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Idea Description
Supplementary Information
Innovation 'Elevator Pitch':
Dr Julian is an innovative mental healthcare platform that aims to increase accessibility of mental healthcare. We connect patients to mental healthcare professionals by secure video/audio/text using a calendar appointment booking system.
Overview of Innovation:
We empower patients allowing them to see who they want to see when they want to see them where they want to see them and how they want to see them, they can choose who they want to see from a list of available therapists and can filter via issue (depression/anxiety etc)/ language/ therapy type/ date/time, therefore finding the therapist that meets their needs. They then book with the therapist on the system and then have the appointment on the system. They therefore can have the appointment from wherever they want so long as they have Internet access.

Notes are then stored securely on that patients profile on the system.

Patients take assessments on the system in line with NHS data requirements, which are stored on the patient’s profile.

Patients have access to their assessment results through their dashboard at any time and they can use the platform for taking and viewing assessments i.e. GAD7 and PHQ9 both during and post NHS treatment including the ability to book further appointments privately.

The platform can store any communication between the patient and therapist in regard to advice and suggestions that they may make in regard to treatment and which are available to the patient at all times.

We can create unique customised sub portal domains we call ‘tenancies’. This can be branded to the NHS trust and have a customised registration form and patient’s notes template. This allows customisation to help NHS staff. We are currently being used in IAPT services with an 80% recovery rate as compared to the NHS under 50%, we are also being used by a number of corporate organisations providing mental health for their employees and could be used by the NHS to help their staff.

We assign therapists to the individual tenancies so that only these show up. This way if an IAPT provider only wants CBT therapists currently working within IAPT they can have this. If they want a pain psychology service we only upload the pain psychology therapists to this tenancy.

A trust could use its own therapists for this platform or could utilise our network providing out of hours and weekend appointments and at periods of high demand.

We can assign admin permissions to NHS staff to onboard patients to the system, see and download the patients notes/ registration/ assessments. When a patient is onboarded they can be assigned a set number of appointments, which is editable.

