the pandemic first began I got the opportunity to pilot a digital technology called Whzan that not only takes temperature, pulse, blood pressure, oxygen saturations and respiratory rate but analyses them to give me a National Early Warning Score (NEWS) which is used nationally by doctors, paramedics, and other clinicians to identify deterioration in adults. The data is put on a web based system which means it can be shared with permission on a need to know basis.

It’s been a game changer for us. The data helps set a baseline for each resident and uses a traffic light system to alert us if their observations are worse than the average normal. This allows me to ring our GP or out of hours doctor and have a more informed discussion with them over the phone so they can create a more individualised care plan, having a multidisciplinary approach. I genuinely believe this has helped keep our residents safe and well at home during the pandemic, only going to the hospital when absolutely necessary.

Listen to Rick talking about Whzan

My staff embraced it as it only took around 30 minutes of training for them and then a few minutes to get them on the system. Taking the observations isn’t onerous and they get satisfaction knowing how we use the information to look after our residents and being able to share the results with them, a real whole home approach. The kit itself is really portable, comes as a briefcase that you plug into the wall and charge and that’s it.

Usually, we do observations once a week as our residents are generally well. However, when they received their Covid vaccine we took their observations three times that week so we could reassure them and their families that they were well. For a non-clinical person, it’s been great.

Next, we are hoping to move to a point where our wider GP services and out of hours access the data. I know there will be some who say that as a residential home we don’t need this but it’s been invaluable providing reassurance to residents and their families and being able to identify early on if someone is becoming unwell.

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South London Trusts winners and finalists at HSJ Awards

Congratulations to our member Trusts in south London who won or were finalists at yesterday’s HSJ Awards ceremony.

Notably ‘Workforce Initiative of the Year’ was won by King’s College Hospital for its Covid-19 Staff Support and Wellbeing Programme and ‘Integrated Care Partnership of the Year’ to Guy’s and St Thomas’ for its Guy’s Rapid Diagnostic Clinic Team.

There were also two initiatives that were finalists where HIN has been closely involved. The categories were:

We are proud of the recognition for the hard work of our colleagues and the impact of working collaboratively.

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Two HIN-supported projects announced as HSJ Value Awards finalists

This week the shortlist for the HSJ Value Awards was announced with two HIN-supported projects included.

The nominated projects were:

Diabetes Care Initiative of the Year‘ for Diabetes Decathlon, run by South West London Health and Care Partnership, which is another HIN Innovation Grants funded project. The Diabetes Prevention Decathlon is a ten-week structured education prevention programme. Decathletes attend weekly and within their teams collaborate to discover how to best reduce the risks through theory sessions, games, discussion and a weekly 45-minute physical activity session including a variety of sports.

‘IT & Digital Innovation Award’ for OneLondon, a HIN-backed collaborative partnership to transform health and care services through joining-up information to support fast, safe and effective care.

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QUiPP app improving outcomes for women in threatened preterm labour

For International Women’s Day, we spotlight QUiPP app an innovation that helps to improve outcomes for woman at risk of preterm labour. QUiPP app (Quantitative Innovation in Predicting Preterm birth) determines the risk of pre-term labour more accurately, helping to improve care for women at risk.

Key achievements

  • QUiPP Toolkit is now been recommended both locally and nationally by NHS England and the British Association of Perinatal Medicine.
  • Version one of this toolkit was rapidly rolled out during Covid-19 in April 2020 as it helps decrease unnecessary admissions and transfers.

The app is an innovative and evidence-based diagnostic tool that uses analytics to help clinicians understand the risk of pre-term labour more accurately. This improves the lives of women and babies by identifying those who truly need medical intervention and reassuring those who don’t.

The app was tested across 20 UK sites and the QUiPP Toolkit has now been recommended both locally and nationally by NHS England and the British Association of Perinatal Medicine.

Pre-term labour is a clinical conundrum: it’s very common for women to be at-risk of pre-term labour, but the actual number of women who go on to deliver early is very low. To be safe, this means that many women are currently over-managed: they are treated as though they will deliver early even if the risk is low in reality. Because it is very dangerous to move an early baby once it is delivered, women at risk of pre-term labour are often moved to specialist hospitals further from home with specialist cots for early babies and are given more invasive care.

“Your good idea is a good idea!”Naomi Carlisle, NIHR Clinical Doctoral Research Fellow

This tool has the potential to make a big difference and to improve care for these women. Whereas currently women are simply either ‘high’ or ‘low’ risk, the app calculates a percentage score so that clinicians can understand risk to a much higher degree of accuracy. This reduces the need for women at lower risk to move far from home and frees up the cots for the women who genuinely need them, so that people receive the care that is most appropriate to their risk and are not moved from their family and familiar midwife team if it is not necessary.

How does it work? It’s a clinical decision support tool based on a validated algorithm that incorporates existing point-of-care tests and risk factors. A clinician enters information about a number of biomarkers, such as the scan that measures the cervical length and the swab on quantitative fetal fibronectin. QUiPP uses all the data across risk range for each variable and provides a user-friendly clinical interface. This is more useful for making management decisions and women find it very useful to see and discuss their risk as a percentage, with a highly visual aid to support discussions and decisions around treatment.

The QUiPP app is free and has significant cost-savings associated with reducing unnecessary admissions and interventions. By freeing up NHS capacity for patients in the most need of care (eg maternal beds, neonatal cots), this intervention can save money and transform maternity pathways beyond the preterm birth setting. Qualitative findings suggest that the majority of clinicians involved in triaging threatened preterm labour found using the QUiPP app time-saving, simple and that it increased confidence in decision-making.

Innovator Spotlight

The QUiPP App was developed by King’s College London Department of Women and Children’s Health. Naomi Carlile co-developed the QUiPP App Toolkit with Dr Ellie Watson and Professor Shennan funded by the HIN Innovation Grants. We spoke to Naomi Carlile about the project one year on…

Tell us what has happened since the Innovation Grants:
I recently co-develop a toolkit to enable hospital sites across England to implement a best care pathway (the QUiPP Toolkit) for women who arrive in threatened preterm labour. I am now working on my NIHR Clinical Doctoral Fellowship, which is looking at how the Preterm Birth Surveillance Pathway is implemented across England (the IMPART study).

What has been your proudest moment so far:
I am proud that our QUiPP Toolkit has now been recommended both locally and nationally (by NHS England and the British Association of Perinatal Medicine), ensuring that more mothers and babies are receiving optimum care.

What your advice for future innovators:
Your good idea is a good idea! Get in touch with organisations like HIN south London to help advise on how to get it off the ground!

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New Chief Executive announced for the Health Innovation Network (HIN)

Following the appointment of the HIN’s previous CEO Tara Donnelly to Chief Digital Officer at NHSX, Dr Rishi Das-Gupta has been appointed as the new Chief Executive for the Health Innovation Network (HIN).

Dr Das-Gupta will be joining the HIN, the Academic Health Science Network (AHSN) for south London, in March 2021 from his current role as Chief Innovation and Technology Officer at the Royal Brompton and Harefield NHS Foundation Trust. He is medically qualified, has worked in management consultancy and is the co-founder of a health tech start-up.

Chair of the HIN Richard Barker said: “Congratulations to Rishi on his new role. The HIN board and I are looking forward to working with him to continue to build the HIN’s reputation for leading innovation-enabled transformation in the NHS.”

“ The HIN enjoys a fantastic reputation, with a great track record and I am excited to be joining the team at a time of rapid change in healthcare.”Dr Rishi Das-Gupta

Rishi said: “The HIN enjoys a fantastic reputation, with a great track record and I am excited to be joining the team at a time of rapid change in healthcare. I am passionate about how innovation and technology can support change to improve the health of residents, outcomes for patients, and the working lives of staff working across healthcare and social care.

“The health system is undergoing wide-ranging changes as we recover from the pandemic and the role of the HIN is critical. Working with the team, I hope that my clinical and innovation experience will help us support high-impact programmes across our member organisations in south London.”

Zoe Lelliott will continue as Deputy Chief Executive after acting as interim CEO while Tara Donnelly was on secondment to NHSX. Richard said: “We want to thank Zoe for her tremendous contribution to building momentum at the HIN and for her valuable contributions at national level.”

 

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London AHSNs work together to embed virtual consultations across the capital

London AHSNs Attend anywhere

Three London Academic Health Science Networks (AHSNs) worked together to support Trusts in the region to quickly embed virtual consultations to safeguard patients and staff during the pandemic.

The challenge

Covid-19 meant NHS Trusts had to find an alternative to face to face consultations for many patients, to both protect vulnerable patients and safeguard staff. NHS Trusts responded by rapidly accelerating the availability of virtual consultations.

NHS England and NHS Improvement (NHSE/I) procured a national licence for Attend Anywhere – a secure web-based video consultation solution – for 12 months, to accelerate uptake of video consultations in all secondary care settings, allowing NHS staff to deliver clinics and services virtually.

Prior to Covid-19 there were some trailblazer sites where implementation was being observed and evaluated, but there had not been plans or the infrastructure normally required for system wide implementation at pace. This meant some Trusts found themselves experiencing similar obstacles and challenges, but there was no ‘system learning’ and ‘solution sharing’ mechanism in place.

The solution

Using a collaborative pan-London approach UCLPartners, the Health Innovation Network, and Imperial College Health Partners (the three London AHSNs) have been working with NHSE/I, alongside hospital Trusts to support the roll out, optimisation and long-term use of Attend Anywhere.

By working together across the region, the London AHSNs have been able to help Trusts quickly embed the new technology by responding to their needs and experiences, producing resources and supporting shared learning. The approach included:

  • Successfully hosting two webinars – “Building video consultations into the workflow” and “Equity of Access”, with over ~70 and ~100 attendees, respectively.
  • Sharing existing documentation and best practice directly with Trusts. This was done by:
    • Creating video and audio footage of clinicians sharing their experience of delivering virtual consultations during the pandemic.
    • Bringing together clinical guides and useful resources, in one place as an impartial, easy-reference resource library.
    • Sharing various resources with Trusts directly through NHS Futures, including Standard Operating Procedures, training packages, equality impact assessments, patient-facing material and Trust individual rollout materials.
    • Producing both a patient and clinician survey template and working with a small number of London Trusts to implement/tailor surveys to meet local needs and gather a first-look evidence base of video consultation usage across London.

Impact and outcomes

The AHSNs engaged with 29 Trusts across London and provided opportunities for colleagues in Trusts to hear from others and share tips of what worked in practice.

This helped to build a community of colleagues working on similar challenges and solutions around the implementation of virtual consultations. For common issues that were not resolved the AHSNs provided a strong platform for these issues to be highlighted and escalated. AHSNs also facilitated conversations about collaboration for sharing best practice and tools.

“ The AHSNs bring a wealth of experience and expertise in working with clinical teams to support them understand, adopt and spread this relatively new innovation ” Vin Dawakar, London Regional Medical Director & CCIO, NHSE & I

Feedback

Vin Dawakar, London Regional Medical Director & CCIO, NHSE & I said: “In response to the initial wave of Covid-19 infections, the AHSNs in London mobilised in days to collaborate with NHSE & I (London), to support acute Trust healthcare providers in London to rapidly deploy, take up and embed video consultations as a way to continue to deliver clinical services to patients in a risk-free way.

 “The AHSNs bring a wealth of experience and expertise in working with clinical teams to support them understand, adopt and spread this relatively new innovation which allowed the London region to lead the successful use of video across the country – a big ‘thank you’ to our AHSN colleagues!”

Claire Kennedy, Project Manager, Service Transformation, Royal Free London NHS Foundation Trust said: “The AHSN team was key to facilitating collaboration that allowed us to become a part of influential brainstorming sessions and informative conversations with a range of people across the London.

“As a result, I had the opportunity to think bigger, to influence across a system and create better things to help our patients access the best care.”

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Innovation Grants 2021

We are looking to support innovative projects that either test or pilot an innovation that improves healthcare, with a grant of up to £10,000 to £30,000

Last year we funded 10 incredible projects that either supported innovative practice that could be spread and adopted across the health and social care landscape or encouraged cross-boundary working in areas of research, education and improvement in healthcare services.

This year, the HIN Innovation Grants programme is open for applications from 1 December 2020 and close at 9am on Monday 1 February 2021. Applications are invited from organisations who are involved in the delivery/commissioning of health/social care in south London. We are encouraging collaborative bids. In all applications, the lead applicant must be a member of the Health Innovation Network.

All applications will be evaluated against the following criteria. If the proposed project does not align with most of these goals, it may reduce the likelihood of being awarded a grant. Prior to starting the application consider whether the project fits the requirements.

We would strongly encourage projects that collaborate with a commercial partner or developer of an innovation or product you wish to trial. In particular, testing of an innovation that is market ready and supported by the HIN, the DigitalHealth.London Accelerator programme, or the National Innovation Accelerator (NIA) would be welcomed. We would not exclude partnering with other commercial innovations.

If you would like to discuss your application or request support with the form, please contact hin.innovationgrants@nhs.net to arrange a call (up to 30min) with our team.

Applications are now closed.

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Apply for the innovation grants by downloading and completing the form and reading the guidance notes.

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Key Dates

5 March 2021: All applicants notified of the outcome

18 March 2021: Video conference on evaluation for grant recipients

1 April 2021: Innovation Grant Programme start date

If you have any questions, please email hin.innovationgrants@nhs.net, before 4pm on 29 January 2021.

Kick-starting creative ways to improve healthcare in south London

Lesley Soden, our Programme Director for Innovation, spells out the magic ingredients for grant success as our new round of funding opens.

One of the most rewarding parts of my job is working with our HIN members to fund innovation projects that kick-start creative ways to improve healthcare in south London. It truly feels inspirational when an idea grows into a fully formed project that has a real impact on patients’ clinical care and their experience using NHS services.

The grants act as a great springboard for success allowing the projects to prove their value and hopefully get adopted elsewhere.
In the past we’ve funded projects ranging from supporting women with perinatal mental health problems, falls training in care homes, the first transgender sexual health service in south London to creative educational course for LGTBQ+ students to improve their mental well-being.

Recently, our HIN Board asked me what factors helped projects to be successful and increased their sustainability once the grant had finished.

From our experience the magic ingredients were:

  • Senior level sponsor to ensure that an organisation is committed, and all the right people are involved at early stage ranging from infection control to procurement teams;
  • Establishing a core project team to ensure that the delivery isn’t the responsibility of just one person who is doing this on top of their ‘day job’;
  • Getting support from our HIN teams for your project to maximise their expertise and networks in south London;
  • Setting out the evaluation strategy at the beginning to make sure the right information is being collected to demonstrate value.

Some of our current projects are already gaining traction in their adoption elsewhere in the healthcare system.
Like the Emergency Department (ED) Check-In project at St George’s Hospital which allows patients to see their real-time queue position on a screen in the waiting room. When the clinician is ready, the patient is ‘called’ and their code moves from ‘please stay seated’ to a ‘we’re about to call’ section. So simple, yet beneficial to both the patient, the clinician trying to find the patient and the receptionists in a busy ED. We are now finding that many other emergency departments in the UK want to use this technology that was initiated by a clinical consultant and the transformation team at the hospital.
If this has inspired you, good news as our next round of funding for our Innovation Grants has now opened. You can find more details on how to apply here and I really look forward to reading through all your creative ideas.

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Remote Monitoring: Keeping patients safe in the community

remote monitoring for diabetes

COVID-19 has accelerated the speed of adoption by NHS providers of technology to deliver care including the use of remote monitoring solutions.

This Innovation Exchange webinar from 9-10.30am, 10 December presented by the Health Innovation Network and DigitalHealth.London Accelerator, will focus upon maximising the use of technology to monitor patients’ health conditions remotely outside of the traditional care settings and empower patients with long term conditions to manage their health better through remote monitoring.

Speakers include:

  • Tara Donnelley, Chief Digital Officer, NHSX on the National Perspective on Remote Monitoring.
  • Oliver Brady and Dr Neel Basudev (Health Innovation Network’s diabetes team)
  • Chris Gumble (Project Manager, SWL CCG) on You & Type 2 Remote diabetes annual reviews – the art of the possible.

Hear short pitches from 5 health tech companies on the DigitalHealth.London Accelerator whose solutions can remotely measure and monitor vital signs including blood pressure, spirometry, oxygen saturation levels, and heart rhythms to name a few.

To attend, please contact laura.walton9@nhs.net to request an invitation.

Meet 20 digital health innovators set to transform London’s health and care system

Digital Health London Accelerator cohort 5 announced

The 20 small and medium sized businesses (SMEs) selected on cohort 5 of the DigitalHealth.London Accelerator programme has been announced.

This year saw an increase in the number and average score of the applications, making it the most competitive selection process since the programme began four years ago. The 20 companies selected for the Accelerator 2020-2021 programme have digital solutions or services that have the highest potential to meet London’s NHS and social care challenges. From patient self-management tools and femtech, to digitizing NHS processes as well as artificial intelligence and cutting-edge machine learning, this group of 20 digital health innovators is set to transform key aspects of health and social care in London and beyond.

Now in its fifth consecutive year, the NHS delivered programme, match-funded by the European Regional Development Fund, has supported some of the most effective digital innovations now being used by the NHS. Many of the digital products and services currently providing vital innovation, support and capacity to the NHS during the response to COVID-19, have come through the Accelerator programme.

Jenny Thomas, Programme Director, DigitalHealth.London said: “We are delighted to announce today the 20 digital health SMEs on our fifth DigitalHealth.London Accelerator cohort. After what was the most competitive selection process yet, it is clear that digital health in London is rapidly growing and supporting patients and our NHS and social care services.

“This year has been a defining moment for digital health as it has been at the forefront of the COVID-19 response and will continue to be part of our country’s recovery in the months and years ahead. These 20 SMEs are all ones to watch and we look forward to working with them and playing our part in supporting the NHS and social care through digital transformation.”

Theo Blackwell, Chief Digital Officer for London, said: “The DigitalHealth.London Accelerator ensures that London is at the forefront of digital innovation in health and social care. Many of the digital health technologies and products that are currently supporting our NHS staff and patients have come through the Accelerator. It has become vital to a future where Londoners benefit from the latest technologies to support their health. The pandemic has brought many challenges and pressures to London, the Accelerator is fast tracking digital health innovations and supporting this dynamic and crucial sector to grow.”

Tara Donnelly, Chief Digital Officer, NHSX, said: “The DigitalHealth.London Accelerator is part of a digital revolution in the NHS that continues rapidly to develop, and we will continue to support innovative organisations delivering ground-breaking work.

“This programme has established itself as an important player in supporting the NHS and social care to make the most of the opportunities digital healthtech offers.”

DigitalHealth.London’s Accelerator aims to speed up the adoption of technology in London’s NHS, relieving high pressure on services and empowering patients to manage their health. For every £1 spent on the Accelerator programme it is estimated £14.50 is saved for the NHS*. It works with up to 20 high potential SMEs over a 12-month period, giving bespoke support and advice, a programme of expert-led workshops and events, and brokering meaningful connections between innovators and NHS organisations with specific challenges. The companies successful in getting onto the Accelerator programme have been chosen through a rigorous and highly competitive selection process, involving expert NHS and industry panel assessments, interviews, and due diligence checks.

The SMEs selected for the 2020-2021 DigitalHealth.London Accelerator programme are:

  • ART Healthcare Software – psHEALTH’s software enables efficient processing of patient referrals, improves capacity planning and patient access.
  • Concentric Health – A digital consent application, with remote consent functionality.
  • Feebris – An Artificial Intelligence powered platform that enables carers to conduct high quality check-ups in communities, triage health issues proactively, and escalate concerns to clinician.
  • Bleepa® – Feedback Medical’s CE marked digital medical imaging communications tool that enables clinicians to view and discuss patient cases at the touch of a button.
  • FibriCheck – A certified solution for symptomatic/known Atrial Fibrillation (AF) patients, and a cost-effective, scalable detection tool for asymptomatic/intermittent patients.
  • getUBetter – An evidence-based, CE marked, digital self-management platform for all common musculoskeletal injuries and conditions.
  • EXi – An app that analyses user’s health and prescribes a personalised physical activity plan.
  • Mendelian – A software solution that supports earlier diagnosis of rare diseases.
  • Odin Vision – An Artificial Intelligence enabled applications for endoscopy and aids endoscopists to detect and characterise polyps during colonoscopy procedures.
  • Oxehealth – A contact-free vision-based patient monitoring platform for use across inpatient and residential care facilities.
  • patientMpower – remote monitoring application across a range of pulmonary conditions, including pulmonary fibrosis, cystic fibrosis, lung transplant and COVID-19.
  • Patients Know Best – A platform that allows patients and professionals to access healthcare records – anytime, anywhere.
  • Peppy Health – app that provides health support through life’s big transitions, such as becoming a parent, going through the menopause or going through a fertility journey.
  • Phlo Digital Pharmacy – a rapid on-demand same-day pharmacy delivery service empowering patients to better manage their healthcare.
  • Regimen – a digital therapy for the 30% of men struggling with erectile dysfunction.
  • S12 Solutions – an app and website which helps Approved Mental Health Professionals (AMHPs) and s.12 doctors to efficiently complete Mental Health Act (MHA) processes.
  • Solutions 4 Health – a CQC registered provider of both lifestyle and clinical services using artificial intelligence, digital health and clinical healthcare.
  • Vantage Health – An Artificial Intelligence platform that transforms the referral process by helping clinicians to direct patients to the best care, based on pathway guidance.
  • PocDoc – A digital platform and associated tests from Vital Signs Solutions that allow individuals to test themselves for major diseases using their smartphone, with results available immediately, see a full health assessment and have access to follow on care where required.
  • VUI Diagnostics – A plug and play retinal screening device and companion software for simple, affordable and accurate retinal screening.

Further reading

For more information about each SME visit the DigitalHealth.London website.

See selected companies

37 NHS staff leading digital transformation projects to be supported by DigitalHealth.London’s Digital Pioneer Fellowship

37 change makers who are employed by NHS organisations and are leading digital transformation projects in London and the South East will join the 2020/21 Digital Pioneer Fellowship programme.

Today, DigitalHealth.London announces the 37 NHS staff who have been successful in gaining a place on the third Digital Pioneer Fellowship. The programme supports change makers employed by NHS organisations in London and the South East to design and lead transformation projects underpinned by digital innovation. As the NHS continues to respond to and recover from the COVID-19 pandemic, digital innovation remains vital to the health and social sector.

The 2020/21 cohort of Fellows come from organisations spanning London and the South East, and represent a diverse range of roles, departments and levels within the NHS. Eighteen are administrative staff, eight are Allied Health Professionals, six are medical professionals and five are nurses. Thirty percent of the cohort identify as BAME which is a relatively high proportion when comparing to the latest overall NHS workforce statistics which show that for NHS staff whose ethnicity was known, 79.2 percent were White (including White ethnic minorities), and 20.7 percent were from all other ethnic groups.

The 37 Fellows will be part of an action focused learning community focussed on accelerating the pace of digital transformation within their respective NHS organisations. Over the 12-month programme, the Fellows will have access to workshops, resources and events throughout the year to share challenges and experience, learn from experts and collaborate to co-design solutions.

Further information

Find the full list of this year’s Digital Pioneer Fellows here.

