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Innovation 'Elevator Pitch':
OurPath is a 6-month online behavioural change programme for people to build healthier habits and manage type 2 diabetes with fewer medications. We provide health-tracking technology, coaching from a dietitian and evidence-based structured education.
Overview of Innovation:
The health needs of the UK population are changing and the way we interact with healthcare is evolving. Nationally, the internet is being used to manage our lives, changing the way we shop, bank, watch TV and communicate. The West Midlands has one of the highest rates of type 2 diabetes and pre-diabetes in the country. Many of these people may benefit from digital services that may help them manage their lifestyles, preventing them from moving into higher risk stratification levels and increasing medication burden which would ultimately require increased GP time to manage and increased costs.
OurPath provide a 6-month behavioural change programme for people living with, type 2 diabetes. The programme helps people to change their behaviours for the long term and improve their health outcomes. The programme delivers:

• Evidence-based structured education on nutrition, exercise, sleep, stress management, and positive psychology
• Peer group support (an online group of 13 others similar to the user)
• Personalised health coaching from a registered dietitian
• Tracking technology (smart weighing scales and a wearable activity tracker).

The programme has been adopted across more than 50 CCGs and is available through NHS England's diabetes prevention programme. We’ve seen uptake rates of >70% and completion rates of 80%, average weight loss of 6.2% at 2-years post-intervention and an average HbA1c reduction of 12.7mmol/mol at 6 months. 40% of participants achieved a HbA1c below the diagnostic threshold for type 2 diabetes.
We are proposing a project to deliver the OurPath programme with the objective of reducing anti-hyperglycaemic medication spend through dietary and lifestyle change across the West Midlands. The ambition is that the programme will provide in-year savings whilst also improving patient outcomes.
This model is being implemented across the 8 North West London CCGs as part of their multi-faceted remission programme.

1-minute introduction to OurPath video: https://vimeo.com/199648301

www.ourpath.co.uk
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)
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Innovation 'Elevator Pitch':
Oviva Diabetes Support and Prevention are QISMET-accredited education and behavioural change interventions for people with or at risk of type 2 diabetes, which have demonstrated signficant improvements in uptake and clinical outcomes.
Overview of Innovation:
Oviva’s services for people with or at risk of type 2 diabetes are now available in 18 CCGs across England, and have demonstrated improved uptake and outcomes in comparison with traditional models of care. 

Oviva services offer accessible, evidence-based, personalised care 
All Oviva services combine:
  • High-frequency, 1-to-1 coaching from a diabetes specialist dietitian to drive behaviour change and tackle psychological barriers, delivered over the telephone or using the Oviva app.
  • Supporting materials for participants to access in their own time, including videos, podcasts, and written guides, which explain more about type 2 diabetes. Participants retain access to resources for life, and they are available online or as hard copy booklet and/or DVD. All Oviva resources reflect NICE and NHS guidelines and are reviewed by a clinical advisory board regularly.
  • Optional use of the Oviva smartphone app, which participants can use to maintain a food diary and access learning resources. This app links to the dietitian’s electronic patient record to enable the dietitian to provide feedback. 
  • Activation call from Oviva patient pathway coordinators, who are trained in motivational interviewing and focused on driving uptake.
This approach is tailored to meet the needs of different patient cohorts, as described below. 

Oviva Diabetes Prevention: an 8 week intensive education and behaviour change programme with follow up care at 3, 6 and 12 months, focused on weight loss and reducing HbA1c levels (for patients with non-diabetic hyperglycaemia). This service has recently been adopted as part of the NHS Diabetes Prevention Programme in England, and real world data will be available for analysis soon.

Oviva Diabetes Support: an 8 - 10 week QISMET-accredited structured education and behaviour change programme, focused on supporting patients to meet diabetes treatment targets, lose weight, and develop sustainable self-management skills. Real world data demonstrates an average HbA1c reduction of 13mmol/mol at 6 months, weight loss of -4.5%, whilst patients report that their average confidence in managing their diabetes increased from 4/10 to 8/10 (clinical outcomes from 85 patients). Uptake in 1453 referrals is c.70%, compared with c.30% in traditional models. 

Oviva Diabetes Support has now been selected by NHS England to join the NHS Innovation Accelerator and the Digital Diabetes Coach Test Bed. 