We have integrated with the PRISM system to allow automatic upload of this data into NHS IAPT systems.
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':
We connect people with a mental crisis to practitioners using a smartphone in an instant. Irrelevant of culture, language, or geography, instant access to counselling will be swiftly available, affordable and secure.
Overview of Innovation:
The launch of TOSPS (The One Stop Psychotherapy Shop) as an online secure platform from which therapy can be both sought & delivered lends itself to a real opportunity to revolutionise the way face-to-face crisis mental health therapy is delivered to people in need, in any location via the introduction of a crisis care platform.
It is vital that people have an opportunity to be assessed as quickly as possible before a crisis point is reached, therefore the development of a minimum interaction app to compliment the TOSPS web site is vital to ensure that people in (or approaching) a crisis are connected to a therapist quickly.
Background applications can enable complicity with NHS, Local Authority & 3rd sector mental health service provider’s requirements & interact with the digital systems records, booking systems within one application. An affordable application that is nondependent on any particular proprietary platform.
Early detection trigger guidelines allow quick diagnosis & referral to treatment for the client. Alerts to service users, carers & professionals when risks of crisis within individuals are elevated, prompting a call from a therapist or practitioner where applicable.
This app ensures that getting help & or treatment is as simple as ordering a pizza, To assist users, all of our registered therapists display our unique “on-line” light showing that they are available right now to provide instant help. The app can analyse stress triggers & alert people to potential looming issues, & seek early prevention treatment & can link to applications such as iHealth & S Health.
Payment modules can be adapted for pre-booked appointments or after event payments. Some people may wish to approach things methodically & be directed to the Mother web site, others who are in advanced crisis can be connected to immediate help via the app. The security protocols are already developed to reach current IGSoC compliance HIPAA & peer to peer security is established.
Stage of Development:
Close to market - Prototype near completion and final form may require additional validation/evaluation and all CE marking and regulatory requirements are in place
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 / Person centred care
Benefit to NHS:
Reduce waiting time within the NHS by providing a pool of therapists across all sectors and specializations to be available at all times for emergency crisis intervention therapy and early diagnostic triggers.
Doctors and emergency services would have a central point of call with said pool of therapists who are available to provide face to face online counselling sessions in real time, day or night .
Reduction of waiting time has a positive effect on the reputation of local NHS facilities. The introductions of a central point of contact for therapy online would complement and provide the newer and more modernised NHS with a natural extension to its future modernisation programs in the deliverance of new methods for client access to crisis therapy, using the technologies the public already use on a day to day basis, phones tablets etc.  
Early intervention will reduce cost of treatment in the short and long terms. People can effectively access counselling from home thereby freeing up seats and room occupation.  Effectively the client pays for their own cyber space as opposed to the costs of the provision of therapy rooms and space.
Emergency room on call crisis mental health teams can see a relief from the growing numbers of people needing mental help assistance in the A & E. A triage type system implemented directing those in need of counselling either direct to a practitioner online or to a hospital department will streamline priorities. Cancellation time loss can be recycled. Run over time can be reduced as the client’s portal closes as soon as the session allocated time has finished. 
Safety to staff and clients is enhanced as there is no physical presence. Holiday and sickness schedules would no longer impact on the availability of counsellors, The pool of available therapists can expand and decrease to meet demand.
Geographic boundaries are removed and a greater pool of therapists are available. Therapists with free time can instantly be available to work. Language skills and multicultural issues can be less hindrance, as availability of specialized counsellors with extra skill sets can be found instantly.
Emergency triage of crisis mental health care can be portable, particularly in suicide situations. A seamless way to integrate private and NHS staff to provide counselling in times of public crisis and emergencies such as acts of terrorism or acts of God will be in place. 
Initial Review Rating
4.40 (2 ratings)
Benefit to WM population:
The West Midlands is a densely populated area; the residents are very diverse, multicultural with wide ranging needs. 
TOSPS has counsellors and therapists with a wealth and bounty of specialisms bringing with them an abundance of different language skills, English to Swahili, African, Asian, and European languages, a wide range of backgrounds, cultures, skills and knowledge would open counselling up to ethnic minorities who might shy away from help due to cultural inhibitors, fear of violence, shame or adversity.
The availability of therapists to meet their own cultural requirements without fear of prejudices is a key for some minority groups.  
The system caters for multiple needs, the 24/7 availability means that shift workers or people who experience crisis at all times of day and night will have access to someone who will help them.
Interactions with the app, intentional or unintentional, can act as a conduit to signpost people in crisis to the correct people for help. The socio-economic effect on work place downtime figures will improve as time away from work travelling to and from appointments can be removed.
Calibration with the Police and other social help associations like suicide watch will offer a portable crisis care that will assist them in their roles on the ground. The domino effect of assisting individuals take control of their mental health will filter through to the family environment.
Push notifications will remind people of follow-up appointments, and assure them that their practitioners have been notified of current or prior episodes.  
Large exhibition centres and train stations will be able to send push notification advising mentally vulnerable people registered on the system what to do in times of crisis, terrorism.  Alleviation of waiting times within NHS will promote a real improvement which will be noted by the people.  The app will empower those who often feel powerless and deliver an element of control back to those patients and can act as a buddy system bringing comfort to the mentally ill.  
A more settled and happy community who will support their NHS when they can see or hear that real progress has been made in the reduction of waiting times and costs to their NHS.  Instant access gives them control and boosts confidence. Portability of the app means counselling can be physically brought to the client any place. 
Current and planned activity: 
To grow the numbers of therapists currently registered to provide counselling online both mainstream and crisis care intervention to a start headcount of 400 therapists initially. This would provide scope to have 6 teams of 66 therapists online in 4 hour shifts across a 24 hour period. Training is already underway to ensure that each therapists IT equipment is cyber safe and certified on an  annual basis to protect data and patient confidentiality.
To develop a single point TOSPS app that can deliver all the benefits previously detailed whilst allowing the NHS to track patient costs / usage / progress automatically and work on a NHS agreed pricing and invoicing schedule for covered therapy. Additional therapy could be purchased directly by the patient or family members to supplement NHS treatment and referral fees could be offered back to the NHS to fund research into the benefits of online therapy to further promote the services and reduce overall costs of care
What is the intellectual property status of your innovation?:
TOSPS own all the rights to the name TOSPS and the delivery platform. The TOSPS app will be owned by TOSPS and their developer Proxicon who will continue to develop and maintain the app. 
Return on Investment (£ Value): 
Very high
Return on Investment (Timescale): 
6-12 mon
Ease of scalability: 
Simple
Regional Scalability:
The model can be classified as Simple scalability : 
Measures:
Due to the nature of the service we will be able to provide in depth reporting on the number of referrals received which have had a successful outcome in terms of delivery, we will be in a position to deep dive data which will show the number of therapeutic hours being delivered over any given time period and relate these back to specific NHS referrals.
We also believe that by engaging with NICE and IAPT and inviting them to independently monitor the quality of service and outcomes, we can confidently report on the successes and the learnings as TOSPS moves forward with the NHS.  TOSPS.com will also commit to working with other external agencies within the NHS and beyond to further understand the outcomes of its service with a view to continued development its services, feedback will be essential not only from clients but also from referring partners and charitable organisations.
 
