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Idea Description
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Innovation 'Elevator Pitch':
ExerSciz Solutions is an on-line tool that creates individualised exercise programs for risk reduction, disease treatment and overall improved health for patients with Long Term Conditions.
Overview of Innovation:
ExerSciz Solutions utilises the latest in exercise and scientific literature to develop programs that are specific to an individual’s physiology, health condition and goals, level of exercise, time available and individual choice of cardiovascular training.
Patients, supported by clinicians, can select from a number of goals. These include weight loss, with or without calorie restriction, risk reduction and treatment of heart disease and stroke, diabetes, metabolic syndrome, arthritis, osteoporosis, balanced health and many other health based goals.
The programs adapt to the availability of various exercise equipment. Programs can be designed for those without any equipment. The programs can be done at home, in the gym, or wherever an individual chooses. The programs will progress week to week and month to month as long as an individual is doing approximately 70% of his or her workouts. The cardiovascular portion of the program gives clients their specific exercise zones to work out in. The exercise zones are unique to each individual's particular health needs as well as body physiology.  By using both screening tools and perceived exertion, the programs are safer than a patient choosing to exercise on his or her own. Since most individuals have smart phones today, an ExerSciz program is just like having a personal exercise trainer in the client's pocket at all times.
Patients are able to perform an assessment using their smart phone in order to give them an ExerSciz Fitness index ("EFI") rating.  The EFI is a proprietary exercise score that compares each client to age adjusted norms and allows each client to benchmark their current status, as well as monitor progress. In addition, patients are able to track their activity on the website, giving them both activity scores and health scores.  We will soon have the ability to automatically track this if the client is using a wearable device that is compatible with the ExerSciz program.
Patients and doctors will be able to see the results and appreciate that they are “Exercising smarter, not harder” as their program is literally putting exercise based science into their unique personalised exercise experience, promoting their health and wellbeing. 
An individualised ExerSciz program will be complementary to any ongoing health or medical intervention, initiative and treatment a patient may be involved in and should reduce health costs, as well as help develop ownership of their own health.
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':
HeadGym coaching is a one to one flexible service providing innovative self help techniqes for adults and children that enable clients with mental health challenges to develop mental resilience and manage their own mental health. 
Overview of Innovation:
HeadGym services are preventative and for those experiencing crisis; we believe in helping the client to help themselves. Many clients we see have undertaken short term interventions over many years which have been inaffective in the long term, creating a revolving door of services and/or becoming dependent on medication.
We address this issue and provide a long term flexible service built around a goals framework, it is about the client having the ability to take control of their own mind and body and finding the solutions to do so. The coach ensures clients are supported in developing their own goals and steps to achieving them meaning that aspirations are built around what the client wants and not a service providers desired outcomes. The ownership of these goals has shown to make a huge difference in clients motivation and success rates are high, inevitably service providers desired outcomes are met anyway. We provide clients with some simple tools, techniques and strategies based around the findings of neuroplasticy using Neuro Linguistic Programming, Cognitive Behaviour Therapy  and other methods. Areas of progress have been: self esteem, mental health, self confidence, self worth, weight loss, nutrition, exercise, career, addictions, volunteering, coming off benefits and re-engaging with education.  A Coach is encouraging and guiding throughout the process, they highlight the positive achievements in an individual’s progress. HeadGym helps a person to identify strengths and provides long term support to enable people to make positive changes. Appointments can go from fortnightly to 3,6, or 12 monthly or longer with the option for a person to alter the regularity of sessions and return to more frequent appointments should their needs change. Sessions can be held face to face, via email, facetime, Skype, Google hangouts and other platforms, this enables us to reach out to more isolated people and to be very flexible and is particular popular with young people.
Using this mechanism people have progressed to manage their mental health and in turn make progress in other areas of life, such as gaining employment, losing weight, starting volunteer work. We have been monitored by referring agents, case studies have been conducted independetly and WEMWEB self assessments have been completed by clients, all of which validate the HeadGym approach.
Due to the proven success of our project we now want to train more Headgym coaches and reach more people.
 