Browse their profiles

Safer care during Covid-19

A rapid-learning report on the role of Patient Safety Collaboratives (PSCs) during the pandemic has been published by the AHSN Network. PSCs are just one part of the health and care system which responded quickly to the immediate Covid-19 crisis in March. They reprioritised their day-to-day work and took on new programmes with speed, such as promoting safer tracheostomy care.

PSCs are funded and nationally coordinated by NHS England and NHS Improvement, and hosted locally by the Academic Health Science Networks (AHSNs) including the Health Innovation Network in south London. They make a significant contribution to the NHS Patient Safety Strategy, by supporting the delivery of the National Patient Safety Improvement Programmes and the AHSNs’ focus on accelerating innovation.

The report has been published as part of the NHS Reset campaign and gives examples of how PSCs refocused their work ‘almost overnight’ to respond to the pandemic. It illustrates some of the creative ways AHSNs supported their local systems and how this experience will be built into future patient safety programmes including our own #OnlyHuman campaign. This work encourages front-line health and care staff to prioritise their physical health and emotional wellbeing needs, which are likely to have been neglected due to the impact of Covid-19.

You can read the report at www.ahsnnetwork.com/patient-safety-covid19-report

 

 

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Is it ok to ask patients if their chronic pain is affecting their mental health?

We ask Diarmuid Denneny, Chair of the Physiotherapy Pain Association (PPA): “is it ok to ask patients if their chronic pain is affecting their mental health?”

With #worldmentalhealthday taking place this week (October 10) there is an opportunity to promote the role that #physiotherapists can play in identifying difficulties with #psychologicalwellbeing at an early stage. As most physiotherapists acknowledge, the impact of pain on mood is enormous and can lead to all sorts of difficulties such as isolation and anxiety.

Pain is chronic if it lasts longer than three months. But for many people pain lasts much longer – sometimes throughout their whole lives. The relationship between chronic pain (which is also referred to as persistent, long-term, or ongoing pain) and mental health is well recognised. Some find their pain and how it affects their mental health can lead them to be less active. It can affect their work, leisure, socialising and can lead to mood difficulties like depression and anxiety.

NICE guidance recommends that psychological based interventions are used in the management of pain and the recently issued draft chronic pain guidance also recommends considering psychological treatments. Physiotherapists are well positioned to offer psychologically informed approaches but research suggests many physiotherapists are reluctant to ask clients about their emotional wellbeing for fear of ‘opening up a can of worms’ and being unable to professionally advise them about where to go for help and support. Physiotherapists are one of the few health professionals that can spend around 30 minutes each week for a number of weeks with patients. This gives physiotherapists a valuable opportunity to build a therapeutic relationship with the patient and understand what is important to them and how to make improvements. They can ask them what is worrying them about their pain and then work together to tackle the physical and psychological impact.

The PPA wanted to support physiotherapists to become more confident when working with people living with pain and the impacts that this can have on emotional wellbeing. In collaboration with Frank Keefe, Duke University USA, we created a training course that explored behaviours and provided opportunities to practice techniques that can be used by physiotherapists when working with patients presenting with pain.

We can now announce that a new innovative training package for physiotherapists has been developed in partnership with the #HealthInnovationNetwork (HIN) AHSN South London, St George’s NHS Foundation Trust and Kingston Hospital NHS Foundation Trust hospitals in South London.

It all started about a year ago when I got a call from the Health Innovation Network project team inviting the PPA to partner with them. I found out that around the same time the PPA were running our training with Frank Keefe, the HIN project team had been running research focus groups with musculoskeletal physiotherapists at St George’s and Kingston hospitals. Their findings echoed ours; low confidence in discussing emotional wellbeing, concerns about ‘opening a can of worms’, but also a gap in skills because of limited training around the link between pain and mental health or training on mental health in general. Physiotherapists were enthusiastic about a possible course on delivering psychologically informed physiotherapy but highlighted the need for ongoing supervision and mentoring after training to embed the learning into daily clinical practice. For the last year, the PPA has been working collaboratively with the four partner organisations and our two brilliant patient representatives who are living with persistent pain, and last week we launched our evidence based Therapeutic Interactions and Person-centred care Skills (TIPS) training package.

The course content is grounded in behaviour change theory and underpinned by aspects of contextualised cognitive and behavioural approaches. The TIPS training draws on theory from Cognitive Behavioural Therapy (CBT), Acceptance and Commitment Therapy (ACT), and Mindfulness. It includes strategies that are widely used in pain management settings, that some physiotherapists may already be familiar with, but may not feel confident using in clinical practice. The course involves eight weeks of experiential learning followed by eight weeks of supervision. Our pilot sites are St Georges and Kingston musculoskeletal physiotherapy teams.

In our profession we hear the term ‘parity of esteem’ quite a lot which means ‘tackling physical and mental health issues with the same energy and priority’. Physiotherapy is a profession that people assume focusses on offering physical treatments, like manual therapies, as well as exercises. Yet we know from engagement with physiotherapists that although many people they work with will not have (or reach criteria for) a mental health diagnosis, they will be experiencing an impact upon their psychological health because of their pain and how it affects their life. Now, more than ever with the pandemic, we need to recognise the contribution that physiotherapists can make to reduce the impact of pain on emotional wellbeing. We have high hopes our TIPS training will deliver the outcomes to support this, for both the physiotherapist and the people who live with pain day-in-day-out. We welcome the opportunity to share our learning to a wider range of healthcare professionals once the course is evaluated next year. Our warm thanks go to the Q Improvement Lab/Health Foundation for funding this work.

View reactions from physiotherapist and patients:

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Our mental health team at the HIN are working on several projects to help people improve their mental health across south London.

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Worldwide experts to explore how digital health evidence generation is transforming healthcare

Experts in their field from around the world are to review the topic Generating Evidence for Digital Health in a series of upcoming webinars. This was made possible through an innovative collaboration between University College London, the Health Innovation Network, the DigitalHealth.London Generator and MedCity.

The series will span a wide range of issues around the topic with special reference to the digital health transformation brought about by the Covid-19 pandemic.

Renowned across the world for their work in the field, the chairs and guest speakers include; internationally recognised academic Professor Trish Greenhalgh, University Oxford; the Co-founder and Executive Director of the Digital Medicine Society and former Olympian and World Championship silver medallist Jen Goldsack; and senior clinical scientist Professor Dame Til Wykes who has carried out research in digital health with service users and has developed her own digital health software for people with a diagnosis of schizophrenia.

The webinars are all free to join and are targeted at an international audience of digital health developers, researchers, students, clinicians and NHS managers and commissioners. Audience members can join discussions with experts on key questions such as, ‘Can we move beyond regulation stifling innovation?’, ‘What can different academic disciplines bring to evaluating digital health?’ and ‘Can I trust digital mental health to work for me?’.

Dr Henry Potts, University College London and Public Health England, said: “Even before the Covid-19 pandemic, there was a momentum building around the importance of generating evidence for digital health. Now as hundreds of digital services and products have been introduced into health and care sectors, the need to understand their impact and use digital technology for lasting change requires real collaboration. We’re delighted so many digital health leaders have been enthused by this webinar series and I am very much looking forward to discussions and information exchanges.”

Dr Jean Ledger, Research Fellow, Department of Applied Health Research, University College London, said: “This webinar series is aimed at sharing perspectives and expertise with the hope of starting a collaborative movement around improving evidence generation in digital health. We hope these discussions raise interesting questions and ideas about how to improve evidence in this rapidly evolving field. There is great potential for digital health to improve health and social care for patients and NHS staff, but we need to get it right and understand what works well for end users, and under what conditions. Generating and applying evidence appropriately is key to that.”

“I would encourage anyone with an interest in digital innovation in health care – whether innovators, clinicians looking to adopt a digital solution or academics hoping to evaluate a digital health tool – to join these fantastic webinars.”Anna King, Commercial Director, Health Innovation Network

Professor Paul Wallace, Clinical Director for Digital at the Health Innovation Network and National Institute for Health Research London Clinical Research Networks, said: “The DigitalHealth.London Generator is committed to promoting the generation of evidence to support the digital transformation of our health and care services and we are delighted to be a founding partner of this exciting webinar series. If you are interested in any aspect of digital health, please join us this unique programme to hear from and interact with some of the most influential pioneers in the digital health space.”

Neelam Patel, CEO, MedCity said: “We are currently at a pivotal moment in digital health where its future will be decided by the success of collaborations between industry, the NHS and academia. MedCity is proud to be a partner in this top-level webinar series and I for one am very much looking forward to engaging debates and discussions on this important topic.”

Anna King, Commercial Director, the Health Innovation Network, said: “We have been inspired by high-profile thought leaders in digital health evidence generation who are sharing their experience and expertise in this webinar series. I would encourage anyone with an interest in digital innovation in health care – whether innovators, clinicians looking to adopt a digital solution or academics hoping to evaluate a digital health tool – to join these fantastic webinars.”

Each webinar will last for approximately one hour and will include presentations and a moderated question and answer session. The webinars will be streamed live, and recordings will subsequently be made available online.

The programme has been made possible by a grant from the UCL Knowledge and Information Exchange and all sessions will be free of charge.

Further information

Join the online discussion on Twitter using the hashtag: #EvaluateDigiHealth.

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DigitalHealth.London Digital Pioneer Fellowship opens for applications

Call out to NHS staff who are pioneering digital innovations within their organisations

Did you know

  • Over 80 per cent of the Fellows surveyed said they had gained specific technical skills.
  • So far 60 innovators employed by NHS organisations have benefited from the Digital Pioneer Fellowship.
  • All Fellows surveyed were confident that being part of the Fellowship was of benefit to their career.

Digital innovations have provided vital support and capacity to the NHS over the last few months and will continue to do so as the impact of Covid-19 continues, and the focus turns to resuming services. Today, DigitalHealth.London opens applications to its Digital Pioneer Fellowship programme, supporting change makers employed by NHS organisations in London to design and lead transformation projects underpinned by digital innovation. This year the Digital Pioneer Fellowship programme is funded through sponsorship from Boehringer Ingelheim Ltd (BI)* – the programme content and delivery is controlled by DigitalHealth.London.

Now in its third consecutive year, the 12-month programme provides up to 30 Fellows with the opportunity to be part of an action focused learning community focussed on accelerating the pace of digital transformation within their respective NHS organisations. The individuals taking part have access to workshops, resources and events throughout the year to share challenges and experience, learn from experts and collaborate to co-design solutions.

They will hear from and be given the opportunity to ask questions of leading sector experts during taught modules on subjects ranging from change management and business case development to agile delivery and service improvement. Fellows will also be able to choose a mentor and be grouped into action learning sets with other Fellows working in similar environments on digital transformation projects.

“I am extremely proud of the individuals we have supported previously through our Digital Pioneer Fellowship programme for the contributions they have made to bringing digital innovation into London’s NHS, and am very pleased today to announce the opening of applications for the next cohort of pioneers.”Sara Nelson, Programme Lead, Digital Pioneer Fellowship

In the first year of the programme over 80 per cent of the Fellows surveyed cited positive gain, saying that they gained specific technical skills and/or had met an individual challenge thanks to the Fellowship. All Fellows surveyed were confident that being part of the Fellowship was of benefit to their career.**

Sara Nelson, Programme Lead, Digital Pioneer Fellowship, said: “The COVID-19 pandemic has been one of the biggest challenges the NHS has faced and I have no doubt that the staff’s quick adaptation and uptake of digital innovations has been vital in enabling key services and care to continue over this period. As a nurse with over 25 years of service to the NHS, I appreciate how challenging digital transformation in the NHS can be if staff aren’t given the support, advice and time to develop professional skills that they need. I am extremely proud of the individuals we have supported previously through our Digital Pioneer Fellowship programme for the contributions they have made to bringing digital innovation into London’s NHS, and am very pleased today to announce the opening of applications for the next cohort of pioneers.”

Tara Donnelly, Chief Digital Officer at NHSX, said: “We need to support the clinicians, service leads, managers and operational staff in our NHS who are at the heart of digital healthcare delivery with the tools they need to drive change in their organisations.

“The DigitalHealth.London Digital Pioneer Fellowship provides them with these tools and I am thrilled it is opening for applications once again and look forward to witnessing the impact this next cohort of change makers have on London’s NHS.”

Nicola Reynolds, Principal Clinical Psychologist at Oxleas NHS Foundation Trust, recently appointed Deputy Clinical Director for CYPMH at Health Innovation Network and 2019 Digital Pioneer Fellowship alumnus, said: “I wanted to develop my skills and knowledge in order to help drive the development and adoption of digital working within my organisation, so I applied to the Digital Pioneer Fellowship programme. Having been successful in gaining a place, I was encouraged to think more strategically, and by doing so, I expanded the remit of my digital role. I recently contributed to a bid for funding from NHSX, we were successful in securing £200,000 to contribute to the development of a digital care pathway for Child and Adolescent Mental Health Services. I found the Fellowship experience invaluable, both the formal teaching and the Action Learning Set groups. I was able to use the insights I gained from the Change Management session to arrange and deliver on an alignment conversation with the senior team. It had a significant impact on the project and led to my solution becoming incorporated into the Trust wide solution.”

Uday Bose, Country Managing Director UK & Ireland at Boehringer Ingelheim, said: “We are delighted to be supporting the Digital Pioneer Fellowship and NHS staff with a learning community and access to leading experts and mentors.  Digital technology is a critical driver in accelerating our healthcare system, whether it’s progress in scientific innovation, sustainable healthcare or better ways to connect Health Care Professionals with their colleagues and patients. As part of our ongoing commitment to improving health, digital innovation is at the heart of delivering better value and care to patients. We are excited to champion NHS change makers who see the potential and benefit of digital transformation as they go about their day to day roles.”

Further information

For more information about the Digital Pioneer Fellowship programme, join a discussion with the Programme Lead and some of the Fellows who have been supported by the programme on the Digital Pioneer Fellowship 101 Webinar at 11:30am Wednesday 12 August on Zoom.

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You can read more information about the Digital Pioneer Fellowship programme and access the online application on the DigitalHealth.London website.

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AHSN Network stakeholder research – national findings

Did you know?

This independent report finds that the quality of HIN’s partnerships is a key strength. Find out more about what we do and how we partner with others across industry, health and care.

NHS England/Improvement and the Office for Life Sciences commissioned research to explore and evaluate the views of AHSN stakeholders. Savanta ComRes conducted this independent evaluation. With input from AHSNs and commissioners, they developed and ran an online survey and telephone interviews. Those taking part were stakeholders in health and social care, private and voluntary sectors, national and local governance bodies, research and academia, patient groups and the general public. Topics covered included familiarity with and perceptions of AHSNs, evaluations of AHSNs’ communications, services, support, work programmes and cross-regional working, and perceived opportunities and challenges for AHSNs in the future.

Key takeaways from the report:
1. Key strengths of Health Innovation Network cited across stakeholders are the quality of partnerships they develop and of the training courses they run.

2. However, there is a sense among some that HIN could be more visible by focusing resources on a smaller number of projects where they can make a significant impact.

3. Some stakeholders make suggestions for HIN around strengthening its ongoing communication with them, for instance by maintaining contact post-project or by targeting the most important individuals.

Download the Health Innovation Network AHSN regional report.

Download the national AHSN report.

“ They’re very motivated, very outcome-oriented and very good at providing connections and support to their local organisations and very focussed on the challenges of innovation and improvements in the NHS.”Industry stakeholder

Further information

Each AHSN is also publishing their individual regional reports. Find a list of England’s 15 AHSNs here. Explore the national AHSN Stakeholder Research findings.

See national findings

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NHS Diabetes Advice Helpline for patients with insulin-treated diabetes

medCrowd partners with Guy’s and St Thomas’ NHS Foundation Trust to provide a new Diabetes Advice Helpline

New virtual service supports self-management for people living with insulin-treated diabetes during the Covid-19 pandemic.

DigitalHealth.London Accelerator alumni, medCrowd, have partnered with NHS England and Improvement, Diabetes UK, Novo Nordisk UK, and Guy’s and St Thomas’ NHS Foundation Trust to provide a new Diabetes Advice Helpline.

The new Diabetes Advice Helpline, supported in its early development stages by King’s Health Partners Diabetes, Obesity and Endocrinology and Health Innovation Network, offers clinical advice for people, putting them in touch with trained clinical advisors with expertise in diabetes. All the advisors are diabetes trained health professionals who are volunteering their time during the pandemic – some are retired and have returned to the NHS to support patients.

The service is available via the Diabetes UK’s support line on 0345 123 2399, Monday to Friday from 9am – 6pm, for adults living with type 1 and type 2 diabetes who use insulin to manage their condition.

For patients who, whether as a direct or indirect result of the coronavirus, have had their routine care disrupted, the helpline provides much needed clinical advice on topics such as: hyperglycaemia, hypoglycaemia, sick day rules and missed injections, which can all lead to serious complications if not managed appropriately.

“This helpline is a fantastic example of how rapid collaboration between NHS organisations and medCrowd has made it possible to provide much-needed support to patients during this challenging time.”Laura Semple, Health and Innovation Network Programme Director in Diabetes and Stroke Prevention

The new helpline is not intended to replace the routine care that patients receive – but if for any reason patients cannot get hold of their usual care team, then the helpline is there to provide advice. The helpline is not able to offer advice for pregnant or paediatric patients. These patients, and their parents or guardians, as appropriate, are advised to contact their own doctor or care team.

Guy’s and St Thomas’ NHS Foundation Trust continues to be a key partner in the project by providing clinical oversight and support.

Mark Brodigan, Programme Lead for NHS England, said:
“Guy’s and St Thomas’ NHS Foundation Trust and our London regional team were instrumental in the inception and development of the programme. They continue to provide clinical, operational advice and support to the service. Without their help and support, we would not have been able to establish this service in such a short period of time. This is a good example of partnership working across the NHS, third and private sectors to establish a service that supports diabetic patients at this time of need.”

Kate Lillywhite, Programme Director of King’s Health Partners Diabetes, Obesity and Endocrinology, said:
“We’re delighted that NHS Diabetes Advice Helpline has launched and our Institute has played a key role in enabling it.”
“No doubt, this service will provide accessible and high-quality advice for people living with diabetes across the UK during the pandemic. None of it would not have been made possible without cross-organisation collaboration and the fantastic support from Health Innovation Network and medCrowd.”

“The experience of setting this service up opens up the possibility of new ways of working, beneficial to both patients and staff alike.”

Laura Semple, Health and Innovation Network Programme Director in Diabetes and Stroke Prevention, said:
“This helpline is a fantastic example of how rapid collaboration between NHS organisations and medCrowd has made it possible to provide much-needed support to patients during this challenging time. We will all be interested to learn from the experience of this advice line as we work with partners to shape the future of diabetes care.”

Sara Nelson, Programme Director DigitalHealth.London Accelerator, said:
“We are very proud that so many of our Accelerator programme companies are at the forefront of the Covid-19 response and are supporting the NHS and patients every day.”

“In this project, medCrowd is adapting its offer to meet people’s needs during the pandemic, giving hundreds of people access to the vital care and support they need.”

Dr Felix Jackson, Founder and Medical Director of medDigital and medCrowd, said:
“It is amazing to see this innovative service set up so quickly by the dedicated and talented team working together across the NHS, Health Innovation Network, medDigital and other key organisations. We were able to configure and roll out NHS Diabetes Advice in just a few weeks so people living with diabetes can get the help and advice they need during this uncertain time.”

Explore our work in diabetes here.

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Further Information

King’s Health Partners Diabetes, Obesity and Endocrinology is improving health and wellbeing for people living with diabetes and obesity across London and south east England.

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Let’s hold the gains

Let’s hold the gains

by Richard Barker, Chair at Health Innovation Network and Guy Boersma, Chief Executive at Kent Surrey Sussex AHSN

In the midst of an unprecedented health emergency, it may seem strange to speak of ‘gains’ – i.e. gains from our experience in combatting Covid-19. The loss of loved ones through Covid-19 is a terrible tragedy and no ‘gain’ or advances in our approach can ever outweigh this loss. But in this context, we face an even greater responsibility to be clear on what we are learning from this crisis and how we see these lessons bearing fruit for others in a future post-Covid world, whenever it arrives.

From our perspective working within the Academic Health Science Network (AHSN) system, we are seeing advances in thinking and practice in several key areas for the future of the NHS, and the Network is collecting lessons learned for future dissemination. But we would like to suggest a few of these at this early stage, under three headings – gains to hold, further gains to push for, based on the Covid experience, and change in healthcare system dynamics if we are to fully grasp these gains.

Gains to hold

‘Gains to hold’ include both how healthcare is being practised in the midst of Covid-19, how we are introducing innovation into practice, greater flexibility in roles within the NHS and productive partnerships between the public, private and third sectors of the health economy.

Most obvious is the rapid and dramatic shift to remote medical consultations. Using online tools and simple phone calls, we have demonstrated that many primary care and specialist consultations can quite effectively be done remotely. For example, skin lesion images and heart irregularities can be transmitted to inform these sessions, and of course patients can report the outcomes of current treatments. The level of such remote consultations will undoubtedly fall to some extent after the crisis, but we will have seen a major breakthrough in their use and widespread adoption of the relevant supportive digital tools, and the AHSNs have been intimately involved in ensuring these tools are introduced. With this learning and with the benefit of a further period of time, there is the opportunity to refine utilisation and get the most out of newly familiar technology.

We have learned that knowledge can be transmitted as fast as the virus, if not faster…

This brings us more generally to the speed of spread and adoption of new technology. Until now, the received wisdom was that the NHS could not be expected to take up innovations rapidly, with 17 years often being quoted as the UK standard for the delay between first appearance and widespread use! Now we know that the system can adopt what it urgently needs in a matter of weeks, if not days. Until Covid struck, the Accelerated Access Review (in which one of us took part) and the Accelerated Access Collaborative that took forward its recommendations, has been focused on accelerating a very few ‘transformative’ innovations. The role of the AAC in this crisis has widened the aperture significantly and we support the aperture remaining wide, and the speed remaining fast.

We have also seen redeployment of people and skills on a massive scale, across medical disciplines, between doctors, nurses, ancillary workers and pharmacists. We have learned that knowledge can be transmitted as fast as the virus, if not faster, and systems for democratising knowledge should emerge from our experience.

As AHSNs, we are also very focused on partnerships across the public, private and charity sectors of the health economy, and our boards are one of the few places in which all three come together around the same problem-solving table. The UK history has unfortunately too often been of mutual misunderstanding or suspicion across cultural divides. The Covid-19 crisis has broken these down dramatically, with just one example of a major pharmaceutical company approaching their local Academic Health Science Network to help plug the yawning gap in viral testing. And, of course, many companies whose business is not health have pitched in, whether to manufacture masks or other PPE, or support their local communities. Let us work so that the partnerships forged in the crisis lay the foundation for a much more collaborative future.

Holding the gains requires us all to capture the learning, now.

These are all solid gains to hold, if we are determined to do so. In addition, we see the need to push for advances in three other areas of huge importance for the future of the NHS: how we prioritise prevention, how we assess value and how we share data.

Further gains to push for

Holding the gains requires us all to capture the learning, now, on how positive change has been delivered at pace and scale: the generous collaborations, the inspired communications, the courageous changemaking, the focused strategy, and so on. We then need to consider how to incorporate this behaviour into a calmer future environment. Learning from the virus’ impact on those who are frail and have underlying health conditions brings into fresh focus how the NHS thinks about its job and its performance. As was pointed out in a recent All-Party Parliamentary Group report, Health of the Nation, the NHS is still an illness service in its productivity measures.

