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Idea Description
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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)
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Innovation 'Elevator Pitch':
Big White Wall provides accessible, evidence based online therapy via a secure platform. Sessions are available 7 days a week between 7am and 11pm, providing enhanced accessibility. KPI's are fully reportable and the service is CQC regulated. 
Overview of Innovation:
Big White Wall (BWW) is a digital mental health support service which has been operating since 2007 and has supported 150,000 members in distress.

BWW provides Live Therapy, which is face to face therapy via the secure platform. Our clients, can complete sessions via video, audio only or text only. We provide NICE guided, evidence based interventions for common mental health disorders, such as OCD, Social Phobias, PTSD, Panic, Depression, GAD, Health Anxiety and Specific Phobias.

Many of our existing commissioners are IAPT services and we are fully IAPT compliant in our delivery including the sessional collection and reporting of the minimum dataset (MDS). Performance data can be submitted by the referrer themselves, either by collecting and inputting data from our platform or through the IAPTus PRISM integration, which feeds session data (clinical notes, attendance data and MDS) directly into the referring IAPT service's own IAPTus system. Or BWW can also submit data through the BWW IAPTus system which allows us to report data directly via an N3 connection, into NHS Digital under the appropriate service code.

We provide both NICE guided evidence based CBT and Counselling interventions and all of our Counsellors are additionally trained in Counselling for Depression. We also have a team of Long Term Conditions specialists (IAPT LTC Top Up trained) who can provide specialised interventions for those experiencing physical health issues. All of our therapists are professionally accredited and are experienced with at least 2 years post-accreditation.

We are CQC registered for our Live Therapy provision and remain the only digital service to have received this registered status. Our governance systems are therefore acknowledged to be safe and robust. We are included in the NHS Apps Library, requiring stringent assurance that we meet national standards, regulations and industry best practice.
 
Live Therapy at BWW is available between the hours of 7am and 11pm, seven days a week. We are able to meet an accessibility standard that many IAPT services are unable to achieve.

We are able to scale up or scale down provision according to demand and our waiting times to assessment / first therapy session are often measured in days rather than weeks or months. We are able to implement new contracts at pace. 

We also provide clinically moderated peer support on the platform 24/7, which can augment patient self-management and provide intersession and pre . post treatment support.

 
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 / Digital health / Innovation and adoption / Person centred care
Benefit to NHS:
The benefits to the NHS of using BWW to deliver services include;

a) Eliminating unwarranted variations in health indicators and the outcomes of care - through the utilisation of national standardised measures and KPIs.

b) Improving and increasing equitable access as outlined in the Five Year Forward View for Mental Health, by providing digital interventions, not reliant on geographical location, not limited by affordability or complexity of transport. Available nationally online to all, removing socio economic barriers, with hours of service availability outside the scope of normal IAPT service provision. Clients can access high quality support from the comfort and safety of their homes.  

c) Giving the best possible experience for patients and carers by providing a high level of customer support and service satisfaction. Measured by standardised Patient Experience Questionnaires (PEQs) and survey data.  

d) More cost-effectively integrating care and resources around the needs of patients and populations though specialist LTC interventions.

e) Reducing healthcare utilisation costs (survey data reveals usage of BWW (peer support network) reduces GP / acute service usage across populations).

f) Reducing social isolation, stigma and associated costs in decreased in wellbeing, and increases in physical health decline and frailty

g) Population based access to BWW, provides early and easy access to mental health support, which aids the prevention and early identification of MH issues.

h) Use of BWW to provide services improves patient choice. Members can choose to remain within the sphere of clinically moderated peer support and self-manage using resources and self-directed courses or can engage with Live Therapy and can select a modality and mode of treatment.


i) Provides an embedded, scalable, evidence based solution which is cost effective, high quality and safe.

 
Initial Review Rating
4.60 (1 ratings)
Benefit to WM population:
Benefits to the WM population as outlined for the NHS
Current and planned activity: 
BWW provides services for several CCG's, Local Authorities and NHS Trusts, augmenting IAPT service provision. BWW has recntly completed a successful single point of access pilot for a London CCG, which allowed for population based self-referral into BWW Live Therapy. BWW submitted monthly data to NHS Digital and reported monthly recovery rates as high as 68% against a nationally set target of 50%. 

BWW is contracted by the MOD and the Home Office to provide Support Network peer support services and is currently commissioned by over 70 UK Universities. BWW is also comissioned by governement in Canada (Ontario Telemedicine Network) and New Zealand to provide Support Network access. OTN video linked here; https://youtu.be/OLG_OMHU4-s

BWW continues to grow and use technology for good and is currently undergoing a refresh of the platform - which  will enable an enhanced user expereince as well as improve the capability to innovate, scale and incorporate new technologies which augment care. 
 
What is the intellectual property status of your innovation?:
Intellectual Property is owned by BWW.
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
0-6 mon
Ease of scalability: 
Simple
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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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