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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)
Similar Content2
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)
WMAHSN priorities and themes addressed: 
Mental Health: recovery, crisis and prevention / Education, training and future workforce / Wealth creation / Digital health / Innovation and adoption / Person centred care
Benefit to NHS:

Workforce provision. NHS can struggle to recruit therapists. As the platform has no barriers of location of the therapist as they work from home it can utilise a workforce nationally and even internationally improving workforce provision and efficiency. It also brings those who may have taken a break from the NHS e.g. Maternity leave the ability to come back and work and provide for flexible working with the therapist putting up availability when it suits them to work.

Cost saving could save the NHS £29 million per annum if only 10% of current NHS face to face mental health appointments were undertaken using video technology. Our Cost for step three patient per appointment £60 NHS national average £100-160 (unit costs of social care).

Dr Julian reduces time taken off work by patients by allowing therapy appointments to be undertaken at the convenience of the patient around their life-style/work 24/7 therefore providing a benefit to the UK economy.

Dr Julian can assist with periods of high demand utilising our network of therapists nationwide and providing 7 day 24/7 help.


By utilising our platform we are able to create huge efficiency in the system and be 1/3 of the cost of traditional models of care. It enables us to utilise a national workforce  of therapists and enable patient choice of who they want to see and when. As therapists work from home it also provides out of hours appointments, is much better for them and allows them to work more efficiently via the platform. As assessments are undertaken on the platform that link with NHS systems it again makes the system more efficient as patients can undertake the assessment before the session maximising their therapy time with the need for minimal admin input as the system does most of the admin.

It also allows patients to see a leading expert in a particular area if they need potentially globally and allows them to be matched to the most appropriate therapist for them. We have already shown better clinical outcomes than standard practice with huge patient satisfaction.

It also helps those patients who may struggle to leave the house/ who are in remote areas and those that cant speak english as allows them to choose a therapist that can speak their language including sign language therefore helps ethnic and minority groups all they need is access to the internet which is ever improving.
 
Initial Review Rating
5.00 (2 ratings)
Benefit to WM population:
Dr Julian is currently being used in Thurrock, Lancashire on an going commercial contract and in Pilot with Oxleas, Milton Keynes and North London. It is gaining momentum with other IAPT services.

In a recent review of outcomes of our longest standing contract in Thurrock IAPT service we have delivered:

Improved recovery rates our recovery rate is 70%. The NHS average is 50%. Patient gets choice of therapist and therefore finds the right therapist for them, fast access to therapy at a time that suits them and from home.

Reduced DNA (did not attend) rates as the platform is built around patient choice. Our DNA rate is 5% as compared to the previous and NHS average over 20%.

Fast access to therapy reducing distress, symptomatology and negative thoughts/thoughts of self-harm. We have appointments available on the same day and all patients are able to book at a time of their choice within 2 weeks of receiving referral.

Dr Julian helps those house-bound and those who find it difficult to travel to appointments by allowing therapy appointments from wherever the patient finds them convenient such as their own home.

Dr Julian improves patient satisfaction as patients feel more comfortable accessing therapy from an environment they are more comfortable in with near 100% user satisfaction rating.

 
Current and planned activity: 
We are currently contracted with Thurrock Inclusion IAPT service, Lancashire Minds Matter with regular patients referred to us per month between 10-20 and increasing. This was post successful pilots with these two trusts. We are in pilot with Milton Keynes and Oxleas IAPT services with plans for longer term provision with them. We are in coversations with multiple other trusts who would also like to use our services due to the very positive word of mouth feedback from the other trusts. 
What is the intellectual property status of your innovation?:
We own all our IP 
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
6-12 mon
Ease of scalability: 
Simple
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Innovation 'Elevator Pitch':
NiceDay provides a complete digital treatment concept:
  • NiceDay app and portal
  • new “flexible” way of working
  • Continuous training, support and knowledgebase
Our validated approach improves cost effectiveness with > 30%, and similar health outcomes.
Overview of Innovation:
Our approach is truly unique: we provide everything needed for services to successfully set up ánd run an Online treatment team that provides fully digital treatments in addition to their regular activities.
 
