Building a supportive maternity network through impacted fetal head training in south London

Published on April 1, 2026 and last updated on April 1, 2026 by Sharon Farnley

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Since September 2025, our Patient Safety team has supported south London maternity services to implement the standardised training, tools and pathways for managing impacted fetal head.

In this blog, Olivia Harris, Clinical Faculty Midwife for the Avoiding Brain Injuries in Childbirth Programme at the Health Innovation Network South London, and Risk and Governance Midwife at St George’s University Hospitals NHS Foundation Trust outlines how the regional implementation is progressing and what early learning is emerging from Trusts as they embed these interventions.

Impacted Fetal Head (IFH) is an uncommon but serious occurrence estimated in one in 10 unplanned caesarean births where the baby’s head is lodged deep in the maternal pelvis making it challenging to deliver. For this reason, standardised teaching to manage this emergency is part of the national Avoiding Brain Injuries in Childbirth (ABC) programme, which is being delivered across England through all 15 health innovation network patient safety collaboratives.

As the clinical faculty midwife for the ABC Programme at the Health Innovation Network (HIN) South London, I’ve had the privilege of teaching, demonstrating, and helping maternity teams prepare for the implementation of training on the management of IFH.

Although IFH remains a relatively infrequent obstetric emergency, these are technically challenging births that pose significant risks to both the woman or birthing person and baby. Potential complications for the woman or birthing person include tears in the womb, serious bleeding and longer hospital stays. Babies are at increased risk of injury including damage to the head and face, lack of oxygen to the brain, nerve damage, and in rare cases, the baby may die from these complications.

What has struck me most is how deeply our midwives, obstetricians, anaesthetists and support teams want to get this right. Our recent training days have offered a practical space to explore that.

Planning meaningful training

We wanted training to be realistic and help maternity teams to build strong relationships. We visited their sites to observe multidisciplinary training days but also the culture and structure of each unit which helped us understand how to individualise our support offer for each team. The value of site visits was known to us from its success with our other projects in the south London maternity and neonatal safety improvement programme, commissioned by NHS England.

Monthly virtual drop-in sessions began to build upon pre-existing networks across south London and initiate engagement and buy-in with key stakeholders. We then held three regional “Train the Trainer” events in person to begin the process of implementing standardised training methods and resources. Delegates arrived from Trusts with different pressures, cultures, and resource, yet they shared a united aim: improving outcomes for women, birthing people and babies.

My contribution centred on facilitating the hands-on techniques using the caesarean birth simulator mannikin. My aim throughout has been to ensure that everyone leaves not only competent in the techniques themselves but also equipped to deliver this training effectively to their own teams.

As a midwife, I find these moments both grounding and motivating, because it is this shared interpretation – “How will this look in practice on our unit at 3am?” that ultimately strengthens safety and consistency in care.

Communication as a clinical skill

One of the most powerful aspects of these sessions has been watching my colleague, Dr Gabby Bambridge, clinical faculty obstetrician for the south London ABC programme, and consultant obstetrician at Kingston and Richmond NHS Foundation Trust, lead discussions on communicating with women, birthing people, and their birth partners during caesareans complicated by IFH. Her emphasis on clarity, compassion and layered communication has reminded me that technical emergencies do not remove the need for relational care; in fact, they heighten it.

Quality improvement: the piece that turns training into change

Another part of these training days that has resonated with me is the deep dive into quality improvement, led by Hebe Davies-Colley, our south London ABC programme lead. Delegates used the “Goal, Reality, Options, Will (GROW)” coaching model to explore what it will take to implement IFH teaching and updated practice locally. Sitting in these discussions, I’ve been struck by:

• How consistent the challenges are across units,

• How honest people are about cultural barriers, and

• How clear the desire is for sustainable systems, not just training days.

What have these sessions have taught me?

Simulation has emotional weight.

Even in a scenario, staff respond with the seriousness they bring to real emergencies. That speaks volumes about their sense of responsibility.

True improvement requires trust.

The honesty in the room about fear of making mistakes, unit pressures, and resource limitations, only happens when people feel safe. I’m proud that our sessions created that space.

Implementation is a marathon, not a workshop.

Teaching is only the beginning. Shifts in guidelines, documentation, culture and confidence take time.

Collaboration across professional boundaries is where change accelerates.

Midwives, obstetricians, anaesthetists, support staff – when they plan together, the result is far more realistic and sustainable.

Looking ahead

Over the last six months we have trained nearly 70 clinicians from the 10 maternity units (within seven NHS Trusts) in south London. Since our regional sessions, early insights show the attendees have increased confidence to manage this emergency themselves in clinical practice as a multi-professional team, but also to teach clinical staff at their maternity units. Each Trust will now take this forward individually, and our team are looking forward to supporting them through teaching, coaching, and problem-solving to create sustainable improvements that become ‘business as usual’.

A thank you

I’m grateful to my colleagues Gabby, Hebe and Claudia Newton, our ABC programme support officer, who have each been crucial in creating a psychologically safe environment and to every participant who has brought honesty, curiosity and commitment.

These sessions have reinforced why I became a midwife: to help create safer, kinder, more informed maternity care. Being part of this work feels like a real privilege.

Learn more about our projects here, and feel free to get in touch with us by emailing hin.southlondonabc@nhs.net if you have any specific questions about our work on management of IFH at caesarean birth in south London.

PIC-C: co-producing a new resource to help healthcare professionals understand and manage pain in younger patients

Published on March 27, 2026 and last updated on April 1, 2026 by Sharon Farnley

A young woman in a surgery talking to a female practitioner.

Since 2018, the Health Innovation Network (HIN) South London has been supporting Psychologically Informed Collaborative Conversations (PIC-C), an innovative project designed to train healthcare professionals to improve how they care for people with pain by implementing psychologically informed treatment strategies.

In this blog, project leads Clair Jacobs (Consultant Physiotherapist, Physiotherapy Clinical Lead Pain Management, Guy’s and St Thomas’ NHS Trust) and Jane Robinson (Principal Physiotherapist, Sheffield Children’s Hospital) reflect on the continued success and evolution of the programme and the latest phase of their work with the HIN – broadening the scope of the training to include specialist content focused on paediatric pain.

Persistent or chronic pain affects almost 28 million adults in the UK, with 8 million of those people experiencing pain which causes moderate or severe disabling. In addition, prevalence of chronic musculoskeletal pain in children (under 18) is 25.7% - that is 274 children in the average senior school in UK (Chambers et al. 2024).

The original intention of our PIC-C project was to design a training course which helped to improve care for the huge number of people affected by pain. Specifically, we wanted to give healthcare professionals the skills and confidence they needed to treat patients with pain in a psychologically informed way – reflecting the bi-directional relationship between physical pain and emotional distress.

The PIC-C training, developed with Professor Frank Keefe at Duke University, the Physiotherapy Pain Association, St Georges NHS Foundation Trust, Kingston Hospital NHS Foundation Trust, the Q Improvement Lab and the HIN has now been running for 7 years, supporting therapists both nationally and internationally. To date, more than 400 professionals have taken part in our unique 16-week training course, including structured education and reflective supervision with many more planned already this year. An evaluation found significant positive changes in practice and professional confidence for trainees, and a celebration event is planned for 22 May 2026.

While the programme has had great success empowering physiotherapists and other healthcare professionals to provide more holistic care for adult patients, we had recognised in recent years that it could be enhanced to fully meet the needs of those working with children experiencing persistent pain. This was backed up by participant feedback. Managing paediatric pain in a psychologically-informed way comes with unique considerations – from the role of therapists in developing therapeutic relationships with parents and caregivers as well as the young person, to the delicate balancing act between the demands of school, family, friends and hobbies required to live a happy life during childhood.

A paediatric element of the training was piloted for two cohorts between 2023-2025, during which the team identified (with participant feedback) some unique needs of young people living with long term pain and persistent physical symptoms (fatigue etc.) that could benefit from some additional targeted training resources.

To address this, we secured funding from the Chartered Society of Physiotherapy (CSP) Professional Network Fund. This continues to be a very successful and enjoyable collaboration between like-minded therapists within two physiotherapy professional networks - the Physiotherapy Pain Association (PPA) and the Association of Paediatric Chartered Physiotherapists (APCP).

It was a natural ask to approach the HIN with a follow up request to work with us to clarify the need and to develop further high-quality resources, maintaining the integrity of the original project concept work. We had funding to support three short (approximately 3-5 minute) videos, to be filmed with the project team in London at Guy’s and St Thomas’, and to update the content of the PIC-C manual. The content would be co-produced by the PIC-C project team, patient partners, Your Rheum (a group for young people with rheumatic conditions) and the HIN.

As therapists, we knew what was missing from the training based on feedback – but we were a little out of our depth when it came to designing the content to fill the gaps. We certainly had no idea how to develop scripts!

The process of co-production was catalysed by our patient partners, who bravely shared their experiences with us via Your Rheum. This gave us all opportunities to work in new ways and to learn from others about the Patient and Public Engagement (PPIE) process. With help from the HIN team, structured interviews, and discussions with young people we were able to tease out three core themes: the therapeutic relationship; the challenge of eliciting values or priorities with a young person; and managing conflicting values between a young person, their parent/carer and a therapist. All felt relevant and rather than trying to create videos to “solve” complex issues related to these themes, we wanted to use the videos to explore realistic scenarios and prompt discussions during the training.

The production of the videos also included us acting, which was very daunting! However, with the professionalism of the HIN team in supporting us (alongside our patient partner Lydia Gahr and two volunteer “patients”), we produced three excellent videos. These videos have been approved by the PIC-C committee and relevant professional networks and disseminated widely to paediatric professionals at national and international conferences.

The next phase of PIC-C paediatric specific training is currently scheduled for Sept 2026, alongside further evaluation. For more information about training see Psychologically Informed Collaborative Conversations for Paediatric Physiotherapists and Psychologically Informed Collaborative Conversations (PIC-C) .

Whilst acting was excruciating for some, as a project team we learned a lot about collaboration and co-production. Lydia, our young patient partner, has a background in film production which further added to the project. We finished the co-production process confident we had created materials which sensitively and accurately conveyed the perspectives shared with us by young people throughout the work.

Thank you to the whole team - George, Natashia and Ismar from the HIN for their guidance script development, filming, post-production and content updates. Thank you also to all our patient partners credited on the videos, to Your Rheum and to the core project team and wider PIC-C team who came together to help us complete this project providing both support for therapists and improving outcomes for people living with pain and persistent symptoms.

We’ve been grateful for the opportunity to work together, and it demonstrates the value of system working when we collaborate – breaking down silos and giving everyone the chance to contribute to making the management of pain better.

HIN team
George London; Natashia Hadley; Ismar Uzeirovic.
Professional Project team
Jane Robinson, Principal Physiotherapist Sheffield Children’s Foundation Trust; Vic Harbottle, Senior Specialist Physiotherapist, Great North Children’s Hospital; Clair Jacobs, Consultant Physiotherapist, Physiotherapy Clinical Lead Pain Management, Guys and St Thomas’ NHS Foundation Trust; Elsje De Villiers, PPA treasurer and the PIC-C committee.
Patient Partners
Lydia Gahr; Project patient partners; Your Rheum volunteers.
Partner Organisations
Kingston Hospital NHS Foundation Trust; Q Improvement Lab

Find out more

To find out more about how we can help create training materials or support with multimedia content, please get in touch.

Relief at last for people with Premenstrual Dysphoric Disorder (PMDD)?