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 / Innovation and adoption
Benefit to NHS:
Due to our long term more flexible approach we have seen that as HeadGym begin appointments other service provider interventions drop off; this varies from client to client, however the lessening dependency upon other services clearly has a benefit to the NHS in terms of cost and time. Clients are no longer repeating short term interventions over and over and start to make progress in all areas of their life, for example relationships, family, work, education and physical health.
Some of the outcomes that we have seen are improved diet, less GP appointments, reduction of dependencies (prescribed medication, alcohol, drugs etc) and therfore reduces the cost of future interventions and treatments.
Psycological interventions for issues such as suicide attempts, self harm, eating disorders are also avoided as clients build mental resiliance. Our approach also recognises the impact on the whole family and potential future generational problems, we have developed techniques for all age groups from age 3 upwards, this negates future requirement for intervention across whole families and generations. The cost saving is difficult to measure and potentialy could be huge not just for the NHS but also for social services, police, probation, courts, schools etc. 

Please see the link to a video of a client explaining her experience of HeadGym the sound quality is poor but the content is useful https://www.youtube.com/watch?v=J9AeJ7dCuYI
Online Discussion Rating
5.76 (33 ratings)
Initial Review Rating
3.00 (1 ratings)
Benefit to WM population:
The benefits to the WM population will be huge, we intend to roll out the HeadGym programme across the whole of the WM as an 'accessible to all' service by a variety of platforms using SKYPE, Google, email and welcome any innovative future platforms that may come along making access easier.

We recognise that mental health difficulties are not exclusive to people claiming benefits, we also recognise that many of the existing short term services are provided in the day when people may be working and are free only to benefits claimants. HeadGym want our service open to all. We are also advocates of a well being at work policy and provide mental health awareness training days for professional organisations, as well as 'in work' coaching for those experiencing mental health difficulties. This would also be encouraged across organisations, companies and statutory bodies throughout the WM area.

The HeadGym philosophy is to work with body and mind as one; therefore as people improve mental health they improve physical health and visa versa. This has an impact on the people around them and creates positive role models within families and for future parents.

Using the HeadGym goals process people using our existing service have made progress with education, volunteer work career development and peer support, in turn this has helped improve self esteem, confidence and creates a sense of purpose within the local area. I believe that replicating our success on a larger scale will have a positive impact upon the WM population. 
Current and planned activity: 
HeadGym currently work closely with the local authority, also  many of our clients have attended CAMHS support or psycological services provided by Hillcrest Hospital, we are in discussion with the CCG and will be providing HeadGym through the new well being hub.

We have integrated a webinar into our website to provide online training and discussions for coaches and are developing a series of  quick and easy videos to help clients. (see link)https://www.youtube.com/watch?v=S9PtKDN9Z24

We have a young persons peer support group in the early stages of development, which will also have a online group.

