Idea Description
Supplementary Information
Innovation 'Elevator Pitch':
This is a risk stratification model that aims to predict and prevent crisis by segmenting the mental health patient population by risk and likelihood of an acute mental health crisis.
Overview of Innovation:
Currently, the response to mental health crisis is mostly reactive. To address the increasing pressures faced by the urgent care services by patients presenting with mental health crisis, prevention and early intervention must be prioritised. This will not only alleviate pressure of several emergency care services but will also improve patients’ prospect by ensuring timely interventions that avoid patients’ mental health deteriorating further.

The Rapid, Assessment, Interface and Discharge Plus project, in partnership with Telefonica Alpha, aims to achieve this by developing and validating a risk stratification model and algorithm to predict mental health crises. The risk stratification model will use four years of pseudonymised clinical and sociodemographic data to capture potentially robust predictors from a wide range of sources to provide an overall indication of a patient’s risk of experiencing a mental health crisis.

By applying the model onto the Trust’s mental health population, we can stratify the patients into different risk groups and subsequently target the highest risk segment of the population for preventative early intervention with improved accuracy. This information will be provided to clinicians who will determine the necessary measures required to prevent the progression from high-risk status to actual mental health crisis. This will act as a ‘clinical support tool’ for clinicians in making their decision and does not replace the clinicians decision on how to manage patients.

The project will look at how the risk stratification model can be implemented into practice, working with Community Mental Health Teams (CMHTs) to pilot the model. The model will be refined, tested and validated by a team of data analysts, clinicians and to embed it into systems for routine clinical care. Using this tool can help improve patient care by avoiding unnecessary admission, presentation at A&E, or potentially prevent an escalation in the worsening of a patient’s mental health state.
Stage of Development:
Trial stage - Trial stage to prove that the idea actually works as intended
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Innovation 'Elevator Pitch':
The bespoke training programme aims to increase mental health awareness and increase skills in identifying and managing mental health crisis with emphases to referral pathways that can be applied in operational practice by frontline professionals.
Overview of Innovation:
Rapid, Assessment, Interface and Discharge Plus takes a more localised training approach and has identified priority front line services that frequently coming into contact with those suffering from mental illness and potentially at risk of crisis i.e. Police officers and Community healthcare professionals who are working with individuals with both physical and mental health difficulties.

The training aims to increase knowledge and understanding of mental illnesses as well as support early referral and appropriate management of individuals who are experiencing deterioration in their mental health. The overall aim is to build confidence and competence in front line professionals and generate a supportive and informed approach when working with those in mental health distress.

The training modules are as follows:
  • Understanding mental illness: Signs and Symptoms of mental health
  • Effective de-escalation and communication skills
  • Understanding Mental Health Act (1983) and Mental Capacity Act (2005)
  • Crisis Prevention and Management (including risk assessment of suicide and self-harm)
  • Dementia
The training package offers provision to tailor elements of the content to suit the locality’s policy and services available, should organisations wish to implement the  training. For example, the 'Crisis Prevention and Management' module explores referral pathways and services available within Birmingham and Solihull Mental Health Trust. These could be easily amended to reflect the organisations services to ensure the training maintains its bespoke, localised approach. The training can be customised but would generally take a full day to cover all modules.

This allows for local frontline professionals that come in contact with mental health patients to be able to identify and prevent patients going into crisis by referring patients to access appropriate mental health support in a timely manner.

The training is delivered by a registered mental health professional to ensure that the full potential of learning amongst participants is achieved. The experience and understanding of such an individual will aid questions posed throughout the training and allows them to draw to from previous experiences/scenarios from real life mental health practice within the delivery.
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 / Education, training and future workforce / Innovation and adoption
Benefit to NHS:
National directives indicate that, in general, the public should have a baseline knowledge and understanding of mental illness (Public Health England, NHS Five Year Forward View). It is nationally acknowledged that many patients with long term physical health care conditions have a diagnosed mental health issue (NHSE FYFV). Due to limited training and data sharing the co-ordination of care for these patients is often fragmented (Crisis Concordat, 2015). This may result in patients experiencing mental health crisis and entering the urgent care pathway unexpectedly. This causes pressure on urgent care services and could also impact the patient experience.

Our vision is to help develop a community healthcare workforce that is fully trained in mental health, with access to the right tools and pathways to support patients suffering with mental health issues. This will ensure that patients with comorbid conditions are positively supported to access the right care, at the right time in the right place. The better management of the mental health care can have a positive impact to patients' care as well as possibly avoiding their mental health deteriorating further.