For the NHS to become more of a health service than an illness service, it needs to value more highly its contribution to maintaining the public’s long-term health and resilience, via an increased investment in self-care and in supporting citizens with long term conditions to manage and maintain independence for longer.

Despite fine words on focusing ‘upstream’, only about 5 per cent of the NHS budget goes on prevention – and secondary care cost inflation pressurises it out of hospital budgets. So, we have a rising tide of health-vulnerable people, particularly in the more deprived sectors of the population. ‘Underlying health conditions’ – most of them avoidable – are clearly major factors in morbidity and mortality from the virus. They are of course major factors in healthy lifespan in general – virus or no virus. We need to keep this firmly in mind when shaping the plans and budgets of the new primary care networks and ICSs and in HM Treasury / DHSC negotiations. And most prevention does not have an in-year ROI.

We believe this period is a wakeup call that should cause us to change some beliefs about our healthcare system

Fast and wide data-sharing is a major feature of the crisis, as specialists and hospitals try to analyse available data on an unfamiliar condition and generate information and insights leading to new approaches and novel therapies. The Health Data Research hub dedicated to critical care, PIONEER, will be in the forefront of this. This data- and knowledge-sharing within the NHS and across the world is itself a ‘gain to hold’. We should see an even more significant advance in data-sharing as citizens report symptoms, or antibody status and potential contacts in the context of an ‘exit strategy’ – a strategy that we are yet to see, but know we will need if we are to emerge from lockdown and not suffer successive future waves of infection. Looking beyond Covid, ready and responsible data sharing between individuals and the system – which of course needs to be two-way, for example through the NHS app – is such an important tool that we need to overcome the reluctance of several stakeholders to support it. Good governance will be key, as will be the ability for people to see and control how their data is used. Good analysis of data to create knowledge and information for decision-taking will also be key.

Changing healthcare system dynamics

Finally, we believe this period is a wakeup call that should cause us to change some beliefs about our healthcare system and the behaviours of staff and citizens. Firstly, the belief that our health is the NHS’ problem, not our own. Personal responsibility for maintaining strong health status and reducing health vulnerability will surely increase in the wake of Covid-19, and we should see a growth in demand from citizens and response from innovators for tools to enable this. Secondly, the belief that health workers – particularly domiciliary workers and health assistants – are doing low level work that merits low pay. Thirdly, that the NHS and private providers are enemies: in contrast, we have seen that agreements to work together and switch capacity reveal that they are on the same side in any health battle. Finally, that the NHS is a supertanker that we can never expect to move fast. It can and it has. We must collectively learn from how this was achieved and how the NHS can continue to respond positively to population needs at a faster pace and scale.

Read here, to find out what AHSNs are doing to transform lives during Covid-19.

Prof Richard Barker is Chairman of the Health Innovation Board. Richard is a strategic advisor, speaker and author on healthcare and life sciences. As a workstream champion in the Accelerated Access Review, he has advised successive UK governments on new healthcare tech.

Guy Boersma has focused on improving public services from within the NHS, central government, private sector and professional services firms. He has worked across the NHS in Kent & Medway, Surrey and Sussex since 2010.​

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DigitalHealth.London Accelerator opens for applications

DigitalHealth.London Accelerator opens for applications today

Call-out for the next generation of digital innovation to transform health and care

Digital products and services are currently providing vital innovation, support and capacity to the NHS during the response to Covid-19. Today, DigitalHealth.London opens applications to their flagship Accelerator programme for the next generation of digital health companies to transform health and care.

Now in its fifth consecutive year, the NHS-delivered programme, funded in part by the European Regional Development Fund, has supported some of the biggest and most effective digital innovations being used by the NHS in London. Companies including LIVIPatchwork HealthEchoSweatcoinHealth Navigator and Perfect Ward have all been through the DigitalHealth.London Accelerator programme. From enabling remote GP appointments, to transforming NHS temporary staffing and patient-facing self-management apps, the Accelerator has supported some of the best digital innovations now being widely used. Whilst the health and care system is under pressure like never before, the need for innovations to solve problems both today and in the future remains vital.

To date, the Accelerator has supported 105 innovative digital health companies, with 160 additional NHS contracts signed by those companies. For every £1 spent on the programme, it is estimated over £14 is saved for the NHS*.

Sara Nelson, Programme Director, DigitalHealth.London Accelerator, said: “Never before has the need for the right digital innovations to be delivering for our NHS and patients been so profound.  Digital health products are introducing new ways of doing things and enabling key services to continue where they might otherwise have been cancelled or postponed. We are extremely proud of the companies and NHS organisations we have worked with over the past five years. Today, we are excited to accept applications for the next cohort of innovators. With the growing need for safe and effective digital innovations, we are looking forward to working with innovators and the many NHS staff and patients across London’s health and care sector who have recently been inspired by technology and its potential.”

Anna King, Commercial Director, Health Innovation Network, one of the founding partners of DigitalHealth.London said: “The DigitalHealth.London Accelerator programme remains one of the most influential programmes of its kind, supporting fast-growing, high-potential digital health businesses. It is also helping London establish its place as one of the most exciting and innovative digital health and care hubs in the world, with scope to develop, validate and scale innovations. I’d urge any digital health innovator who has a product or service that could support the NHS to consider joining this programme.”

Theo Blackwell, Chief Digital Officer for London, said: “I am delighted to continue to support the Accelerator as it opens for applications again, and I am looking forward to the next group of innovators bringing their products and services to Londoners. The programme’s work ensures that London is at the forefront of digital innovation and is vital to building a future where its citizens benefit from the latest technologies to support their health.”

Tara Donnelly, Chief Digital Officer, NHSX, said: “The DigitalHealth.London Accelerator is part of a digital revolution in the NHS that continues rapidly to develop, and we will continue to support innovative organisations delivering ground-breaking work.

“This programme has established itself as an important player in supporting the NHS and social care to make the most of the opportunities digital health tech offers.”

Anas Nader, Co-Founder, Patchwork Health, Accelerator programme 2019-20, said: “We’re so proud of how widely our technology has already been embraced across the NHS and the impact we’re having on the lives of thousands of clinicians. We were delighted to join the 2019-20 cohort of DigitalHealth.London’s Accelerator, a brilliant programme speeding up adoption of digital health innovations in the NHS. The programme has provided us with opportunities to connect with industry experts as well as other health tech innovators. I’d encourage companies like ours with good ideas and big ambitions to apply.”

Joachim Werr, CEO, Health Navigator, Accelerator programme 2018-19, said: “The most valuable thing we experienced on the DigitalHealth.London Accelerator programme was the connections made with executives and decision makers within NHS organisations, and with central NHS policy makers, for example in NHS England and NHS improvement. Our NHS Navigator, combined with the expertise within the Accelerator’s network, have helped us reach the people that can make change happen in the NHS. We’d like to wish all companies applying good luck in what is a hugely competitive and valuable programme.”

DigitalHealth.London’s Accelerator aims to speed up the adoption of technology in London’s NHS, relieving high pressure on services and empowering patients to manage their health. It works with up to 20 high-potential SMEs over a 12-month period, giving bespoke support and advice, a programme of expert-led workshops and events and brokering meaningful connections between innovators and NHS organisations with specific challenges. The companies that are successful in getting onto the Accelerator programme are chosen through a rigorous and highly competitive selection process, involving expert NHS and industry panel assessments, interviews and due diligence checks. Companies that have a product or solution that is well-defined and are ready to start building their evidence base are likely to benefit the most from the type of support offered through the programme. Throughout the 12 months, the programme focuses on engagement with different elements of the health and care system. Company suitability is assessed based both on product maturity (meaning products that are ready to be trailed or bought that have high potential to meet NHS challenges) and on the company’s capacity to benefit from the programme (meaning companies have enough time and staff to engage).

For more information and how to apply, click here.

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Helping break unwelcome news

Helping break unwelcome news COVID-19 outbreak

Health Education England has published a set of materials and films which aim to support staff through difficult conversations arising from the Covid-19 outbreak.

The AHSN Network was part of a small group of people that helped pull this resource together in less than two weeks.

The framework includes posters and films based on the evidence base from Real Talk and then filmed with willing volunteers.

You can also follow #UnwelcomeNews on Twitter.

Start here for an introduction to the framework: Discussion of Unwelcome News during the Covid-19 pandemic: a framework for health and social care professionals

You can watch the films here:

  1. The framework
  2. Community
  3. Breaking bad news
  4. Ceilings of treatment

Then access the resources here:

Follow this link for more information on patient safety during Covid-19.

ESCAPE-pain resources to support people with chronic joint pain during Covid- 19

ESCAPE-pain: supporting people with chronic joint pain during Covid-19

The ESCAPE-pain programme is usually delivered as a face-to-face class to groups of about 10 people in Physiotherapy Outpatient Departments, leisure or community sites in over 290 venues across the UK. However, the Covid-19 epidemic has meant these venues have been forced to suspend face-to-face classes.

This has encouraged the team to find innovative new ways of supporting people with knee and hip pain who are now confined to their homes. Which includes, a new public ESCAPE-pain Facebook page has been launched where participants can visit to share stories, ask for guidance, and seek and provide peer support.

In addition the ESCAPE-pain smartphone app and online is now free-to-use and the hope is that is through the programme people can remain active and manage their joint pain during this time through the following resources:

  1. ESCAPE-pain Online can be viewed on a range of mobile devices but is best viewed on a computer;
  2. The ESCAPE-pain app is available on Android devices from the Google play store.

Note – Both tools require users to register and then follow a six-week programme, with two sessions each week, using exercise and educational videos and measuring the user’s ability at the start and end so they can see their progress.

To support home exercise further, the exercise and educational videos from the app are now also freely available on the ESCAPE-pain website so that people don’t need to create an account to view them, or for people who don’t wish to follow a structured programme and just want a reminder of how to do an exercise.

ESCAPE-pain has changed my life a great deal actually and I am just over the moon about it.
  1. The exercise videos are designed so that the exercises can be done in a home setting using everyday household items like chairs or steps. They are simple and easy to follow with audio instructions. Just click on each video to get started. You don’t have to do them all, choose a few you find easy, then add or drop exercises as you want. If you want to view the exercise in full screen mode, click on the bottom right hand corner of each video where you can see a small square. Why not also look at our top tips (on the same page) of how to exercise safely in your home?
  2. The educational videos can be viewed at any time to learn more about your joint pain. They give simple advice and information to help people learn about how to better manage their condition. Just click on each video to get started. If you want to view the video in full screen mode, click on the bottom right hand corner of each video where you can see a small square.
  3. It is recommended that people read through the ESCAPE-pain support tools guidance which contains top tips for getting the best out of the digital tools. In addition, some ESCAPE-pain sites have started delivering virtual ESCAPE-pain classes. So, if you’re one of those people who would benefit from the interaction and would find it more motivating then follow the @escape_pain Twitter account to find out where and when these are happening.

For more information, and support contact hello@escape-pain.org.

Reduced pain and improvement in physical function are only some of the positive results of the programme. Watch the latest participant video below.

New digital innovations tested for vulnerable people during Covid-19 outbreak

New digital innovations tested for vulnerable people during Covid-19 outbreak

Testing starts today as 18 winners of TechForce19 challenge announced

People who are particularly vulnerable or isolated as a result of the coronavirus (Covid-19) outbreak could soon benefit from a range of innovative digital solutions selected as part of the TechForce19 challenge.

NHSX and MHCLG have announced 18 digital solutions that have been awarded funding under the TechForce19 challenge. TechForce19 has awarded up to £25,000 each to innovation that offers a digital way to support vulnerable people who need to stay at home or need other help in the community for extended periods of time. The response to the challenge was extremely strong, with over 1,600 innovations submitted.

The successful solutions will now receive funding to rapidly test their product to meet specific Covid-19 related needs.

This testing phase will last for two to three weeks, and be followed by an assessment to better understand the potential and scope for accelerated deployment at scale, based on evidence.

NHSX has been working with partners PUBLIC and the AHSN Network to run the fast-track competition for innovators, creating a pool of technologies that have the potential to be rapidly scaled regionally and nationally.

Each prospective technology must have the capability to operate on a standalone basis without the need to be integrated with existing health or care systems.

Examples of the solutions going forward include:

  • Feebris for the most vulnerable who are isolating

Feebris helps carers to identify health risks and deterioration within elderly communities. The Feebris app guides a carer through a 10min check-up, including capture of vital signs from connected medical-grade sensors (digital stethoscope, pulse oximeter etc.). Powerful AI augments clinical guidelines and personalised monitoring to help decisions on triaging health issues. The intention is to provide Feebris to care homes to help carers triage the day-to-day health needs of their residents during the Covid-19 pandemic, and also enhance the capabilities of remote clinicians.

  • Neurolove to support young people with mental health

Chanua provides Neurolove.org, a platform providing a friendly ear and human support for young people to help them to keep virtually social and safe online. Supporting young people to manage anxiety and low mood, they can book sessions directly with mentors and therapists and find content that will support them to manage their emotional and mental health in this current period of uncertainty.

  • Peppy for new parents

Peppy helps parents-to-be and new parents remotely access trusted, convenient advice from perinatal and mental health experts. This includes remote support via phone/video with lactation consultants, baby sleep consultants, specialist mental health support and more. Peppy provides timely interventions that reduce stress, anxiety and burn out for parents-to-be and new parents.

  • Team Kinetic for volunteers

TeamKinetic’s digital platform helps organisations better manage community-led volunteer programmes. The solution helps manage recruitment and retention of volunteers, as well as monitoring the impact of these programmes in real time. TeamKinetic are also looking at developing and documenting some open standards and establishing a model for better service interconnectivity across the voluntary sector.

  • Vinehealth for cancer patients

Vinehealth is a mobile app to support cancer patients and their loved ones during treatment by allowing them to easily track and understand their care, including their symptoms, side effects, appointments and medications. By completing a 1-minute daily log, cancer patients can develop a clear overview of their progress through treatment and access advice on how to cope and when to access health services. The Vinehealth app empowers cancer patients who are self-isolating to self-manage and feel more in control.

“The TechForce19 challenge has harnessed some of the incredible talent we have in our tech sector to help the most vulnerable. Many of the problems created by isolation lend themselves to digital solutions, and we hope this process will help people take advantage of the potential that digital technology offers.

“The 18 companies we are announcing today have the potential to help a number of the key affected groups during Covid-19, including young parents, the elderly at home, and the homeless, as well as giving people tools to look after their own mental health during isolation.”

Guy Boersma, Digital & AI Lead, The AHSN Network, said:

“This list of solutions is testament to the talent being harnessed to address the consequences of the Covid-19 crisis. The health and care sector has already seen many solutions being deployed to support vulnerable citizens with mental health needs or other specific conditions, and the pandemic makes it even more necessary that we address the needs of citizens unable to access face-to-face care or even their usual social networks.

We are delighted that we have a series of solutions which can be piloted and then scaled to address these pressing needs.”

Daniel Korski, CEO of PUBLIC, said:

“As social distancing measures continue, today’s selections amount to a wealth of possible answers to helping the most vulnerable through these difficult times.

These companies demonstrate the valuable role for new technologies in helping public services adapt to new challenges, and we’re excited to follow their journeys from here through to deployment.”

For more information about the programme visit Techforce19.uk

Full list of digital innovations:

  1. Feebris for the most vulnerable who are isolating

Feebris helps carers to identify health risks and deterioration within elderly communities. The Feebris app guides a carer through a 10min check-up, including capture of vital signs from connected medical-grade sensors (digital stethoscope, pulse oximeter etc.). Powerful AI augments clinical guidelines and personalised monitoring to help decisions on triaging health issues. The intention is to provide Feebris to care homes to help carers triage the day-to-day health needs of their residents during the Covid-19 pandemic, and also enhance the capabilities of remote clinicians.

  1. Chanua / Neurolove to support young people with mental health

Chanua provides Neurolove.org, a platform providing a friendly ear and human support for young people to help them to keep virtually social and safe online. Supporting young people to manage anxiety and low mood, they can book sessions directly with mentors and therapists and find content that will support them to manage their emotional and mental health in this current period of uncertainty.

  1. Peppy for new parents

Peppy helps parents-to-be and new parents remotely access trusted, convenient advice from perinatal and mental health experts. This includes remote support via phone/video with lactation consultants, baby sleep consultants, specialist mental health support and more. Peppy provides timely interventions that reduce stress, anxiety and burn out for parents-to-be and new parents.

  1. Team Kinetic for volunteers

TeamKinetic’s digital platform helps organisations better manage community-led volunteer programmes. The solution helps manage recruitment and retention of volunteers, as well as monitoring the impact of these programmes in real time. TeamKinetic are also looking at developing and documenting some open standards and establishing a model for better service interconnectivity across the voluntary sector.

  1. Vine Health for cancer patients

Vinehealth is a mobile app to support cancer patients and their loved ones during treatment by allowing them to easily track and understand their care, including their symptoms, side effects, appointments and medications. By completing a 1-minute daily log, cancer patients can develop a clear overview of their progress through treatment and access advice on how to cope and when to access health services. The Vinehealth app empowers cancer patients who are self-isolating to self-manage and feel more in control.

  1. Beam for homeless population

Beam is a digital platform that supports the homeless and vulnerable people sleeping rough. Beam takes referrals from local authorities and homeless charities, then ensures goods are funded, delivered and documented.

  1. Alcuris Ltd

Alcuris’ Memohub® prolongs the independence of elderly or vulnerable people, enabling them to return to home quicker, from hospital discharge. A digital platform collates data from unobtrusive sensors placed in the home, then provides actionable alerts when behaviour changes, enabling families to intervene early to delay or reduce the frequency of professional ‘crisis intervention’ help. This gives family a reassurance of loved one’s safety and wellbeing even when left alone for extended periods. Also provides objective information to inform professional care planning.

  1. Ampersand

Ampersand Health‘s self-management apps help people with long term, immune mediated diseases (such as Crohn’s and Colitis) live happier and healthier lives. Using behavioural and data science, the apps deliver courses and programmes designed to improve sleep quality, stress management and medication adherence; with modules for activity, diet and relationships in the works. During the Covid-19 crisis, this will help these people better manage their conditions and reduce the need for clinical support. Ampersand are also offering their clinical management portal free of charge to NHS Trusts until January 2021, no strings attached. This will allow clinical teams to help manage their patients, remotely.

  1. Aparito

Aparito uses remote monitoring technology (videos, wearables, photos and text) to gather patient-generated data outside of hospital. This is focused on patients with rare diseases. Data is captured and transferred via the patient’s own smartphone / tablet and made available to clinicians or researchers in real-time to help avoid direct contact during the Covid-19 crisis.

  1. Birdie

Birdie provides a digital platform for home care agencies to better manage the care they provide. Through an easy to use app, care workers capture daily visit logs, and a central hub allows staff to track real-time information. Family members receive live and daily safety and well-being updates through the app, including from optional home monitoring sensors. Birdie helps domiciliary care agencies to increase efficiency, and improves the care people receive in their homes through systematic monitoring, prevention of risks, and support to carers.

  1. Buddi

Buddi Connect is a smartphone app, enabling people to stay in touch with those they care for. Safe groups of connections are united through the app to share private, secure messages and raise instant alerts when help is needed. Important messages from the NHS can be shared directly to users. During this difficult time, while many vulnerable people are missing the face-to-face contact of family, friends and carers, the reassurance that help is available at the touch of a button is more important than ever.

  1. Just Checking

Just Checking supplies activity monitoring systems, used by local authorities to help with assessment of older people in their homes, for social care. Sensors pick up activities of daily living and display the data in a 24-hour chart. The company also has a second, more sophisticated activity monitoring system, to help manage the care and support of adults with learning disabilities.

  1. Peopletoo Ltd/ Novoville

Peopletoo and Novoville have been selected to launch GetVolunteering, a volunteering app to fast track volunteers into clinical and non-clinical roles to support the fight against Covid-19. It will enable local authorities to quickly identify and assess capable volunteers in the local community to fill key roles to support social care in areas that have been impacted by loss of staffing capacity due to Covid-19, or for new roles that are required during the crisis.

  1. RIX Research & Media, University of East London

The RIX Multi Me toolkit provides highly accessible and secure social networking that serves as a support network for people with learning disabilities and mental health challenges. This easy to use multimedia network, with accompanying communication, personal-organiser and goal-setting tools, enables isolated and distanced vulnerable people to build stronger support circles. It helps them self-manage their care and actively limit the impact and spread of Covid-19 infection. Care professionals use the ‘Stay Connected’ RIX Multi Me Toolkit to remotely monitor and support people’s wellbeing in an efficient and friendly way.

  1. Simply Do

Simply Do will develop a virtual community of NHS medical professionals currently in self-isolation. These employees have significant expertise, experience and skills which can be unlocked virtually to help solve Covid-19 care challenges set within the platform. This will create a powerful ‘think-tank’ of medical professionals to contribute virtually to fight Covid-19 by solving wider health challenges (i.e. challenges faced in the care sector).

  1. SureCert

SureCert is a digital platform that connects people with job and volunteering opportunities. The system also manages background checks. SureCert can provide data on successful placements, and information to enable policy makers to better understand the labour market and volunteering supply and demand.

  1. VideoVisit Global Ltd

VideoVisit® HOME allows the elderly to communicate with their family members and home care providers through a virtual care tablet designed specifically for elderly. VideoVisit will measure how this virtual home care service can increase people’s feeling of safety and decrease loneliness during self-isolation.

  1. Virti

Virti aims to make experiential education affordable and accessible for everyone. Virtual and augmented reality, coupled with AI, transports users into difficult to access environments and safely assesses them under pressure to improve their performance. The system is used for training and patient education.

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Volunteer Support for Care Homes and Care Home Staff now available

Volunteer Support for Care Homes and Care Home Staff now available

A new organisation of volunteer health and care students has offered support to care homes and care home staff through a HIN pilot scheme.

HealthSHIP (Health Students Helping in Pandemics) are mostly health students (i.e. nursing, physio, occupational therapy, medical) with valid DBS certificates, and free time on their hands who are keen to support NHS and social care staff with everyday needs (errands, childcare, pet care, grocery shopping, admin, non-clinical tasks, etc). The scheme is nationwide – it’s free, quick and easy, representing 87 universities and over 1,100 users.

HealthSHIP are keen to support Care Home Pioneer staff with any shopping, errands or help for their own families. In addition, care homes wanting volunteers to volunteer in their care homes can also request help – local medical students will volunteer to support if they can. The Health Innovation Network is helping to coordinate this pilot.

To register for the scheme, care home managers should:

1) Make an account for your care home on www.healthSHIP.org with your email and post tasks/roles you need help with. This would then prompt medical student volunteers to respond to the requests and then become volunteers of the care homes / care home staff.

2. Distribute the HealthSHIP website to your care home staff members who can sign up in a personal capacity and request help for their personal lives. You will need to email HealthSHIP with the personal email addresses of care home staff who want to register, so they can be verified.

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Maintaining Activities for Older Adults during Covid-19

Maintaining activities for Older Adults during Covid-19

Click here to watch the YouTube video to understand the needs of people living with dementia during the Covid-19 pandemic. The Activities Guide below will signpost you to excellent activities suitable for such population.

This guide to online resources for those providing care for people with dementia, is a resource that Health Innovation Network has compiled in collaboration with CHAIN members.