To view our Information Pack - click here.
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: 
Long term conditions: a whole system, person-centred approach / Wellness and prevention of illness / Digital health / Innovation and adoption / Person centred care
Benefit to NHS:
Oviva Diabetes Support and Prevention benefit the NHS by widening access to effective care, and generating improved patient outcomes for people with or at risk of type 2 diabetes. In turn, this drives efficiency savings in terms of avoiding preventable utilisation of services in primary and secondary care, along with medications and treatment costs associated with disease progression and diabetes complications. 

As described in the overview, service uptake is c.71%. By contrast, the National Diabetes Audit indicates that uptake of structured education for people newly diagnosed with type 2 diabetes is c.7.4% (2.9% in the West Midlands), and uptake of the National Diabetes Prevention Programme is 49%. Increased accessibility and flexibility enables people unable or unwilling to access traditional face-to-face courses, along with supporting commissioners and clinicians to meet targets associated with attendance at diabetes structured education included in the NHS Improvement and Assessment Framework and Quality and Outcomes Framework.

Moreover, real world data (85 Oviva Diabetes Support patients) demonstates an average HbA1c reduction at c.6 months of 13mmol/mol, and bodyweight loss of 4.5%, supporting the achievement of diabetes treatment targets (also included in the Improvement and Assessment Framework and Quality and Outcomes Framework). 

These clinical outcomes can drive a return on investment for CCGs; Frontier Economics modelling indicates that based on existing clinical outcome data, provision of Oviva Diabetes Support for 500 participants achieves £219k of year 1 savings, rising to £550k by year 5. This is comprised of avoidance of 72 admissions, 100 outpatient and 280 GP visits, along with avoidance of more than £17k of prescribing costs. Targeting the service at patients receiving or likely to need high cost medications (including insulin, SGLT-2, and GLP-1) could drive additional savings of more than £800 per participant per year. 

Oviva Diabetes Support and Prevention also offer commissioners a 'payment by engagement' cost model, ensuring that commissioners only fund the service for active participants. This contrasts with the block contract model of traditional face-to-face group courses, which offers commissioners limited recourse to challenge poor uptake locally.  
Initial Review Rating
4.60 (1 ratings)
Benefit to WM population:
By providing an accessible, flexible and effective approach to improving outcomes for people with type 2 diabetes Oviva Diabetes Support and Prevention can impact on the WM population (7.7% of whom have type 2 diabetes, and 11% of whom are likely to be at risk) beyond the local health economy by:
  • Reducing the need for people with or at risk of type 2 diabetes requiring time away from work to attend education courses or future appointments associated with the treatment of complications, thus contributing to maintaining productivity and the local economy.
  • Providing participants with personalised and remote care widens access to cohorts identified as less likely to attend traditional programmes, such as working age men, BME groups, or rural communities, particularly essential in diverse populations such as the West Midlands. Evidence of accessibility can be seen in the success of Oviva Diabetes Support in areas such as London and Devon.   
  • Reducing the impact on the environment associated with delivery of traditional models of care, which drives a number of journeys for patients and staff and the environmental costs associated with physical premises.
  • Improving outcomes enables people with type 2 diabetes to remain in work; Diabetes UK has estimated that the costs of reduced productivity at work due to people with diabetes not working because of death or poor health, or working at a lower level of productivity are estimated at nearly £9 billion.  
Current and planned activity: 
Oviva Diabetes Support is currently in pilot or commissioned in the following areas: North West London collaborative of CCGs, South West London collaborative, NEW Devon CCG, Chiltern and Aylesbury Vale CCGs, Swindon CCG, Somerset CCG, Leicester, Leicestershire and Rutland CCGs, and Salford CCG. Oviva Diabetes Support will soon be available to self-referral nationally as part of the Diabetes Digital Coach Test Bed. Oviva Diabetes Support is supported through NHS England through the NHS Innovation Accelerator, and has been rewarded a research grant via Innovate UK and the digital health catalyst to evaluate our clinical outcomes with King's College London. 

Oviva Diabetes Prevention is part of the NHS England Healthier You - Diabetes Prevention Programme digital stream, recently launching in North West London, Somerset, and Chiltern and Aylesbury Vale CCGs. 