In 2015 the Mental Health Network Confederation highlighted; "the police and mental health providers need to understand each other’s legal powers, roles and responsibilities "to manage /reduce the risks associated with mental health crisis". Additionally, the police often come in contact with people experiencing mental health distress and usually have to manage difficult and complex situations. Training is needed to equip them to recognise and assist when someone has a mental health issue or learning/intellectual disability. This is in line with the College of Policing requirements for mental health awareness training within the police force.

The police are frequently in contact with people suffering from mental health problems, so to be able to identify these symptoms and be able to direct them to right pathway in a timely manner is a huge benefit as it can save the person further unnecessary complications and faster access to help. The police would also benefit by being able to correctly manage people undergoing mental health distress when responding to mental health-related incidents. They will be able to acquire practical skills to spot the triggers and signs of mental health issues and be able to confidently step in, reassure and support a person in distress.
Initial Review Rating
1.00 (1 ratings)
Benefit to WM population:
Within the West Midlands 20-40% of police time is dedicated to those experiencing mental health difficulties. Therefore, the ability to identify symptoms and signs of mental health distress and be able to refer patients to the appropriate pathways ensures a better and efficient system. The training helps police develop skills to manage those with mental health illness/facing mental health crisis and saves time and resources. The training will cover the Mental Health Legislation and Mental Capacity Act which aligns with the College of Policing training requirement for the West Midlands Police.

By training the Birmingham Community Healthcare Trust staff, this supports staff being able to ensure the patients with long terms conditions that have signs of mental health issues are supported to access the right care in a timely manner. Having an understanding of the mental health support pathways and services for patients avoids patients experiencing mental health crisis by early intervention and reduces unplanned emergency visits to the urgent care system.

There is wider scope however for target audiences and suggestions to be considered for future delivery of the training include:
  • Wider community and health care teams within Birmingham/ Solihull
  • Schools, universities and colleges
  • Ambulance services
  • Fire Services
  • Workplace learning and team building
Current and planned activity: 
To date, the RAIDPlus training package has been created and delivered by the mental health trainer who is a registered mental health nurse with a number of years’ experience within acute mental health. The training was delivered to 1600 staff across the West Midlands Police and 150 Birmingham Community Healthcare staff.  

The police training was tailored and aligned to the learning objectives of West Midlands Police. This is in connection to the College of Policing requirements and Authorised Professional Practice for mental health within the police force. The community trust training was tailored to meet the learning needs of staff to capture the referral pathways and crisis prevention elements relevant to their services. Overall, the training was positively received by staff and early outcomes suggest improved capacity to provide supporting interventions to reduce the risk of crisis.
What is the intellectual property status of your innovation?:
BSMHFT is the provider of this training package.
Return on Investment (£ Value): 
Return on Investment (Timescale): 
Ease of scalability: 
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Innovation 'Elevator Pitch':
Our expert people and advanced health analytics reveal insights from complex data that enable health & care professionals working across the West Midlands to make better decisions for the patients and populations they serve.
Overview of Innovation:
Sollis and the world-renowned Johns Hopkins University have collaborated to produce a population health analytics platform that helps health & care professionals transform services for patients and populations.
Sollis Clarity and The Johns Hopkins  ACG ®System is a person-focused case-mix system that captures the multi-dimensional nature of an individual’s health. It considers the total disease experience of each patient, including the implications of co-occurring disease, encouraging a holistic view of the patient rather than the management of specific diseases or episodes.
Sollis Clarity supports:
  • Case Finding - Patient level risk stratification
  • Resource Management - Case-mix risk adjustment and benchmarking
  • Population Health Needs Assessment - Population level risk stratification
  • Fair Shares Budgeting - Capitated budget setting
Sollis Clarity delivers robust business analytics and data management to identify and analyse populations across the continuum of care to help health & care providers and commissioners get a precise understanding of patterns of mult-morbidity across populations and its relationship to utilisation, costs and outcomes.
Sollis Clarity delivers insights into the morbidity patterns of different populations, supporting population health management, service transformation, integrated care and, ultimately, better outcomes for patients.
Sollis Clarity goes beyond patient level risk stratification. Risk stratification at a population level helps the health economy — providers and commissioners — analyse and minimise the progression of diseases and the exacerbation of co-morbidities. When combined with the ACG System it is a comprehensive family of measurement tools designed to help explain and predict how healthcare resources are delivered and consumed.
Sollis Clarity provides the evidence base to support:
  • Planning and service re-design
  • Clinical decision making
  • Outcomes-based commissioning
  • Risk stratification and predictive modelling
  • Population profiling / segmentation
  • Case-mix adjusted benchmarking
  • Integrated multi-disciplinary care
To view Sollis - Nigel's Story - click here.
To view UK Healthcare data analytics for NHS CCGs - click here.
To view The Proactive Care at Brighton & Hove - click here.
To view Population Profiling at NHS Slough CCG - click here.
To view Using Data to Gain Greater Insight - click here.
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 / Wealth creation / Digital health
Benefit to NHS:
Population health analytics delivers an evidence base (insights from data) that supports large scale health & care service transformation. It is an essential component of any Population Health Management strategy and as such underpins the journey to a fully fledged Accountable Care System (ACS).