Published on December 8, 2025 by Sharon Farnley

Side view image of two women sitting face to face in comfortable armchairs. Stylish mature female psychotherapist conducting counselling with young pregnant woman. Job interview and human resources

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Premenstrual Dysphoric Disorder (PMDD) is often described as ‘bad PMS’, however it is much more than that. PMDD is a debilitating psychiatric disorder that affects an estimated 820,000 women in the UK, costing the economy a staggering £8.47 billion annually.

In this blog by Laura Walton, Project Manager in the Mental Health team at the Health Innovation Network South London, she reflects on the potential impact of the Nettle™ device on people with PMDD.

PMDD is characterised by intense symptoms of depression, anxiety, and even suicidal thoughts, occurring in the two weeks before menstruation. For many, this means living with intense mental and physical distress for nearly half of their reproductive years.

Despite its impact, PMDD remains underdiagnosed and misunderstood. On average, it takes 14 years to receive an accurate diagnosis. Current treatments such as psychotherapy, antidepressants, oral contraceptives and hysterectomy are largely inadequate. They’re not tailored to alleviate the specific symptoms of PMDD, can be hard to maintain, and come with unwanted side effects or can be extremely invasive.

Nettle™, a Class-IIa, CE-marked, non-invasive, drug-free, hormone-free wearable device offers a new approach to treatment of PMDD. Developed by Samphire Neuroscience, Nettle™ uses transcranial direct current stimulation (tDCS) to deliver painless stimulation to two key brain regions: the motor cortex (to alleviate pain) and the prefrontal cortex (to improve symptoms of mood disorders).

This innovation was at the centre of a 6-month Small Business Research Initiative (SBRI) project, led by Dr Paul Faulkner at Queen Mary University of London in partnership with the HIN South London. The project, ‘Validation of a Non-Invasive Brain Stimulation Device (Nettle™) to Manage Symptoms of Premenstrual Dysphoric Disorder’ had two main goals:

To validate the at-home use of Nettle™ for alleviating PMDD symptoms

To explore strategies for integrating Nettle™ into NHS treatment pathways

The study recruited 44 women diagnosed with PMDD, who participated in either real or sham stimulation over a three-month period. The findings were highly encouraging. The at-home use of the Nettle™ device proved to be both practical and acceptable to participants, demonstrating strong feasibility. More importantly, real stimulation produced measurable benefits compared to sham treatment, including reductions in anxiety and pain/discomfort, as well as improvements in emotion regulation.

However, PMDD patients often require multiple, combined interventions rather than a single solution. So, although results from the study suggest that Nettle™ could become a valuable add-on treatment offering extra support alongside existing therapies, understanding the true impact of the innovation on complex conditions such as PMDD will require more real-world research.

The UK Government’s renewed Women’s Health Strategy, aligned with the Fit for the Future 10-Year Health Plan, signals a growing commitment to addressing gender-specific health challenges, and discussions about conditions such as PMDD highlight the urgent need for funding and integration of evidence-based solutions into NHS care.

Dr Paul Faulkner and his team at Queen Mary University of London are currently applying for NIHR Invention for Innovation (i4i) funding to support a larger clinical trial of Nettle™. We’re looking for NHS clinical sites interested in supporting participant recruitment for this trial. If you know of any suitable sites, colleagues who may be interested, or would like more information, please contact Dr Paul Faulkner directly at p.faulkner@qmul.ac.uk.

Together, we can advance innovative, patient-centred solutions for PMDD and improve the lives of thousands of women.

Want to know more about our mental health work?

Click on the link below to go to our dedicated webpage

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It takes a network: Clinicians are building AI healthcare from the ground up

Published on September 2, 2025 and last updated on September 3, 2025 by Sharon Farnley

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Artificial Intelligence (AI) is transforming healthcare—not from the top down, but from the ground up. In this blog, the Health Innovation Network South London’s Medical Director Natasha Curran explores how clinicians across the UK could lead the charge in embedding AI into everyday practice. Drawing on insights from recent reports, personal reflections, and collaborative projects, she highlights the importance of inclusive, clinician-led innovation.

AI is no longer a distant promise—it’s already reshaping clinical care. UCLPartners short explainer video clarifies how AI can be applied meaningfully in healthcare. It introduces four guiding principles—predictive, preventative, personalised, and participatory. These principles aren’t theoretical; they’re being applied across the country to identify risk, reduce admissions, tailor treatments, and support shared decision-making.

Reading Musafa Suleyman’s fantastic blog on seemingly conscious AI last week, I wondered about the use of AI companions as personal health partners. It also reinforced my view that we need AI to support clinicians—not replace them (a big fear for some).

As the AI in London Healthcare: The Reality Behind the Hype report makes clear, the real challenge isn’t the technology—it’s how we enable its adoption. Interestingly, clinicians were ranked as the most influential stakeholder group driving AI in their organisation, chosen by 27% of survey respondents, followed by senior management (17%) and IT departments (11%). Some organisations are taking a top-down approach, with senior leaders setting direction and allocating resources. Others are more organic, with clinicians driving innovation from the ground up. What’s consistent is that AI projects thrive where there are passionate champions—whether they’re executives or frontline staff.

One of the most powerful enablers is inclusivity. As one interviewee put it: “Being very inclusive to different groups of people actually makes the work better… far too much of healthcare is delivered in a very hierarchical way where the sort of ‘senior old people’ feel like they know it all. This is a brilliant area where… they categorically don’t.”

This quote captures a growing recognition that AI adoption must be collaborative. It’s not just about digital teams or governance leads—it’s about bringing together clinicians, informaticians, and patients to co-design solutions that work in practice.

Our blog with our other London health innovation networks “Run Before You Can Walk“, adds another layer to this conversation. It challenges the traditional “crawl, walk, run” model of tech adoption, arguing that AI often starts fast—with enthusiastic pilots—but then slows down as it scales. The authors propose a new model: “run, walk, drag”. It reflects the reality that while pilots may be energised by local champions, broader rollout requires deeper integration, training, and cultural change. And sometimes, it’s hard work.

Despite growing interest, structured working groups dedicated to AI and well-established forums for cross-organisational collaboration may not be so visible to all. Much of the current exchange happens informally—at conferences or through personal networks. There’s a clear opportunity to build more formal mechanisms for sharing use cases, strategies, lessons learned, and for bringing more people into the conversation. Now is the time to get connected.

If you’re keen to know more, please join us for a one hour webinar on AI in Action – Enhancing Triage in 111 and A&E / Optimising Patient Flow: AI Applications in 111 and A&E on September 18th. Two clinicians will share their experiences implementing AI tools that support patient prioritisation in NHS 111 and ambient voice technology in A&E triage and consultations.

AI in healthcare is exciting—but it requires graft to implement. It isn’t just about algorithms; it’s about people. And when we empower our people, across all levels and disciplines, we unlock the true potential of AI to transform care.

Want to know more?

Get in touch with us if you’d like to find out more about our work with AI

How Mindset innovators are helping to “Get Britain working”

Published on June 13, 2025 and last updated on July 2, 2025 by Sharon Farnley

Image looking down on people working at desks

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By the Health Innovation Network South London’s Head of Mental Health, Aileen Jackson.

Concerns about mental ill health and its impact on employment have grown significantly in recent years. The UK Government’s Get Britain Working white paper paints a stark picture: mental health is now the largest work-limiting health condition among people under 45. For younger people, the number reporting that mental illness limits their ability to work has soared by over 400% in the past decade.

In this context, innovation is no longer a “nice-to-have” – it’s essential.

To address this, innovators have been tackling how the NHS, employers and communities can respond to the growing challenge of mental ill health in the workforce.

Why mental illness is a workforce crisis

In the Get Britain Working white paper, mental health is mentioned more than any other health condition – 33 times, to be precise – reflecting its central role in the broader employment challenge.

And it’s not hard to see why. The COVID-19 pandemic pushed an already over-stretched mental health system beyond its limits with referrals to Child and Adolescent Mental Health Services (CAMHS) rising by more than 50%. Meanwhile, NHS mental health staff are burning out, leaving behind increased waiting times and unmet needs.

When people can’t access timely mental health support, it’s no surprise that many find it hard to hold down employment or to return to work after illness. The result? A workforce that is increasingly fragile and unsupported, especially among younger generations.

Innovation: creative solutions to support our workforce

While the challenges are significant, the response from healthcare innovators has been both creative and effective. Across the UK, forward-thinking projects are not just improving mental health outcomes, they’re directly supporting people to stay in or return to meaningful employment.

Good mental health starts in childhood. One example of an intervention with children is our collaboration with Oxleas NHS Foundation Trust to implement BfB Labs’ Lumi Nova, a therapeutic gaming app designed for young children with anxiety. Lumi Nova doesn’t just treat children – it equips them with lifelong skills in resilience potentially reducing their risk of serious mental illness as they grow into working adults.

Other innovators working in this space are Scenegraph Studios who offer a six-part mindfulness course for children and young people, and Phase Space who help young people in education reduce feelings of anxiety, regulate their emotions and grow in confidence.

Both help users manage their mental health in and outside the apps by teaching mindfulness skills that can be applied to everyday life.

Immersive tech for a digital generation

Several tech companies supported through the Innovate UK Mindset-XR programme are using virtual and augmented reality to enable mental health support to be accessible and appealing to young people.

InsideOut, Tend VR, alongside TellMi (a peer-support app for teens) have all received a share of £1.7m from SBRI to further develop their products particularly focusing on how they can positively impact users’ employability and workplace wellbeing.

These innovations recognise that for digital-native generations, conventional care pathways often fall short. By providing digital-first, evidence-based solutions, they’re bridging the gap between clinical care and real-world user needs.

Addressing the hidden barriers to work

Mental health conditions like Premenstrual Dysphoric Disorder (PMDD) are often overlooked yet can be deeply disruptive to working life. Through another SBRI-funded partnership, the HIN South London is working with Samphire Neuroscience and Queen Mary University London to evaluate Nettle, a non-invasive brain stimulation device designed to reduce PMDD symptoms.

By improving access to effective, non-traditional treatments for lesser-known conditions, this kind of innovation directly supports people to stay in work and maintain a better quality of life.

A whole-society responsibility

While the Get Britain Working white paper puts mental health at the heart of productivity discussions, economic output is only part of the story. Work is not just about earnings, it’s about purpose, social interaction, and stability. A mentally well workforce benefits not just GDP, but society as a whole.

That means the responsibility for change cannot rest solely on NHS shoulders. Employers, universities, schools, communities need to all play their part.

With the right support and investment, the innovators we’re working with today are helping to redefine what mental health care looks like, and in doing so, support a happier, healthier, and more productive workforce.

The way forward

Mental ill health is a complex and growing challenge, innovation has a part to play in the path forward. By rethinking how we deliver care, supporting people earlier, and embracing both digital and human-led solutions, we can turn today’s crisis into tomorrow’s opportunity.

The good news? Those solutions already exist. Now it’s up to all of us – policymakers, health and care providers, employers, educators, innovators and communities to work together.

Read the full list of Mindset immersive tech solutions.

Want to know more?

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Innovation in mental health: a critical enabler to “Get Britain Working”?

Published on April 17, 2025 and last updated on April 22, 2025 by Sharon Farnley

Concerns about the scale of the impact of ill-health on employment prospects have grown in recent years, with the government’s Get Britain Working white paper outlining a number of worrying trends.