Activities for Older Adults During Covid-19 – aims to support the provision of free to use dementia friendly activities for older adult’s in mental health inpatient settings, Care Homes, supported housing and to those living in their own homes during the national response to Covid-19. You can download using the link below. Please share this guide with your colleagues and other relevant organisations.

 

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Looking after your mental health and wellbeing: our staff and community Covid-19 resilience message

Looking after your mental health and wellbeing: our staff and community Covid-19 resilience message


In these uncertain times following the outbreak of Covid-19, it is more important than ever that we exemplify our HIN value of ‘Together’ – not only among our own staff, but to our members, stakeholders, partners and the people we serve. There isn’t one “right” way to process and deal with a situation like this, but one thing that we can all do to make this time easier is to look after our own health and wellbeing and support others to do the same.

We have collaborated with King’s Health Partners to create the following practical tips for how to look after your mental health and wellbeing sustainably. To access the full resilience message, which includes resources and information for accessing additional support during this time, click the button below.

Tech challenge launched to offer digital support during Covid-19 outbreak

Tech challenge launched to offer digital support during COVID-19 outbreak

  • Tech challenge launched to combat effects of social isolation;
  • Innovators urged to find ways to deliver mental health and social care support digitally;
  • £500,000 worth of Government funding available to start work within weeks.

People confined at home because of Coronavirus (Covid-19) could soon benefit from new technology to combat the effects of social isolation.

Funding is being made available by NHSX through ‘Techforce 19’, for innovators who can find digital ways to support those who need help, including people requiring mental health support and those with social care needs.

The technology is intended to support those who may be most affected by the consequences of remaining housebound for long periods of time.

Announcing the fund, Matt Hancock, Secretary of State for Health and Social Care, said:

“If people cannot leave the house, we need to quickly find ways to bring support to them and today I am calling on the strength of our innovative technology sector to take on this challenge. Techforce19 will mobilise the UK’s incredible reservoir of talent to develop simple, accessible tools that can be rolled out quickly and help tackle the effect of social isolation.”

The programme is being launched by NHSX and is being managed by GovTech venture firm PUBLIC and the AHSN Network.

Piers Ricketts, Chair of the AHSN Network, said:

“The AHSN Network is dedicated to furthering successful collaborations between innovators and the health and social care system. Our well-connected teams throughout the country are ready to support NHSX and PUBLIC with this important call out to industry.

I encourage all innovators with a relevant idea, or with existing technology which could be adapted or scaled, to apply to this programme and help support the most vulnerable and isolated during this difficult time.”

In total, there is £500,000 available to bid for – with funding of up to £25,000 per company available to innovators with solutions that could be deployed at scale in the next few weeks. Specifically, the programme is looking for digital solutions that can be deployed quickly, and could include:

  • Providing remote social care;
  • Optimisation of the care and volunteer sector;
  • Messaging and communication;
  • Mental health support – for example through peer communities or self-management tools;
  • Any other solutions to ease pressures on services and people during this time.

Matthew Gould, Chief Executive of NHSX, said:

“Tech can play an important role in helping the country deal with the challenges created by the Coronavirus.  This competition is focussed on the problems created by isolation, which lend themselves to digital solutions. It will allow NHSX to accelerate the development of those solutions, so within weeks they can help those in isolation suffering from loneliness, mental health issues and other problems.”

The Government has strongly advised everyone in the country – but especially those aged 70 or over, people with underlying medical conditions or pregnant women – to reduce social interaction to help minimise the spread of the virus. Those considered most at risk of having serious complications from the virus – for instance people receiving treatment for cancer – have also been asked to stay at home for 12 weeks as part of efforts to ‘shield’ them from the virus.”

Techforce19 is a new challenge, open to innovative tech companies in this country who will compete to develop accessible digital tools to support people who are staying at home over the coming weeks and months.

For more information on the programme and how to apply, visit Techforce19.uk.

Recruitment for innovators taking part in the challenge programme opens today, Monday 23 March. The closing date for applications is 1 April 2020.

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How is the AHSN Network supporting the response to Covid-19?

Map of the AHSNs

How is the AHSN Network supporting the response to COVID-19?

All AHSNs within the AHSN Network are actively supporting the NHS and social care system regarding the Covid-19 pandemic.

If you would like advice on immediate or future needs, and how best to present your offer to local and/ or national commissioners, please contact the commercial team at your local AHSN via the AHSN Network Innovation Exchange or register online. Use the postcode checker to help you find your local AHSN.

The government has provided national guidance on where to register products to support the Covid-19 response. Please find these details below.

PPE (Personal Protection Equipment)

Contact the Surgical MedTech Co-operative (one of NIHR’s Medtech and In vitro diagnostics Co-operatives) if you have a technology that could be adapted quickly for the healthcare setting to help protect healthcare workers against aerosol contamination. Find out more about their ‘Covid-19 PPE Challenge’ here.

 Vaccines

Contact Public Health England: nervtag@phe.gov.uk

 Ventilators

Contact the Government’s Department for Business, Energy & Industrial Strategy (BEIS): ventilator.support@beis.gov.uk or call 0300 456 3565

 Innovation and Tech

Contact NHSX: DNHSX@nhsx.nhs.uk

 Diagnostics

Contact Public Health England: coviddiagnostics@phe.gov.uk

General

The UK government has set up a service allowing businesses to share any support that might help the Covid-19 response, from PPE and medical testing equipment to transport/logistics and warehouse space. Find out more here.

If you have any other solutions (not specifically Covid-19 related) that could be useful to the health and care system during this unprecedented time, you can access AHSN advice and support by visiting www.ahsninnovationexchange.co.uk.

Are you taking your medicine? Nearly half the time, the answer is “no”

Are you taking your medicine? Nearly half the time, the answer is “no.”

This blog is by Ayobola Chike-Michael, Patient Safety Project Manager at the Health Innovation Network

The real life cost of non-adherence

Medicines are made to be taken. Right? Well, medicines are being manufactured, prescribed and dispensed, but up to 30–50 per cent of prescribed medicines may not be taken as directed. This is a big issue for John Weinman, distinguished Professor of Psychology as Applied to Medicines at King’s College London, who recently gave a presentation to representatives from all 15 Academic Health Science Networks (AHSN) on this topic. It’s also a prevalent issue for doctors, pharmacists, patients, carers and relatives. If this is not an issue in your world, it should be.

“Non-adherence” to prescribed medication is when a person does not take the medications as directed. This is surprisingly very common. As a result of this, many kitchen drawers overflow with medicines that eventually get thrown away, or worse, cause harm to an unintended consumer.

A look at some of the contributing factors
It’s not only patients who feel the negative impact of non-adherence; evidence shows that there are poorer clinical outcomes and increased healthcare costs associated with it too. This 2018 OECD report states that poor adherence contributes to 200,000 premature deaths in Europe per year and costs 125 billion euros through avoidable hospitalisations, emergency care and outpatient visits. Good-quality health as defined by the OECD is three times lower in those who do not adhere to their medication. It is a huge drain on public reserves and a massive health challenge to overcome. Most significantly, it does not have to be this way.

So why would someone who is unwell and needs medication not take it? The reasons why transcend the smell or size of the tablets they are given. Some people do not believe that medication is important for them. Some worry about side effects or lose motivation and so refuse to take them or do not take them as prescribed. Research literature identifies almost 200 reasons for non-adherence. Some are obvious, others are less so. But when there are so many factors involved, how do we know where to begin supporting patients?

With adherence, patients experience an improved quality of life because their symptoms can be reduced…

Understanding the why

King’s Health Partners established a centre that addresses these questions and many others relating to matters of adherence. The Centre for Adherence Research & Education (CARE) provides a hub for understanding and addressing the reasons for non-adherence. The team of experts at CARE aim to improve patients’, caregivers’ and health and social care staff’s awareness of non-adherence and provide approaches to support patients.

CARE has carefully grouped the many reasons for non-adherence into three manageable areas: Capability, Opportunity and Motivation.

Capability. Some people do not know how to properly take their medication, or may have problems with their understanding, memory or physical ability to do so.

Opportunity. Some people are limited by situations outside of their control. These are external challenges such as financial constraints, access and lifestyle opportunities.

Motivation. Some have developed a negative perception about their medication through social pressures and stigma, or as a result of their perspectives and experiences (those of side effects or low moods, for example) can become convinced that the medications are not necessary or beneficial to them.

Improving adherence

It is important that healthcare professionals and carers understand, and support their patients’ understanding of, the impact of non-adherence. But equally important is that we promote and celebrate the benefits of adherence. With adherence, patients experience an improved quality of life because their symptoms can be reduced and they can benefit from increased physical function and improved health outcomes. This is a win-win for patients and healthcare professionals.

Some healthcare professionals feel limited in supporting their patients to improve adherence because of the tremendous time pressure they’re under, or because they don’t know how to go about it. The CARE approach enables collaborative working with the patient to find solutions. They train clinicians to understand the issues and provide them with user-friendly tools and support strategies designed for routine care. These are available on the King’s Health Partners Learning Hub.

To join our conversation around how to support patients in getting the most out of their medicines, contact a member of our patient safety team at hin.southlondon@nhs.net. Let us all in our individual capacities do what we can to make the world of medicines a better place.

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Don’t talk to me about savings – my innovation saves lives

Don’t talk to me about savings – my innovation saves lives

Patient safety and benefits are paramount when assessing new innovations, but commissioners need to understand the financial benefits too. Here Lesley Soden, Programme Director of Innovation at Health Innovation Network, explains how innovators can make sure they have a robust case by gathering the right data and accessing the right support.

Picture the scene: you’re promoting the ground-breaking clinical benefits of your innovation to a potential NHS customer, but the conversation quickly turns to questions about savings and ensuring a return on investment. This topic soon overpowers the discussion, and everything you had prepared on improving patient care or helping health professionals do their jobs better is forgotten. You’re left feeling perplexed about the NHS customer’s priorities and your own responsibility to the system.

The bottom line is that every NHS provider and commissioner will have a year-on-year savings target, usually between two per cent and nine per cent. To put this into context, for a specialist hospital with a £200 million budget, even just a two per cent savings target would be £4 million. This doesn’t mean that they aren’t interested in hearing about the workforce or patient safety improvement potential of your innovation. It does mean that they also need to see how you will help them save that cold hard cash.
How you can help
It’s imperative that you can prove your return on investment, or ROI, as well as talk about the system benefits of your idea. And the two aren’t mutually exclusive. Your ROI can be based on a number of factors, such as incident rates, patient or staff satisfaction rates, length of stay, emergency re-admission rates, infection rates, A&E waits, etc., all of which can offer an overall financial benefit to the NHS provider. While there is typically a lot to consider, the good news is that there is funding available from bodies such as the NIHR (National Institute for Health Research), Innovate UK or health charities to pay a university or health economist for ROI expertise.

Your ROI must not only be more appealing than similar options available on the market; it must also be impressive against cost-saving innovations in other categories.

But what does ‘return on investment’ actually mean? Put simply, ROI means that the financial benefits associated with the investment are greater than the costs incurred. For example, Locum’s Nest, the digital app that allows doctors to book and get paid for additional shifts, identified that one Trust recorded savings of £1.3 million in its opening 10 months after adopting the app. The cost of implementing the system was significantly less than this figure, giving a clear return on the finances and time invested by the Trust.
 
Articulating the benefits
This example clearly demonstrates a direct benefit, but there are a number of indirect ones that can be used to illustrate return on investment as well. In healthcare, these are often calculated in productivity, or the time saved by clinicians with which they can treat more patients and reduce delays in a patient’s pathway through the hospital, the cost saving of which can be inferred. For example, the use of the Infinity ePortering solution at Northwick Park Hospital, which coordinated approximately 9,000 requests for porters to transport patients and equipment each month, reduced the average request-completion time by six minutes, saving the hospital indirect financial costs of over 10,000 hours in productivity time per year[1]. Other indirect benefits can be factors such as staff satisfaction, which are qualified through an increase in staff retention and, therefore, reduced recruitment costs.

As seen in these examples, good ROI analysis measures an innovation’s efficiency in terms of the expected benefit flow, whether direct or indirect. It should not be confused with “budget impact analysis”, which is an economic assessment used to calculate the actual cost of specific resources and equipment required to adopt and implement an innovation or service. Being able to effectively communicate the value of both direct and indirect ROIs is one of the most important skills any innovator for the health and care system can develop.
 
Understanding your audience
It’s important to remember that the benefits associated with an investment are not always measurable in a direct cash return to the investor. The value could be identified in terms of improved population health, the resulting decrease in demand on health services and an increase in system-wide savings. These can be more complicated ROIs to demonstrate, because the savings may not be immediately felt by the part of the system you are asking to implement your innovation. Convincing a commissioner to pay for something that they will not directly see a financial return on is not as straightforward a task. For example, asking a hospital to pay for an innovation that supports early patient discharge might seem like an obvious win for the trust, but in reality, the savings generated would directly benefit the commissioner, not the hospital itself. In these instances, you need to highlight the benefits to all parties. For the hospital, this could be freeing up bed capacity, resulting in an increased number of elective operations, which would generate an income for them.

Your ROI must not only be more appealing than similar options available on the market; it must also be impressive against cost-saving innovations in other categories. For example, a Board might decide, rather than choosing between two digital innovations capable of reducing temporary staff agency costs, to simply pay for online infection-control training in order to reduce infection spread rates among staff. Your innovation must be able to demonstrate a better return on investment than all other options, too.

Being able to effectively communicate the value of both direct and indirect ROIs is one of the most important skills any innovator for the health and care system can develop.

Calculating your ROI
A financial ROI is calculated through a cost-benefit ratio, which is the cost of an innovation divided by its benefits. This is often represented as an estimated value generated for every £1 spent on the intervention. The ROI value should be greater than every £1 spent to show a good return on investment.

For example, Public Health England’s 2017 report[2] on the prevention and treatment of musculoskeletal (MSK) conditions showed that ESCAPE-Pain, an MSK prevention programme, had an ROI of £5.20, which is a great return for every £1 spent on the intervention. This demonstrates to commissioners and providers that the intervention of commissioning ESCAPE-Pain will generate a financial ROI.

Another example of a good cost-benefit ratio can be seen in SecurAcath, which secures percutaneous catheters in position on the skin, reducing the need for frequent catheter replacement or reattachment. In a comparison study against the use of a similar device, they found that SecurAcath decreased costs in catheter replacement by £17,952, as SecurAcath resulted in a 0% catheter replacement rate compared to 5.9 per cent for the other device in the same year it was implemented.

The most attractive cost-benefit ratios promise in-year savings, meaning that commissioners don’t have to wait a long time to reap the rewards of their investment.

However, don’t be dissuaded if your idea is more of a long burn. There is a focus in the NHS Long Term plan on keeping people well for longer, and whilst people prefer quick wins – don’t we all – it’s not a guarantee that you will get rejected if you can’t promise a short-term return. In this instance, your ROI analysis could focus on the cost of preventing diseases and conditions in contrast to the cost of treating these conditions (e.g. cardiovascular disease or diabetes).

Getting support
 If you are piloting your innovation within a health or social care service, you don’t just need to work out your costs; you also need to understand the current system data you’re claiming to be an improvement upon. You might be asked by a service lead to help identify the baseline data at the start of the pilot, and this data is contingent upon how your innovation will impact the service.

Normally, a provider will have key monthly performance indicators (KPIs) that are reported to their commissioners and their Trust Board in aggregated data. This could be measured in things like the number of face-to-face patient contacts, waiting times or staff agency costs. The piloting of an innovation within a specific service may require the running of tailored data reports for these KPIs to provide valuable baseline information.

A service lead will request that their internal informatics / business intelligence teams run these reports, as they are the only people in the company who are allowed access to that level of data. You will, then, receive this report from a business intelligence employee to build up your knowledge of the current system data. The request for data reports is often overlooked by innovators and makes it difficult to maximise the pilot benefit outside of a specific site if the right evidence is not generated.

Evidencing the ROI of your innovation is often challenging and costly. However, it could be money well spent if this evidence leads to paid contracts. There are several options available:

  1. Do the work in-house. It should be reasonably straightforward for you to provide estimations of savings based on the improvements or outcomes your innovation has achieved in health care settings. You could use data that is readily available such as:
  • Number of bed days that your innovation has saved (e.g. by avoiding admission or reducing planned admissions). This can be quantified by the cost of an NHS bed per day.
  • Staffing hours saved by the innovation and the associated benefits (e.g. efficiencies, more patient-facing time, reducing unpaid overtime, more effective management of follow-up appointments or reducing DNAs).
  • Better management of medicines, which leads to a reduction in medicines being prescribed.
  • Prevention of deterioration through early diagnosis or better management and the savings associated with reducing the risk.
  1. Find a masters student. Many masters students will be up for taking on your research as part of their dissertation project. Specifically targeting universities that have students from relevant health economics or data science backgrounds or who are specializing in the same area as the product (e.g. a physiotherapist) is a good place to start.
  2. Commission an external and impartial consultancy. The outcome of which should be a robust piece of work that clearly demonstrates the ROI. Some AHSNs provide this service.

 

Conclusion
It would be great if innovations were only assessed on the patient benefit, but unfortunately, the NHS doesn’t have a bottomless purse. And neither should it. That absolutely doesn’t mean that patient safety isn’t of the upmost importance, it just can’t be the only deciding factor. Make it easy for commissioners and NHS providers to  see the value – both financial and otherwise – of your innovation by making sure you start with a robust baseline, gathering the right data during any pilots, looking out for funding opportunities and working with your local universities to access masters or PhD students who are keen to undertake your health economics study.

 

 

For more guidance on understanding health economics and how to calculate an ROI, check out these resources:

https://www.gov.uk/guidance/health-economics-a-guide-for-public-health-teams

https://www.weahsn.net/toolkits-and-resources/quality-improvement-tools-2/more-quality-improvement-tools/return-on-investment-roi/
 

References
[1] https://infinity.health/eportering/

[2] Return on Investment of Interventions for the Prevention and Treatment of Musculoskeletal Conditions (PHE, 2017)

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Meet the new NHS Innovation Accelerator fellows

Meet the 2020
NHS Innovation Accelerator Fellows

The NHS Innovation Accelerator (NIA) has announced the 11 high impact innovations joining the national accelerator in 2020. Four of the 11 innovators are DigitalHealth.London Accelerator companies; Health Navigator, Locum’s Nest, MyPreOp (Ultramed) and Safe Steps.

At a launch event chaired by Professor Stephen Powis, National Medical Director for NHS England and NHS Improvement, the 2020 cohort of Fellows presented their innovations to key stakeholders, including Tony Young, National Clinical Lead for Innovation of NHS England and NHS Improvement, and Nigel Edwards, Chief Executive of the Nuffield Trust, both of whom also spoke at the event.

The innovations joining the award-winning NIA offer solutions supporting priority areas for England’s NHS as laid out in the NHS Long Term Plan. Their recruitment follows an international call and rigorous selection process, including review by over 100 clinical, patient and commercial assessors, an informal review by the National Institute for Health and Care Excellence (NICE), interviews, and due diligence. This year’s finalists include a medically certified smartwatch app capable of detecting atrial fibrillation (AF), a device reducing the angst of parents by enabling faster ADHD diagnosis, and an artificial intelligence (AI) platform bringing patients’ voices to life to improve care.

This marks the fifth year of the NIA, which is an NHS England initiative delivered in partnership with England’s 15 Academic Health Science Networks (AHSNs), hosted at UCLPartners. Since 2015, it has supported the uptake and spread of 62 evidence-based innovations across more than 2,210 NHS sites. Independent evaluations report that NIA innovations save the health and social care system £38m a year, conservatively.

Professor Stephen Powis, National Medical Director for NHS England and NHS Improvement, said:

“The NHS Long Term Plan puts the latest technology and innovation at the heart of people’s care and the future of our health service.

“Right across the NHS patients are benefitting from world-beating innovations, spread as part of this programme, and now even more patients will be supported by new tools.”

Piers Ricketts, Chair of the AHSN Network, said:

“The NHS Innovation Accelerator is one of the flagship programmes of the AHSN Network. NIA Fellows have made a huge contribution to our health and care system since we started the programme five years ago, and we are proud to have supported these remarkable individuals on their development journey. It is gratifying to see their high-impact innovations gaining traction and visibility through our accelerator programme, and we are delighted that several NIA innovations have now had national impact in the NHS.

We look forward to working with the new NIA Fellows to help them scale and deploy their innovations across the country for the benefit of patients and the NHS.”

The 11 innovations selected to join the NIA in 2020 are:

Fibricheck: A medically certified app (CE Class IIA, FDA approved) capable of the early detection of heart rhythm disorders, such as atrial fibrillation, using a smartphone or smartwatch
Health Navigator: AI-guided proactive health coaching to prevent avoidable urgent and emergency care
Locum’s Nest: A locum app that connects doctors to locum work in hospitals, while cutting out the inefficient, ineffective and expensive agency middleman
Management and Supervision Tool (MaST): A dashboard that uses predictive analytics to generate insights which support staff to deliver high quality, effective mental health care by identifying those people who are most likely to require crisis services
MediShout: The world’s first platform to integrate all logistical departments in hospitals, giving clinicians an app to instantly report issues and using AI to predict future problems
MyPreOp: A cloud-hosted programme enabling patients to enter, own and share their preoperative assessment information
Patient Experience Platform (PEP): AI platform transforming healthcare and improving safety by empowering the digital voice of patients
QbTest: A CE-marked, FDA approved medical device that simultaneously measures attention, impulsivity and motor activity to speed up ADHD diagnosis and treatment evaluation
RIX Wiki: Software that enables people with learning disabilities to share personal health and care information for effective person-centred support in their communities
Safe Steps: Reducing the number of preventable falls in the ageing population through digital, evidence-based interventions
The WaterDrop: A low-cost, high impact innovation that enables patients to easily access fluids at any time without needing to call for help to help prevent dehydration and avoidable intravenous drips

Saved by social: can young people be helped to cope online with social networks

Saved by social: supporting young people with mental health challenges using apps

By Rita Mogaji, Digital Marketing Manager at Health Innovation Network

I love social media. I love everything about it. I love that you can learn most things, connect with likeminded people, or even better, very different people from all over the globe. In that one click a whole world of interests, breaking news and funny memes is opened up to you. As Digital Marketing Manager of Health Innovation Network, I get a kick out of being able to share the latest digital innovations with healthcare professionals, connect with GPs on how they can bring Atrial Fibrillation (AF) checks to their clinics and – of course – stay up to date with the latest gifs, all through the power of social media.

But I appreciate that’s not everyone’s experience of the cyber world. And, while I am a lover of the online world, I am not ignorant to the darker side, where bullies troll and perfection is presented as a casual everyday occurrence. This is particularly saddening in the way that it is potentially affecting young people’s mental health.

In February, HIN hosted a Maximising Digital in Mental Health event, specifically aimed at discussing how we can maximise digital  opportunities in mental health for 0-25 year olds. At the event, leading children’s mental health expert and Professor of Contemporary Psychoanalysis and Developmental science and Head of the Division of Psychology and Language Sciences at University College London (UCL), Professor Peter Fonagy OBE, brought the problem to life in the statistics he presented. According to the first national review of children and young people’s mental health, the number of children and young people referred for mental health treatment has risen by two-thirds since 2012, university students reporting a mental health problem has risen five-fold.