The Sollis Clarity health analytics platform is a modular system with mix-and-match components to help you achieve your healthcare analysis and commissioning/budgeting requirements.
Population health management helps Health & Care stakeholders identify and quantify the drivers and outcomes for addressing the needs of local populations.
Led by directors with decades of NHS experience, Sollis analytics software and professional services have been used to analyse data on nearly half the population of England. We believe patient-centred care strategies based on the needs of local populations provide the key to better population health management.
Sollis Clarity is helping several CCGs in the UK to implement new reporting and service planning initiatives.  To view examples of ‘Service Transformation: Stories from the CCG Frontline’ summarising how CCGs are using the insights provided by Clarity Patients and ACG® System analysis for service planning and transformation – click here.
The Sollis Clarity health analytics platform has two distinct but complementary solutions — Clarity Patients and Clarity Finance — address population health management and financial analysis respectively.
Clarity Patients, combined with the Johns Hopkins ACG® System, provides a comprehensive family of measurement tools that helps explain how healthcare resources are delivered and consumed. It supports new commissioning models such as Commissioning for Value, Outcomes Based Commissioning and Year‑of‑Care Commissioning. It delivers analytics that provide insights to support health & care interventions and innovation and it will help you track the success — or otherwise — of those innovations over time.
Clarity Finance provides contract management and activity costing with multiple tariffs, giving you business critical evidence on which to base commissioning decisions. It enables you to store and compare different versions of cost and volume type tariffs as well as non-activity tariffs, such as year of care or outcome based currencies, to give you insights on the most effective commissioning decisions.
Initial Review Rating
5.00 (1 ratings)
Benefit to WM population:
Knowledge of the risk profile of the region’s population (based around a population segmentation approach) will help Health & Care stakeholders across the West Midlands commission and deliver appropriate preventative services that will drive positive health outcomes for the 'at need' populations of the West Midlands. 

Through the innovative use of information technology to identify patients most in need of an intervention (impactable patient cohorts) Sollis Clarity helps to identify patients who could most benefit from earlier, better informed health care interventions.
The Sollis population health analytics platform allows the patient population to be risk assessed to provide timely, evidential data to all members of a Multi-Disciplinary Team (MDT), to include clinicians but not limnited to them. This enables MDT members to provide focused levels of care to specific groups of patients, reducing the risk of a patient’s condition worsening due to it being identified early so assisting MDT members in identifying and improving the care of at-risk patients.
Much can be achieved through the acquisition of primary care, secondary care, community care, mental health, prescribing and social care data. It can provide a rich understanding of how healthcare resources are delivered and consumed and by whom. Such analysis can aid an understanding of whether scarce resources are being deployed to those population groups in greatest need.
It is important that any population health analysis should focus not on single disease conditions, but on the burden of multi-morbidity observable in a local population.  Population health programmes that have the best chance of success will be those that demonstrate an understanding of the importance of multi-morbidity and its impact on the local health and care economy.
Using data to identify early healthcare interventions can provide significant benefits to patients, particularly those with long-term conditions. Providing the functionality to make real time decisions based on clinical evidence will improve outcomes for patients.
Sollis exist to help our customers deliver better patient outcomes, better patient experiences at an affordable cost and are wholly focused on the delivery of insights that will help deliver a sustainable and transformed health and care system in the West Midlands.
Current and planned activity: 
We are currently providing analytics support to thirty (30) plus Clinical Commissioning Groups (CCGs) nationally as well as nine hundred (900) plus GP practices and a number of NHS Vanguards, principally Multispecialty Community Providers (MCPs).

