Online courses for parents help meet their own and babies’ & children’s long term emotional and well-being needs (#2198)

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Idea Description
Overview of Innovation:
The Solihull Approach, an NHS based team of health professionals, have developed exciting online courses for parents-to-be, parents, carers and professionals. The focus of the courses is relationships, especially how our emotions affect our relationships and behaviour, right from birth. They look at brain development, play, styles of parenting, sleep, temper tantrums, communication and more. They are based on the solihull Approach's nationally and internationally acclaimed face to face courses.
Unlike antenatal support, there is a stigma around accessing parenting support.
We know a great deal about preventing mental health problems in future generations. We know that the brain develops in response to its environment and is especially sensitive to the quality of relationships with caregivers, particularly in the first three years of life.
There is “floor to ceiling” evidence that intervening early and preventatively pays both economically, emotionally, and cognitively and achieves life long impact.
A trial of universal parenting support was undertaken by the coalition government (CanParent trial 2012-15). The Solihull Approach was a provider in the trial. A CanParent survey revealed that most 98% of parents would be interested in a course, but the difficulty is accessing one.
The Solihull Approach developed the online coures in response to this finding.
The Solihull Approach face to face course and online course were the first in the country to be awarded the DfE’s Quality Mark.
We offer Multi-User Licences to corporates, schools, NHS trusts, local authorities, public health, and prisons as part of a strategy to normalise parental education and lift the emotional health of the nation.
Data analysed so far: highly significant reductions in conflict and increases in closeness in relationships between 121 parents and their children.
Published research demonstrating effectiveness of face to face course:
  • Johnson, R., Wilson, H. (2012) Parents’ evaluation of Understanding Your Child’s Behaviour, a parenting group based on the Solihull Approach. Community Practitioner, 85: 5, 29-33.
  • Vella, L., Butterworth, R.,  Johnson, R.  and Urquhart Law, G. (2015) Parents' experiences of being in the Solihull Approach parenting group, ‘Understanding Your Child's Behaviour’: an interpretative phenomenological analysis. Child: Care, Health and Development41:6, 882–894.
Solihull.approach@heartofengland.nhs.uk 0121 296 4448
www.inourplace.co.uk, www.solihullapproachparenting.co.uk
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Overview summary:
The Solihull Approach, an NHS based team of health professionals, have developed an exciting online course for parents, carers and professionals. ‘Understanding Your Child’ includes 12 modules (20 minutes each) and follows 5 other families. The focus of the course is  how our emotions affect our relationships and behaviour. It looks at brain development, play, styles of parenting, sleep, temper tantrums, communication and more and is based on the nationally and internationally acclaimed face to face course.
Challenge identified and actions taken :
Unlike antenatal support, there is a stigma around accessing parenting support.
We know a great deal about preventing mental health problems in future generations. We know that the brain develops in response to its environment and is especially sensitive to the quality of relationships with caregivers, particularly in the first three years of life.
There is “floor to ceiling” evidence that intervening early and preventatively pays both economically, emotionally, and cognitively and achieves life long impact.
A trial of universal parenting support was undertaken by the coalition government (CanParent trial 2012-15). The Solihull Approach was a provider in the trial. The range of courses on offer were very popular with those who took them but the trial reached only a fraction of the intended audience, less than 3000 out of an intended 20,000. A CanParent survey revealed that most 98% of parents would be interested in a course, but the difficulty is accessing one.
The Solihull Approach developed the online coures in response to this finding.
The Solihull Approach face to face course and online course were  the first in the country to be awarded the DfE’s Quality Mark.
The Solihull Approach is offering multi-user licences to corporates, schools, NHS trusts, local authorities, public health, and prisons.
 
Impacts / outcomes: 
Data analysed so far: 121 parents highly significant reductions in conflict and increases in closeness in the relationships between the parents and their children on the two subscales and overall score on the Child Parent Relationship Scale (Pianta, 1992).
Published research demonstrating effectiveness of face to face course:
 