In this blog, HIN Head of Mental Health Aileen Jackson explores the relationship between mental health and our workforce – and the role of innovation in helping NHS services, employers and the government to turn the tide.

The Government’s Get Britain Working white paper on reversing recent trends around unemployment makes it clear the role that mental ill-health plays in limiting people’s ability to work.

From its mention in the second paragraph of the foreword – and 33 times subsequently, more than any other health condition – it is impossible to miss how much focus the paper puts on the importance of fixing our collective mental health to boost society’s productivity.

As the paper examines the drivers of unemployment in the UK in detail, the reasons for this focus become clear. Mental health is now the largest work-limiting health condition among those aged 44 and younger. The number of young people who report that their mental health limits the amount or type of work they can do has risen by more than 400% over the past decade.

So – what has gone wrong? And how could the NHS work with employers and other partners to fix the relationship between mental health and work?

Covid-19 and a mental health system pushed beyond its limits

Like many parts of the health and care system, mental health services in the UK were under significant pressure before the Covid-19 pandemic hit.

Recruitment and retention of staff has been a long-term challenge in the sector, with particular shortages in nursing and senior medical staff being raised as serious risks well before the spectre of coronavirus reared its unwelcome head.

2020 and the years that have followed have stretched our systems to the brink.

Demand for treatment following the detrimental impact of the pandemic on individual mental wellbeing has spiked, with some services such as Child and Adolescent Mental Health Services (CAMHS) experiencing a rise in referrals of more than 50%.

At the same time, staffing issues have worsened, with excessive workloads leading to a vicious cycle of sickness, burnout and staff leaving the sector.

All this has led to a situation where – despite the best efforts of staff and service leaders – hundreds of thousands of people across the UK are unable to access the diagnosis and treatment they need for mental health conditions in a timely manner.

In this context, it is unsurprising that we are struggling to support a significant proportion of our population to be mentally “fit to work”.

Doing things differently: the role of innovation in improving the mental health of our workforce

The challenges facing the mental health sector are undeniably intimidating. Patience and well-intentioned tinkering will not deliver the improvements that we need to get the mental health of the nation back on track; transformative change is what we need.

At the Health Innovation Network South London, we are proud to be working with some of the innovators facing those challenges head on – and making real progress towards overcoming them.

Many of the innovators we are working with recognise the vital importance of childhood in determining long-term mental health.

As the Faculty of Public Health describe the situation: “The most important opportunities for prevention of mental illness and promotion of mental health therefore lie in childhood, many of them in the context of the family”. Helping young people to build their mental wellness and resilience during childhood could be key to addressing the long-term illness keeping so many young people out of work.

Among the work we have done in this area recently is a project with Oxleas NHS Foundation Trust to implement Lumi Nova, a therapeutic gaming app to support young children with anxiety.  One of the key themes from the work has been the importance of “whole system” thinking – recognising that mental health is the responsibility of more than just mental health services.

A number of the early-stage innovators we support through the Innovate UK Mindset-XR programme are focused on using immersive technology to support children’s mental health in new and engaging ways. Through these technologies, we hope that in the future we can provide children with the option of safe and effective care delivered in ways that reflect their increasingly digital-first lifestyles.

Two of our Mindset-XR companies (InsideOut and Tend VR) and TellMi, a company we have supported through our other programmes, have just received a share of £1.7m from SBRI to continue their work, focusing on workplace impact.

But not all innovation has to be digital. For several years, we have supported the development and national adoption of FREED, a groundbreaking early intervention for eating disorders. This new model of care, originally developed by South London and the Maudsley NHS Foundation Trust and King’s College London, has helped thousands of young people access earlier diagnosis and more effective treatment for eating disorders.

Our work on FREED continues with the pilot of peer support workers, a project that is looking to diversify the FREED workforce and enable people with lived experience of eating disorders gain paid employment – the report on this project is due in summer 2025. 

Elsewhere, we work closely with innovators tackling mental illnesses which are less well known and highly relevant not just to tomorrow’s workforce, but to the workforce of today.

Also through SBRI funding, we are currently working in partnership with Samphire Neuroscience and Queen Mary University London to support the validation of a Non-Invasive Brain Stimulation Device (Nettle) to manage symptoms of Premenstrual Dysphoric Disorder (PMDD). PMDD is another example of an often-overlooked condition causing increased absenteeism, decreased productivity and decreased work-related quality of life.

Although the approach taken by each of these innovations varies significantly, they all share the same drive to do things differently – supporting the workforce to access effective care through less-traditional means.

Working together to support the mental health of our workforce

Get Britain Working reinforces that mental health is at the heart of people’s everyday lives; a welcome and worthwhile reflection. However, economic productivity is just one aspect of a person’s life impacted by mental ill-health. A holistic approach beyond counting the cost in terms of pounds lost or employment rates impacted remains vital.

A thriving mentally and physically well workforce is as much the responsibility of all employers (small and large) and our educational systems as it is NHS mental health services.

Innovation holds a key to helping all those with a vested interest in a healthier working population achieve their collective goals. And those innovations are out there – with the support and investment, they will help us turn the tide.

Find out more about our Mental Health projects

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Exploring the Future of Mental Health Care: Key Insights from the Forum for Mental Health Technology Innovators in Liverpool

Published on April 15, 2025 by Sharon Farnley

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Dr Jade Thai, Senior Research Lead, Mental Health Research for Innovation Centre (M-RIC), Mersey Care NHS Foundation Trust.

The Forum for Mental Health Technology Innovators in Liverpool on 27 March, organised by the National Institute for Health and Care Research (NIHR) HealthTech Research Centre for Mental Health (MindTech) on behalf of the NIHR Mental Health Translational Research Collaboration (MH-TRC) UK Mental Health Mission (MHM), brought together a diverse group of stakeholders including several of the UKRI funded Mindset innovators to explore the future of mental health care through technology.

The Forum was held at the iconic Royal Liver Building in Liverpool in recognition of the advances made in mental health research by Liverpool’s Mental Health Research for Innovation Centre (M-RIC) – a partnership between Mersey Care NHS Foundation Trust and the University of Liverpool.

By connecting academic researchers, healthcare providers, industry innovators, and service users, the forum provided a platform for discussing how emerging technologies like XR (Extended Reality), Big Data, and AI can be applied in clinical mental health care settings.

Key themes included:

• Collaboration across sectors: The event demonstrated the power of bringing together diverse stakeholders – from innovators and clinicians to academic researchers and service users. The shared enthusiasm stemmed from the success stories of overcoming challenges through collaboration, showing how a unified approach could lead to more impactful mental health solutions.

• Overcoming barriers: Challenges such as navigating regulatory pathways, engaging with the NHS, and securing funding were discussed. Speakers and panellists shared their experiences, offering insights on how these hurdles could be overcome and how innovators could better navigate the complex landscape of healthcare technology.

• Bridging the gap between innovation and clinical needs: A critical discussion centred on the tension between entrepreneurial innovation and the real-world needs of clinicians and service users. Innovators were encouraged to move beyond creating technologies based on assumptions “We’ve built it, they will come” and instead focus on co-designing solutions based on the needs and feedback of those directly impacted by mental health issues.

• Real-world insights: Innovators gained valuable direct feedback from clinicians and service users, helping them refine their products and align them more closely with the NHS care pathways. This interaction emphasised the importance of understanding the lived experience and ensuring that technology solutions complement human care rather than replace it entirely.

• Human-centred technology: NHS professionals reinforced the need for technology to be used in a way that supports and enhances care rather than diminishing the human aspect of mental health services. There was a shared understanding that innovation must always be balanced with duty of care and must be designed to be safe, accessible, and beneficial for both patients and clinicians.

The atmosphere of the day was positively charged – and it was apparent how delighted the innovators and industry reps were to meet clinicians, academics and support organisations such as MindTech, M-RIC and the Health Innovation Network.

Several innovators had the opportunity to demonstrate their products including those supported by the Mindset-XR Innovator Support Programme such as Anagram, Human Studio, PWFL Health, Scenegraph Studios, SyncVR and Tend VR.

By the end of the forum, many attendees I spoke to felt more informed about the complex landscape of mental health technology innovation.

Specifically, innovators left with clearer pathways for collaboration, access to NHS resources, and a deeper understanding of how to align their work with the needs of both service users and healthcare professionals.

Overall, the event highlighted the exciting potential for technology to transform mental health care, while emphasising the need for collaboration, human-centred design, and a deep understanding of the real-world challenges faced by both healthcare providers and those with lived experience.

Keep in touch with the Mindset-XR Innovator Support Programme

Finding your community through involvement in research

Published on March 27, 2025 by Sharon Farnley

Group of four people sitting on a stage facing an audience.

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The Health Innovation Network (HIN) South London believes that involving patients, people and communities in making decisions about improving health and care makes things better for everyone.

This ethos is echoed by our local partners at King’s Improvement Science (KIS), who use improvement science to support service change.

In this guest blog, KIS Steering Group member, peer supporter and community organiser Chris Pavlakis shares his experience of building community through involvement in research and co-producing an event.

Community is central to our life and wellbeing. Lucky are those of us who grew up surrounded by family, friends and members of our community. Growing up, I always had ‘my people’, which cemented the feelings and benefits of having a network around.

But moving to England almost a decade ago for family and work exposed me to the many challenges of making friends and creating community, especially in spaces lacking in diverse representation, such as research.

Financial woes and a difficult physical and mental health journey hindered further my ability to effortlessly meet new people. There are significant comforts and unsaid ways of being that come with being in spaces with others that I had to let go of in my day-to-day life. Without such spaces, I often did not feel like myself, and I continue to yearn for communities where I could just ‘be’ and discuss shared concerns and aspirations with others.

This drew me to ponder the many ways in which members of marginalised groups create and maintain community, in-person and online. It is important to highlight the need for spaces and communities that are centered around marginalised groups, and especially to dispel the notion that the creation of these spaces is exclusionary for members of the dominant culture(s).

And then, in 2022, I decided to express an interest in joining King’s Improvement Science (KIS)’s Patient and Public Involvement (PPI) steering group. The group brings lay members with lived experience of accessing health and care services for themselves or loved ones together to discuss current issues around the public engagement landscape, and in so doing, generate better health outcomes.

Back in October 2024, KIS held a conference at Coin Street Neighbourhood Centre, titled ‘The value of partnering with the public to improve healthcare services’. The event was co-designed, organised and carried out with patient and public involvement members. When I was initially invited to join the planning group, I could not have believed that the journey would be so rich in experiences. The planning meetings I attended exposed me not only to different life experiences, but also to different lines of thinking around public involvement. But we found common ground to work together and discovered common hindrances that hold us back from speaking up and taking action.

‘Safe Space’, was a term used often at our meetings, especially when they were delivered online. It is a call to action to ensure that everyone in that space feels safe, is not exposed to harm, and at a minimum, is protected if safety is not met. My experience of being in the planning group was that we created a culture where everyone’s views and knowledge was valued, paid attention to and contributed to a collective body of knowledge that could be delved into for the benefit of meeting our objectives.

For instance, when different views came to the surface regarding the language we should use in the event title, and what it would mean to find a truly accessible venue, discussions remained rich and insightful. All views were heard and respected and decisions were taken on a consensus which left all members of the group ‘owning’ the final choice. This led to a highly productive, humane and positive experience for all, in my view. This sentiment was reinforced by the collective responsibility undertaken and care shown by everyone in the group, whether KIS staff or fellow lay members. Plus points are to be given for the efforts to be flexible around arranging meetings (either online or in person, according to our needs) at convenient times, and parity in decision making.