Adoption target:
Currently the infrastructure to deliver this service is in a state of readiness; We believe that in order to launch effectively for WM NHS we will need in the region of 400 additional therapists. We will need some support from the NHS in the form of internal marketing to NHS therapists and referring agencies,
Rejection Reason:
Suitability of model to NHS
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Innovation 'Elevator Pitch':
Ieso Digital Health delivers NICE recommended cognitive behavioural therapy (CBT) one-to-one between patients and IAPT trained therapists via online (live) typed conversation. Appointments are available when suit patients on any web enabled device.
Overview of Innovation:
Ieso Digital Health (“Ieso”) provides NICE recommended cognitive behavioural therapy (CBT) through our proprietary 'ThinkWell' web-based platform. Both Step 2 and Step 3 therapy is delivered one-to-one between a patient and an IAPT-trained PWP or a BABCP-accredited high intensity therapist online through typed conversation, supported by offline messaging in-between sessions; treating all IAPT-applicable conditions:
  • depression
  • generalised anxiety disorder
  • social anxiety disorder
  • panic disorder
  • agoraphobia obsessive-compulsive disorder (OCD)
  • specific phobias (such as heights or small animals)
  • PTSD
  • health anxiety (hypochondriasis)
  • body dysmorphic disorder
Ieso’s fully-managed service has been developed in association with, and operating within, the NHS IAPT services since 2011. We have steadily built up our customer base and are now commissioned in over 65 CCG areas across England, either working directly with the CCGs or as sub-contractors to NHS Trusts and independent healthcare providers. To date Ieso have treated in excess of 43,000 patients and conducted over 210,000 hours of therapy within the IAPT programme.

Ieso summary information sheet is attached for review.
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 / Digital health / Innovation and adoption
Benefit to NHS:
With growing demand for psychological therapies, traditional services can struggle to maintain NHS service standards relating to access, waiting times and recovery. As a result, services from around the NHS need to consider how to extend their care to patients without increasing their costs; including delivering digital interventions for appropriate cohort of patients. Although our service utilises the same human resources for the therapy itself, we have no additional overheads with regards to room hire, travel costs or other traditional overheads seen within the NHS.

Ieso's financial model is focused around patient treatment with no limit on session numbers. Pricing is based upon per episode of care, meaning a certain number of patients will be treated as part of allocated budget rather than assumed therapist capacity. 
 
Analysis of that data (Jan-Dec 2017) shows that Ieso delivers:
  • 22% better outcomes than the national average
  • 48% more patients’ complete treatment than the national average
  • 96.5% accessing treatment within 6 weeks, compared to 93.7% nationally, but with no waits for subsequent appointments.
In addition, Ieso’s “patient experience questionnaire” data shows that 82% of patients rate Ieso as good or excellent, and 66% of patients’ treatment is conducted outside of normal office hours.
 
The benefits of our innovation are not limited to quick and flexible access to treatment and better outcomes for patients. Our unique position of having access to extensive patient data can be used in clinical research to develop improvements in mental health care:
• Catarino, A. et al. (2018) Demographic and clinical predictors of response to internet-enabled cognitive–behavioural therapy for depression and anxiety. BJPsych Open (attached.
• Ewbank, M. et al (2019) Quantifying the Association Between Psychotherapy Content and Clinical Outcomes Using Deep Learning (attached)
Initial Review Rating
5.00 (1 ratings)
Benefit to WM population:
Patients are able to access clinically validated, NICE-approved, one-to-one typed CBT with an IAPT-trained PWP or BABCP-accredited high intensity therapist from the comfort of their own home using nothing more than their smartphone, tablet or computer to access our ThinkWell platform via a reliable internet connection.

With appointments available 24/7, traditional CBT can be conducted at a time and place that suits the patient. This means that those who are time poor, struggle to access traditional services due to geography, physical difficulties or personal boundaties are able to access the treatment that's right for them.

Approximately 66% of Ieso’s therapy sessions happen outside the traditional Monday-Friday 9-5 window,
with the majority taking place on week day evenings; in addition, Ieso’s “patient experience questionnaire” data shows that 82% of patients rate Ieso as 'good' or 'excellent'.