Oviva is keen to explore opportunities for adoption of our service in the West Midlands. 
What is the intellectual property status of your innovation?:
All intellectual property is owned by Oviva. 
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
1 year
Ease of scalability: 
Simple
Read more
Hide details
Innovation 'Elevator Pitch':
Digital behaviour change platform for people with type 2 diabetes and prediabetes providing goal-focused education, personalised resources and support to implement a lower carbohydrate lifestyle. 
Overview of Innovation:
The Low Carb Program is an award-winning digital health intervention for people with type 2 diabetes, prediabetes and obesity. The Low Carb Program provides the education, resources, and, most importantly, support required when reducing the amount of sugar (or carbohydrates) in the diet.

The platform is available in the NHS Apps Library and is an NHS Innovation Accelerator Fellow for 2019. The platform is QISMET approved to be provided as structured education for people with type 2 diabetes and prediabetes.
 
The platform comprises:
  • Education: members participate in a core 12-week structured therapeutic nutrition and wellness program, personalised to disease type and profile
  • Community peer support with over 400,000 members
  • Behaviour change mentoring, goal identification and setting
  • Library of personalised resources, including culturally-specific meal plans, food swaps and over 1,000 searchable recipe ideas
  • Data insights and AI-led feedback to support sustainable behaviour change
The Low Carb Program was developed with Dr David Unwin in 2015 (NHS Innovator of the Year 2016, RCGP National Champion for Collaborative Care in Obesity and Diabetes), and the feedback of 20,000 people with diabetes. 

DDM is conducting a three-year study on a randomly selected cohort of people who joined the Low Carb Program. One-year outcomes have been published in JMIR Diabetes with two-year outcomes are currently under review. The first evidenced benefit is a 71% platform retention at 1-year, which is unrivalled for any digital platform. Engagement within the platform is critical as without engaging users, behaviour change is not possible. The retention evidenced by the Low Carb Program is pioneering.
 
For people with type 2 diabetes who complete the platform, outcomes are:
  • 7.4kg weight loss
  • 13mmol/mol HbA1c reduction
  • 39% place HbA1c under type 2 diabetes threshold, with 26% placing type 2 diabetes 'in remission'
Remission is defined as an HbA1c under type 2 diabetes threshold and on no medication or metformin only.
 
In addition, to this:
  • 40% of people on medication eliminate at least one treatment from their regime
  • 60% of people on insulin eliminate or reduce it from their regime
The Low Carb Program has tiered licencing costs, with a patient licence cost of £90, which lasts 3 years. Given the affordability of the platform the Low Carb Program offers significant cost-savings from the perspective of reduced medication through improved patient health and reduced GP burden.
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: 
Long term conditions: a whole system, person-centred approach / Wellness and prevention of illness / Education, training and future workforce / Digital health / Innovation and adoption / Person centred care
Benefit to NHS:
The Low Carb Program is scaling type 2 diabetes and prediabetes remission and benefits are most immediately seen in reduced medication dependency through improved HbA1c. A three-year study is underway on a randomly selected cohort of 1,000 people who joined the Low Carb Program. One-year outcomes have been published in JMIR Diabetes. The first evidenced benefit is a 71% platform retention at 1-year, which is unrivalled for any digital platform. Engagement within the platform is critical as without engaging users, behaviour change is not possible. The retention evidenced by the Low Carb Program is pioneering.
 
For people with type 2 diabetes who complete the platform, outcomes are:
  • 7.4kg weight loss
  • 13mmol/mol HbA1c reduction
  • 39% place HbA1c under type 2 diabetes threshold, with 26% placing type 2 diabetes 'in remission'
Remission is defined as an HbA1c under type 2 diabetes threshold and on no medication or metformin only.
In addition, to this:
  • 40% of people on medication eliminate at least one treatment from their regime
  • 60% of people on insulin eliminate or reduce it from their regime
A conservative cost-saving medication deprescription analysis was conducted on this cohort of users, and calculated at £835 per-patient, per-year in reduced medication deprescription savings.
 
Given the affordability of the platform, particularly when compared to competitors, the Low Carb Program offers significant cost-savings from the perspective of reduced medication through improved patient health and reduced GP burden.

There is clinical evidence of the Low Carb Program in practice, where it is being used with patients by NHS Symphony Healthcare health coaches with patients with type 2 diabetes in Yeovil in a blended care approach.