On the day of the event itself, I was nervous to be on stage and felt somewhat vulnerable speaking about my lived experience, however, I was well supported and empowered by each one in the planning group and the entire KIS PPI crew. The high turnout and the great engagement level from attendees has energised me beyond the event and confirms to me the importance of this type of work, our collective choices, and my participation in discussions.

Video link: The Value of Partnering with the Public to Improve Health Services on Vimeo

At this point of the iterative journey, I can see the positive impact of participating within myself: exposure to a highly stimulating group has given me greater self-confidence to discuss, peer reflect and brainstorm. I believe in myself more, see a brighter future, and tend to express increasing interest in joining other initiatives in the field of mental health.

I hope that more people with lived experiences will see the relevance of joining such spaces and making a difference, and ideally, find a community that lifts their spirits and broadens their horizons. In the words of the great poet and civil rights activist Audre Lorde: “Without community, there is no liberation”.

About Chris Pavlakis: Chris is a peer supporter and community organiser active in immigrant and neurodivergent spaces. He has been a regular public contributor utilising his lived experience in various health and care studies and working with NHS trusts, research organisations and charities. He is often consulted and asked to contribute to projects related to mental health, cancer and adult social care.

Find out more about the work of King’s Improvement Science.

Find out more about the event: ‘The value of partnering with the public to improve health services’.

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What does it take to deliver an economically viable virtual ward?

Published on March 20, 2025 and last updated on March 20, 2025 by Sharon Farnley

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The Health Innovation Network South London and NHS England (London Region) have worked with London’s Integrated Care Boards (ICBs) to co-develop a health economic cost model for virtual wards.

In this blog NHS England Regional Director of Digital Transformation Luke Readman and HIN Executive Director of Digital and Transformation Amanda Begley introduce the tool and highlight its importance.

Our previous work on the business case for virtual wards and national surveys (Thorton, et. al. 2023) demonstrate that patients and clinical staff want care to be provided in people’s homes. These sentiments are echoed by the national drive to go further and faster on improving out-of-hospital access to urgent care services, highlighted in both the Department of Health and Social Care’s Road to recovery mandate and NHS England’s 2025/26 priorities and operational planning guidance.

Virtual wards are designed to do just this, preventing avoidable admissions and safely reducing inpatient lengths of stay. However, are virtual wards a wise investment of taxpayers’ money?

Emerging research shows a range of economic benefits, including reducing hospital admissions, length of stay, and transportation costs. Potential efficiency gains from using remote monitoring and telemedicine also appear encouraging.

This is all very promising, but two key questions remain for decision makers considering whether the theoretical business case stacks up against their real-world budget pressures:

• Is the virtual ward that I am commissioning or delivering economically viable, given local or service-specific considerations?

• What variables would make it more or less economically viable?

This is why we’ve worked with London ICBs and virtual wards colleagues to co-develop an economic cost model for virtual wards.

Feedback so far on the tool is that:

• The model and outputs are easy to use and interpret;

• The tool can be used for retrospective evaluation and prospective planning across various virtual ward pathways;

• Results can be used to understand the cost implications of clinical and operational decisions around the deployment of virtual wards.

When we ran real-world data through the model, we also identified opportunities for cost savings within services by:

• Identifying efficiencies such as reducing the time taken to identify, refer and onboard patients, reducing the number of home visits and reviewing the grade of staff needed for different tasks;

• Improving outcomes such as reducing length of stay and readmission rates.

As is often the case with economic models, there are some limitations – which are detailed in the report – and there is more work we’d like to do, particularly the inclusion of acuity data.

But for now, we hope this practical model will help you determine whether (or how) your virtual ward can become a sustainable and cost saving staple for patients in need of urgent and emergency care services.

Find out more about our work on virtual wards

The Health Innovation Network have extensive experience planning, delivering and evaluating a wide range of digital transformation projects.

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What’s changing in the UK regulatory landscape for AI and health technologies?

Published on March 12, 2025 and last updated on March 18, 2025 by Sharon Farnley

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The UK Medical Device Regulations landscape is going through a period of regulatory reform. To keep us informed of changes, Hardian Health, one of our delivery partners on the Mindset-XR Innovation Support Programme, discuss developments expected in the near future.

Launch of new Regulatory Innovation Office

In October 2024, the UK government announced the launch of the new Regulatory Innovation Office (RIO).

The office was set up to try to speed up access to new technologies by looking for ways to reduce the time taken for regulatory compliance processes. A key focus is innovative medical technologies and artificial intelligence (AI) in healthcare.

As the current UK Medical Device Regulations (UK MDR) were originally created in the 1990s, one area this new office aims to support is in updating these regulations and improving the efficiency and speed of approvals.

Many recent advances in healthcare innovation, including XR and VR tools for mental health, are not well described by current regulatory frameworks. This can pose challenges for innovators and manufacturers of such technologies when attempting to understand and apply the appropriate regulations.

The creation of this office appears to align well with the current government’s pro-innovation approach to AI regulation and ambitions to make the UK a hub for the development of innovative technologies, as described in the AI Opportunities Action Plan.

Notably, the RIO is not limited to healthcare. The mission of the RIO is to support four key innovative sectors including the UK space industry, autonomous technologies and vehicles like delivery drones, biotechnology and most relevantly to the Mindset-XR Programme, the use of AI and digital technologies in healthcare.

In the healthcare sector, the office aims to support the NHS and UK healthcare to utilise AI and digital technologies to improve efficiency and patient outcomes. A chair of the RIO will soon be appointed to lead and progress these aims.

Proposed changes to regulations

While the set-up of the RIO is underway, updates to the regulatory landscape for medical devices in the UK have been progressing.

In fact, proposed changes to the UK MDR 2002 have already been announced by the Medicines and Healthcare products Regulatory Agency (MHRA), the UK’s medicines and medical devices regulatory authority.

Most recently, amendments were made to incorporate new, strengthened and risk-proportionate post-market surveillance requirements for medical devices on the UK market.

These updates will come into force on the 16 June 2025 and include introduction of a mandatory requirement for a post-market surveillance plan, as well as improved data collection and more stringent timelines for incident and summary reporting (among other requirements).

Over the winter, the MHRA also held a public consultation on the proposed changes to regulatory frameworks for medical devices on the Great Britain market, including increasing the classification of certain Software as a Medical Device (SaMD) and routes for international recognition.

The results of this consultation will be used to inform planned regulatory framework updates.

The UK Medical Device Regulations landscape is going through a period of regulatory reform, with increasing pressure to keep up with the rapid pace of technological innovation, particularly in the healthcare sector.

On 3 February 2025, the MHRA published pivotal new guidance on the regulation and evaluation of Digital Mental Health Technologies (DMHTs).

This guidance is the culmination of a unique collaborative project between the MRHA, NICE and the Wellcome Trust and provides the DMHT sector with a clarity on the interpretation of the regulations for mental health tech.

The guidance document and extensive examples are a must-read for innovators aiming to access the UK market.

Ultimately, the purpose of medical device regulations is to protect patients and the public while facilitating UK market access to innovative and responsibly-developed technologies.

Moving forward

Any manufacturers or developers working in the healthcare space, such as those involved in the Mindset XR programme, should keep abreast of developments in the space as there are more changes on the horizon.

As part of the innovation support offering, we at Hardian Health have worked with the HIN South London team to develop 10 bespoke Introduction to Regulation educational modules for the Mindset-XR programme cohorts.

Programme participants are also encouraged to engage in the one-to-one consulting hours being offered by our team to support any project-specific regulatory questions.

To find out more, email hin.mindset@nhs.net

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Mental Health in Northern Ireland: Pathways to innovation and effective collaboration

Published on February 10, 2025 and last updated on August 12, 2025 by Sharon Farnley

In this blog written by Andrea Cartmill from the Health Innovation Research Alliance Northern Ireland (HIRANI), she examines the robust strategies being implemented to address mental health challenges in the region, and underlines the importance of addressing socio-economic inequalities, empowering communities, and embracing innovation.

HIRANI are one of the partners working with the Health Innovation Network South London to deliver Innovate UK's Mindset-XR Innovation Support Programme.

Mental health is an important part of overall well-being. It enables people to cope with life stresses and to contribute to their communities. Promoting good mental health for all is one of the main challenges faced by society. We know that many different factors can affect mental health. These include the continued impact of the COVID-19 pandemic, as well as the influence of health and socio-economic inequalities.

Common mental health conditions, including anxiety and depression, can be associated with significant distress and impaired function. Although many mental health conditions can be managed with relatively low costs, there are often gaps in care delivery. Economic impacts are also significant, with productivity losses far outstripping the direct costs of care.

In Northern Ireland, the impact of mental health conditions is substantial. In adults, 1 in 5 live with a probable mental condition. This number is 1 in 8 among children. Northern Ireland reports the highest prevalence of mental ill-health across the United Kingdom, underlining the urgent need for action.

Steps being taken to address these issues

In recent years, Northern Ireland has begun implementing robust strategies to address mental health challenges. In May 2020, the Department of Health launched a Mental Health Action Plan, followed by a comprehensive Mental Health Strategy in June 2021. This strategy focuses on prevention, early intervention, and care for those experiencing poor mental health. Its priorities include:

Promoting mental well-being and resilience.
Ensuring timely access to the right support.
Exploring innovative approaches to treatment and care.

The appointment of Professor Siobhan O’Neill as Northern Ireland’s Mental Health Champion in 2021 brought renewed focus. Serving as a prominent advocate, this role champions evidence-based services and interventions.

These initiatives signal a commitment to fostering a healthier, more resilient society, but challenges remain, particularly for marginalised communities.

Tackling social exclusion and inequalities

The Mental Health in Northern Ireland Fundamental Facts 2023 report underscores the harsh reality of socio-economic disparities. Residents in the most deprived areas are far more likely to suffer from mental illness than those in affluent communities. Child poverty is a significant factor, with 1 in 4 children living in poverty. Stable housing also plays a critical role, as evidenced by the stark statistic that nearly 70% of people experiencing homelessness have a diagnosed mental health condition.

One initiative is the (CHOICE) Project (Challenging Health Outcomes/Integrating Care Environments). This innovative network collaborates with individuals, organisations, and communities to combat social exclusion and address the physical health disparities faced by those with severe mental health conditions. By addressing social and psychological factors, the CHOICE Project places the lived experiences of individuals at the centre of the conversation. The project is focused on community-based participatory research to co-create solutions, as well as a whole-systems approach to engage public, private, and voluntary stakeholders.

The work of mental health charities

Northern Ireland’s mental health charities play a pivotal role.

MindWise supports individuals, families, carers, and workplaces through its services across Northern Ireland. In addition to helping those directly affected by mental health challenges, MindWise offers mental health training for employers, empowering workplaces to foster well-being and empathy.
Inspire operates across Northern Ireland and the Republic of Ireland, promoting "well-being for all". They aim to eliminate stigma and discrimination while celebrating the unique abilities of individuals. Campaigns like ‘Time to Talk Day’ encourage open conversations, reducing stigma and building stronger communities.
Action Mental Health provides a range of services, including its New Horizons program, which equips people with vocational skills, personal development opportunities, and employability training. Their ‘I AM SOMEONE’ campaign, launched in October 2024, highlights individual stories, and underscoring the importance of access to mental health services.
AWARE offers support groups across urban and rural areas. Their work involves support groups for those living with depression and bipolar disorder, as well as carers for people with illness, engaging with communities, schools, colleges, universities and workplaces. Programs, such as Mood Matters, Living Life to the Full, and Mental Health First Aid, educate communities and equip individuals with practical tools for resilience.