The same report, titled “Impact of social media and screen-use on young people’s mental health”, published in 2018, found that despite there being a disappointing amount of robust research in this area, there was evidence of the potential negative impacts of social media, ranging from causing detrimental effects on sleep patterns and body image, through to cyberbullying, grooming and ‘sexting’. In these instances, social media was described as a facilitator to the risk, rather than the general root cause.

What if instead of carrying around trolls and bullies and anxieties in their pockets, young people were carrying around peer support and mental health professionals.

Harnessing the power of sharing

If social media is a facilitator to the risks, surely, it could also be a facilitator to a solution? While social media’s potential to be destructive and unkind cannot be denied, it also provides direct access to young people who otherwise are not accessing the professional help they need.

Research recently published by the Education Policy Institute (EPI) found that one in four children and young people referred to mental health services in England last year were not accepted for treatment, and those who are accepted have to wait an average of two months to begin treatment. What if we harnessed the power of social sharing? What if instead of carrying around trolls and bullies and anxieties in their pockets, young people were carrying around helpful advice through peer support and  mental health professionals. The same touch of a button that could see them post their latest adventure, is the same single-click with which they can access potentially life-saving help.

Facebook asks us what’s on our mind, LinkedIn asks us if we want to connect. What if we created bespoke social networks that used these mechanisms and approaches to help young people feel comfortable opening up to professionals who could help them? What if the technology for this already exists?

BESTIE, an app created by a team of young people, NHS professionals from Worcestershire Health and Care Trust and digital innovators, combines digital media, instant messaging, built-in games and supportive help and information within a safe, anonymous, online platform. Kooth is a digital tool that provides easy access to an online community of peers and a team of experienced counsellors, which more than 1,500 children and young people across England log in to everyday.  Calm Harm is a multiple award-winning app to help young people manage their urge to self-harm, which has been downloaded 1.13 million times worldwide and reports a 93 per cent reduction in self harm behaviour after each use.

The effectiveness of these innovations? They have taken the end user’s behaviours and preferences into account.

Time to listen

Time to Change, is actively campaigning to bring mental health to the public consciousness with its movement to get more discussions about our mental wellbeing out in the open – and that’s great. listening to the discussion at our digital mental health event it struck me that for young people it’s not only time to talk; it’s time for us to listen. Young people want to talk about their problems, we need to give them opportunities for exchanges they feel comfortable with.

Young people want anonymity. An irony that I’m sure isn’t wasted on anyone is young people’s desire for anonymity when it comes to mental health. When co-creating the Chat Health app with young people, the ability to be anonymous and create avatars was a much requested functionality. The same people who crave sharing their every dinner, dance move or new outfit, may want to remain faceless when talking about their personal challenges.

Young people want to text. During the Maximising Digital in Mental Health event we heard from different people about how young people felt that the telephone was too personal and they didn’t always feel comfortable talking to an ‘adult’ about the challenges they might be facing. But texting made it easier to talk and was more aligned with how they usually used their smartphones.

Young people want to be involved. Most of us are not digital natives, now most commonly determined by you having owned a smartphone from the age of 12. But most young people growing up are. The same way their feedback is adapted in every other app they interact with to personalise it to their specific preferences; they want co-design and to know they have helped shape and inform the end product.

Closing the gap

Deprivation heightens a young person’s propensity to experience mental health challenges. Dr Fonagy described how you can almost perfectly follow the underground line from east to west across south London, mapping the deteriorating outcomes and quality of care that children receive based on where they are from. On the face of it, investing in digital may serve to only increase this socio-economic divide. However, in the young person’s category access to technology is possibly less of  a concern with 96 per cent of 16-25 year olds own a smartphone, with tablet access expected to reach similar ownership in the next few years.

Younger generations will continue to become more digitally aware and savvy, and as a result, more susceptible to the negative sides of such digital maturity, and at an even younger age. So instead of all of our efforts going into stopping the rise of social media or preventing young people’s access, I believe we should  harness the power of social media to offer them support, help and – most importantly – the tools to manage their own mental wellbeing.

Young people want to talk about their problems, we need to give them opportunities for exchanges they feel comfortable with.

Check out the full list of digital tools presented at our Maximising Digital opportunities in mental health 0-25 years event, which also included tools to support new parents.

BESTIE is a mobile application that aims to help reduce the mental health risks of social media to children and young people. It combines digital media, instant messaging, built-in games and supportive help and information, all within an anonymous, safe online platform.

Baby Buddy is an award-winning, quality-assured pregnancy and parenting app, providing timely, relevant and personalised, bite-sized daily information for parents and families. The app signposts people to local support help lines and ensures new parents are confident and equipped to make decisions about their child and themselves during pregnancy and early parenthood.

BfB Labs’ mission is to develop and deliver highly engaging, clinically evidenced and cost-effective digital interventions that provide timely and effective support to young people so they can improve and sustain their mental health. BfB Labs evidence-based digital treatment interventions can be delivered at all points in the care pathway: before, during and after clinician-led support. Evidence

Calm Harm is a multiple award-winning app to help young people manage their urge to self-harm using ideas from evidence-based Dialectic Behaviour Therapy (DBT). The app has been downloaded 1.13 million times worldwide with a reported 93 per cent rate in the reduction of self-harm behaviour after each use.

ChatHealth is a multi-award-winning, risk-managed messaging helpline platform, providing a way for service users to easily and anonymously get in touch with a healthcare professional. Backed by NHS England’s Innovation Accelerator, evaluated by NICE and NHS Digital, ChatHealth is used by half of public health school nursing teams in England.

The free-to-download distrACT app by Expert Self Care allows NHS and other providers to give people easy, quick and discreet access to information around self-harm and suicidal thoughts. Created by a team of experts in self-harm and suicide prevention, doctors, NHS organisations and charities, the app can be customised for local areas that want to signpost local services and support all in one place.

Dr Julian is an innovative mental healthcare platform that increases accessibility of mental healthcare. It connects patients almost immediately to mental healthcare therapists by secure video/audio/text appointments using a calendar appointment booking system, which matches a patient to the correct therapist using filters such as language, issue and therapy type.

QbTest is a continuous performance test (CPT) that simultaneously measures the core indicators of ADHD: attention, impulsivity and motor activity. Evaluation of the QbTest showed pathway efficiencies, quicker diagnosis, release of clinical workforce time and improved patient experience.

Recognising that one in four young people who use a smartphone have experienced depression, anxiety, perceived stress and poor sleep, Humankind designed the pocket digital trainer, Goozby, which improves sleep, concentration and sedentary behaviour, using behaviour science and health analytics.

Kooth, from XenZone, is a transformational digital mental health support service. It gives children and young people easy access to an online community of peers and a team of experienced counsellors. Access is free of the typical barriers to support: no waiting lists, no thresholds and complete anonymity. Evidence here and here

MeeTwo is a multi-award winning fully moderated, anonymous peer support app for young people aged 11-23. MeeTwo integrates the latest psychological research to promote the development of protective factors such as emotional resilience, empathy, social skills, stress management and coping techniques. Evidence

Mind Moose builds digital tools to support early intervention in children’s mental health. They are currently piloting virtual reality (VR) and online emotional support to help children with their mental and emotional wellbeing.

Mum & Baby app is a personalised digital toolkit to support women and their families through pregnancy, birth and beyond with access to local, national and international guidance and resources.

Mush brings women together to prevent social isolation and reduce anxiety in pregnant women and new mums. It empowers women to build local friendships, share advice and find support from an understanding community.

My Possible Self is the mental health app clinically proven to reduce stress, anxiety and low mood, developed by our team of in-house psychologists. The app empowers people to become their best possible self by using proven psychological methods and clinically-proven research from world-leading experts in e-mental health research.

Shout is the UK’s first 24/7 text service, free on all major mobile networks, for anyone in crisis anytime, anywhere. Shout exists in the US as ‘Crisis Text Line’, but this is the first time the tried and tested technology has come to the UK. The anonymised data collated by Shout gives unique insights into mental health trends to help improve people’s lives.

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A tale of my grandfathers and the revolution in cardiovascular disease prevention

A tale of my grandfathers and the revolution in cardiovascular disease prevention

Laura Semple, Programme Director for Diabetes & Stroke Prevention at Health Innovation Network, reflects on how new prevention techniques might have changed her grandparents’ lives.

I’ve often wished I’d had the chance to meet my grandfathers, Gerry and David. They were both fascinating and spirited people, who led interesting lives. Gerry travelled the world, had a successful career in industry and loved fishing for trout in the Welsh countryside. David worked in finance for London Transport and enjoyed vintage cars.

Sadly, I didn’t get to meet them because, like many people of their generation, they died too soon from cardiovascular disease in the 1970s and early 1980s.

This part of my family history is far from unique. It’s also a big reason why I find it so rewarding to be part of the movement of committed people working to prevent cardiovascular deaths in this country. February is National Heart Month and I’m thoughtful about the real progress that we’re seeing in south London in this area.

One of the main drivers of cardiovascular disease in the UK that Gerry and David grew up in was a lack of understanding around the impact of certain foods and other lifestyle aspects on heart health. It was very common to eat a high fat diet and the true scale of tobacco-related harm was not yet understood. But since the 1970s we have gained a rich understanding of the impacts of diet, exercise, tobacco and medication on heart health.

What’s more, we now have risk models, which enable us to accurately predict how likely it is that someone will have a heart attack or stroke in the next 10 years, simply by knowing their BMI, blood pressure, cholesterol and blood glucose measurements today.

This all makes me wonder just how different it could have been for Gerry and David. Not only are we now able to offer preventative care that extends lives, but crucially these are also improving the quality of those lives.

At its core, most of our work is really about giving Londoners the support they need to live full lives without the burden of diabetes and cardiovascular disease.

The first success to highlight on the prevention front is south London’s contribution to the Academic Health Science Network’s national stroke prevention programme.

Atrial Fibrillation (AF) is one of the most common types of irregular heart rhythm and contributes to one in five strokes. If Gerry and David had been born 20 years later, there’s a good chance that they could have been two of the more than 4,500 additional south Londoners whose AF has been newly detected since 2017.

The latest national stroke audit data shows that in the two years to March 2019 there were approximately 150 fewer AF-related strokes in south London than would have been expected from the previous years’ data. This is 150 Gerrys, Davids, Simones, Ritas, Mohammeds, and many others, who are still thriving as a result. We’ve recently published the results of our innovative work in improving AF detection through mobile ECG devices here and an ongoing pilot of 14-day ECG patches on page 12 of Cardiac Rhythm News January 2020 here.

Then there’s diabetes.

This is a major driver of cardiovascular disease and it’s simply astonishing how much our experience and understanding has transformed since Gerry and David were alive. Back in the 1960s and 1970s, we were not as good at detecting type 2 diabetes, so some people lived with the condition for many years without a diagnosis, which in itself increased their risk of preventable ill health.

In general, there was far less freedom and choice for people with diabetes in how they lived their lives, with many being told to stick to rigid set diets.

But in 2020, we believe in giving people with diabetes as much freedom as possible to live the lives they want, without diabetes getting in the way. South London has a formidable partnership of colleagues committed to minimising the impact of diabetes on citizens’ lives. Together we represent 12 clinical commissioning groups, 12 local authorities, seven acute hospitals, two universities, the King’s Health Partners Institute of Diabetes, Endocrinology and Obesity, the Applied Research Collaborative, several industry partners and community organisations like the Wandsworth Community Empowerment Network The last two years has seen a major focus on type 2 diabetes prevention, with over 30,000 south Londoners referred to the NHS.

I’m curious as to what Gerry, David and their friends might have chosen if they had had access to Diabetes Book & Learn, a radical move to scrap the previous postcode lottery of self-management support for people with diabetes. In this new system, south Londoners are learning how to live well with diabetes at a time and place that works for them in their busy lives, with different languages, digital options, evening and weekend courses and telephone coaching all available.

Would Gerry and David’s employers have supported their access to diabetes education through the learnings of our Think Diabetes report?

People with type 2 diabetes are also increasingly taking charge and setting the agenda for their doctors and nurses in the innovative You & Type 2 programme in primary care.

Would Gerry and David’s employers have supported their access to diabetes education through the learnings of our Think Diabetes report? This was supported by former Labour Party deputy leader Tom Watson. Many forward-thinking employers are using the recommendations in this report to offer support directly in the workplace.

At its core, most of our work is really about giving Londoners the support they need to live full lives without the burden of diabetes and cardiovascular disease. Healthy living is far from easy. People need holistic and non-judgemental support and this is why the offer of psychological support is built into Diabetes Book & Learn and many other new services.

There is a great deal more to do to prevent cardiovascular disease and exciting plans are afoot to do even more to tackle the longstanding health inequalities in our region. For now, I’m asking everyone who has played a role in the great progress so far to take a moment this heart month to remember the strides we have made together and renew our energy to take this to the next level.

If you are keen to join the fantastic team of people saving lives by preventing cardiovascular disease in south London please visit our webpages on diabetes and cardiovascular.  Alternatively, get in touch with me on laurasemple@nhs.net. This year we will be focussing on cholesterol and blood pressure as well as continuing to support our members with AF detection and improvements in diabetes care. The more collaborators we have, the more lives we can save.

I know that Gerry and David would be only too happy to see that things are different and getting even better, for the generations who came after them.

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NB: Gerry and David are not the grandfathers’ real names.

Self-management could help ease the high demand on GPs

Self-management could help ease the high demand on GPs

To help ease the high demand on GPs across south London, self-management is a priority in the NHS 10-Year Plan and focuses on key areas like diabetes prevention and management, cardiovascular, asthma and respiratory conditions, maternity and parenting support and online therapies for common mental health conditions.

Individuals need support to build the skills and confidence necessary for effective self-management of longstanding conditions, and health professionals need to be aware of and trained on the available supportive tools, taking account of any inequalities and accessibility barriers their patients may face.

Research presented by Self Management UK[1] shows that, on average, people living with a heath condition spend just three hours per year with their healthcare team—the rest of their time is spent self-managing these conditions. NHS organisations need to work closely with local authorities and other partners to provide the support and guidance to help south Londoners self-manage properly.

There are many interventions available to help support the self-management of common conditions, some of which are:

  • education for specific health conditions;
  • peer-led courses;
  • online self-management tools;
  • telephone support and telehealth; and
  • self-monitoring of medication and symptoms using digital technology.

How can innovation help? 

You can help respond to our local needs by addressing the following challenge statements:

  1. How might we maximise digital solutions to support self-management of health risks and chronic conditions?
  2. How can digital solutions emphasise patient responsibility and, acting in conjunction with the provider community, move beyond education, enabling individuals to actively identify challenges and solve problems associated with their illness?
  3. What are the barriers to public awareness and successful patient uptake of these self-management solutions?

We’d love to collaborate with you on these challenges. Please get in touch with Karla Richards karla.richards@nhs.net if you have a digital solution for health and care self-management, including for long-term conditions, mental health, heart disease, COPD etc.

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How technology can improve the delivery of social care services

 

How technology can improve the delivery of social care services

With a growing population of older and disabled adults, London’s demand for care is placing the social care system under huge strain. Further to this, London Councils estimates that boroughs across the city have experienced a combined loss of more than £4 billion in core funding since 2010 (a reduction of around 63%). We need to think differently about how and where services are delivered, utilising digital solutions to maximise the workforce and care provided.

Health and social care systems are critical to maintaining the physical and mental wellbeing of Londoners. We need a digital revolution in adult social care, starting with exploring how social care services could be delivered digitally. Technology has the potential to help free up staff time by enabling users to access services digitally, thereby improving their independence, efficiency and wellbeing and reducing the need for in-person care visits simply for reassurance. Where this type of digital solution has been implemented, service users report that it helps to increase their digital literacy and independence and reduces their social isolation. It has also led to more flexible working for social care staff.

On Friday 13 March 2020 at St Thomas’ Hospital we hosted an Innovation Exchange event on the ‘Digital Revolution in Social Care’. The event brought together our members and key stakeholders in this field to discuss and showcase the most cutting-edge digital innovations to both inspire and practically help our industry partners to shape the future of social care delivery.

If you are interested in learning more about this innovation challenge please email Lesley.soden@nhs.net or if you missed the event you can see a glimpse of what you missed below.

Enough of being digitally ‘done-to’

Enough of being digitally ‘done-to’: 2020 is the year of the nurse, let it also be the year of digital nursing

Recently, Health Innovation Network (HIN) hosted a roundtable discussion with senior nurses involved in digital from across south London. The event was chaired by Breid O’Brien, Director: Digital Transformation at Health Innovation Network with special guest speaker Natasha Phillips, Chief Nursing Informatics Officer: University College London Hospitals NHS Foundation Trust (UCLH) and Digital Health’s CNIO of 2019. Breid and Natasha share some of the discussion highlights and why they are evidence that if 2020 is to be the year of the nurse, then nursing needs to be made a central part of the digital discussion in 2020.

We have a combined 62 years of nursing and healthcare experience and have seen an incredible amount of change in our profession during our careers, but the most significant has probably been the transformation of the time nurses spend with patients. Based on our experience and what we observe happening now, and depending on which studies you read, nurses currently spend approximately 20 – 25 per cent of their time on medication administration. In addition, data from Safer Nursing Care Tool (SNCT) observations shows nurses spend 10 per cent of their time acting as the glue in the system by communicating and raising issues. Seven per cent of time is spent on documenting care away from the patient (i.e. excluding documentation that happens by the bedside). At best, this means 37 per cent of nursing time is not spent on direct care.

This calculation started a lively discussion at our recent roundtable for senior nurses involved in digital across south London, prompting some to suggest that, in their personal experience, it is much closer to just one third of their time that is spent with patients. Additionally, data from “Productive Ward: Releasing time to Care” shows another third is lost to looking for things and duplicating work.

For many nurses, time spent on direct patient care is where the joy of work resides, and this is the time our patients’ value most. The group concluded this imbalance between time spent on tasks and time to care needs to change. We need to release time to care.

How technology could help

It’s undoubtedly true that technology is a huge part of the answer, but, as a profession, nursing is not yet reaping the benefits. We are often digitally ‘done-to’. We often have systems that are designed by others, such as patient flow systems, which, although fulfilling an important need, were designed to meet the needs of the organisation with little understanding of the increased workload for nurses. Attendees gave examples of innovative new systems implemented in their practices, which have led to the need for nurses to duplicate their notes. Under these systems, if nurses see 14 patients, they end up writing 28 sets of notes, as they have to create a physical and a digital copy.

Nurses are not routinely involved in the design of new systems, and other countries like the US are much further ahead in recognising nursing informatics as a profession. The group identified a lack of education for nurses in undergraduate and post-graduate environments when it comes to using digital tools in care delivery, though the group recognised HEE is working to change this.

Nurses are in a prime position to lead transformative change, with a depth of experience and a very rounded view of the system. Sometimes, we underestimate the role that nurses can and should be playing right now in system design. Technology can be overwhelming, the volume of data alone. But let’s remember – nurses have been using data for years, and effectively. If someone cannot explain a new technical system clearly to a nurse, then we argue that they need to get better at explaining it.

Imagine a world where digital is at the heart of our practice, the heart of our education and the heart of our leadership. This is happening in patches and where it does, the results show the great potential. It’s happening where change is clinically-led, where nurses sit on advisory committees and where nurses are embracing the opportunity to change their practice, not just digitise what is already happening.

Technology will not always save time, but it will make our practice safer, and it does have the power to improve our approach to tasks.

Year of the nurse

If 2020 is to be the year of the nurse, let’s make 2020 the year that nursing and nurses are put at the heart of digital transformation, and where these examples become the norm. Let’s make 2020 the year that we stop walking back and forth to computers and put the power in our pockets, the year we embrace audio and voice recognition. Let’s create a culture where newly trained nurses come in with bright ideas, and we create the right opportunities for them. Technology will not always save time, but it will make our practice safer, and it does have the power to improve our approach to tasks.

To do this, we need to stop the feast and famine approach to technology spending and projects. Bursts of capital funding won’t do the trick – expensive, capital-funded roll-outs are just the beginning. Successive governments have proclaimed innovation is a panacea and announced new policies, CQINs and mandates, as though they are the answer to a problem rather than the first step in a long journey of change. Privately, most will admit that they understand that change takes time. Let 2020 be the year that this is publicly recognised, and the slow, painstaking work of ongoing training and optimisation of systems is sustainably funded.

Nurses are close to their patients. Let 2020 be the year we use this to drive real change. What could we be asking our patients to do with technology to help us? Entering their own health information, accessing information, monitoring their own health trends? Too often there is still a fear of putting people in charge of their own care – hunger from patients to change the system will help encourage people to take risks, never with patient safety, but with innovative approaches to care delivery.

2020 is the year of the nurse – let it also be the year of change. If that sounds optimistic, that’s because it is. But after spending time in conversation with fellow senior nurses discussing these issues, we were left inspired and hopeful. Rather than battling organisational hierarchy and tradition alone, we vowed to do it together. To share and learn from each other and to create a new community of digital nurses. No more digitally done-to. The opportunity is there for us to work as a community. Let’s let 2020 be the year we take it.

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We know we need genuine public involvement in healthcare. Why are we still getting it wrong?

We know we need genuine public involvement in healthcare. Why are we still getting it wrong?

Andrew Walker, Deputy Clinical Director MSK and Evaluation Lead, Health Innovation Network reflects on a recent patient and public involvement and engagement process and the need for a relentless focus on true engagement.

Healthcare in the NHS has come a long way from the paternalistic, prescriptive model and principles upon which it was founded in post-war Britain.

The aspiration for greater and better patient and public involvement and engagement (PPIE) is at the heart of today’s NHS. There are multiple, high profile policy documents that reiterate its importance and the need to continue to focus on increasing patients’ voice to improve care. We now have lay member representation on the boards of NHS trusts and clinical commission groups and embedded into how research is prioritised (such as James Lind Alliance), designed and approved (such as INVOLVE and NHS Research Ethics Committees). There is also an increasing wealth of resources and guides from organisations such as INVOLVE and The King’s Fund to help us do PPIE well and in a meaningful way.

There are many examples of when PPIE has been done well, but there are still many occasions when we still fall short. Recently, I was involved in a PPIE process and I wanted to share my experience of how we fell short, despite best intentions.

Background to the process

In 2017, NHS England and NIHR published ‘12 actions to support and apply research in the NHS’, which tasked AHSNs to set out local NHS research and innovation priorities. Collectively, the AHSN Network, NIHR and NHS England commissioned ComRes to undertake a Local Survey of Innovation and Research Needs by engaging with key senior stakeholders nationally and locally. Published in June 2019, the report identified a number of priorities across workforce, mental health, digital technology and more. As part of an on-going engagement to explore and refine local priorities, the Health Innovation Network and CLAHRC south London jointly held a Patient Public Engagement event on with service users from across south London.

There were 10 participants with a mix of gender, ethnicity, age and physical/mental conditions. Dr Jane Stafford (South London ARC Associate Director of Operations) and I presented the background to the Survey, AHSNs and CLAHRC/ARCs. The session was facilitated by a PPI expert.