Currently, clinical data demonstrates improvements in HbA1c and weight for the majority of patients using the platform.
Benefits of engaging within the education are truly brought to life by many of the 400,000 members' stories, including:
Initial Review Rating
5.00 (2 ratings)
Benefit to WM population:
Adoption of the Low Carb Program will significantly improve patient and population health of people with type 2 diabetes and prediabetes in the West Midlands. 

Benefits are most immediately seen in reduced medication dependency through improved HbA1c. A three-year study is underway on a randomly selected cohort of 1,000 people who joined the Low Carb Program. One-year outcomes have been published in JMIR Diabetes. The first evidenced benefit is a 71% platform retention at 1-year, which is unrivalled for any digital platform. Engagement within the platform is critical as without engaging users, behaviour change is not possible. The retention evidenced by the Low Carb Program is pioneering.
 
For people with type 2 diabetes who complete the platform, outcomes are:
  • 7.4kg weight loss
  • 13mmol/mol HbA1c reduction
  • 39% place HbA1c under type 2 diabetes threshold, with 26% placing type 2 diabetes 'in remission'
Remission is defined as an HbA1c under type 2 diabetes threshold and on no medication or metformin only.
In addition, to this:
  • 40% of people on medication eliminate at least one treatment from their regime
  • 60% of people on insulin eliminate or reduce it from their regime
A conservative cost-saving medication deprescription analysis was conducted on this cohort of users, and calculated at £835 per-patient, per-year in reduced medication deprescription savings.
 
Given the affordability of the platform, particularly when compared to competitors, the Low Carb Program offers significant cost-savings from the perspective of reduced medication through improved patient health and reduced GP burden. 
Current and planned activity: 
The Low Carb Program is currently being showcased through the NHS Innovation Accelerator. It is also a member of the RCGP Innovation Mentorship Programme. Ascensia Diabetes Care lead implementation of the Low Carb Program within local areas once commissioned, including on-site healthcare professional training and support, patient onboarding resources and Key Manager 24/7 support. 
What is the intellectual property status of your innovation?:
All copyright and IP belongs to Diabetes Digital Media (DDM). Patents pending.
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
6-12 mon
Ease of scalability: 
Simple
Read more
Hide details
Innovation 'Elevator Pitch':
Oviva Diabetes Support and Prevention are QISMET-accredited education and behavioural change interventions for people with or at risk of type 2 diabetes, which have demonstrated signficant improvements in uptake and clinical outcomes.
Overview of Innovation:
Oviva’s services for people with or at risk of type 2 diabetes are now available in 18 CCGs across England, and have demonstrated improved uptake and outcomes in comparison with traditional models of care.

Oviva services offer accessible, evidence-based, personalised care
All Oviva services combine:
  • High-frequency, 1-to-1 coaching from a diabetes specialist dietitian to drive behaviour change and tackle psychological barriers, delivered over the telephone or using the Oviva app.
  • Supporting materials for participants to access in their own time, including videos, podcasts, and written guides, which explain more about type 2 diabetes. Participants retain access to resources for life, and they are available online or as hard copy booklet and/or DVD. All Oviva resources reflect NICE and NHS guidelines and are reviewed by a clinical advisory board regularly.
  • Optional use of the Oviva smartphone app, which participants can use to maintain a food diary and access learning resources. This app links to the dietitian’s electronic patient record to enable the dietitian to provide feedback.
  • Activation call from Oviva patient pathway coordinators, who are trained in motivational interviewing and focused on driving uptake.
This approach is tailored to meet the needs of different patient cohorts, as described below.

Oviva Diabetes Prevention: an 8 week intensive education and behaviour change programme with follow up care at 3, 6 and 12 months, focused on weight loss and reducing HbA1c levels (for patients with non-diabetic hyperglycaemia). This service has recently been adopted as part of the NHS Diabetes Prevention Programme in England, and real world data will be available for analysis soon.

Oviva Diabetes Support: an 8 - 10 week QISMET-accredited structured education and behaviour change programme, focused on supporting patients to meet diabetes treatment targets, lose weight, and develop sustainable self-management skills. Real world data demonstrates an average HbA1c reduction of 13mmol/mol at 6 months, weight loss of -4.5%, whilst patients report that their average confidence in managing their diabetes increased from 4/10 to 8/10 (clinical outcomes from 85 patients). Uptake in 1453 referrals is c.70%, compared with c.30% in traditional models.

Oviva Diabetes Support has now been selected by NHS England to join the NHS Innovation Accelerator and the Digital Diabetes Coach Test Bed.