Innovations in mental health treatments

Northern Ireland is also leveraging cutting-edge technologies to transform mental health care. The Health Innovation Research Alliance Northern Ireland (HIRANI) has partnered with UKRI Innovate UK and the Health Innovation Network South London to bring the £20 million Mindset programme to the region. This initiative fosters collaboration between mental health providers and the immersive technology sector. Two Northern Ireland-based companies have already received funding as part of the programme.

Propeer Solutions Ltd has developed a VR platform to enhance treatment of post-traumatic stress disorder (PTSD) by immersing patients in realistic, immersive environments, providing access to support which could reduce therapy times.
MindTrack 360 is an immersive, virtual reality-based approach to addiction recovery that integrates evidence-based psychological methods including Cognitive Behavioural Therapy (CBT), Motivational Interviewing (MI), and strengths-based practices.

Looking forward

While there is no quick fix, a combination of sustained collaboration, strategic policy, co-design, good community engagement, and implementation of effective technological solutions offers hope. By addressing socio-economic inequalities, empowering communities, and embracing innovation, Northern Ireland can chart a path toward a place where mental health is prioritised, and every person has access to the care and support they need.

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Mindset-XR Innovation Support Programme company spotlight: SyncVR Medical

Published on November 12, 2024 and last updated on November 12, 2024 by Sharon Farnley

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Our Mindset-XR Innovation Support Programme spotlight for November is on SyncVR Medical.

Floris van der Breggen, SyncVR Medical’s founder and CEO, tells us a bit about the company and their Virtual Reality programme, Project Zenith. The Health Innovation Network South London is supporting SyncVR Medical as part of our delivery of the Mindset-XR Innovation Support Programme for Innovate UK.

Please give us some background on SyncVR Medical

SyncVR Medical was founded in 2019 to reimagine healthcare with XR technology, and we’re now the largest Extended Reality (XR) healthcare platform in Europe. We’re like often described as the Netflix for XR in healthcare, selecting the best XR tech from around the world and making them available under one platform. Similar to Netflix, we develop our own content and also select/curate tech from around the world, so that a healthcare organisation has the best selection available to them. Our team is a mix of healthcare experts, engineers, and creatives, all dedicated to solving real problems with innovative, patient-focused tools. We’ve built partnerships with over 250 hospitals across Europe and the UK, implementing our applications from A to Z.

Can you tell us about Project Zenith?

Project Zenith is something we’re incredibly proud of. It’s a Virtual Reality (VR) program designed for young people with Autism Spectrum Disorder (ASD) who experience anxiety – an underserved group when it comes to accessible therapy. Zenith provides a safe, immersive space where users can build coping skills through VR-based Cognitive Behavioural Therapy (CBT) techniques. We’re developing Zenith alongside Hertfordshire Partnership NHS Foundation Trust, with the goal of not just supporting patients, but also relieving pressure on NHS services by reducing waiting times. For us, this isn’t just a project; it’s a pathway to make mental health care more proactive and approachable.

How do your innovations tackle inequalities in mental health?

Access and affordability are the biggest challenges in mental health, especially for marginalised groups. With our XR solutions, we’re bridging that gap by bringing therapy to people wherever they are, on their terms. Project Zenith is just one example: ASD patients who may not respond to traditional therapy environments can access therapeutic tools through VR, opening doors that were previously closed to them. We’re focused on making mental health care more inclusive, empowering people from all walks of life to get the support they need.

What is the biggest challenge you have faced so far in developing your innovation?

Healthcare is a highly regulated field – and that’s partly a good thing. However, it also means extra layers to navigate, from ethics approvals to clinical trial protocols. With Project Zenith, we’ve had to plan carefully around these requirements and delay formal patient inclusions. It’s challenging but eventually worth it.

Why should the NHS be excited about your innovation?

The NHS should be excited because SyncVR aligns directly with NHS priorities: faster access to care, innovative treatment options, and reduced cost pressures. Project Zenith is a perfect fit, as it offers the NHS a scalable, evidence-backed tool for ASD patients dealing with anxiety. It’s a chance to transform patient pathways with a solution that doesn’t rely on medication and offers personalisation at scale. Collaborating with us means unlocking new ways to support patients and elevate the standard of mental health care.

What three pieces of advice would you give budding innovators?

Go deep on the problem: Real impact comes from understanding the problem you’re solving from all angles – especially through the lens of those directly affected. Collaborations with clinicians is absolutely essential here.

Think beyond today: Whatever you’re building, make sure it’s designed to grow. The healthcare landscape changes fast, so adaptability is key.

Stay resilient and keep learning: Innovation is a rollercoaster. Learn from each challenge, and don’t let setbacks derail your commitment to solving the problem

What are your hopes and ambitions for the future?

Simply put, we want XR to become a trusted, mainstream part of healthcare. We’re building on Zenith’s success to create a full XR treatment that is ready for international rollout. We hope to make this happen using innovation grants to bring the tech to the next level!

Want to find out more about our Mindset-XR Innovation Support Programme?

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Mindset-XR Innovation Support Programme company spotlight: Play Well For Life

Published on October 14, 2024 and last updated on October 15, 2024 by Sharon Farnley

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Our Mindset-XR Innovation Support Programme spotlight for October is on Play Well For Life, established by Dr. Sarah Campbell in 2019.

Background

Having experienced my own mental health struggles as a young person, I saw that treatment often involved very long waits and traditional psychological therapeutic approaches that didn’t work for everyone, and I wanted to do something to address this.

While studying for a PhD in Psychology, I worked as Head of Wellbeing at a small university and started to think about technology solutions as being the way forward rather than the traditional hard to scale models of psychological intervention.

I co-founded an award-winning wellbeing app called 87%, and learnt a huge amount about developing digital products for psychological intervention. I also saw that apps struggled with the long-term engagement needed to bring about behavioural change. I was using game-based approaches in workshops, and that is where I started to explore digital game-based learning. I did a post-doc at University of Southampton, developing a digital game for children with chronic health conditions to learn transition skills, and started to understand these approaches.

During my PhD I used music to study emotions, and developed a music-based listening intervention and evidenced it compared to mindfulness. As a result of this, I won funding to turn it into a digital prototype, and this was the start of Play Well For Life.

Play Well For Life was established to use game-based learning to deliver psychological intervention to young people. Our unique selling point is that all our games are social, meaning young people inherently develop communication skills, social connections and a sense of belonging, which we know is vital, particularly for teenagers, to develop a sense of wellbeing. We have developed and commercialised several games, employing game development teams from the games industry to ensure the games look and feel great, and co-producing with adolescents, clinical psychologists and educators to ensure the necessary skills are developed and have a strong evidence-base. We then work with academics to evidence that are games are doing what they were designed to do.

How does your innovation tackle inequalities?

Dragons of Afterlands is an award-winning, evidence-based augmented reality board game that can be played in-person, remotely or hybrid. Free-at-the-point of access, we are targeting Dragons of Afterlands specifically at those who experience higher challenges with their mental health. Young people with chronic health conditions are 60% more likely to experience a mental health issue by the age of 15 than other teenagers. Adolescents with complex medical conditions are often uprooted from their environments and isolated in hospital when undergoing treatment. Such hospital stays reduce a young person’s autonomy, activity levels and disrupt peer relationships, leading to anxiety, depression and social withdrawal.

Our tool has been identified as an innovative way to support young people transitioning into hospital, building relationships with staff and peers during their stay and supporting continuity of care when they leave hospital. It is also being used by staff during hospital stays to help have tricky conversations and develop essential skills to support resilience, socio-emotional and advocacy skills.

A second group we are targeting are those receiving education from hospital education services. Whilst some are young people with chronic health conditions, hospital education services increasingly support young people who experience Emotionally-Based School Avoidance (EBSA). These young people are currently offered minimal 1:1 tutoring (two hours per week in some areas). This is resource intensive and doesn’t allow for the benefits that come from learning with peers. Our tool has been identified as an innovative way to extend resources by enabling 1:3 delivery, and to build peer support opportunities, ultimately leading to faster re-integration to in-person and group learning.

What is the biggest challenge you have faced so far in developing your innovation?

As with all projects, finding continuous funding, and enough funding is always a challenge. That’s why the Innovate UK Mindset-XR programme, and the support that comes with it from the Health Innovation Network South London, are so valuable. Aside from that, one of the big challenges we are facing at the moment is ensuring our product meets NHS infection control standards, and is inclusive and accessible to be used by young people with quite severe physical needs.

Augmented reality tracking (similar to scanning a QR code) can be affected by lighting, reflective surfaces etc. so finding a board material that works, and also can be repeatedly wiped clean with bleach has been an interesting and unexpected part of the research and development!

In terms of accessibility and inclusion, to play the game and interact with the augmented reality gameplay, players need to move their phone or tablet around to reach the different parts of the board, and some of the scenarios and content have needed to be redeveloped to be sensitive and appropriate to these audiences. We overcome challenges like these by co-producing with specific groups of young people and staff members to ensure as many barriers are removed as possible.

What are your hopes and ambitions for the future?

Through this project, we are really coming to understand the gaps that exist for young people with chronic health conditions and for those struggling with mainstream education. Our hope is to move from piloting within the NHS to securing contracts to facilitate the adoption of Dragons of Afterlands, and then develop some of our other prototypes into fully-fledged game-based tools for healthcare staff to use with adolescents in healthcare settings.

We are also in the planning stages of developing a strong community of practice focused on adolescents, for those supporting young people in healthcare, such as Health Play Specialists, Clinical Psychologists, Occupational Therapists, and Head Teachers within alternative provisions.

What advice do you have for other innovators?

If you are planning on selling to the NHS, plan and budget for medical device registration, co-produce your innovations with staff and users from the outset, and make the problem drive the innovation, rather than the other way round.

Finally, understand the care pathway your innovation fits into and what outcomes you need to demonstrate to convince commissioners your innovation is worth a try. And enjoy the journey!

Want to know more about the Mindset-XR Innovator Support Programme?

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Why is Lived Experience involvement and engagement so important?

Published on September 16, 2024 and last updated on September 18, 2024 by Sharon Farnley

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MQ Mental Health research is an award-winning charity which funds much-needed scientific research to transform the lives of everyone affected by mental illness, working to create a world where mental illness is understood, effectively treated and ultimately prevented. MQ Mental Health Research are partnering with the Health Innovation Network South London to provide learning and advice around the role of lived experience for the Mindset-XR Innovation Support programme. Through fostering collaboration between the immersive technology sector and mental health providers, Mindset-XR aims to accelerate treatment by leveraging immersive digital therapies to offer faster and more accessible support for individuals with mental health concerns.

Championing the voices of people with lived and living experience of mental illnesses in research is at the core of MQ Mental Health’s work, and they have set up a Lived Experience Expert Network made up of over 100 people from 25 countries around the world who collaborate on our research programmes and projects. In this blog, Mariana Bolivar, Research Programme Lead at MQ Mental Health, discusses why lived experience involvement is crucial for innovators to consider.

People with lived experience of mental illness, either because they themselves have experienced it or they are caring for someone who does, have a wealth of valuable knowledge to share. We know that lived experience involvement and engagement are crucial for successful and impactful research and product development in mental health tech research.

Within the context of healthcare, we define lived experience as personal knowledge gained directly and first-hand, rather than through representations constructed by other people.