You can view an Ieso explainer video here:
https://www.youtube.com/watch?v=H5cID-JGSXU

As well as a 'people' video showing some of the people behind Ieso Digital Health here:
https://www.youtube.com/watch?v=ryIFZNBVkhk

We have also attached a patient case study.
Current and planned activity: 
Ieso manages IAPT contracts with large footprints, such as in Surrey, where we treat approximately 20% of the total number of patients accessing IAPT across the five CCGs within the AQP contract. In addition to Surrey, Ieso holds 26 IAPT contracts delivering a Primary Care Psychological Therapies Services. These contract areas are listed below;
•        Bolton
•        Bromley
•        Camden
•        Cambridgeshire and Peterborough
•        Derbyshire
•        Devon
•        Dorset
•        Dudley
•        East Riding of Yorkshire
•        Gloucestershire
•        Buckinghamshire
•        Herefordshire
•        Islington
•        Lancashire
•        Leeds
•        Medway
•        Merton
•        Norfolk
•        Nottinghamshire
•        Salford
•        Southampton
•        Southwark
•        Suffolk
•        Sussex
•        Wandsworth
•        West Kent

We continue to expand enabling more and more people to access clinically-validated CBT at a time and place that suits them.
What is the intellectual property status of your innovation?:
All IP is owned by Ieso Digital Health.

Ieso is ISO9001 and ISO27001 compliant and our IG Toolkit for 2017-18 (v14.1) had an overall score of
95%.

Ieso is fully operable with all major patient management systems (IAPTus, PCMIS).
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
6-12 mon
Ease of scalability: 
Simple
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Innovation 'Elevator Pitch':
The groundbreaking, secure hub that allows therapists to seamlessly and securely refer patients for online psychological treatment, and receive progress notes and outcomes data directly back into their NHS electronic patient record.
Overview of Innovation:
The Prism referral hub connects psychological therapy services with a variety of online digital therapies. Prism enables services to seamlessly and securely refer patients to a chosen online therapy and receive progress notes and outcome measures back, all from within their NHS electronic patient record. 

The Five Year Forward view for mental health and NHS Long Term Plan set ambitious targets to widen access to Improve Access to Psychological Therapies (IAPT) services across the country. This can only be achieved with greater uptake of online therapy options alongside growth in face to face and group therapy.

Prism was designed to make it easy for IAPT services to make use of online therapies. When a referral is received into the iaptus patient management system used by the majority of IAPT services, that patient can be referred straight through to a chosen online therapy partner from within the patient's electronic health record in iaptus so they can start virtual treatement without delay. The online provider can then securely send progress notes and outcome measures straight back into their health record. Previously, referring to an online therapy provider required, at best, laborious copying and pasting, or, at worst, a serious data quality challenge often with significant administrative support. The Prism hub has overcome all of this. Services gain efficiencies, patients have an improved experience, therapists can focus on the patient rather than admin, and outcomes are maintained – or even improved.

Since launching in 2014 Prism has been used by more than 60 IAPT services and currently handles 3000 referrals to online therapies each month. Prism is already  connected to Big White Wall, Compass, Dr Julian, ICS Digital Therapies, Living Life to The Full, Minddistrict, Silvercloud, Wellmind Media and OxCADAT SAIT with new online therapy partners being added all the time.

Prism was developed and is managed by Mayden. We have worked with IAPT services since 2008 to provide iaptus, the leading patient management software for psychological therapies. During this time, we have seen first-hand the limited resources and growing demand for IAPT services and recognise a need to provide innovative solutions that increase capacity.

Prism was developed with support from the NHS SBRI Healthcare initiative. We continue to work closely with IAPT and with a variety of online therapy providers to offer a breadth of choice for patients and services.
 
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 / Digital health / Innovation and adoption / Person centred care
Benefit to NHS:
Services gain efficiencies by making use of online therapies for appropriate patients which can be cheaper and more cost effective than face to face treatments. Patients have an improved experience with immediate access to treatment, and virtual treatment being more convenient or preferred to face to face therapy. Therapists can focus on the patient, rather than administration of referrals and can maintain an overview of the patient using digital treatments. They may also blend digital with face to face where clinically appropriate. Outcomes are maintained – or even improved - through online therapies.
Initial Review Rating
4.60 (1 ratings)
Benefit to WM population:
As for the NHS as a whole.
Current and planned activity: 
Prism is connected to ten digital providers. It handles around 3000 referrals a month now, and is used by 60+ IAPT services across England. We continue to add new online digital partners to the Prism platform.
What is the intellectual property status of your innovation?:
Mayden holds the IP for Prism.
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
0-6 mon
Ease of scalability: 
Simple
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