To view our Information Pack - click here.
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: 
Long term conditions: a whole system, person-centred approach
Benefit to NHS:
Oviva Diabetes Support and Prevention benefit the NHS by widening access to effective care, and generating improved patient outcomes for people with or at risk of type 2 diabetes. In turn, this drives efficiency savings in terms of avoiding preventable utilisation of services in primary and secondary care, along with medications and treatment costs associated with disease progression and diabetes complications.

As described in the overview, service uptake is c.71%. By contrast, the National Diabetes Audit indicates that uptake of structured education for people newly diagnosed with type 2 diabetes is c.7.4% (2.9% in the West Midlands), and uptake of the National Diabetes Prevention Programme is 49%. Increased accessibility and flexibility enables people unable or unwilling to access traditional face-to-face courses, along with supporting commissioners and clinicians to meet targets associated with attendance at diabetes structured education included in the NHS Improvement and Assessment Framework and Quality and Outcomes Framework.

Moreover, real world data (85 Oviva Diabetes Support patients) demonstates an average HbA1c reduction at c.6 months of 13mmol/mol, and bodyweight loss of 4.5%, supporting the achievement of diabetes treatment targets (also included in the Improvement and Assessment Framework and Quality and Outcomes Framework).

These clinical outcomes can drive a return on investment for CCGs; Frontier Economics modelling indicates that based on existing clinical outcome data, provision of Oviva Diabetes Support for 500 participants achieves £219k of year 1 savings, rising to £550k by year 5. This is comprised of avoidance of 72 admissions, 100 outpatient and 280 GP visits, along with avoidance of more than £17k of prescribing costs. Targeting the service at patients receiving or likely to need high cost medications (including insulin, SGLT-2, and GLP-1) could drive additional savings of more than £800 per participant per year.

Oviva Diabetes Support and Prevention also offer commissioners a 'payment by engagement' cost model, ensuring that commissioners only fund the service for active participants. This contrasts with the block contract model of traditional face-to-face group courses, which offers commissioners limited recourse to challenge poor uptake locally.
Initial Review Rating
5.00 (1 ratings)
Benefit to WM population:
By providing an accessible, flexible and effective approach to improving outcomes for people with type 2 diabetes Oviva Diabetes Support and Prevention can impact on the WM population (7.7% of whom have type 2 diabetes, and 11% of whom are likely to be at risk) beyond the local health economy by:
  • Reducing the need for people with or at risk of type 2 diabetes requiring time away from work to attend education courses or future appointments associated with the treatment of complications, thus contributing to maintaining productivity and the local economy.
  • Providing participants with personalised and remote care widens access to cohorts identified as less likely to attend traditional programmes, such as working age men, BME groups, or rural communities, particularly essential in diverse populations such as the West Midlands. Evidence of accessibility can be seen in the success of Oviva Diabetes Support in areas such as London and Devon.
  • Reducing the impact on the environment associated with delivery of traditional models of care, which drives a number of journeys for patients and staff and the environmental costs associated with physical premises.
  • Improving outcomes enables people with type 2 diabetes to remain in work; Diabetes UK has estimated that the costs of reduced productivity at work due to people with diabetes not working because of death or poor health, or working at a lower level of productivity are estimated at nearly £9 billion.
Current and planned activity: 
Oviva Diabetes Support is currently in pilot or commissioned in the following areas: North West London collaborative of CCGs, South West London collaborative, NEW Devon CCG, Chiltern and Aylesbury Vale CCGs, Swindon CCG, Somerset CCG, Leicester, Leicestershire and Rutland CCGs, and Salford CCG. Oviva Diabetes Support will soon be available to self-referral nationally as part of the Diabetes Digital Coach Test Bed. Oviva Diabetes Support is supported through NHS England through the NHS Innovation Accelerator, and has been rewarded a research grant via Innovate UK and the digital health catalyst to evaluate our clinical outcomes with King's College London.

Oviva Diabetes Prevention is part of the NHS England Healthier You - Diabetes Prevention Programme digital stream, recently launching in North West London, Somerset, and Chiltern and Aylesbury Vale CCGs.

Oviva is keen to explore opportunities for adoption of our service in the West Midlands.
What is the intellectual property status of your innovation?:
All intellectual property is owned by Oviva.
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
1 year
Ease of scalability: 
Simple
Read more
Hide details
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