Clinicians, researchers and innovators may not have first-hand experience of living with the mental health condition they are trying to find solutions for, which makes active participation from people who can provide personal insights on how the condition made them feel and what it’s like to live with on a daily basis all the more important.

Many research projects fall into the so-called ‘valley of death’ in research where, following what can be as long as a 17-year period of going through the process from discovery to basic research to applied research, product development and ultimately production, they fail to have real-life application.

Actively engaging Lived Experience Partners from the outset, seeking their feedback and using their insights to help inform the design and delivery of a research project, leads to more active co-production where responsibility and power are shared at all stages, leading ultimately to healthcare solutions that better suit their needs.

However, we know there are barriers to be aware of when engaging with Lived Experience Partners, which include digital inequalities, communication challenges and accusations of tokenism.

These can all be avoided by taking the time to understand the needs of lived experience partners, making sure there are alternatives to digital strategies where necessary, limiting the use of jargon and hard-to-understand terminology and ensuring that Lived Experience Partners are included in every stage of the decision-making process, so their contribution is valued and actual.

It is also important to make sure you involve a range of voices where possible, with a diversity of experience and backgrounds.

There are UK Standards for Public Involvement which are a useful starting point, providing guidance around inclusivity, working together in a respectful way that values all contributions and offering support and learning opportunities.

The Association of Medical Research Charities (AMRC) is another helpful resource offering information on how to fairly compensate those with lived experience who take part in your projects.

We know from our own experience that working in partnership with those with lived experience and making projects more user-led brings better results, ensuring tech products lead to tangible improvements in people’s lives.

MQ Mental Health Research are one of our partners on the Mindset-XR Innovation Support programme.

Please visit our dedicated pages to find out more about the programme and sign up to our monthly newsletter.

The power of community for the Mindset-XR Innovation Support Programme

Published on August 27, 2024 and last updated on August 27, 2024 by Sharon Farnley

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The Mindset-XR Innovation Support Programme recently went out on the road, holding a series of sold out events around the country. Here, Sarah Ticho, Co-Founder of XR-Health Alliance, who chaired the event in Cardiff along with her colleague Ross O’Brien, reflects on the importance of bringing people together.

This June and July, the Mindset team travelled across the UK, connecting with innovators and creators in the XR (Extended Reality) mental health space in a series of road show events organised by the Health Innovation Network South London as part of their delivery of UKRI’s Mindset-XR Innovation Support Programme. From Belfast to Cardiff, London to Exeter, we experienced the incredible diversity of thought, passion and innovation driving our industry forward.

Ross O’Brien and I had the privilege of representing the XR Health Alliance, chairing the event in Cardiff and facilitating one of the sessions in London. Across these events, we were deeply moved by the range of voices and perspectives present. These gatherings were more than networking opportunities, they were evidence of a seismic shift in the industry. XR is no longer just a novel concept showcased at conferences; it’s gaining serious investment from a range of stakeholders committed to its development and implementation in improving mental health.

For years, XR was seen as a niche within the NHS, with projects often starting in academic labs but rarely finding a path to wider adoption, or creatives making impactful ideas but struggling to find the right partners or investors to help scale. Reservations by investors due to the lack of adoption and pathways to distribution, combined with unclear regulation and compliance has been a significant barrier. The Mindset tour is evidence that our industry is changing. From islands and pockets of innovations left isolated, we are witnessing a new wave of XR for mental health, where lived-experience experts, commissioners, regulators, award-winning artists, theatre makers, students, and seasoned mental health professionals are coming together to create transformative products and pathways that reach people who can truly benefit from these innovations.

This superfusion of industries, skills and perspectives is unlocking a reimagining and reinventing the field, with incredible innovations being developed, researched and deployed. However, we still have a long journey ahead of us before XR and mental health reaches the mainstream. We are inching closer and closer as we are finally having meaningful conversations and taking action to tackle the challenges of regulation, distribution, financing, raising public and clinical awareness and supporting long term collaboration. These gatherings demonstrate the sheer passion and willingness to carve news pathways into spaces where people can best implement XR for mental health – from social prescribing in libraries or delivering at home to homebound patients, to bringing XR into schools for student wellbeing, collaborating with Mental Health charities or delivering within a hospital context.

The investment in the Mindset-XR programme demonstrates the willingness of UKRI and Innovate UK to create a foundation for us to build upon, enabling vital R&D and developing channels to obtain future investment by bringing on board investors. Increasingly, we are beginning to create confidence by stakeholders, as we develop more evidence and work to create a clearer path to compliance and regulation for safe deployment of XR. Working with a range of partners is essential in unlocking that next step, as well as working together to inform how policies and regulations will evolve for XR in the future.

These events organised by the Health Innovation Network South London provided a chance to explore our future direction and identify what needs to be done, not just by individual companies or groups, but by us all as a community of experts. As the proverb goes, “If you want to go fast, go alone; if you want to go far, go together.” These gatherings are essential for gauging the industry’s progress and offer opportunities to share knowledge, insights, and to form new partnerships and communities of practice.

I am both curious and excited to see how our industry will evolve as we build momentum. It truly takes a collective effort to drive this progress. I invite you to continue joining us on this journey, bringing your spirit, enthusiasm, and commitment to true transdisciplinary collaborations where technology, healthcare, and storytelling come together to enhance lives across the country.

Many thanks to Sarah for sharing her reflections on the recent Mindset-XR Innovation Support road show events.

The Health Innovation Network South London is grateful to all our delivery partners on the Mindset-XR Innovation Support programme: XRHA, Health Innovation South West, Health Innovation North West Coast, Health Innovation North East and North Cumbria, Hardian Health, MQ Mental Health Research, The Health Innovation Research Alliance Northern Ireland and King’s College London.

Mindset-XR programme receives new funding boost

Published on August 23, 2024 and last updated on August 28, 2024 by Sharon Farnley

Innovate UK have today announced funding worth £3.2m for 24 projects as part of their Mindset-XR programme.

The Health Innovation Network South London will be supporting these projects as part of our delivery of the Mindset-XR Innovation Support Programme for Innovate UK.

Over the past few months we have seen increasing interest in the potential of immersive digital health therapeutics; hundreds of academics, clinicians and innovators attended our sold-out roadshows across the UK and more than 4,000 people are regularly receiving the latest XR in mental health news through our newsletter.

We have been working with projects that have already received funding as part of the Mindset-XR programme, delivering advice and expert tailored support, providing opportunities for them to meet potential collaborators and hosting subject-specific webinars and round tables.

We look forward to continuing this work and will be sharing more information over the coming months about the innovators and how their projects aim to help millions across the UK with their mental health.

“I am so excited to learn more about the newly announced projects that we will have the privilege of working with through our Mindset-XR Innovation Support Programme. So many of us are impacted by poor mental health, either directly ourselves or through our loved ones. These novel technologies offer new hope to service users and staff within the health, care and education sectors.”Dr Amanda Begley, Director of Digital Transformation and Technology, Health Innovation Network South London

You can find out more about the Mindset-XR Innovation Support Programme on our dedicated web page, including links to a range of articles and all the previous editions of our newsletter.

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Immersive technology for mental health: understanding the evidence-generation landscape

Published on June 11, 2024 and last updated on June 13, 2024 by Sharon Farnley

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Building a reliable evidence base is an important consideration for any innovator in the healthcare space. In this blog, HIN Head of Insights Dr Andrew Walker provides a high-level introduction to evaluation and evidence-generation in the context of the Innovate UK Mindset-XR Innovation Support Programme.

One of the most exciting things about the Mindset-XR programme is how we are bringing together experts from so many different fields to make a difference to mental health; This includes supporting innovators with backgrounds in technology, the creative arts, education, media and gaming.

While this diversity of thought and perspective is a strength when it comes to finding creative solutions, it also poses some challenges for people less familiar with healthcare as a sector. One of the biggest challenges – and something which we’ve already heard investors flag – is around innovators understanding the importance of robust and compelling evidence for the safety and effectiveness of their XR-based intervention.

Without the right types of high-quality evidence, scale and spread of any commercial innovation is nigh-on impossible. This is especially true in the current economic environment. Commissioners, payers and patients need to be highly confident they understand how a technology will perform before they even consider paying for it.

As a result, the team that I head up at the HIN – covering evaluation, informatics and health economics – is extremely busy. We’re also involved in delivering DigitalHealth.London’s Evidence Generator Bootcamp, which has seen an explosion in interest recently.

Evaluation and evidence generation is a complex field, and the HIN south London Mindset XR Innovator Support Programme will be providing bespoke support for innovators taking part, along with in-depth online learning resources. The purpose of this blog is to provide a very brief overview of what the evidence generation landscape looks like in the UK, and start innovators down the right path when it comes to collecting the evidence they need for their work to succeed.

What do we mean by evidence and evaluation?

Although specialists working in the field have strict definitions for what these terms mean, you might hear them used interchangeably. Broadly speaking, it can be helpful to think of them as the below:

Evaluation: judging the worth or value of something, often in comparison to other available options. For example, you might seek to evaluate whether your innovation delivers better clinical outcomes than the current treatment approach.
Evidence: the sources of information that you might use to make a decision about something. This could include evaluations, feedback from patients or users, analytics or analyses of population health.

Within health and care innovation, it is generally considered best practice to integrate evaluation and evidence-related activities into every stage of your projects. Your stakeholders will want to see that you have used evidence to understand a particular disease area to specialise your solution for; there will be an expectation that you have methods for measuring how your innovation works with users (such as analytics within your XR software); to drive widespread adoption will eventually need to have compelling evidence that your innovation provides advantages over what is out there already.

As you start to look at what evidence and evaluation might mean for your innovation, the complexity and costs associated might begin to look quite daunting quite quickly – especially for more complex formal evaluations with patients such as clinical trials.

Luckily, in recent years, the path for developing good-quality evidence for digital health interventions has become much clearer.

The role of NICE and the MHRA

There are two key organisations who immersive technology innovators need to be aware of when it comes to defining national standards for evidence:

The National Institute for Health and Care Excellence (NICE)
The Medicines and Healthcare Regulatory Agency (MHRA)

Probably the best starting point for most digital innovators is to look at NICE’s Evidence Standards Framework (ESF). The ESF is intended to be a shared framework which allows innovators and commissioners to understand the most important types of evidence for different digital health technologies (DHTs).

Using the ESF, DHTs are grouped into three tiers based on the intended use of the innovation. While the range of applications for XR in mental health is almost limitless, we anticipate most innovations we come across during the Mindset programme will fit into Tier C (DHTs for treating or diagnosing medical conditions) or Tier B (DHTs which help people to manage their own health and wellness).

After the correct tier has been identified, the ESF lays out 21 standards for consideration, ranging from clinical effectiveness to environmental sustainability.

Because the ESF is a framework rather than a formal assessment, it does not prescribe exact evidence requirements for each of these standards. Instead, it provides a comprehensive overview of all the different evidence areas which are likely to need to be considered. Within these, companies can develop their evidence base over time as their innovation scales.

The MHRA’s role is different – they regulate (by law) all medical devices in Great Britain and Northern Ireland.

Defining what is and is not a medical device in the world of DHTs is not always straightforward; the MHRA have produced guidance on digital apps which may help to establish whether your technology falls under their remit. You can also contact them for additional guidance.

If your immersive technology is classed as a medical device, you will need to meet strict standards around safety and efficacy, including carrying out a clinical investigation. Meeting these standards is a significant undertaking and you should begin planning to meet MHRA certification criteria as early as possible in the development of your product.