PPI perspectives on the priorities

In terms of the contents of the report, participants felt it was a useful start and broadly concurred with the priorities. However, they felt that some priorities did not resonate with them as patients (e.g. workforce) and illustrated the disconnect between what professionals working within the system perceived as local priorities and service users’ needs. The group wanted a greater focus on research and innovation that addresses the health inequalities and health needs of underrepresented service users. Participants were passionate in expressing a need to implement and deliver interventions and services that meet the needs of people from different ethnic backgrounds (e.g. Southwark has the largest African diaspora of all London boroughs) and excluded/marginalised groups (such as those experiencing homelessness). Participants also felt there was not enough focus within the priorities about improving patient experience, patient choice or personal budgets.

A feeling of ‘rubber stamping’

What I had not expected was the group’s strong criticisms about the process that had been used to identify local priorities. I had seen the session with PPI members as a step in the process of engagement. Whereas, they perceived it more as ‘rubber stamping’ a report that had already defined the local priorities. Specifically, they questioned why there hadn’t been public/patient involvement from the outset. Rightly, participants felt this would have improved the balance of priorities and made the survey more inclusive and comprehensive, and their involvement more meaningful. As I listened, the penny dropped and I thought ‘you’re right, we did it again!’

We highlighted that the survey report provided a sample of stakeholder perspectives and was a starting point for discussion and their input as valid and important as what was in the report. However, the group’s perception was that the timing and scale of PPI in the process gave greater status to stakeholders’ priorities. It also meant that whilst they broadly agreed with the priorities, they felt disconnected with some and couldn’t always see themselves or things that were important to them in the survey.

Being bolder and getting it right

For me, this process was a valuable reminder of the power words gain when committed to paper and how we can always improve our engagement with service users. The experience has renewed my personal commitment to this and to support others to do the same.

We need to be bolder in challenging colleagues and ourselves when we see PPIE is not being done appropriately or a process could be improved. For me, it comes back to the INVOLVE core principles for PPI of respect, transparency and responsiveness. If we can’t clearly demonstrate we’re addressing these principles – no matter the pressure – we need to stop and re-think our approach.

Health and social care are complex, dynamic systems where not one person or group can understand the whole system. It’s only by engaging with people from across the system (public and professionals) and by sharing our perspectives and knowledge that we can bring about system change.

This calls for a more radical shift where we cede power to patients and start to co-design and co-produce health and social care. But to get it right, this approach must also be backed up a commitment to provide adequate time, resources and political will and leadership – across the whole system.

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Latest innovation projects set to improve care for south Londoners revealed

Latest innovation projects set to improve care for south Londoners revealed

Ten NHS teams, working with universities and a wide range of partners, have been given vital funding to kickstart innovation projects designed to help health and care teams improve care for south Londoners and help services evolve to meet future health needs. The funding comes from the Health Innovation Network Innovation Grants, which have been announced today.

The innovations that will receive support to spread or be piloted range from apps for women in pregnancy to understand the risk of preterm birth or manage diabetes, to new devices to detect dangerous bleeding, to virtual reality on acute mental health wards to reduce stress and new ways to access mental health support that improve access while taking pressure off primary care. One of the projects will also develop mobile simulation labs for the NHS to test and improve technology.

All of the innovations meet current NHS and care needs – whether by addressing major health challenges such as diabetes, mental health and stroke prevention, or specifically helping the NHS to meet nationwide goals on safety or the NHS Long Term Plan.

Each project has been given up to £10,000 in funding. Small amounts of funding can be crucial for innovation projects to become a reality. NHS teams often struggle to find the initial funding to pilot new ideas in real-world settings to demonstrate the kind of results they need for support for wider roll outs. Academic Health Science Networks like the Health Innovation Network play a crucial role by helping these projects prove themselves in real world settings before going on to spread across the NHS where successful.

The winners were chosen after a rigorous selection process from an expert panel. In total 68 applications were received, with ten selected to receive funding.

Zoe Lelliott, Chief Executive at the Health Innovation Network, said:

“When it comes to innovation we have no shortage of great ideas in the NHS. What we often lack is the initial finance needed to get a new idea off the ground, and to generate evidence of outcomes so that others will support the project. The projects we’re supporting today are truly exceptional and stood out to us as highly innovative approaches that meet pressing health and care needs. We’re looking forward to working with these teams to turn these ideas into real benefits for local people.”

Dr Lindsey Bezzina, Junior Clinical Fellow, Emergency Medicine, St George’s University Hospitals NHS Foundation Trust, who has won an award to develop visible electronic queues in hospital emergency departments to improve patient experience and reduce pressure on staff, said:

“We are passionate about trying new ways to improve patient experience and safety and we believe better queue visibility will give patients reassurance and free up reception team time. Emergency departments are pressured and all you want is to do the best for patients. It’s difficult at the moment when we can’t easily answer their top question: when will I be seen? With relatively simple technology we believe we can answer this and make a huge difference to their experience, as well as supporting our staff. Technology and innovation will allow us to answer this and more. We’re well supported by our colleagues and leaders to innovate and try new ideas: this funding is additional piece of the puzzle we need to propel our project to the next level.”

Dr. Nicola Jones, a GP and Chair of Wandsworth Clinical Commissioning Group, whose team has won an award for mass screening in Wandsworth to prevent strokes and reduce health inequalities, said:

“The people of Wandsworth can look forward to a new and innovative local approach to stroke prevention. At the moment, over a third of people invited for a health check do not attend. We’re using this funding to kickstart an innovative new collaboration between Wandsworth community leaders and the health service, working hand-in-hand with local groups to get our services to those who need them most. By targeting hard-to-reach communities we will reduce health inequalities and we expect this award to be the first step in developing a new approach to screening that will benefit the communities we serve.”

The ten teams will be supported by the Health Innovation Network over a 12 month period to develop their ideas and pilot them in south London.

The winning projects receiving support to expand, pilot or develop further are:

1. Diabetes Prevention Decathlon, South West London Health and Care Partnership

2. Engage Consult – Digital Self-Referral for MSK, Oxleas NHS Foundation Trust

3. ‘Mass screening!’ – an innovative healthcare delivery approach to stroke prevention in high risk, hard to reach communities in Wandsworth through ‘Stroke Busting Health Checks’ in local places of worship and community networks, Wandsworth CCG

4. Creating a toolkit for effective implementation of the QUiPP app, King’s College London & Guy’s and St Thomas’ NHS Trust

5. Transforming delivery of antenatal care in gestational diabetes, Kingston Hospital NHS Foundation Trust

6. CRADLE Scale up South London: Effect of a novel shock index early warning system on recognition and management of the compromised bleeding woman,
King’s College London & Guy’s and St Thomas’ NHS Trust

7. Improving Patient and Staff Experience and Safety with Queue Management Software in the Emergency Department, St George’s Universitys Hospital NHS Foundation Trust

8. Simulation Lab for Health Technology Development and Adoption: Discovery project, Oxleas NHS

9. Lewisham Primary Care Recovery College Pilot Project, South London and Maudsley NHS Foundation Trust

10. Virtual reality relaxation and coping skills for reducing stress and challenging behaviour on acute psychiatric wards, South London and Maudsley NHS Foundation Trust

Winners of the 2019 Recognition Awards Announced

Winners of the 2019 Recognition Awards Announced

The Health Innovation Network (HIN) work together with a variety of health and care teams in south London to speed up the best of health and care for our communities. The HIN Recognition Awards 2019 celebrate some of the fantastic work and partnerships we are involved in.

Our membership is made up of organisations from across south London’s academic, local government and health and social care landscape. We work with acute and mental health trusts, clinical commissioning groups, community providers, local authorities, universities and third sector bodies.

Zoë Lelliott, Chief Executive of the Health Innovation Network said: “The enthusiasm and commitment across our membership to improve the lives of patients through innovation never ceases to inspire me. The Recognition Awards are a great opportunity to celebrate some of the very best work of our members. I am delighted the Health Innovation Network is highlighting examples of excellence in partnerships, Trusts and individuals in our community through these awards, and I congratulate the worthy winners.”

Over half of our team participated in the Recognition Awards in August 2019. We received many nominations and the winners were announced at the Health Innovation Network Award ceremony in Guy’s Hospital on Tuesday 24 September.

The results of the HIN South London 2019 Recognition Awards are:

Innovative Trust of the year

Winner: St George’s University Hospitals NHS Foundation Trust

Special credit is given to the innovation and improvement initiatives by Ben Wanless, the physiotherapy team, Emma Evans and the New Beginnings Experience Based Co Design project improving the experience of birth in theatres, and Edward Jebson’s work in adoption of innovation products.

Excellence in adoption of Innovation and Technology Payment (ITP) products

Winners: Lewisham & Greenwich NHS Trust

Special credit is given to Elizabeth Aitken and David Knevett’s strategic approach to the adoption of ITP with full commitment to adopting all relevant products across the hospital.

Winners: Kingston Hospital NHS Foundation Trust

Special credit is given to Jonathan Grellier for his continued enthusiasm and support for the ITP and Accelerated Access Collaborative, helping to achieve collaboration across the trust within both clinical and managerial teams.

Partnership of the year

Winners: Oxleas NHS Foundation Trust, South London and the Maudsley NHS Foundation Trust, South West London and St George’s Mental Health NHS Trust and the Metropolitan Police

Special credit is given to Rachel Matheson, Magda Berge, Jon Garrett and Superintendent Mark Lawrence representing the three trusts and the Metropolitan police who have worked together, sharing learning to help each other succeed to successfully implement Serenity Integrated Mentoring (SIM).

Innovator of the year

Winner: Chegworth Nursing Home (Sutton Homes)

Special credit is given to Rekha Govindan, the first care home nurse to create Coordinate My Care (CMC) plans single-handedly as part of the CMC in Care Homes project.

For more information on how we work with members on innovation projects please contact hin.southlondon@nhs.net.

CRADLE Scale up South London

CRADLE Scale up South London

CRADLE VSA at-a-glance


Shock Index device introduced to save lives in maternity wards

HIN Innovation Award funding will be used to pilot a device that helps teams identify patients experiencing serious bleeding in maternity wards more quickly. The new device, CRADLE VSA (CVSA), is a hand-held, upper arm, semi-automated blood pressure device that has been specifically designed and validated for use in pregnancy and pre-eclampsia by King’s College London.

Globally, bleeding is one of most common reasons women die around the world in childbirth. The main reason things get so serious is that the issue is not recognised and managed quickly enough. Identifying women with dangerous bleeding can be very difficult and it is widely acknowledged that delays in spotting and starting treatment for bleeding patients contributes to death and harm. Additionally, clinicians are not able to predict haemorrhage (bleeding) from risk factors very easily. This means the focus needs to be on early recognition of a compromised patient, appropriate escalation and prompt management.

Although the NHS has sophisticated systems to spot deteriorating patients in many clinical settings, the predictive capacity of early warning systems in pregnancy is less well-evidenced and most blood pressure devices are not designed with pregnant women in mind. The CRADLE VSA device was created by UK doctors working in developing countries, in response to a severe and urgent need to spot bleeding patients in the context of very high maternal death rates. However, its simplicity and effectiveness could also have huge benefits in other healthcare settings globally, including in the NHS.

How does it work? CRADLE VSA uses a simple traffic light system to warn clinicians when a woman may be in trouble after giving birth. The lights are triggered by standard thresholds of blood pressure as well as shock index to alert health care professionals to a patients’ risk of compromise. The shock index is an innovative and simple measure. It is calculated by dividing heart rate by systolic blood pressure and it is a highly effective way of signalling that someone is in trouble and needs help.

The biggest impact of this device is expected to be on patient safety. Use of this device should reduce delays and reduce maternal death rates and morbidity. This would also lead to a reduction in length of stay for patients and faster return to daily activities and time with their newborn.

The Innovation Grant funding will be used to introduce the CRADLE VSA device into labour wards and high dependency units at Kingston Hospital and St Thomas’ Hospital. The results will be analysed using PSDA cycles and a quality improvement toolkit will be created so that the device can be used more widely if successful in these settings.

This ground-breaking device has been extensively validated. It was recognised in the PATH – Innovation Countdown 2030 award as one of the top 30 high impact global health innovations to help accelerate progress towards the United Nations Sustainable Development Goals. It also won the prestigious Newton Prize in 2017 for excellence in research and innovation.

Find out more about our work in maternity and patient safety


Innovator Spotlight

Professor Andrew Shennan, Professor of Obstetrics at King’s College London and Guy’s and St Thomas’ NHS Foundation Trust, said:

“If we can find ways to spot women who need interventions more quickly, we will save lives. I was inspired, with colleagues, to develop this device to help maternity wards in Africa but we believe that the simplicity and effectiveness of the device mean that it could also be really useful here.  I’m passionate about the potential for high-income countries to learn from low-income countries and think that some of most eye-catching innovations can come from teams working in extremely difficult circumstances.

“We’re starting with maternity wards for this initial project, but it’s possible that this device could improve safety in a wide range of settings in countries around the globe.”

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Improving Patient and Staff Experience and Safety with Queue Management Software in the Emergency Department

Improving patient and staff experience and safety with queue management software in the emergency department

Visible queue management software in the emergency department at-a-glance


Visible queuing: a game changer in hospital emergency departments

HIN Innovation Grants will fund an innovative project to improve patient experience in the Emergency Department at St George’s University Hospitals NHS Foundation Trust.

This project will pilot a visible electronic queue management system so that patients can see where they are in the queue to be seen at any time. The team is understood to be among the first in the UK to introduce this.

The new system aims to improve patient experience and reduce the time receptionists in the Emergency Department at St George’s spend dealing with waiting time or queue position queries. Staff in Emergency Departments around the country deal with a high volume of these questions which can have a knock-on delay in booking-in new patients.

The idea for the new system came from junior doctor Dr Lindsey Bezzina who worked in the Emergency Department for a year and witnessed the problems reception teams and other staff encounter first-hand when it comes to waiting times queries. Currently, a whiteboard behind the reception desk is used to display general waiting times and updated every hour. Lack of visibility of individual positions in the queue can cause concern for patients, who can worry that they have been forgotten, passed over or missed their call to see the emergency team. This leads to repeated queries to reception staff about the waiting time and these queries are not always easy to answer due to the complexity of queues. As well as frustration for patients, these queries can occasionally result in aggressive and abusive behaviours which put additional pressure on staff.

The new system will offer people a code when they first arrive and register their details. This code will correspond with a number shown on an electronic screen, showing where the number is in the queue. The display will be visible from all parts of the waiting room and will make clear that there are multiple queues at any one time and that if someone arrives who needs more urgent care, the queue positions will move accordingly.

This means patients will be able to monitor their own position and progress in the queue, which provides assurance that they have not been missed or forgotten, reducing anxiety as well as the likelihood of aggression directed towards other patients or staff. The transparency the system will offer has the potential to educate people waiting about the multiple queues in operation at any one time, aiding understanding about the way Emergency Departments operate and why some people are seen more quickly.

The grant awarded will be used toward developing and implementing the queue management software in the Emergency Departments department. If this innovative pilot is successful and adopted as business as ususal, the software can be spread and adopted by other NHS emergency departments. There is also an opportunity for use of this system in outpatient departments at a later stage.

Find out more about our work in patient experience


Innovator Spotlight

Dr Lindsey Bezzina, Junior Clinical Fellow, Emergency Medicine, St George’s University Hospitals NHS Foundation Trust said:

“We are passionate about trying new ways to improve patient experience and safety and we believe better queue visibility will give patients reassurance and free up reception team time.

“Emergency departments are pressured and all you want is to do the best for patients. It’s difficult at the moment when we can’t easily answer their top question: when will I be seen? With relatively simple technology we believe we can make a huge difference to their experience and support staff at the same time by reducing interruptions. Greater transparency over the complex queues we operate will help everyone gain a greater understanding of how teams are working to help people.”

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Virtual reality relaxation and coping skills for reducing stress and challenging behaviour on acute psychiatric wards

Virtual reality relaxation and coping skills for reducing stress and challenging behaviour on acute psychiatric wards

Virtual reality on the wards at-a-glance


Virtual reality on acute wards to help people with complex mental health conditions

Service users on psychiatric wards often report high levels of stress and difficulties regulating emotions, which can lead to violence and aggression toward staff and others. A team at South London and Maudsley (SLaM) NHS Foundation Trust plans to address this through pioneering use of virtual reality.

Funded by the HIN Innovation Grants, this project aims to evaluate the implementation of a new virtual reality (VR) technology, VRelax, to reduce stress and arousal in service users with complex mental health conditions. The VR headsets allow people to experience calming and relaxing environments. Previously, the NHS typically asked people to think of positive mental imagery, which requires more concentration and imagination and can be challenging to sustain. Virtual reality will give people the chance to feel immersed in a more calming environment.

The team will introduce 12 new VRelax headsets and assess their effectiveness in reducing service user stress and associated risks (violence, aggression and seclusion) on six acute psychiatric wards within SLaM. VRelax consists of 360 degree videos of calm, natural environments. This includes a scuba diving experience with wild dolphins, a sunny meadow in the Alps, a coral reef, a drone flight, a sunny mountain meadow with animals, a guided mindfulness meditation on the beach or a wide range of other options, all shown in a VR headset. The team will train the nursing staff on the software and nurses will then be able to decide how and when to offer this to their patients, as an additional option that complements existing relaxation techniques.

Heightened stress reactivity is not good for individuals: it’s related to recurrence of mood, anxiety as well as psychotic disorders and it’s not good for staff or ward environments: difficulties regulating emotions can increase risk of violence and aggression, which put both service users and staff at risk. This can result in seclusion being necessary, with isolation potentially increasing service user stress and costs. A previous randomised cross-over trial of VRelax with 50 psychiatric outpatients showed strong immediate effects on stress level, and on negative and positive mood states. The team at SLaM wants to bring these promising findings to service users on acute wards in the UK.

In addition to improving care for service users, VR has the potential to have a real impact on the overall ward environment. By reducing stress and anxiety, the project hopes to reduce violence and aggression. This will create a better environment for both staff and service users.
The project has collaboration at its heart. The team will link three main institutions – SLaM, University Hospital Lewisham, King’s College London and University Medical Center Groningen, in the Netherlands.

Find out more about our work in mental health


Innovator Spotlight

Dr Simon Riches, Highly Specialist Clinical Psychologist, South London and Maudsley NHS Foundation Trust said:

“At a relatively low cost, this technology could have a major impact on the ward environment and the people in our care. Service users will have the chance to feel immersed in a more calming environment, meaning that both staff and service users can benefit from reduced levels of stress and challenging behaviour.

“We’ve brought a lot of people together for the project who are very passionate about digital health, including international colleagues. It’s still very new and the opportunity to collaborate on this emerging area of research is exciting.”

Dr Freya Rumball, Clinical Psychologist, South London and Maudsley NHS Foundation Trust, said:

“There is strong evidence that relaxation and grounding techniques can have a positive impact on stress and anxiety, and we will be among the first teams to test this exciting new technology on acute wards in SLaM. Our pilot will advance the evidence base and we are keen to disseminate our findings as widely as possible.

“Innovating in the NHS can be challenging, as it can be hard to find the time to think about things from a fresh perspective. However, we’re really passionate about bringing new technology to the forefront of our clinical work and are actively supported in this by our management and leadership.”

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Simulation Lab for Health Technology Development and Adoption: Discovery project

Simulation lab for health technology development and adoption

Tech simulation labs at-a-glance


Mobile simulation labs for health technology

A new type of simulation lab aimed for the NHS to test and develop digital health technology is being designed by NHS teams. The HIN Innovation Grants have funded a new discovery project aiming to bring the benefits of hi fidelity simulation to health technology procurement and implementation in the NHS.

The NHS has used hi fidelity patient simulation for high pressure clinical scenarios for many years, where either actors or sophisticated dummies act as patients and scenarios are played out and recorded. This gives NHS staff a learning environment that is safe and controlled so that the participants are able to make mistakes, correct those mistakes in real time and learn from them, without fear of compromising patient safety. It also allows for changes in process and workflows to be identified and tested, to improve ways of working.

Simulation labs are well evidenced and used in contexts such as medical training (for example crash calls or trauma) but their application in a digital health context has not previously been systematically researched and tested in the UK. Given the abundance of new technology that NHS teams are now using, ranging from apps to new handheld devices to multi-million pound electronic record systems and equipment, this project aims to test the benefits of simulation for digital health.

At its most basic, simulation requires a screen and camera set-up, typically with cameras in the room that can show the action in real time. The simulation can use a mix of clinicians, staff and actors. Recording the action is crucial so that reflection and learning can take place effectively.

This project aims to show that simulation can be done in a cost effective, mobile way. For example, it will explore whether Trusts could create their own simulations by putting their own screens up and using in-house cameras and laptops at relatively low cost. If this is achieved it could help the NHS make better technology procurement decisions, help staff feel confident in stressful scenarios that involve multiple combinations of technologies and identify design improvements more quickly.

Technology simulation is the norm in many industries. NASA simulates its technology in the closest possible conditions to space using a neutral buoyancy lab. In healthcare, many American hospitals simulate technology on a regular basis. By contrast, while the NHS uses simulation for many traditional clinical scenarios it rarely tests new technologies in a genuinely live environment before they are procured.

The NHS invests millions in new technology every year. Roll outs of technology are complex and it can take many years for the full benefits of new technology to be realised. User testing of digital technologies at the development stage often take place separate to the clinical setting because tech companies struggle to access real-world practice settings as a result of governance, safety and capacity in teams. As a result it is not possible to identify, mitigate and manage problems faced by real users in the context of clinical care.

The team will be focusing on mental health contexts and will start with digital apps, aiming to create a simulation environment that is mobile so it can be easily repeated by other trusts without the need for an expensive standalone simulation lab. The pilot simulation model will be developed drawing on simulation theory and research, user-centred design, agile and implementation methodologies and technology engineering. The final result from this pilot project will be a powerful resource that supports adoption of digital technologies in practice and promotes a technology simulation culture within the NHS.

Find out more about our work in mental health


Innovator Spotlight

Dr James Woollard, Chief Clinical Information Officer, Consultant Child and Adolescent Psychiatrist, Oxleas NHS Foundation Trust

“The amount of technology we procure is only set to increase and often as clinicians, we find ourselves needing to use multiple new pieces of technology simultaneously to care for patients. The NHS has used clinical simulation for years and it’s time we applied this same theory to digital technology. At the moment, we’re asking our staff to use equipment that has very rarely been tested live in the kind of high pressure scenarios they face.

“Our focus is on developing cost-effective mobile simulation labs that will help us all learn, build confidence and make roll outs much faster. If technology companies can rapidly find and address real world problems associated with using their technology before they are rolled out to staff, we’ll see better product design, ease of use and faster adoption.”

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‘Mass screening!’ – an innovative healthcare delivery approach to stroke prevention in Wandsworth

Mass screening! – an innovative healthcare delivery approach to stroke prevention in Wandsworth

Stroke-busting health checks at-a-glance


Stroke-busting health checks for Wandsworth 

To increase detection of the main cardiovascular risk factors across the most deprived areas of the borough, HIN Innovation Grants will fund a new project to offer ‘Stroke Busting Health Checks’ to 1,000 people at greatest risk of stroke in Wandsworth.

This co-produced, community-led scheme will see the NHS partner closely with faith and community groups, led by Wandsworth Community Empowerment Network, to use mobile ECG devices to test people for irregular heart rhythms (a warning sign for stroke) and offer wider health advice. The health checks will include Atrial Fibrillation (AF) checks using innovative mobile ECG devices, diabetes testing, blood pressure, cholesterol, and body mass index. They will be an opportunity to talk about the risk of smoking, including the direct link to stroke.