  • Johnson, R., Wilson, H. (2012) Parents’ evaluation of Understanding Your Child’s Behaviour, a parenting group based on the Solihull Approach. Community Practitioner, 85: 5, 29-33.
  • Vella, L., Butterworth, R.,  Johnson, R.  and Urquhart Law, G. (2015) Parents' experiences of being in the Solihull Approach parenting group, ‘Understanding Your Child's Behaviour’: an interpretative phenomenological analysis. Child: Care, Health and Development 41:6, 882–894.
  • Baladi, R., Johnson, R., and Urquhart Law, G. (in progress) A pre, post and follow-up evaluation of Understanding Your Child’s Behaviour (UYCB): A parenting group intervention based on the Solihull Approach. Child: Care, Health and Development.
Which local or national clinical or policy priorities does this innovation address:
National Institute for Clinical Excellence (NICE) Guidelines for conduct disorder: ‘Antisocial behaviour and conduct disorders in children and young people: recognition and management’ NICE guidelines [CG158] Published date: March 2013 http://www.nice.org.uk/usingguidance/sharedlearningimplementingniceguida...
Supporting quote for the innovation from key stakeholders:
“The most amazing and immediately life changing course I have ever been on! And that’s after 5 years in childcare!” (Parent)
“Really enjoyed doing it and found it useful. Yes it made a difference. Was going to make a referral to the MAT team. Children's behaviour problematic at home, being managed at school, but a problem. Saw an improvement after the parent took the course. We could see a difference in school. Children much, much better. The mum was being more positive, a bit more confident, she seemed able to see things from their point of view, and had  changed the way she spoke to the children.” (Pastoral Lead at a Primary School)
 
Plans for the future:
To engage with corporate partners, health, education and social care. Develop implementation kits  to assist organisations to launch the course to employees and customers. Reach the whole population thereby elevating the emotional wellbeing of future generations.  
 
Tips for adoption:
Multi-user licences are available. Implementation kits are in development.
 
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Overview summary:
The Solihull Approach is a training method for practitioners working with families, children and young people, developed from within the Heart of England NHS Foundation Trust. Hazel Douglas, a clinical psychologist is the Director of the approach.

The approach began in 1996 as a new method of training health visitors supporting parents of children experiencing sleep, feeding, and toileting or behaviour difficulties. As the approach became popular it now needed trademarks, intellectual property agreements etc. This is when MidTECH was contacted.
Challenge identified and actions taken :
The approach was successful with health visitors who first utilised it, that it quickly began to be applied more broadly, becoming an integrated model for many practitioners. Hazel and the team wrote and produced their own course packs. These ever since have been used to think about the behaviour of children in a holistic, relationship-based way.
Trademarking:
 This success posed challenges, however: as the approach grew and began to be disseminated widely, questions of ownership arose. For Hazel, who had devised the method the question of rights to the ideas behind it became critical.
Franchising the Model:
In addition franchising the model also had its difficulties. MidTECH thus helped to protect Hazel and her team from copy-cats looking to steal their work. MidTECH enabled them to establish a framework for establishing franchises.
Action:
Trademarking:

MidTECH became Solihull Approach's in-house IP specialists. They explained the process of registering a trademark so clearly and MidTECH worked with lawyers who inevitably became involved.
Franchising the Model
MidTECH enabled a framework for establishing franchises. Via an intensively consultative process, MidTECH worked extensively with lawyers on Solihull Approach's behalf to devise a set of proper legal agreements which could govern these sorts of arrangements.
Impacts / outcomes: 
The security MidTECH provided to the Solihull Approach and their efforts to spread their successful model ever further can't be underestimated: on the day we touched base with Hazel to write this article, the Trademark Office had called her to highlight a new trademark which had the potential to infringe upon Solihull Approach's.  Needless to say, she turned immediately to MidTECH for advice on liaising with her lawyers, the Trademark Office – and assessing the potential clash.
MidTECH have helped to create a strong theoretical model which now educates people in how to understand their relationships and in a way that increases the wellbeing of individuals with of training health visitors supporting parents of children experiencing sleep, feeding, and toileting or behaviour difficulties.
Which local or national clinical or policy priorities does this innovation address:
The Solihull approach was developed from within the Heart of England NHS Foundation Trust but now the model is used Nationwide.
Supporting quote for the innovation from key stakeholders:
"They explained the process of registering a trademark so clearly that we could do it ourselves. That advice was absolutely crucial, and MidTECH was able to work with the lawyers who inevitably became involved”. 