Stay informed

Although evaluation can seem like a highly complex area of innovation to navigate, there is support available.

The Mindset-XR Innovator Support Programme provides specialist support – including advice on evaluation – to companies on our programmes. The team will also be producing publicly available learning materials about regulation and evidence generation for immersive technologies in the coming months; please do sign up to our newsletter if you want to be the first to get access to them.

Elsewhere, regional health innovation networks also provide support for innovators and can give you impartial advice on evaluation, as well as helping with connections to evaluation specialists.

Another useful resource for getting practical information on how to approach evaluation/evidence generation is a collection of resources on evaluating digital health products produced by the Office for Health Improvement and Disparities.

In memory: Paul Wallace

Published on March 8, 2024 and last updated on March 11, 2024 by Sharon Farnley

It is with great sadness that we mark the passing of Professor Paul Wallace, Health Innovation Network (HIN) South London’s Clinical Director for Digital. Paul passed away on 28 February 2024, following a long period of illness due to prostate cancer.

Paul was internationally recognised for his contributions to health and care at the intersection of clinical practice, academia and implementation science. He leaves behind a legacy of pioneering research into alcohol interventions and digital technologies in primary care, as well as driving forward the standard of evidence for digital health technologies more generally.

Paul originally began working with the HIN as Clinical Director for our alcohol programme. Much of Paul’s research portfolio was centred on the detection and management of alcohol misuse, generating more than 100 papers and book chapters on this topic. His work made particular contributions towards the development, assessment, and distribution of digital applications to reduce alcohol-related harm, being part of the vanguard for the use of digital technologies in this space.

Paul’s most recent role in the HIN began in 2017, when he was appointed Clinical Director for Digital. In the following years he brought his vast knowledge and ambition to bear primarily on DigitalHealth.London’s programmes. Initially Paul helped to assess fledgling technologies and provide advice on their evidence base; over time this focus on evidence grew into a dedicated programme which we now know as the DigitalHealth.London Evidence Generator Bootcamp. Dozens of the UK’s most promising digital health companies have directly benefitted from Paul’s support in navigating the complex yet crucial journey of evidence generation as part of the programme; countless more will indirectly benefit in years to come. Paul has left an enduring mark on Health Innovation Network and DigitalHealth.London, and his influence will live on in our work.

Paul began his professional career in primary care, practicing as a GP in north London for 20 years. He showed an early interest in clinical academia, being awarded a Medical Research Council (MRC) epidemiology training fellowship shortly after completing his specialist medical training. He went on to hold posts at the MRC, Imperial and University College London (UCL). He formerly served as National Primary Care Director for the NIHR Clinical Care Research Networks, as well as contributing to various national working groups on alcohol and acting as a senior advisor to charities Alcohol Concern and Drinkaware.

Paul’s varied and significant contributions to clinical practice and academia were recognised by a number of prestigious awards and appointments over the course of his career. He was Emeritus Professor of Primary Health Care at UCL and a Fellow of the Royal College of General Practitioners (RCGP), which awarded him its President’s Medal in 2013. Paul was also a Fellow of the Faculty of Public Health Medicine at the Royal College of Physicians.

In 2012, he co-founded the Foundation for Family Medicine in Palestine. Through the Foundation, Paul has played a major role in developing primary care infrastructure and provision in an area in desperate need.

Paul’s tireless determination to improve the world around him was exemplified by his enthusiasm for work in the final months of his life, helping to shape the latest Evidence Generator Bootcamp alongside playing an integral role in a number of academic projects.

Paul is survived by his wife Sabrina and his children.

“Paul contributed to the HIN over many years, and his passion for evidence generation in innovation was evident through his dedication until the end. He helped design and optimise programmes of support for innovators, and build relationships with partners nationally and internationally that are central to the HIN’s work.”Anna King, Commercial Director, Health Innovation Network South London

Developers of immersive technology for mental health to benefit from £20m investment and Innovator Support Programme

Published on February 6, 2024 and last updated on October 7, 2024 by Sharon Farnley

A new supportive ecosystem for UK innovators working on immersive digital mental health therapeutics is being launched.

The UKRI Mindset XR Innovator Support Programme is going to be led by the Health Innovation Network (HIN) South London it was announced today.

The full Mindset extended reality (XR) for digital mental health programme 2022- 2026 is a £20m investment which aims to treat more people with mental health needs by investing in Extended Reality (XR) and other immersive technologies; achieving transformation through the development and scale-up of emerging digital mental health therapies.

Through collaboration with experts across the UK, the HIN will deliver a programme of innovator support including:

Creating a networking and information sharing platform for potential collaborators.
Providing advice and expert support to existing and future competition applicants.
Delivering a programme of outreach and engagement activities to cover the whole of the UK, including the devolved administrations.
Facilitating knowledge sharing across a community of practice.
Providing tailored support for larger scale industrial research projects and smaller feasibility projects.
Delivering a learning package on a range of key topics.
Driving the conditions for change through industry-wide and health system-wide roundtables.

The collaboration brings together UK wide reach and a set of complementary skills – service user engagement, clinical research design, regulation and digital therapeutics – critical to address the challenge of bringing immersive tech to our population and staff. As part of the Health Innovation Network, we will collaborate with networks across the country, including Health Innovation North West Coast, Health Innovation South West and Health Innovation North East and North Cumbria. As well as these we will also collaborate with:

Hardian Health
Hill Dickinson LLP
The Health Innovation Research Alliance Northern Ireland (HIRANI)
King’s College London
MQ Mental Health Research
XR Health Alliance

Dr Rishi Das-Gupta, CEO of the HIN said: “Immersive technology has the potential to dramatically improve the treatment of those with mental health conditions, which is an area we know has seen increased demand and widening health inequalities.

“Working with Innovate UK and our collaborators across the UK presents an exciting opportunity to make a wide-scale difference.”

Quotes from Partners’ Spokespeople

Hardian Health

“Hardian is excited to be working with innovators at the cutting edge of healthtech to ensure that their novel extended and virtual reality devices are as safe, effective and performant as can be when applied across a range of medical purposes. We look forward to stretching the boundaries of what is possible with the Mindset cohort.”

Health Innovation North East and North Cumbria

Dr Nicola Hutchinson, CEO of Health Innovation North East and North Cumbria, commented: “We are delighted to be a partner on this important project, which will help to mobilise groundbreaking immersive innovations to address the mental health challenges facing many people in our communities. Through the Mindset programme, we’re looking forward to working with innovators in the immersive technology space in our region to support the development of solutions that will hopefully result in people with mental health needs being treated more quickly through immersive digital mental health therapies.”

Health Innovation North West Coast

Dr Phil Jennings, Chief Executive of Health Innovation North West Coast, said: “We’re really excited to be involved in a project that promises to deliver tangible improvements in patient outcomes.

“The challenges are as acute in our region as anywhere in the country but there’s also an abundance of talent and creativity we can draw on. The Mindset programme will help us bring that creativity to bear on one of our most enduring challenges.”

Health Innovation South West

Jon Siddall, Chief Executive Officer of Health Innovation South West, said: “This is an exciting opportunity to build upon the existing novel technologies developed in, and deployed across, the South West to support those with mental health needs. We are working with our partners in the South West to maximise the impact of research and innovation in mental health care. Mindset’s innovative therapeutics offer promising digital solutions to the mental health challenges experienced by people living within our rural and coastal communities, and will enable us to drive a digitally-enabled health and care sector across our Peninsula.”

Hill Dickinson

“The Mindset XR Innovator Support Programme will be a brilliant vehicle for innovators to collaborate and develop new and immersive technologies for adoption into everyday healthcare settings. Extended Reality [XR] and similar technologies have the potential to transform our current approach to treating patients accessing mental health services here in the UK. For us as specialist healthtech lawyers it’s incredibly exciting to be a part of that.” Jamie Foster, Partner, Hill Dickinson

Hira-ni

“In Northern Ireland there is a distinctive mix of capabilities in digital technology and the creative industries, coupled with expertise in mental health research – so we are delighted to partner with Health Innovation Network South London to support the Innovate-UK Mindset XR programme network in this region to support innovators to unleash their potential to forge new collaborations to develop and test XR technology solutions for mental health” Joann Rhodes CEO of HIRANI.

Innovate UK

Dr Stella Peace, Executive Director for the Healthy Living and Agriculture Domain at Innovate UK, said: “Fostering collaboration between the immersive technology sector and mental health providers is pivotal to driving innovation to address critical challenges in mental health care. This programme, with its commitment to empowering innovators and providing robust support, will drive business growth by inspiring and unlocking innovations that make life better.”

King’s College London

Fiona Gaughran, Professor of Physical Health and Clinical Therapeutics in Psychiatry, King’s College London said: “We are very excited to be part of this innovative collaboration aiming to develop and scale-up new immersive digital mental health technologies. At King’s College London we have a wealth of clinical researchers who bring their patient experience right into the heart of their research to positively impact the lives of people with mental health needs and their families. We are looking forward to sharing our knowledge in this area and providing support and training across the partnership.”

MQ Mental Health Research

“MQ is excited to be a capacity development partner, alongside the Health Innovation Network, supporting innovators in the creation of digital therapeutic Extended Reality (XR) solutions in mental health. Specifically, and in line with what MQ stands for and strives to achieve, we look forward to helping these passionate individuals ensure people with lived experience and their needs are at the heart of their innovations and to help them along their pathway to impact.”

XRHA

“We desperately need to bring together science, storytelling and innovation to solve some of society’s greatest challenges. The XR Health Alliance are utterly elated be part of the Mindset program, which has the bold goals of doing exactly that. We are particularly excited to be supporting and bringing together a transdisciplinary community of patients, XR creatives, healthcare professionals and researchers to create powerful new solutions for mental health and wellbeing.”

Notes to Editors

Hardian Health

Hardian health is a clinical digital consultancy helping researchers, industry and investors bring digital solutions to healthcare.

Health Innovation North East and North Cumbria

Health Innovation North East and North Cumbria supports the health and care system to accelerate innovation which improves people’s health and the regional economy.

It works closely with the NENC ICS and its member organisations, including the NHS Trusts and universities, across the NENC to help them identify, evaluate, adopt and disseminate transformative innovation. It works a lot with industry too, as a source of innovation and also to help industry access the expertise within the NHS that is so crucial to the development, testing and deployment of products and services that are the basis of the UK’s Life Sciences sector.

Health Innovation North West Coast

Health Innovation North West Coast supports the discovery, development and deployment of innovations and improvements in health and care across Cheshire, Merseyside, Lancashire and South Cumbria.

The innovations it supports are ideas, services, products and processes which improve health and the quality of care and drive costs down.

Health Innovation South West

Health Innovation South West is one of 15 Health Innovation Networks set up by NHS England in 2013.

It exists to help transform the way health and care systems in the South West identify, adopt and spread innovation to transform lives, improve population health, and drive economic growth. Together with its local and national partners it is increasing the impact of research and innovation across the peninsula.

Hill Dickinson

An international commercial law firm that provides wise counsel and market insight, to not only help deal with the issue at hand, but to help seize opportunities and plan ahead.

Hira-NI

The Health Innovation Research Alliance Northern Ireland (HIRANI) was established to strengthen the Life & Health Sciences ecosystem by maintaining a clear vision and strategic direction, and to act as a single voice for the sector with a focus on promoting Life and Health sciences capabilities in Northern Ireland.