It is widely recognised that hard to reach groups have greater health inequalities and poorer health outcomes, with Black, Asian and minority ethnic (BAME) communities at substantially higher risk of poor health and early death, including due to stroke. Traditional NHS approaches aren’t working well enough – these communities are less likely to attend NHS health checks, despite being the most at risk. Therefore, this team is going to work in an innovative new way to go to these communities and work alongside local leaders to engage people.
In total, the project aims to perform at least 1,000 “Stroke Busting Health Checks” in hard-to-reach communities at high risk of stroke. It will use healthcare assistants from local GP practices to offer regular checks through a hub and spoke model of engagement in high volume places of worship and association, including temples, mosques and churches.
To support the checks and help engage the community in this work, the team will also produce a bespoke film, distributed through social media, featuring local faith and community leaders with a call to action to take part in the checks. This culturally specific content can support other health projects elsewhere in the borough and beyond.

The project is expected to increase awareness of stroke and cardiovascular disease as well as reduce the prevalence of stroke in the Borough. All those identified at risk of stroke through the checks will be supported to attend further tests and commence treatment. Faith and community leaders will trained and upskilled to support and encourage their communities to access additional services where needed, including registering with GPs.

Find out more about our work in stroke prevention


Innovator Spotlight

Dr. Nicola Jones, a GP and Chair of Wandsworth Clinical Commissioning Group said:

“The people of Wandsworth can look forward to a new and innovative local approach to stroke prevention. At the moment, over a third of people invited for a health check do not attend. We’re using this funding to kickstart an innovative new collaboration between Wandsworth community leaders and the health service, working hand-in-hand with local groups to get our services to those who need them most.

By targeting hard-to-reach communities we will reduce health inequalities and we expect this grant to be the first step in developing a new approach to screening that will benefit the communities we serve.”

Malik Gul, Director of Wandsworth Community Empowerment Network, Wandsworth, said:
“Together, we’re bringing health checks into the community in a way that is unique and transformational. The approach unlocks the value and capabilities held in communities – in mosques, churches, temples, as well as in community groups and associations. This is a vital network of microsystems – the project is creating an innovative, emergent system that can offer the NHS new ways to make early health interventions more effective and work towards reducing health inequalities.

“Leadership has been essential – senior people across Wandsworth have been brave enough to say yes, we need change and yes, we’re ready to get behind this. Without strong collaborative and cross-sector leadership, the NHS would not be working in these new ways.”

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Lewisham Primary Care Recovery College Pilot Project

Lewisham primary care recovery college pilot project

Recovery College Pilot at-a-glance


Recovery College: innovating to improve mental health support in primary care 

A new project to take mental health recovery, self-management and wellbeing workshops into GP practices will be funded by the HIN Innovation Grants.

From the team that leads SLaM’s successful Recovery College, this project will take its model to GP practices. Recovery Colleges focus on hope, opportunity and choice/control- co production. They enable the students to become experts in their own self-care, and develop skills they need for living and working.

Students are usually individuals who do not currently need acute mental health services but do need more support than they’re able to get from busy GPs at present. It could be for a very wide range of conditions, for example long term stress or low-level depression and anxiety that affects people’s daily lives but not to the point where it needs acute intervention.

The project will provide free, co-produced self-management, recovery and wellbeing workshops and courses for patients, carers and staff in primary care, using shared perspectives, skills and knowledge to help people recover and live as well as possible. By extending into GP practices for the first care, it aims to reach more people with support and improve access.

The pilot college will be based within a health centre in Lewisham and aimed at service users/patients registered with five GP surgeries at in and around New Cross. A key part of the approach is that the trainers are paired together so that there is one ‘peer recovery trainer’ – someone who has lived experience of mental ill-health or distress as a service user – and a ‘professional trainer’ – someone who has professional experience. This means students get the clinical perspective and a personal narrative so that they can discuss and learn from someone who knows what it can be like, and feel more comfortable to share personal experiences.

Recovery College also helps people to network and meet people who are in a similar circumstance, increasing peer support. Often people are isolated and benefit from social networks. Learning about staying well in addition to having opportunities to stay connected can be very helpful for recovery. The team plans to offer a range of courses over a ten week pilot period. The courses will be co-designed, based on current SLaM Recovery College content, including topics around depression, anxiety, mindfulness, staying well and making plans and wellbeing.

The pilot will accept both referrals from GPs as well as self-referrals, with a maximum of 20 – 25 per workshop. Increasing access and routes to this kind of support will not only support people with their mental health, it aims to reduce the need for these individuals to use GP appointments for support that can be offered through the college.

The use of peer trainers has been very successful at SLaM Recovery College to date. Taking the peer trainer model into primary care is likely to be an extra and impactful support for the current NHS workforce when designing services and an additional forward step to tackle stigma and culture around mental health services.

Find out more about our work in mental health


Innovator Spotlight

Kirsty Giles, Manager (OT), SLaM Recovery College, South London and Maudsley NHS Foundation Trust, said:

“Our hope is that this pilot shows that recovery colleges can become an essential part of the primary care landscape, improving access to support for people with mental health needs while reducing the pressure on traditional GP appointments. Our trainers and our students are really brave, by putting themselves out there and sharing their story to help someone else. The approach is welcoming and effective.

“The college works with a really diverse group of people. As clinicians, we’re always learning from our students’ lived experience and are inspired by how they look after their wellbeing. This is a two-way knowledge exchange.”

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Transforming delivery of antenatal care in gestational diabetes

Transforming delivery of antenatal care in gestational diabetes

Improving care for women with diabetes in pregnancy at-a-glance


New innovations to improve care for women with diabetes in pregnancy 

A HIN Innovation Grant will go to fund the Kingston Hospital team to introduce innovative approaches to supporting women with diabetes in pregnancy (gestational diabetes). The team plans to introduce a sugar monitoring app (GDM-Health), guided shopping trips and a ‘connected waiting room’ with added benefits.
Currently women are required to prick their fingers four times a day, record this in a book and then have a face-to-face appointment once a fortnight. This new app and the changes that will be made to specialist midwives job plans will mean daily virtual clinics with midwives, run via the app and phone. Every day, midwives will go through all of the information received and contact anyone who needs support to get their blood pressure under control. Too often at present, such regular face-to-face appointments for diabetes in pregnancy can overly medicalise their pregnancy, increase anxiety, result in lots of time spent at the hospital and take away a woman’s feeling of control over their pregnancy as it is closely monitored by medical professionals.

Research has shown that gestational diabetes can be an indicator that a woman is more likely to develop diabetes later in life, and that the children of mothers with gestational diabetes are more likely to be obese and to develop diabetes themselves. Risk factors for this condition include increased body mass index, maternal age and non-caucasian ethnicity, factors which are present in south London’s population. Effective interventions that support education around diet, weight and exercise are essential to try and prevent poor health later in life.

There are three main aspects to the pilot:

• Using a new app, women will upload the sugar measurements they take four times each day so it can be reviewed in real-time by specialist midwives. Work arrangements for the midwives will be redesigned to ensure that there is someone available Monday to Friday to answer queries by phone or email, and proactively monitor results – so that the team can act more quickly with diet advice or medication adjustments to improve sugar control and reduce the risks to mother and baby.
• The team will also seize the opportunities of the waiting room to create a ‘connected waiting room’ that encourages exercise, healthy eating and peer bonding to help women explore ways to maintain good sugar levels alongside a healthy pregnancy. The waiting room is a key opportunity as women will often have appointments with more than one team member in the clinic, meaning that there is time spent in the room between appointments. To maximise the value of that time, the team will bring the room alive and introduce a library of recipe books, posters around diet and exercise in pregnancy and conversation prompts to encourage women to talk to each other. They will also hold drop-in education sessions covering diet tips, breast feeding advice, first aid for newborns and other topics suggested by the women using the service.
• To support the women in their care further, the team plans to pilot guided tours in a local supermarket, where they will guide women through changes they can make to their weekly shopping and hold an education session on healthy eating at the supermarket, suggesting alternatives and exploring barriers to change.

The project aims to reduce caesareans and interventions in birth through more responsive antenatal care as well as increasing the space for education around food and exercise. The plans are also designed to improve continuity of care. Most women with gestational diabetes are diagnosed at around 28 weeks. When their care is transferred to the diabetic clinic it breaks already established relationships with their community midwifery team.

The new app’s ability to monitor sugars more easily and remotely should mean that women need two fewer face-to-face appointments with the diabetic clinic. Instead, women can then make two appointments with their usual community midwifery teams, maintaining consistent contact with the team that will support them when they deliver their baby and in the community after delivery. Continuity of carer is proven to reduce preterm birth and pregnancy loss, as well as increasing maternal satisfaction with the care received. The team predict that if successful, the pilot could move as many as 600 appointments each year back into community settings.

Find out more about our work in diabetes


Innovator Spotlight

Caroline Everden, Consultant Obstetrician and Gynaecologist, Lead for diabetes in pregnancy, Kingston Hospital NHS Foundation Trust, said:

“It’s really exciting when you see something and realise the impact it can have on the women you care for. Women’s time in pregnancy is valuable and we want to use it effectively as we can. Whether it’s through the app to monitor sugars more easily, making the most of the waiting room or by giving them more time back to spend with community midwifery teams, we believe that there is more we can do.

“Our model will hopefully demonstrate that specialist input and education can be delivered in a way that values and supports the relationship established between a woman and her midwife, while also ensuring that expert attention is paid to a potentially very serious condition in pregnancy.”

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Diabetes prevention decathlon

Diabetes prevention decathlon

Diabetes Decathlon at-a-glance


Diabetes Prevention Decathlon to increase choice and prevent diabetes

A new Diabetes Prevention Decathlon programme will be funded by the HIN Innovation Grants. This project will pilot a new type of diabetes prevention programme over 10 weeks that offers patients more choice and encourages them to work together as a team, by introducing different types of physical activity while learning key information that can help prevent the onset of Type 2 Diabetes.

There are currently five million people in England at high risk of developing Type 2 diabetes, which is largely preventable through lifestyle changes. If current trends persist, one in three people will be obese by 2034 and one in 10 will develop Type 2 diabetes. About 10 per cent of the entire NHS budget is spent treating complications from diabetes. Reducing this would have a major impact both on people’s well-being and on resources.

The new pilot programme will include all of the diabetes education and self-management aspects included in a typical programme but will be marketed as a combined education and fitness programme for diabetes prevention. It will be designed to offer choice to patients who can only currently access the NDPP.

The Diabetes Prevention Decathlon will:

• allow participants to try a different sport each week, and with their teams achieve goals based on activity levels and weight loss and participate in organised team activities at the end of every session;
• hold sessions in sports centres, overseen by qualified coaches;
• pilot the benefits of gamifying weight loss, while incorporating key messaging about diabetes prevention, psychological support, and healthy cooking advice;
• provide every applicant with a basic activity tracker, to encourage them to continue to remain active between sessions, and reward those who meet their goals with points for their team;
• integrate with mental health support from a psychologist;
• be considerably shorter in length than the national diabetes prevention programme: 10 weeks compared to nine months.

The diabetes prevention space is well represented by the National Diabetes Prevention Programme, which is the largest of its kind in the world and includes both digital and face-to-face providers. While it’s a proven programme, the dominance of a centrally funded programme has led to a lack of choice as CCGs/Public Health teams are under no pressure to seek alternative local solutions. This new programme seeks to offer more choice and test new ways of combining curriculums and activities for patients in south London.

All diabetes prevention programmes, both digital and face-to-face, need to align to the same NICE guidance and provide broadly the same advice, and this programme will be no different in that respect. The course will be designed by expert diabetes clinicians and will align to NICE guidance to ensure it provides the best possible health advice to people at risk of diabetes. The programme will also be designed with input from local people in Merton.
Its key innovation is to pair the usual behaviour change advice with a truly engaging physical activity programme, psychological support, and live cookery classes to provide a more holistic experience in the one programme.

The funding will help the team co-design and deliver this course.

Find out more about our work in diabetes


Innovator Spotlight

Chris Gumble, Project Manager, South West London Health and Care Partnership, said:

“Often, Type 2 diabetes can be prevented and we’re passionate about helping to do that in south London. At the moment we’re asking everyone to take up a one-size-fits-all prevention programme, rather than offering a range of options. The Decathlon will add something new and exciting, combining physical activity with diabetes prevention over a fun, interactive 10-week period.”

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Engage Consult – Digital Self-Referral for MSK

Engage Consult – Digital Self-Referral for MSK

Digital self referral at-a-glance


Digital self-referral for people with musculoskeletal problems and pain  

Key Successes

  • Development of condition specific online resources
  • 2946 number of patients utilised digital self-referral
  • 796 number of patients utilised online resources without completing a self-referral

HIN Innovation Grants will fund a new project to improve care for people with musculoskeletal (MSK) conditions or injuries.
Musculoskeletal (MSK) conditions affect the joints, bones and muscles, and also include rarer autoimmune diseases and back pain. More years are lived with musculoskeletal disability than any other long-term condition. This includes chronic back, hip and knee pain. It is estimated that 30 per cent of GP appointments are due to MSK conditions.

The project will introduce a new digital self-referral route that will allow for faster triage for people needing MSK treatment. Using a system called Engage Consult, people will be able to self-refer via a website. As well as triaging people for treatment, the site will include pop up information about other local services that could help such as weight management, exercise and walking groups. Over time, the system will link up with other digital technology in use so that patients and clinicians can see and discuss care plans, along with additional education and videos designed to help people manage their condition more easily.

At the moment, patients are referred via GPs and must first speak to an administrator before receiving a call from the triage team. Digital self-referral will improve this by picking up any worrying signs and symptoms more quickly, without the current gap between the administrator’s call and telephone triage. Engage Consult is able to ask smart questions to screen for sinister problems such as Cauda Equina, Metastatic Cancer ‘Red Flags’, or Charcot. This will allow for screening for serious warning signs from the point of contact, reducing the timeline between someone deciding they need help and the time they receive clinical advice. In some cases, this could have a significant impact on safety.

Additionally, the new system is expected to speed up telephone triage when it does take place. At present, it can take up to 20 minutes to take a patient’s history over the telephone. By placing the digital history in front of the clinician the length of these calls can be reduced, freeing up staff time to do more triage calls more quickly.

This means more people can be seen and access can be faster. The service receives approximately 2,000 referrals coming in via GPs every year. Even if only 50 per cent of people decided to go direct to MSK specialists, the impact on GPs and extra capacity in the system would be very significant.

The project is taking a longer term view and working hard to introduce a modern care model, supported by digital platforms.

Find out more about our work in MSK


Innovator Spotlight

Heather Ritchie, Service Lead and Operational Manager, Oxleas NHS Foundation Trust, said:

“MSK affects so many of us and puts huge pressure on primary care. We’re passionate about finding ways to speed up access to our expert team and our management team has supported us to develop and try new ideas.

If people can get clinical advice more quickly it doesn’t only improve safety, it means that individuals will feel more supported and less anxious. What’s great is that this is additional to the 1-1 care we provide at the moment, so it’s adding a better experience for patients while at the same time removing some of the pressure from our GP colleagues.”

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Innovating in Urgent and Emergency Care

Innovating in Urgent and Emergency Care

Join our Urgent and Emergency Care Innovation Exchange event exploring the solutions that could transform urgent and emergency care services.

Briefing for innovators to apply to pitch at the event

The Health Innovation Network, and DigitalHealth.London Accelerator are hosting an Innovation Exchange showcase event on Urgent and Emergency Care on Tuesday 31st October 9.30 to 12pm.

We would like to showcase innovations that meet the challenges within London’s urgent and emergency care for example:

• Improving patient flow through emergency departments
• Supporting clinical decision systems
• User experience – directing patients to the most appropriate service
• Predicting emergency admissions
• Alternative models of care eg. Virtual / remote clinical support
• Quicker access to diagnostics / point of care testing
• Real time information for clinicians

We’re looking for a diverse range of digital technologies that are operational in emergency care clinical services to attend the event to pitch their innovations. The event will enable discussions with commissioners, providers and innovators on the potential for technology to address the challenges and pressures on all urgent and emergency care.

On the day we will start with our guest speaker from Healthy London Partnership to give a policy perspective and presentation from the Chief Clinical Information Officer from London Ambulance Service.

Following these presentations there will be an opportunity for innovators to provide a short pitch (3 minutes) to the audience on how they may adopt your innovation(s) in their organisations and participate in our world café session to discuss your solution in more detail. We are aiming to generate warm leads and fruitful follow on discussions by curating a receptive audience for urgent and emergency care innovations.

In order to select the best innovators to showcase, we are asking innovators to complete this short application form, to allow the Health Innovation Network and stakeholders to select an interesting and varied agenda. Please complete the attached for and return to us by 20th September 2019 at 5pm.

Successful applicants will be expected to complete a short registration form immediately, and 3 months after the event for us to quantify the impact of the event on generating new leads and conversations.

Timeline

• Application submission deadline: 20th September 2019
• Notifications to successful applicants: 30th September 2019
• Urgent and Emergency Care Innovation Exchange event: 31st October 2019

Applications to pitch are now closed please email  steph.mckenzie@nhs.net to register for the upcoming event on 31st October 2019.

 

20 New digital health care innovators set to transform the NHS

20 New digital health care innovators set to transform the NHS

Today the DigitalHealth.London Accelerator announce the 20 new digital health care innovators to be supported by the 2019-20 Accelerator programme at a launch event in central London.  Now in its fourth year, the Accelerator supports small and medium-sized enterprises (SMEs) accelerate the adoption of digital health innovations into the NHS each year. The programme gives innovators improved access to the wealth of world-class research, medical technology, and resources London has to offer and supports NHS providers and commissioners find, and adopt, the new technologies.

Each of the 20 innovators selected for this year’s programme directly support the ambitions of the NHS Long Term Plan published earlier this year. The programme will support these SMEs to develop and deploy solutions to some of the most pressing challenges facing the NHS.

The exciting innovations include a technology that helps clinicians plan and rehearse heart surgery by using patient scans and mechanics to predict the behaviour of a device once inside a patient (Oxford Heartbeat).  Another is a mobile app that tracks the number of steps walked by an individual and incentivises them to walk more through reward points that can be redeemed for products, goods and services (Sweatcoin). Cutting edge technology such as sensors, machine learning and home devices have been brought together in a digital solution to help carers monitor the health and well-being of elderly patients better at home (Birdie).

Anna King, Commercial Director of the Health Innovation Network said: “The Academic Health Science Networks (AHSN) have a unique role helping companies navigating the health system and supporting the NHS in the adoption of value-enhancing innovations. The DigitalHealth.London Accelerator programme helps deliver both improved patient care through the use of digital innovations, but also economic growth through the supporting the best innovative companies. The track record of previous participants in the programme has been fantastic, and we are excited about introducing these new innovations to the NHS.”

Sara Nelson, Programme Director, DigitalHealth.London Accelerator, said: “I feel really proud of the Accelerator and its achievements over the last three years. Today is another step forward and represents how both sides – innovators and the NHS – are coming together more and more to solve the very real challenges NHS organisations face every day. Digital technologies are not only creating new opportunities to change things for patients, they are also creating new opportunities to make things better for staff, and the wider system. We all share the ultimate objective of making our NHS sustainable and I am looking forward to helping the next set of digital innovators make this a reality.”

Theo Blackwell, Chief Digital Officer for London, said: “I am delighted to support the Accelerator and this latest intake of digital health companies looking to bring their innovations to Londoners. The programme’s work ensures that London is at the forefront of digital innovation and is vital to building a future where its citizens benefit from the latest technologies to support their health.”

Tara Donnelly, Chief Digital Officer, NHSX said: “The DigitalHealth.London Accelerator is part of a long- overdue digital revolution in the NHS. We must create a system whereby healthtech innovators are supported and can really feel our commitment to them and their ground-breaking work. This programme does just that, plus it supports the NHS and social care to make the most of the digital opportunity.”

Success stories the DigitalHealth.London Accelerator in previous years include; a product from MIRA Rehab that turns physiotherapy exercises into video games that can be customised to individual patients’ needs. This has been particularly useful for children and orthopaedic patients who often do not achieve their rehabilitative potential because they do not complete their exercises. As a result of its engagement with the Accelerator, MIRA Rehab is now working with Great Ormond Street NHS Foundation Trust, Chelsea and Westminster Hospital NHS Foundation Trust, and Royal National Orthopaedic NHS Trust. It is now available in 10 NHS organisations across the country.

Infinity Health developed an app to improve patient flow in hospitals. It provides clinical staff with an improved experience from the traditional paper-based processes for requesting, tracking, and prioritising porter requests. The app is now used in Northwick Park Hospital in Harrow, one of the busiest Emergency Departments in the country. It has helped save over 10,000 hours of staff time.

The work of DigitalHealth.London Accelerator companies has resulted in almost £76 million in savings for the NHS, with just over a third of this (£24.8 million) credited to the DigitalHealth.London Accelerator’s support – based on information self-reported by companies involved. Some of these savings are made in efficiency gains, for example finding more efficient ways of supporting patients to manage their own health conditions, whilst others may help reduce inappropriate urgent care attendances by providing easier access to GP services.

There have been an estimated 22.2 million opportunities for patients to benefit from new technologies supported by the DigitalHealth.London Accelerator.

For more information please contact hin.southlondon@nhs.net.

South London’s first transgender sexual health service, funded by HIN receives positive feedback from patients

South London’s first transgender sexual health service, funded by HIN receives positive feedback from patients

Last year King’s College Hospital in Camberwell were awarded funding from the Health Innovation Network to open the first sexual health service in south London for trans people. The clinic celebrated it’s formal launch at King’s on Friday 13 July 2019. Since its opening the new trans service at has already had a positive impact on trans people’s lives, giving people easier access to an informed, respectful, dedicated local service in South London.

In partnership with cliniQ, the new service offers a range of health and wellbeing initiatives to meet the needs of trans people. Services include STI testing and treatment; contraception; counselling; cervical screening; hormone testing, hormone injection and advice; sexual assault support; hate crime support; housing advice; and the PrEP Impact Trial.

The service includes a counsellor; a support worker; a nurse; and a doctor. Although the focus of the service is sexual health, it has adopted a holistic approach and works with other relevant services such as primary care, mental health services and social services.

In addition to clinical and support services, King’s is also developing and delivering a range of training materials for healthcare professionals to raise awareness, knowledge and skills in relation to trans health.

Since the clinic opened the clinic has seen over 50 people for a range of issues including sexual health testing; contraception; hormone level monitoring; hormone injections; advice and counselling. The feedback from patients so far has been really positive.

Evren Filgate, a 24-year-old service user, said: “With long waiting times for the specialist Gender Clinics, a lack of training for GPs and hospitals, and a general lack of understanding of trans healthcare, combined with difficulties accessing healthcare CliniQ at King’s as a walk-in clinic accessible to all trans people provides dignified, non-judgemental care for myself and my friends. Without CliniQ I would not have been able to access life-saving care many times over. Many trans people I have spoken to agree that CliniQ is absolutely vital to trans people in south London and its importance cannot be overstated.”

Dr Killian Quinn, Clinical Lead for Sexual Health Services at King’s, said: “I’m really proud that King’s and cliniQ are delivering this service here in South London. The service has the expertise of both sexual health professionals and trans community leaders to address not only any medical and sexual health needs but also psychosocial health inequalities of trans people.”