“People in professions are trained to give advice – but it’s often difficult to make it heard. We now have in place a strong theoretical model which educates people in how to understand their relationships and in that way increase their well-being.”
“We got in touch with MidTECH through our Trust, the Heart of England NHS Foundation Trust," recalls Hazel. "They very quickly got to work."
"Not only that, but we recently needed our trademark to be appropriate to new activity in China: without MidTECH, we wouldn't have known whether or how to extend ours to cover a range of much less obvious classes in order to protect us in challenging international markets. There's no way we could have done that ourselves.”
“That's why it's so helpful to be able to access people who do know this world, who are experts. It gives you the confidence you need to innovate and expand."
Plans for the future:
Talks currently underway with China and adoption in Australia is underway.
Tips for adoption:
If you are interested in using Solihull Approach in your organisation please contact the team at - https://solihullapproachparenting.com/contact-us/
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Innovation 'Elevator Pitch':
Unique evidence-based app that teaches doctors & nurses to manage stress & avoid burnout. Designed specifically for, and with, NHS staff. The efficacy of Working Stress was proved by a Randomised Controlled Trial (RCT) with 227 NHS doctors in 2016.
Overview of Innovation:
Being a doctor or nurse can be extremely challenging and the negative effects of work-related stress are significant. They affect patient safety, sickness absence and job satisfaction. However, staff can learn to manage stress and develop resilience if they are given effective and practical support to acquire these skills.

Working Stress is a unique evidence-based App that offers this vital support, it teaches individuals to manage stress, grief and avoid burnout. Working Stress was developed specifically for NHS staff by leading psychologists in consultation with practicing doctors. Efficacy of the underlying interventions was proved by a Randomised Controlled Trial (RCT) with 227 NHS doctors in 2016:

Reduces:
  • Psychological symptoms such as anxiety, psychiatric morbidity and emotional exhaustion
  • Physical symptoms such as insomnia and changed eating habits
  • Maladaptive coping mechanisms such as alcohol and drug use
Increases:
  • Positive ways of coping with stress such as emotional support and humour
Working Stress offers clinicians 2 modules
  1. Managing Stress & Burnout – relevant to all clinical staff
  2. Dealing with Patients’ Death – for those particularly affected by the death of patients
A single 15-minute interaction with the App is effective. No other commitment is required. If Effectiveness = Adherence x Efficacy Working Stress is perfect for busy professionals and their employers.

The App works on any mobile device or PC. When offered to all clinical staff in a Trust, it can reduce the incidence of workplace stress across the organisation. Deploying Working Stress in a Trust is fast and efficient and the benefits are realised rapidly. Working Stress is a cost-effective way for the NHS to reduce workplace stress and its consequences. 

The benefits for individual clinicians are clear, the benefits for employers are potentially significant; healthy employees are more productive and provide a better and safer quality of care. Doctors who completed Working Stress in the RCT evaluated their organisation more favourably, saying that they receive the respect they deserve and that salary and work prospects are adequate.

Working Stress is an immediate intervention that teaches individuals to recognise and manage their own stress more effectively. No customisation is required and Working Stress is easy to deploy, easy-to-use, anonymous and cost-effective. It can be used during formal induction programmes for new employees and with existing staff at any time
Stage of Development:
Market ready and adopted - Fully proven, commercially deployable, market ready and already adopted in some areas (in a different region or sector)
WMAHSN priorities and themes addressed: 
Mental Health: recovery, crisis and prevention / Long term conditions: a whole system, person-centred approach / Wellness and prevention of illness / Education, training and future workforce / Wealth creation / Clinical trials and evidence / Digital health / Innovation and adoption / Patient and medicines safety / Person centred care
Benefit to NHS:
Work related stress accounted for 43% of all lost working days in 2014/2015 (Buckley, 2015; Beheshtifar & Nazarian, 2013). 37% of National Health Service (NHS) staff reported feeling unwell due to stress and pressure at work (The Picker Institute & National Health Service, 2015). Moreover, Goodwin et al. (2013) meta-analysis revealed a much higher percentage of health care professionals and NHS staff were suffering from a common mental disorder (psychiatric morbidity; 32%) compared with general population (19.1%).

Poor occupational health in the NHS is costly and puts patient safety at risk. For example, Boorman (2009) calculated that better staff health might be associated with up to a million extra working days a year and could save approximately £13.7 million a year to NHS as a whole. The cost of sickness absence alone has been estimated at £2.4 billion a year.