All HeadGym coaches have professional support/supervison and feedback sessions to evaluate and improve the service.
At present we are using WEMWEB and case studies to evaluate the service and would welcome any alternative evaluation tools. 
We would benefit from:
Financial investment to set up and create a sustainable business model.
Assistance with evaluation on social return.
What is the intellectual property status of your innovation?:
HeadGym does not have intellectual property status or trademark, we operate as a limited company.
Return on Investment (£ Value): 
Very high
Return on Investment (Timescale): 
1 year
Ease of scalability: 
2
Regional Scalability:
We intend to scale up in the same way we have done in Redditch and Bromsgrove. With our licensing model and online service we feel we could expand one area at a time taking care to retain quality of service. The model we have developed is a sustainable business model which ensures that income is generated from licensing training and ongoing coaching and expansion of existing income streams as previously mentioned.
Measures:
We will ensure that we are following the NICE guidelines as well as following the policies and procedures we have already adopted such as safeguarding CPD and DBS. With funding we will engage an independent evaluation and research agency who will provide full ongoing evaluation of the economic impact we are making and ensure a high quality of service in line with NICE guidance. We aim to have a sustainable business model that continues to achieve the outcomes we have made in the past and improve on them having independent evaluations and case studies.
Adoption target:
We aim to take a phased approach by licensing to operate our service one area at a time, rolling out across the West Midlands over the next 3 years, until fully adopted. We feel that retaining the quality of service is paramount to the success  therefore a well structured phased approach will enable thorough monitoring and evaluation.
Rejection Reason:
Further development required
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Initial Review Rating
3.93 (3 ratings)
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Innovation 'Elevator Pitch':
ACTIVATE YOUR HEART (AYH) is an online self-management Cardiac Rehabilitation (CR) programme that has been designed by cardiac rehabilitation specialists and patients at the University Hospitals of Leicester NHS Trust.
Overview of Innovation:
The ACTIVATE YOUR HEART (AYH) programme can be offered as an alternative way of delivering cardiac rehabilitation that is time and location independent.AYH was launched in November 2012 and is currently part of routine clinical care within the UHL NHS Trust.
The aim of the programme is to help people with coronary heart disease to manage their condition more effectively. It provides advice and support for individuals to make lifestyle changes and reduce their risk factors for coronary heart disease. Progress is monitored throughout by a CR specialist. AYH is password-protected and only those registered can access the programme. There is a mobile version of AYH. Over the last several years we have tested the acceptability and effectiveness of a web based approach to CR as an alternative to our hospital based programme
Patients proceed through four stages, each stage comprising specific tasks and individualised exercises. Interactive elements allow patients to record and monitor their weight, stress levels, smoking habit and exercise levels. Automated goals are generated based on the patient’s risk factor profile, such as the need to lose weight, stop smoking or exercise more.

The AYH web-based programme collates the following information; activity/exercise levels, stress levels, smoking cessation, goals (generated and own goals – achieved/not completed), how many log ins, how many questions to the ‘ask the expert’ link or forum.
Process outcomes
Uptake will be monitored and completion rates for
  1. Self-management programme offered in the community (closer to home)
  2. Uptake of cardiac rehabilitation (AYH website)
Value outcomes
  1. Improved quality of care for patients with cardiac disease
  2. Reduced A&E presentations for chest pain
  3. Reduced follow up appointments for chest pain
  4. Reduced readmissions rates for chest pain.
 
Patient & Public involvement - Two patients from our Patient and Public Involvement Group were asked to help develop our online cardiac rehabilitation programme. Both patients made a very positive contribution to the development of AYH, helping with the design and testing of the programme.
 
Very positive patient feedback "It has provided focus through its goals - and discipline in changing eating and exercise habits which I believe will be maintained in the future. An invaluable service - thank you."
 
Increased uptake to CR programme. There is a proposed ‘best practice tariff’ for patients diagnosed with MI.
 
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 benefits of Cardiac Rehabilitation (CR) are well established (Domain 1 of the NHS Outcomes Framework), although uptake remains disappointingly low at 50% (NACR report 2016). The NACR report acknowledged that ‘more should be done to support these options as part of the menu of approaches offered by programmes, as this can only help to improve uptake and adherence to CR’. The report also suggested that’ greater innovation in the mode of CR delivery, aligned with core evidence based components, should be undertaken by providers and commissioners to capture the large group of patients that are presently not taking up the offer of CR’.

ACTIVATE YOUR HEART (AYH) web-based CR programme was developed an alternative approach to providing support to patients with the diagnosis of Coronary Heart Disease (CHD) but with remote supervision. AYH is an online self-management Cardiac Rehabilitation (CR) programme that has been designed by cardiac rehabilitation specialists and patients at the University Hospitals of Leicester NHS Trust. Our initial development was supported by a Shine Innovation award from the Health Foundation. AYH is also documented in the National Institute for health and care excellence (NICE) website; https://www.nice.org.uk/sharedlearning/maximising-access-to-a-cardiac-rehabilitation-service-through-service-redesign-and-an-innovative-web-based-approach-activateyourheart

 The AYH web programme also addresses the British Association for Cardiovascular Prevention and Rehabilitation (BACPR) core components for change which includes; Lifestyle/cardio-protective therapies/psychosocial health/risk factor management, health behaviour change,exercise performance (Physical activity, risk factors, psychosocial, anxiety & depression and quality of life.
 