With NiceDay you can provide CBT, and EMDR, with treatment protocols available for Mood disorders, anxiety disorders and trauma
 
IT platform:
Patients use a mobile application, therapists use an online environment:
  • Communication between patient and therapist through secure chat, videocalls, audio calls
  • Threeway calls to include specialist therapists into calls
  • Patients can easily connect to a therapist
  • Daily planner for patients to actively work on recovery
  • Tracking and monitoring, e.g. automatic step count tracking, diary, emotion logging
  • CBT tools, such as thought scheme.
  • ROM measurements before ánd after every session
  • Shared meeting notes from therapists or patients
  • Psycho education librairies for depression, anxieties, trauma
  • Community experiences and –content from both therapists ánd patients
Working and communicating in a new way:
Therapists have a “decision support” dashboard to help them work more flexibly, delivering care and support at the moment (and in the context) in which it matters. Therapists will still have sessions (screen-to-screen) with patients, but in between they will be much more pro active and involved in the progress and activities of the patient. Typically, therapists will spend up to 2 hours per day on interactions with patients based on their progress, and communications.

Setting up and supporting Online teams:
We help services setup their online team. We require the service to create a dedicated new online. We then provide full support in setting up the service. We also provide the training of the Online team members to develop new skills such as:
  • Using the NiceDay platform
  • How to create a therapeutic relationship through digital communications
  • How to work more flexible, more interaction with patients
  • Get familiar with digital CBT protocols and way of working.
  • regular (monthly) contact moments to provide feedback based on the data, and reinforce the digital way of working.
Key innovation:
NiceDay offers a complete end-to-end approach based on best practices that allows services to easily (within 3 months), safely (without high up front investments), and securely (NiceDay is ISO 27001 certified) setup a new online service for their clients.
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:
First of all, the NiceDay concept for Online teams works! In the Netherlands, we are able to get up to 35% of all patients with depression or anxieties treated within the Online teams. On average, the duration of the treatment goes down with 40%, and therapist time spent per patient goes down by 30%.

Patients rate the NiceDay service really high. They feel supported by having a therapist “so close” to them. Furthermore, they feel more flexibility to organize treatment around e.g. their work or family life. They feel more empowered in their own recovery.
 
Benefits for the NHS are to be expected in different areas:
  1. Cost effectiveness. Less time has to be spent per patient
  2. Reduce waiting lists. Treatment can be shorter in terms of duration and minutes.
  3. Better adherence. The NiceDay way of Working creates a therapeutic relationship faster. We expect dropout rates after 1 or 2 sessions to go down significantly.
  4. Access to underrepresented groups. A new online form to provide help can attract people that would find the threshold to go into regular treatment too high.  
In the Netherlands, NiceDay is mainly used in higher intensity treatment (up to 20 sessions). The results within the UK system, and specifically within IAPT is something that we would love to learn and evaluate within this innovation program!
Initial Review Rating
5.00 (1 ratings)
Benefit to WM population:
Benefits to health outcomes and cost-effectiveness:
NiceDay provides a cost-effective digital treatment concept (technology and CBT protocols):
  • Average time in treatment goes down with 30%
  • Effectiveness goes up based on the concept of “operant conditioning”
Benefits to mental health workforce:
NiceDay allows therapists to work more flexibly.
  • Location: NiceDay therapists work up to 80% from home, based on their individual preferences
  • Working hours: NiceDay therapists work more flexible hours to allow for a better work-life balance. Our experience is that if you leave this up to the individual therapist, they can find a way to structure their work that is fitting for them
Therapists feel more empowered, and experience less stress because of these benefits. Sick leave due to mental health problems has decreased drastically within our Dutch therapist teams.
 
Attracting new user groups:
As NiceDay allows to launch a digital service, it is the expectation that it will attract different user groups that are normally underrepresented in current patient populations. Our experience is that the threshold (e.g. in patients who experience a lot of shame) is lower with an online service. Furthermore, people who find it problematic to visit a location (e.g. because of mental stress, disability (in elderly people) ) or in areas in which population is scattered and services are not nearby, there is a huge benefit of online treatment.
 
Fighting mental health stigma:
The NiceDay community allows (and encourages) both therapists and patients to share their experiences. (www.blog.niceday.app) This community also helps fight stigma, and lower the threshold to seek help.
Current and planned activity: 
We are currently active in the Netherlands.

We have an R&D collaboration with Mayden Health. We are now investigating how we could help services in the UK setup Online teams in line with the Dutch model.

The collaboration with Mayden Health will help integrate our digital treatment into existing service infrastructure through the Prism service offered as connectivity with Iaptus.
What is the intellectual property status of your innovation?:
All IP held by company
.
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
6-12 mon
Ease of scalability: 
2
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