Innovate UK

Innovate UK is creating a better future by inspiring, involving and investing in businesses developing life-changing innovations.

We provide targeted sectors with expertise, facilities and funding to test, demonstrate and evolve their ideas, driving UK productivity and economic growth. Join our network and communities of innovators to realise the potential of your ideas and accelerate business growth.

King’s College London

King’s College London is an internationally renowned university delivering exceptional education and world-leading research. It is dedicated to driving positive and sustainable change in society and realising its vision of making the world a better place.

MQ Mental Health Research

Its vision is to create a world where mental illness is understood, effectively treated and ultimately prevented. With the help of its supporters and a global network of leading scientists, it is championing and funding research into mental health that will change millions of lives.

XHRA

The XR Health Alliance is dedicated to the responsible development, investment and adoption of immersive technologies in healthcare. Bridging the gap between industry, research and healthcare to unlock new cross-sector innovation and collaboration. XRHA aims to share best practice, support and connect inclusive and diverse communities of patients, creators, researchers and healthcare professionals.

Mental Health

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Reducing restrictive practice: it’s always the right time to make a difference

Published on November 28, 2023 and last updated on November 28, 2023 by Sharon Farnley

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Forensic mental health units (sometimes referred to as secure units) provide a vital service in caring for people with severe mental health conditions who may be a risk to the safety of themselves or others.

Reducing the use of restrictive practices (such as inappropriate physical restraint or rapid tranquilisation) in these units poses a unique set of challenges. In this blog, we hear from HIN Project Manager Ayobola Chike-Michael, Expert by Experience, Igoche Ikwue and Ward Manager Toheeb Bawala about how a recent visit to a forensic ward provided proof that impactful interventions can still be implemented successfully in the face of significant operational pressures.

This is the latest in a series of reflective blogs about the Health Innovation Network’s involvement in local efforts to reduce restrictive practice based on the findings of a successful pilot led by the National Collaborating Centre for Mental Health. Find links to all our blogs here.

Ayo

An integral part of our reducing restrictive practice programme is to visit participating mental health wards to build relationships and support systematic quality improvement. We have worked with ten wards across our region to enable shared learning, suggesting and supporting change ideas through codesign and coproduction with experts by experience and insights related to health inequalities.

One of the wards we have visited is Ruby Ward – a 10 bedded, female forensic ward. Although Ruby Ward was not the first mental health ward we have visited, visiting a forensic ward was a unique experience which offered valuable insights into the world of forensic mental health and challenges faced by both staff and service users.

As expected, there was a high level of security at the ward. This meant we passed through several checkpoints and adhered to strict rules before being allowed access to the unit. The ward itself was clean, well-maintained and staffed by a team of dedicated healthcare professionals led by Toheeb Bawala, the ward manager.

Delivering high-quality person-centred care on forensic wards is inherently more complex and potentially more challenging than other inpatient settings, and the Ruby Ward team also have to contend with limited physical space (although we were pleased to hear that the ward is moving to a more spacious location) and the current workforce pressures affecting mental health staffing levels. Although many mental health services are experiencing problems with recruitment and retention of staff, forensic units face particular challenges due to the high staff-to-service user ratio required to safely deliver this type of specialist care.

Despite these difficulties, we immediately noticed that the staff demonstrated a deep understanding of the unique needs and challenges faced by service users and they were committed to providing the best possible care and support.

We also discussed positive interventions that had worked to reduce restrictive practice in their environment. The ward manager Toheeb talked us through their collaborative daily planning exercises with service users; a simple but highly effective technique which they had found reduced conflict and created a calmer environment for everyone on the ward. Daily, staff engaged with all patients after their breakfast to co-plan their day. This helped staff with planning and gave service users a voice to express their own preferences.

Although the intervention itself was straightforward, coming to these arrangements needed flexibility on the part of staff to move away from previous protocols (such as more rigid weekly activity planning), working with service users to listen and adapt the approach taken to their care.

I was grateful to the staff for allowing us to visit at a time when pressures were so high, for showing us that a quality improvement philosophy can still make a difference to outcomes even when teams are exceptionally busy. It also served as a reminder to me of why support from the rest of the system for frontline teams is so important – sharing learnings and helping to catalyse service development.

Igoche

My reflections as an expert by experience remain fresh in my mind every day. I keep thinking about the best ways to improve mental health services in a more compassionate and humane way, while also ensuring safety.

My visit to Ruby Ward felt like diving into the unknown, and from the moment I began the series of security checks to enter, I knew it was different to anywhere we had visited as part of our project so far.

I believe that walking into such an environment and interacting with members of staff must be done in a person-centred way. My thought process focused on showing more compassion and kindness through communication to demonstrate that we are truly there to support, listen and learn.

One of the things that struck me was the physical space. We know that having the right physical environment is important for service user recovery and reduces the need for restrictive practice. Well-designed spaces can reduce stress and anxiety, promote social interaction and support a sense of normalcy and autonomy. They can also support the efforts of staff, for example designing clear sight lines throughout the unit so that service users can be monitored and situations can be identified early and de-escalated before restrictive practice becomes the only option.

Ruby Ward’s current setting included some recreational spaces and a gym, but it also had features that were less than optimal, such as a lack of natural light in some areas. The overall footprint of the unit is fairly small, meaning that personal space for service users could feel limited.

It was great to hear from Toheeb that the Ward will be moving to a more well-suited location. I am sure that this new space will make a real difference to service users and staff, and I think it is important to reflect on the commitment that it has taken to make this happen. Some interventions can be straightforward to implement – such as the daily planning exercises Ayo has discussed – but others may take months or even years of work to bring to fruition. It is important that we provide the practical support and knowledge required to help teams make changes of all sizes which can improve care.

My main takeaway from visiting the ward was that quality improvement support needs to be offered in a way which demonstrates kindness and compassion. Services such as forensic units care for extremely vulnerable people who are often very unwell. This is not easy work, especially when combined with external factors such as the shortage of mental health professionals across the NHS. We must recognise that the staff of these wards are striving to do the best they can in challenging circumstances, and that our efforts need to be led by love and humanity if we want to build relationships which will allow us to help them on their journey.

Toheeb

Ruby Ward is an extremely busy and complex environment to work in. We care for patients who can be very unwell and we operate with greater restrictions than many other services because we must maintain a secure environment.

As such, it is perhaps unsurprising that the staffing pressures affecting the whole mental health sector have had a particularly pronounced impact on forensic wards like ours.

Despite these challenges, I am proud of the quality of care we deliver and the spirit in which we deliver it.

The visit of Ayo and Igoche was a welcome chance to take a step back and gain additional perspective on how we might be able to continue to reduce the use of restrictive practices on our ward. We discussed interventions that had worked in our setting (such as the daily planning exercises) and we also talked about other ideas from the Mental Health Safety Improvement Programme, such as safety crosses.

Since the visit, our work on reducing restrictive practice has continued on a positive trajectory; there were no uses of restrictive practice in March and April 2023. We have also made positive progress on recruitment, and in the longer term we have a move to a new ward to look forward to.

Regardless of the setting or service, quality improvement does not happen in theory or in textbooks. It is about making a real difference to real patients. Sometimes that means we must strive to make things better in challenging situations or with limited resources. I hope that our own progress on Ruby Ward helps to remind staff in similar scenarios that with dedication and access to the support, positive progress is always possible.

Find out more

Please get in touch if you would like to learn more about our work in quality improvement, mental health or patient safety.

Transforming Mental Health Care: A Journey to Reduce Restrictive Practices

Published on October 16, 2023 and last updated on October 17, 2023 by Sharon Farnley

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

The inappropriate or overuse of restrictive practice in mental health services has been identified as an area of concern in healthcare since at least 2015, and our ongoing work to reduce restrictive practices was highlighted as part of our celebration of World Patient Safety Day in September.

Following on from her visit to an acute female psychiatric ward in August, HIN Patient Safety Project Manager Ayobola Chike-Michael visited Tolworth Hospital’s Jasmines Ward in South West London to see how they are working to reduce restrictive practices and create a compassionate and supportive environment for all patients.

In the ever-evolving landscape of mental health care, the Mental Health Safety Improvement Programme has been making significant strides since its inception in 2021. With a strong focus on reducing restrictive practices, the programme aims to reduce occurrences of physical restraints, seclusion, and rapid tranquilisation across participating wards. During my visit to Tolworth Hospital's Jasmines Ward in South West London, I had the opportunity to meet Hannah McCarthy, the new ward manager, and gain valuable insights into their innovative approach to care. The commitment and dedication of the Jasmines Ward staff to create a safe and compassionate environment were evident from the moment I stepped in.

Jasmines ward, a 16-bed mental health ward for older adults presented a unique set of challenges and requirements. A large proportion of the patients on the ward are living with dementia. While incidents of restrictive practices were explained to me as rare due to the frailty and older nature of the patients, the ward manager and her team seem prepared to handle any situation that might arise. The staff focus on providing personalised care, ensuring everyone’s needs were met. One notable practice was the "This is me" profile on the door of each patient, fostering a sense of identity and promoting a person-centered approach acknowledging each individual’s cultural and family background, as well as their interests and achievements.

The success of Jasmines Ward in providing comprehensive care can be attributed to its robust Multidisciplinary Team (MDT). Comprising of doctors, occupational therapists, physiotherapists, a dietician, an activity coordinator, an exercise therapist, the pharmacist and, upon request, visits from a chiropodist. The MDT works seamlessly to address the diverse needs of the patients. This collaborative approach ensures that the care provided is holistic, focusing not only on mental health but on physical wellbeing too.

The team working on Jasmines Ward recognises the importance of maintaining the dignity and pride of their patients, even during moments of potential restraint. Incidences of restrictive practice are handled sensitively, ensuring safety whilst minimising distress.

Like any healthcare setting, Jasmines Ward faces its own set of challenges; ensuring staff have time and are trained to lead on person-centred care remains a priority. To address this issue the ward is actively seeking long-term solutions; a recent recruitment drive has been successful and the ward are expecting the arrival of five new nurses to join the team in the near future. Flexibility with shifts and a focus on work-life balance are expected to create a more sustainable and fulfilling work environment.

The Mental Health Safety Improvement Programme has introduced several tools to monitor and track restrictive practices effectively. One such tool, the safety cross, is a simple visual representation that enables staff to identify patterns at a glance

In addition to their existing use for falls, the ward is encouraged to also implement safety crosses specifically for restrictive practices. This tool has proven invaluable in other participating wards to shape discussions around frequency of restrictive practices, de-escalation techniques, and proactive interventions.

Stepping into Jasmines Ward, I was greeted by a fast-paced atmosphere catering for patients’ needs constantly. Each patient's door bore a simple profile, offering a personal touch that goes a long way in making patients feel comfortable. The ward faces challenges related to the space available, particularly around storage, but despite this the staff remain dedicated to finding solutions and putting patient well-being at the centre of everything they do.

Jasmines Ward recognises the importance of feedback from service users and their carers. Verbal feedback is consistently positive, and I was shown an example of handwritten feedback that further exemplified the impact of the compassionate care provided.

A poignant poem displayed on the ward about dementia served as a reminder to both staff and visitors about the ongoing need for kindness and empathy towards patients.

Using the poem as an active reminder and not just part of the wallpaper would be part of my advice to pass on. I believe with their multidisciplinary approach, dedication to feedback, and continuous drive for improvement, Jasmines Ward will remain dedicated to reducing restrictive practices.

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