During our local Care Quality Commission (CQC) review AYH was highlighted under the heading of ‘Innovation, improvement and sustainability’, they also identified that there was a positive working culture at Glenfield, and innovative practices, particularly in cardiac and respiratory rehabilitation’.
 
Benefit to WM population:
AYH provides patients with an alternative choice to conventional cardiac rehab programme, one that better suits their lifestyle needs. The AYH Cardiac Rehabilitation programme is able to promote self-management, influence physical, psychosocial, and behavioural changes in a low to moderate risk group of patients.
Following a pilot study that we conducted using AYH, we found that 65% of patients who were enrolled on to the AYH programme would not have attended any other Cardiac Rehab programme. Uptake to cardiac rehabilitation within our trust is approaching 65%, well above the national average.
AYH programme has the benefit of being able to produce reports however data collection would continue via the local department specific database.
Staff would receive direct training from Cardiac Rehabilitation team within University Hospital of Leicester NHS Trust and have on-going telephone/email support in relation to patient and website queries for the year (Mon-Friday).
Activate your Heart provides patients with choice and a location and time independent rehabilitation service.
Over the last several years we have tested the acceptability and effectiveness of a web based approach to CR as an alternative to our hospital based programme, see evidence below;
Evaluating the Interactive Web-Based Program, Activate Your Heart, for Cardiac Rehabilitation Patients: A Pilot Study. Brough C, Boyce S, Houchen-Wolloff L, Sewell L, Singh S. J Med Internet Res 2014;16(10):e242 URL: http://www.jmir.org/2014/10/e242/ doi:10.2196/jmir.3027
Exploring the experience of using a web-based cardiac rehabilitation programme in a primary care angina population: a qualitative study. Reena Devi, Christine Carpenter, John Powell, Sally Singh. International Journal of Therapy and Rehabilitation | Vol. 21 | No. 9 | pp 434–440
A Web-Based Program Improves Physical Activity Outcomes in a Primary Care Angina Population: Randomized Controlled Trial, Devi R, Powell J, Singh S; J Med Internet Res 2014;16(9):e186, URL: http://www.jmir.org/2014/9/e186, DOI: 10.2196/jmir.3340, PMID: 25217464, PMCID: 4180351
Current research:
 
A Web-Based Cardiac REhabilitatioN Alternative for Those Declining or Dropping Out Of Conventional Rehabilitation: The WREN Feasibility Study. Two site blinded RCT. NIHR RfpB funded study.
 
Development of a web based rehabilitation module for those with Chronic Heart Failure.
Current and planned activity: 
AYH web-based programme has been developed for many years. It was re- launched in its current format since November 2012 where it has been embedded into the clinical service. Therefore we can offer years of expert knowledge of the site alongside our specialist clinical knowledge.
The AYH web-based CR programme is now being utilised by Trusts within the NHS to include; Forth Valley and Lothian, Leeds and Lincoln (research trial).Therefore training for the website has been delivered to a number of individual Trusts.
What is the intellectual property status of your innovation?:
Cardiac rehabilitation, University Hospitals of leicester NHS Trust own the licence for AYH web-based CR programme.
UKFast owns and operates all its datacentres and internal procedures independently.We have a sub contract with HARK 2 who maintain and update the websites.
All software management and support would be managed by UHL NHS Trust and HARK2.
Return on Investment (£ Value): 
medium
Return on Investment (Timescale): 
6-12 mon
Ease of scalability: 
Simple
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