We would like to engage with health and care professionals involved in the development and evaluation of New Care Models throughout the West Midlands who want to use evidence based data to understand patterns of multi-morbidity and its relationship to utilisation, costs and outcomes. We are particularly interested in engaging with Sustainability & Transformation Paernerships (STPs) and emerging Accountable Care Systems (ACS).
What is the intellectual property status of your innovation?:
Sollis owns all Intellectual Property (IP) for the following software applications:
  • Sollis Clarity (Population Analytics Platform)
  • Sollis Clarity Patients
  • Sollis Clarity Finance
 Johns Hopkins Health Care (JHHC) owns all Intellectual Property (IP) for the following software:
  • ACG® System
  • ISO9001
  • IG Toolkit Certified
Return on Investment (£ Value): 
Return on Investment (Timescale): 
3 years +
Ease of scalability: 
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Innovation 'Elevator Pitch':
CaDDI provides ‘live’ capacity and demand information across the Mental Health Urgent Care Pathway through an internet based dashboard. This provides a realistic resource and bed capacity and referral demand across the urgent care pathway and beyond.
Overview of Innovation:
The Midlands and Lancashire Commissioning Support Unit (MLCSU) , in partnership with Birmingham and Solihull Mental Health NHS Foundation Trust (BSMHFT), have developed a live Capacity and Demand Dashboard Information (CaDDI) system for use across the mental health urgent care pathway. It delivers improved patient pathways by providing managers and operational staff instant access to ‘live’ patient flow information, allowing them to make more informed decisions on staff deployment and onward referrals based on data-led assessments. 

The CADDI package consists of two elements:
  • A mobile APP solution to collect ‘live’ data from operational teams, on their current capacity, and progress of their patients’ journey throughout the referral process;
  • A ‘live’ dashboard providing an overall capacity and demand summary status across the Urgent Care pathway, with drill down functionality to a service/team level.

The CaDDI system can be populated from any source that can send live structured data or can use the app developed to enable the live gathering of data.

Currently the data capture systems options include:
  • Rapid, Assessment, Interface and Discharge teams (In-reach service hosted within another organisations)
  • Decision Unit (location based service, with defined number of places available)
  • Place of Safety (specialised location based service, with defined number of places available)
  • Street Triage Team (Out-reach service in partnership with Ambulance and Police Service)
  • Bed management (populated through PAS) – Inpatient demand and capacity, key metrics on patients waiting for a bed, occupancy rates, patients waiting for discharge, and patients out of area.
The CaDDI mobile app enables urgent care teams to access an ‘at an glance’ worklist view of the referrals currently open on their team, including at which point each patient is in within the referral process. The staff can then record timely information in the app any action taken, what is the next action and if patient is waiting for services. This chronological record of the steps from when the patient enters the system until departure helps in the completion of the patient’s clinical record and can be can be accessed by all team members until patient has been discharged.
The 'live' dashboard will then display this information obtained by the mobile app and bed management system, providing a holistic and comprehensive view of capacity and demand across services. 
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 / Wealth creation / Digital health / Innovation and adoption
Benefit to NHS:
The CADDI system aims to streamline the way in which patients move through the Urgent Care pathway. The new system will be able to demonstrate realistic capacity and demand across the Urgent Care system. The information team will be capturing the data delivered by theRapid, Assessment, Interface and Discharge Plus CADDI mobile app and using this data to better understand the way in which the Urgent Care teams deal with increasing demand.
Expected Outcomes

The system will be able to provide an overview of the urgent care system in real time which will allow proactive realignment where required. It will also help capture data that can be used to inform decisions on the ground.
Patient experience:
  • Reduction in waiting times
  • More timely response from services
  • More clinician time to ensure appropriate placement that meets needs
  • Reduction in out of areas placement
  • Reduction in overall in-patient admissions
  • Safer care for patients as a result of a more efficient system
  • Improved patient focused services leading to improved patient and carer experience
Operational Effectiveness
  • The availability of valuable structured quantitative data that has not been collected before
  • Increased ability to monitor and plan across the system
  • Better decision making and improved use of system resources
  • Live data on demand allowing for prioritisation
  • Reduction in duplication and waste within the referral process
The CADDI system has been developed so it is scalable to regional and national requirements. The system can be adapted to an organisations patient administration system and the dahsboard can also collect data  using an alternative system, if available, as long as data is available in real time. 
Initial Review Rating
1.00 (1 ratings)
Benefit to WM population:
The CADDI system will provide the most realistic and timely method for assessing the capacity of Urgent Care mental health teams across Birmingham and Solihull. As a result, potential savings can be made by  utilising resource effectively to meet demand. We expect to see a reduction in acute hospital waiting times as a result of more efficient staff deployment.

Our RAIDPlus test bed partners West Midlands Ambulance service and West Midlands Police will be better informed about the more appropriate pathway to bring patients experiencing mental health crisis. Unnecessary pressure on staff will be evidenced by the CADDI system and will lead to a precise reporting system examining capacity and demand across the system in a way that is not currently possible.

RAIDPlus has links with the MERIT Vanguard programme, the project aims to spread the experiences, learning and opportunities identified through the development and implementation the CADDI system throughout the partnership.
Current and planned activity: 
The MLCSU and BSMHFT are working on new ways to populate the internet dashboard directly from the patient administration system as an alternative for using the mobile app.
Return on Investment (£ Value): 
Return on Investment (Timescale): 
0-6 mon
Ease of scalability: 
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