80% of NHS staff admit that their state of health has an impact on a patient’s care (Boorman, 2009). A number of systematic reviews and meta-analyses showed that occupational health is negatively linked to a patient’s care, satisfaction and safety outcomes (Boorman, 2009; Edwards, Burnard, Park, MPhil, & Edwards, 2003; Hall, Johnson, Watt, Tsipa, & O’Connor, 2016; Nahrgang, Morgeson, & Hofmann, 2011), leads to lower job satisfaction, poorer performance, work-life imbalance (Edwards et al., 2003), intention to leave an organisation and earlier retirement (Buckley, 2015; Taylor et al., 2007).

Our academic partners, Dr Caroline Kamau and Asta Medisauskaite, published Prevalence of oncologists in distress: Systematic review and meta‐analysis assessing occupational distress among oncologists. Their analyses showed that:
  • Up to 69% feel stressed at work
  • Up to 51% positive for depression
  • Up to 44% have sleep problems
  • 32% have a high level of burnout
  • 27% have psychiatric morbidity
In response to their own research Kamau & Medisauskaite designed 3 simple online interventions to help reduce levels of occupational distress and burnout. These interventions were tested with a Randomised Control Trial (RCT) Occupational Distress in Doctors: The Effect of an Induction Programme. The participating doctors (n=227) came from a range of specialities and seniority, including consultants. The Working Stress app has been built around these 3 interventions. The potential benefits are clear.
 
Initial Review Rating
5.00 (1 ratings)
Benefit to WM population:
The impact of occupational health for the wider NHS and its patients have been investigated and documented. The potential benefits of improving occupational health for the wider NHS are clear. It can be assumed that the WM would derive identical benefits if Working Stress were offered to NHS clinical staff in the WM.

A number of systematic reviews and meta-analyses showed that occupational health is negatively linked to a patient’s care, satisfaction and safety outcomes (Boorman, 2009; Edwards, Burnard, Park, MPhil, & Edwards, 2003; Hall, Johnson, Watt, Tsipa, & O’Connor, 2016; Nahrgang, Morgeson, & Hofmann, 2011), leads to lower job satisfaction, poorer performance, work-life imbalance (Edwards et al., 2003), intention to leave an organisation and earlier retirement (Buckley, 2015; Taylor et al., 2007).

Poor occupational health in the NHS is costly. For example, Boorman (2009) calculated that better staff health might be associated with up to a million extra working days a year and could save approximately £13.7 million a year to NHS as a whole. The cost of sickness absence alone has been estimated at £2.4 billion a year.
Current and planned activity: 
Discussions about the Working Stress app are ongoing with NHS England, NHS Innovation, NHS Employers, NHS Resolution, MIND and a growing number of individual NHS trusts.

Working Stress is being offered to the clinical, occupational health and finance leadership within targetted NHS trusts. The intention is to create ongoing commercial relationships with NHS trusts whereby Working Stress is offered to all frontline doctors and nurses in a single programme to address immediate issues. Working Stress would then be added to formal inductions for all new staff members and also for existing staff who are facing a significant change their professional personal circumstances. Long-term sustained cultural change is the objective. 

NHS Practitioner Health Programme has confirmed a formal partnership and is working with Focus Games Ltd to develop a face-to-face group intervention to complement the Working Stress app. This is a board game.
What is the intellectual property status of your innovation?:
Intellectual property is wholly owned by Focus Games Ltd, the developers of Working Stress.
Return on Investment (£ Value): 
medium
Return on Investment (Timescale): 
0-6 mon
Ease of scalability: 
Simple
Regional Scalability:
The app is very scalable. It can be easily deployed anywhere in the world.
Measures:
For individual clinicians the proven benefits of using Working Stress are:

Reduce:
  • Psychological symptoms; anxiety, psychiatric morbidity and emotional exhaustion
  • Physical symptoms; insomnia and changed eating habits
  • Negative coping mechanisms; alcohol and drug use
  • Root causes of Chronic Embitterment
Increase:
  • Positive coping mechanisms; emotional support and humour
  • Improved perception of employer and working conditions
The benefits for NHS employers, and wider society, are reasonably well-documented regarding reduced staff absenteeism, staff turnover and patient safety risks.
 
Adoption target:
Ideally all employers will recognise the benefits but this will take time. In year 1 we would aim to have 4 medium sized West Midlands Trusts contracted.
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