Dr Michael Brady, Consultant Sexual Health and HIV at King’s and National Advisor for LGBT Health, NHS England, said: “Trans and non-binary people experience unacceptable health inequalities and poorer experience of healthcare in general. Services like this one delivered by cliniQ and King’s provide essential clinical care and support as well as training for healthcare professionals and the opportunity to raise awareness locally of trans health issues.”

Michelle Ross, Founder of cliniQ, said: “cliniQ at King’s is fundamental in establishing trans and non-binary people’s health services in South London and further afield. At cliniQ sexual health and HIV are central to our services, as are holistic health and wellbeing. Trans people are disproportionately affected by all health issues – it is cliniQ’s reason for beginning to change these inequalities.”

Dr Natasha Curran, Medical Director, Health Innovation Network, said: “This clinic is a first for South London and fantastic example of genuine co-design in the NHS.  The Health Innovation Network are delighted to have helped open this important service that offers an innovative, holistic approach to the specific needs of trans people. We aim to fund and support healthcare innovation that improves people’s lives and helps staff deliver the best possible care, the innovation grant we awarded the clinic, will help it do just that.”

Cllr Ed Davie, Cabinet Member for Health and Adult Social Care, London Borough of Lambeth, said:

“This new service is something we’re very proud to deliver alongside King’s and the Health Innovation Network. I’m certain that it will make a positive difference to the lives of trans people in Lambeth and across South London, providing a whole range of health support in a safe, comfortable environment. This will increase learning and awareness, both for health professionals in the issues that trans people and non-binary people face, and also for trans and non-binary people themselves around sexual health and wellbeing, helping us reduce inequality and ensure that everyone can access the support that is right for them. From our black mental health commission to leading the Do It London HIV campaign, Lambeth Council has a proud record of working with our minority communities to improve health and I’m very pleased this new trans clinic builds on this offer.”

Cllr Evelyn Akoto, Southwark Council Cabinet Member for Community Safety and Public Health, said: “I am hugely proud that the first dedicated health centre for trans, non-binary and gender diverse people is coming to South London. Everyone has a right to access healthcare safely and with dignity, however trans people can face unique barriers to certain services. Anything that we can do to help people lead healthier and happier lives is a step in the right direction. I am sure that this will have a positive impact on the lives of many people who live in Southwark and South London.”

Mayor Damien Egan, London Borough of Lewisham, said: “I am delighted that cliniQ has officially launched today. In Lewisham we proudly support the trans community, including the principle of self-definition. As the first sexual health service in south London for trans people we know that clinicQ will make a real difference for Lewisham residents, by making sure they receive the advice and care they need. This is a vital service and I am delighted that Lewisham is supporting it. I hope that more clinics will open in the future so that we can continue to support trans people”

The new service is funded by the London Boroughs of Lambeth, Southwark and Lewisham and the Health Innovation Network (South London) and is run every Tuesday from 4pm – 7pm at the Caldecot Centre at King’s College Hospital.

 

South London NHS Innovation and Research Priorities Highlighted

South London NHS Innovation and Research Priorities Highlighted

Following a national consultation of key local health stakeholders conducted across all regions in England, the NHS innovation and research priorities for south London have been outlined in the regional statement from the Health Innovation Network.

The views of clinical leaders, managers and directors within each Academic Health Science Networks (AHSN) region were collected through qualitative interviews with 61 people and a questionnaire which received more than 250 responses in total. The survey was conducted by ComRes, an independent research agency.

This widespread consultation was commissioned by the AHSN Network, in partnership with NHS England and the National Institute for Health Research (NIHR) to inform the publication of a statement of local NHS research and innovation needs for each AHSN region – as one of the actions in the NHS England and NIHR joint paper on ‘12 actions to support research in the NHS’.

Whilst there were some differences in regional priorities, common themes emerged which reflected both south London priorities and wider challenges facing the NHS and align with the priorities of the NHS Long Term Plan. These include:

  • a need for innovation and research addressing  workforce challenges
  • delivery of mental health services and providing care for patients with mental health needs, particularly in children and young people
  • integrating services to provide effective care for patients with complex needs – including  multimorbidity and frailty
  • use of digital and artificial intelligence technology

The National Survey Full Report outlines the findings from the consultation with local health and social care stakeholders across England. It includes a detailed analysis of the innovation and research needs at local level across all AHSNs.

Natasha Curran, Medical Director, Health Innovation Network said: “Thank you to the south London stakeholders for their invaluable contributions. The statement provides a really useful starting point to build discussions with wider stakeholders, patients and others in the community to address the priorities outlined.”

Professor Gary Ford, Chief Executive of Oxford AHSN, led the AHSNs input into the survey. He said: “The survey provides important information on the research and innovation needs of the NHS which will shape future work of AHSNs and the research community”.

The first cohort of LGBTQ+ Project Dare graduate!

The first cohort of LGBTQ+ Project Dare graduate!

Last week, Project Dare celebrated the graduation of their first LGBTQ+ cohort with a showcase event that saw students performing excerpts of the work they have created on the subject of positive body image.

LGBTQ+ Project Dare, funded by the Health Innovation Network, is a 12-week practical, creative and educational course that encourages individuals to participate in dares as a way of approaching wellbeing, encouraging confidence. It gets students to step out of their comfort zones in a safe space amongst their peers whilst also providing support for those within the LGBTQ+ community, for whom resources are often limited.

Ursula Joy, Lead Facilitator said: “LGBTQIA+ Dare Sessions allow participants a judgement free safe space in which to express themselves creatively, and address head on the issues that affect LGBTQIA+ bodies.”

“Within the gay community, there can be immense pressure to look certain ways. The need to conform in a society dominated by social media and marketing where binary bodies are under the spotlight and non-conformity is monetised.”

“LGBTQIA+ Dares not only gives participants a voice but challenges them to step out of their comfort zones, make positive and accepting connections to who they are, forge meaningful relationships and make changes in their lives.”

“Drama is the perfect vehicle for personal growth and the final showcase provides a sense of ownership, empowerment, and achievement.”

Josh Brewster, Project Manager, Health Innovation Network said:“The Innovation Grants are crucial for projects like “Project Dare” that would be unlikely to receive support from the usual commissioning sources. The grants are a fantastic opportunity to fund projects that can make a huge different to people and do so in ways that are very unique. They act as a great springboard for success allowing the projects to prove their value and hopefully get adopted elsewhere.”

Project Dare ran this course in collaboration with the Recovery College and all of the participants were recruited from the College’s database of service users. The Recovery College offers recovery and wellbeing courses with co-production at the heart of everything they do.

Think Diabetes Report calls on London employers to better support staff living with diabetes

Think Diabetes Report calls on London employers to better support staff living with diabetes

London employers are being urged to ‘Think Diabetes’ in the workplace in a new report published by the Health Innovation Network. Figures in the report show a major gap in the number of with people living with Type 1 and Type 2 diabetes attending free educational programmes to help them learn about their condition and live healthier lives.

There were more than 3.1 million people  diagnosed with Type 1 and Type 2 diabetes  in England in 2017-18 and it is estimated that in London over 671,000 people of working age (over the age of 16) have  either Type 1 or Type 2  diabetes. But the Think Diabetes Report shows less than 8 percent of eligible Londoners living with Type 2 diabetes are attending these courses (this figure is less than 9 percent of eligible people across England).

Reasons for people not attending these courses are varied, but previous reports have cited ‘time off work’ as one of the key issues.  Given the potential for employers to support staff with health, the Think Diabetes report makes a series of recommendations on how employers can help support their staff to take advantage of the education opportunities available to them, or even provide education for staff themselves.

To celebrate the launch of the report, we partnered with Diabetes  UK  to deliver the Think Diabetes Summit. The event brought employers, diabetes experts and patients together, to discuss ways in which organisations can support their staff including; running education sessions in the workplace, sharing new digital approaches to education with their teams so staff can complete these courses online and by making sure staff are supported to take time off work for education to help them live with a long-term health condition.

Diabetes is covered by the Equality Act 2010 as a long-term condition that has significant impact on individuals’  lives and employers are therefore obliged to make reasonable adjustments, although these adjustments are not defined. The case for employers adjusting their policies and supporting individuals to attend structured education is overwhelming.

The event was chaired by Dr Neel  Basudev, Diabetes Clinical Director of the Health Innovation Network and GP in Lambeth, who said:

“Employers have huge influence over the lives of the working population and a unique opportunity to help with what is arguably the greatest challenge facing our nation’s health: diabetes.

“There are more ways for people to access vital education about diabetes than ever before, with many parts of the NHS innovating with digital courses and new approaches to offer support. We now need to raise awareness of what’s on offer and remove as many barriers as we can. Workplace barriers are some of the simplest to address and changes can be made to support staff that will increase the health and productivity of the workplace.”

As well as hearing from diabetes experts and representatives from the organisations who were case studies in the report, Deputy Leader of the Labour Party and Shadow Culture Minister Tom Watson MP shared how he self-managed his own type 2 diabetes into remission. A passionate advocate for helping people learn to self-manage, he said: 

“By changing my diet and lifestyle I’ve put my Type 2 diabetes into remission. I feel fitter, faster, and healthier than ever before and this has given me a new mission to help others get healthy.

“Supporting people who live with diabetes is a major challenge facing our society, and one in which we all have a part to play. Employers in particular can play a key role in supporting people in their journey to learn more about their condition, and how best to manage it.

“It is time employers think differently about diabetes in the workplace and the Think Diabetes Summit is bringing together key leaders from across businesses and organisations to do just that.”

The Think Diabetes Summit was attended by organisations that collectively employ thousands of Londoners. TechUK attended the event and their CEO Julian David said: “techUK represents the companies and technologies that are defining today the world that we will live in tomorrow. I feel passionately that our members should also be leaders in supporting and developing the workforce for the future.  Diabetes is an increasing problem in our society and employers should be engaging with innovative ways to help support staff living with Type 1 and Type 2 diabetes to better manage their condition.”

Download the Think Diabetes Report and Toolkit here.

Innovation Exchange – the digital innovations transforming the NHS

Innovation Exchange – the digital innovations transforming the NHS

As part of London Tech Week, Health Innovation Network and DigitalHealth.London Accelerator partnered with DAC Beachcroft and NHS Improvement to deliver an Innovation Exchange evening at the Wallbrook Building.

At the event, NHS leaders from across the health system, came together to learn about the innovative digital solutions that are already helping trusts across the country to tackle current NHS workforce challenges and discuss the challenges of implementation, interoperability and cost. Attendees included; HR directors from Acute & Mental Health Trusts around London, Borough Councils as well as representatives from national bodies such as Care Quality Commission CQC, NHS England & NHS Improvement.

The overwhelming response to the information shared was encouraging, but also very timely. The recently published Interim People Plan highlighted the important role that digital will have to play to help the NHS combat the current workforce crisis, particularly in relation to productivity.

But digital transformation can be difficult when you consider challenges with costs, planning and implementation. As well as showcasing some of the solutions available right now, discussions were centred around what cultural change is needed to find and uptake digital solutions. A key point that was raised is interoperability – new innovations must be able to work seamlessly with existing systems for compliance and adoption to happen.

And as is always the case with any discussion around digital, the question of how automating services will affect patient care was raised. Workforce shortages are a fact of the NHS and while not all services can be automated, using AI to support the workforce in areas such as rotas and training will help clinicians spend more time on delivering better patient care.

As well as looking to the future, a series of innovations that are already transforming NHS services, by saving money, time and supporting staff, were presented on the night:

  • Locum’s Nest – a temporary staffing management platform to simply connects doctors to locum work in healthcare organisations. The App matches doctors to short-staffed shifts available within preferred hospitals across a chosen geographic area.
  • Virti – Virtual and augmented reality platform for workforce training that transport staff users into realistic environments and uses computer vision to assess how they respond to stress to reduce anxiety and improve skills. Used for mental health staff to provide simulation training.
  • Establishment Genie – An NICE-endorsed digital workforce planning tool for health and social care staff. The Genie collects staffing data for instant reporting at individual unit, organisation and group level, providing analysis and benchmarking capability not previously available to assure and support professional judgement in identifying safe and appropriate staffing levels.
  • Infinity – a secure collaboration and task management solution that integrates with existing health information systems and transforms the way healthcare professionals coordinate their activity and access critical information.
  • Lantum – is a total workforce platform transforming how healthcare organisations and professionals connect. Their next generation AI-powered software helps staffing managers to better manage their rotas, fill shift gaps & drastically reduces reliance & money spent on temporary staffing agencies.
  • Truu – is a digital identity platform that enables secure, digital, remote pre-employment checks. Truu’s approach uses direct connections between doctors’ and hospitals and the sharing of verified credentials that meets regulatory standards and is inherently GDPR-compliant.
  • CoachBot – is the world’s first digital team coach and is designed to help managers get their team performing at the top of their game. It’s built on the principle that technology should make us interact offline more, not less. CoachBot makes it easy for teams to regularly have conversations about the things that matter – it’s not about teaching managers how to be good managers, it’s about making it easy for managers to do the things that great managers do.
  • SilverCloud Health – is a platform that’s provides clinically effective and easily accessible digital programmes that reduce barriers to engagement for those wanting emotional or mental health support. Life changing for users, especially those who feel unable to access help due to stigma, personal situation, location, or service wait times;
  • Q doctor – uses secure video consulting as a workforce solution; to allow NHS organisations to delocalise their workforce across their geography, putting the right clinician in the right place at the right time. Video consulting decreases workforce travel time between sites and in the community and introducing more flexible working.
  • Induction App – is a secure communications toolkit that quickly connects healthcare professionals to the people and information they need to work more efficiently and effectively in hospitals. The functions include a directory of bleep and extension numbers, document and guideline sharing, secure messaging and departmental workspaces. Induction is used by over half of all NHS doctors and is used by healthcare professionals in most NHS trusts.

“It was incredible to see so many well presented company pitches for innovative solutions to tackle the workforce crisis in the NHS. Overall the responses were positive and no doubt many of the conversations that started here will help mitigate the workforce crisis and result in improvements to the NHS using digital technology in the future.” Lesley Soden, Head of Innovation, Health Innovation Network.

To meet the gaps in NHS workforce, the adoption and spread of innovation across the NHS must be accelerated. Increasing awareness of the products that are currently available and their successes in different trusts is the first step to ensuring a robust NHS workforce fit for the future.

Got a digital innovation project or pilot that could improve the lives of people within NHS south London but would benefit from some additional funding? Then make sure you apply for the Innovation Grants 2019.

Homeward Bound

Homeward Bound Grant Winner Kim Nurse

Winning films selected as part of Homeward Bound Project

Homeward Bound, an innovative project in which patients, carers and clinicians from across Kingston Hospital Trust worked with local students to create short films that explain the transfer home process for patients who have had prolonged hospital stays, has confirmed it will begin showcasing two of the final films to patients, family and carers.

The Homeward Bound project, funded by the Health Innovation Network, brought together film students from the University of the Creative Arts, along with the hospital’s staff and volunteers, to create a series of original animated short films. The films explained some of the issues and practicalities involved in the discharge process from hospital back home, which can often be an anxious process for people who have experienced prolonged hospital stays. The films were then entered into a competition and the winning two films will now be shown to hundreds of patients and carers across the hospital and wider community as part of the patient discharge process.

The first winning film, the Panel’s Choice, was selected a special screening of the shortlisted films at the VIP Screen in Kingston’s Odeon Cinema by an expert judging panel that included, Jan Ives, Patient and Carer Partner, Bob Suppiah, Director of Promotions and Partnerships at SkySian Bates, Chairman of Kingston Hospital, Sophie Beard, University of the Arts Senior Lecturer, Dr Kim Nurse, NHS England and the Health and Innovation Network’s Director of Digital Transformation, Breid O’Brien.

Breid said: “We’re delighted to have supported this fantastic project that is a great example of real co-production in action; hospital staff working alongside students, carers and patients and everyone involved having an important and equal role to play.

“I think all involved should be incredibly proud of what they managed to achieve with the Homeward Bound project. Ultimately what these films will do is make the transition from hospital to home that bit easier for patients, families and their carers, at a what is a very difficult time in their lives.”

The second winning film, the People’s Choice, was voted on by patients and hospital staff online and was announced at the Kingston Hospital Improvement Seminar. Both winning films uniquely provide information to patients to feel more in control of their departure and return back home more quickly and comfortably.

Both films will soon be shown on television screens around the hospital and made available online too.

Polypharmacy in Care Homes

Reducing Inappropriate Polypharmacy in Care Homes

Aiysha Saleemi

Polypharmacy – literally meaning ‘many medicines’ – is defined by the World Health Organisation (WHO) as use of four or more medicines and is extremely common among the older population. In fact, on average, care home residents in the UK take seven medicines a day1. This mix of numerous medications, at times prescribed by multiple clinicians, comes with a massive 82% risk of adverse drug reactions2.

Dementia week

I have been a qualified pharmacist for over 10 years and I am currently completing the Darzi Fellowship; a one year leadership course accredited by London South Bank University (LSBU). Within this year, I have been tasked with a project to ‘reduce inappropriate polypharmacy in south London care homes’. An exciting but daunting task for a 12-month period, which if I am successful in, has the potential to reduce hospital admissions, 5-20% of which are related to adverse drug events, and subsequently contribute to saving the NHS millions of pounds per year3 As part of this project, I also aim to specifically reduce the use of anticholinergics in people with dementia. Anticholinergic medicines, often prescribed for various conditions (such as hay-fever and depression), can cause a number of uncomfortable side-effects such as constipation, dry mouth, dry eyes and confusion, but beyond that, they also block the beneficial effects of medicines used for dementia.

Dementia generally affects the older population, for whom polypharmacy is commonplace. Taking numerous medications poses the risk of medication errors, non-adherence and adverse drug reactions and is particularly dangerous for the older population as some of these individuals may also be extremely frail leading to increased susceptibility to illness and slower recovery times. Between this, and the fact that at the current estimated rate of prevalence, the number of people with dementia in the UK is forecast to increase to over 1 million by 2025 and over 2 million by 2051, I was determined that my project would contribute to improving the quality of life of care home residents living with dementia.

My project has been focussed on four care homes in south London. At each of these care homes, we are trialling several interventions. One involves the nurses and carers being informed on the dangers of anticholinergic drugs for people living with dementia and which medications have high anticholinergic activity so they can highlight their use to the pharmacist or doctor. The aim is that the medicines will be reviewed and hopefully reduced or stopped if no longer providing the most benefit to the resident. Another intervention involves educating residents and relatives on the potential risks of polypharmacy so they will understand why some medicines might be stopped. Data is being collected around the knowledge and confidence of nurses and carers to highlight these medicines for review to the pharmacist or doctor and if the reviews result in reduced use of anticholinergics.

Working on this Darzi project is very new to me, but it has been a great way to not only use my pharmacy background to have a direct impact on improving outcomes for a vulnerable patient group, but it has taught me a lot about project management and the importance of building good relationships with all your stakeholders. I have thoroughly enjoyed meeting new people from different organisations and getting to share my knowledge with others, knowing it might help them to improve outcomes for care homes residents. Although there are no results to report yet, I have learnt a great deal.

My top tips so far, for how to reduce inappropriate polypharmacy in care homes are:

1. Involve everyone in the decision-making. Polypharmacy affects the care home residents, relatives and staff members and so ensuring that everyone’s voice is heard is imperative. Consider holding focus groups for residents/relatives and attending GP and care home meetings to capture healthcare professionals’ opinions.
2. Keep your stakeholders updated and informed. Engaging all stakeholders once and then not communicating with them again will lose their enthusiasm for the project. Attend regular meetings or send information to be added to their local newsletters so that everyone is kept informed. Also, ensure that the GPs have agreed for any interventions to be trialled.
3. Target the type of medicines you want to concentrate on reducing. There are hundreds of medicines available in the UK and so it is important to pick the specific medicines you want to work on first. Think about the medicines that may be causing the most harm in your chosen population.

I hope the data collected from this project will demonstrate that these simple but effective interventions can contribute to reducing the use of inappropriate polypharmacy in care homes, and – most importantly – improve outcomes for residents with dementia. And if so, I hope that other care homes in south London will be able to easily adopt some of the methods used in my project and perhaps even spread it across the rest of London.
There are no results to report on this yet but final results will be published on the Health Innovation Network website in August 2019.

Be the first to read Aiysha’s final report, by signing up here

References
1. The Royal Pharmaceutical Society (2016) The Right Medicine – Improving Care in Care homes Available from https://www.rpharms.com/
2. Prybys, K., Melville, K., Hanna, J., Gee, A., Chyka, P. Polypharmacy in the elderly: Clinical challenges in emergency practice: Part 1: Overview, etiology, and drug interactions. Emergency Med Rep. 2002;23:145–53.
3. Barnett N., Athwal D. and Rosenbloom K. (2011) Medicines related admissions: you can identify patients to stop that happening. Available from: https://www.pharmaceutical-journal.com/learning/learning-article/medicines-related-admissions-you-can-identify-patients-to-stop-that-happening/11073473.article?firstPass=false

Sport England award ESCAPE-pain a grant to tackle inactivity

ESCAPE-pain awarded a Sport England grant to tackle inactivity in inactive people over 55

Inactivity among the over 55s is responsible for as many deaths as smoking. Research has shown that as you get older, you’re far more likely to do less than 30 minutes of moderate intensity physical activity a week.

Sport England is investing £10 million of National Lottery funding into projects that will help inactive people to become active. The Active Ageing fund is supporting innovative and experimental approaches that put older people at the heart of efforts to tackle inactivity.

They are investing up to £10 million of National Lottery money into 20 projects across England that are working to reduce the number of inactive older adults.

Today, they announced ESCAPE-pain has been awarded funding as part of the Active Ageing funding programme to continue to deliver their Rehabilitation programme for people with Arthritic pain in south London.

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AbbVie Sustainable Healthcare announces ESCAPE- pain as finalist for award

AbbVie, a global biopharmaceutical company, today announced the finalists of its inaugural Sustainable Healthcare ‘Patients as Partners’ Award. The AbbVie Big Ideas for Better Health Awards were launched by AbbVie in 2015 as a way to recognise, celebrate and share exceptional examples of improvements and innovation that demonstrate a clear benefit to the lives of patients.

The ESCAPE-pain team was recognised for enabling patients with exercises that can manage pain caused by osteoarthritis, also known as chronic joint pain. This has empowered patients to manage their osteoarthritis through selfcare, has reduced hospital admissions and saved NHS resources. Winners will receive a £3,000 bursary to extend their project or pilot new ideas for the benefit of patients and/or the NHS.

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ESCAPE-pain selected as semi-finalist for the Harvard Business School Acceleration challenge

ESCAPE- pain has been selected as a semi-finalist in Harvard Business School and Harvard Medical School’s Health Acceleration Challenge.

The Forum on Health Care Innovation, a collaboration between Harvard Business School (HBS) and Harvard Medical School (HMS), announced today the semi-finalists in its Health Acceleration Challenge, which focuses on taking compelling, already-implemented health care solutions and helping them to grow and increase their impact through powerful networking and funding opportunities.

When announced in August, the finalists will share $150,000 in prize money, with an additional $50,000 going to the eventual winner, who will be named a year from now after the four finalists have pursued their dissemination plans. All of them will become the subject of an HBS case study. Since its launch in 2014, the Health Acceleration Challenge has received over 600 applications and attracted more than 25,000 online visitors from 29 countries.

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