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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':
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
Regional Scalability:
Easily scalable through referral code - either physical or digital.
Measures:
KPIs include engagement, weight and HbA1c outcomes. There is a real-time population dashboard.
Adoption target:
Adoption targets are 10% of the type 2 diabetes population.
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