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Idea Description
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Innovation 'Elevator Pitch':
Unique evidence-based app that teaches doctors & nurses to manage stress & avoid burnout.Designed specifically for, and with, NHS staff. The efficacy of Working Stress was proved by a Randomised Controlled Trial (RCT) with 227 NHS doctors in 2016.
Overview of Innovation:
Being a doctor or nurse can be extremely challenging and the negative effects of work-related stress are significant. They affect patient safety, sickness absence and job satisfaction. However, staff can learn to manage stress and develop resilience if they are given effective and practical support to acquire these skills.

Working Stress is a unique evidence-based App that offers this vital support, it teaches individuals to manage stress, grief and avoid burnout. Working Stress was developed specifically for NHS staff by leading psychologists in consultation with practicing doctors. Efficacy of the underlying interventions was proved by a Randomised Controlled Trial (RCT) with 227 NHS doctors in 2016:

Reduces:
  • Psychological symptoms such as anxiety, psychiatric morbidity and emotional exhaustion
  • Physical symptoms such as insomnia and changed eating habits
  • Maladaptive coping mechanisms such as alcohol and drug use
Increases:
  • Positive ways of coping with stress such as emotional support and humour
Working Stress offers clinicians 2 modules
  1. Managing Stress & Burnout – relevant to all clinical staff
  2. Dealing with Patients’ Death – for those particularly affected by the death of patients
A single 15-minute interaction with the App is effective. No other commitment is required. If Effectiveness = Adherence x EfficacyWorking Stress is perfect for busy professionals and their employers.

The App works on any mobile device or PC. When offered to all clinical staff in a Trust, it can reduce the incidence of workplace stress across the organisation. Deploying Working Stress in a Trust is fast and efficient and the benefits are realised rapidly. Working Stress is a cost-effective way for the NHS to reduce workplace stress and its consequences.

The benefits for individual clinicians are clear, the benefits for employers are potentially significant; healthy employees are more productive and provide a better and safer quality of care. Doctors who completed Working Stress in the RCT evaluated their organisation more favourably, saying that they receive the respect they deserve and that salary and work prospects are adequate.

Working Stress is an immediate intervention that teaches individuals to recognise and manage their own stress more effectively. No customisation is required and Working Stress is easy to deploy, easy-to-use, anonymous and cost-effective. It can be used during formal induction programmes for new employees and with existing staff at any time
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':
Evidence-based intervention enabling clinical staff to manage stress and avoid negative effects. Unique 'serious' tool developed for healthcare professionals with ‘gold standard’ RCT trial evidence with 227 NHS doctors to prove efficacy. 
Overview of Innovation:
Clinical practice is stressful, and the negative effects of stress can be harmful and expensive. Working Stress is an evidence-based intervention that enables clinical staff to cope with stress and avoid its negative effects. It is the only occupational health tool developed specifically for healthcare professionals with ‘gold standard’ evidence to prove that it is effective within the NHS. 

It develops valuable lifelong personal skills that have a positive effect on patient safety, sickness absence, staff turnover and organisational culture.

Evidence and effectiveness
The Working Stress is based on widely recognised academic research and cognitive frameworks. It helps users to view stress more constructively and cope with it more effectively. A randomised controlled trial (RCT) with 227 NHS doctors tested the effectiveness of Working Stress. In the trial Working Stress reduced the number of doctors suffering:
  • Severe anxiety by 33%
  • High burnout by 9.5%
  • Severe insomnia by 60% 
  • Hazardous drinking by 50%
It reduced fatigue and improved doctors’ perceptions of their employer and working conditions. It also increased use of coping strategies, such as humour, seeking emotional support and self-reflective practice.

Is it another mindfulness app?
No. Working Stress is not a mindfulness, meditation or yoga app. It is based on widely recognised academic research and frameworks. The Working Stress app contains 3 modules:
  1. Understanding Stress & Burnout
  2. Managing Stress & Burnout
  3. Dealing with Patients’ Death
It targets an individual’s cognitive appraisal of stressors and improves their ability to cope with them. It provides information about stress, grief and burnout and explores their psychological and physical effects. It then presents a range of evidence-based coping strategies that clinicians can apply immediately. Quizzes and self-reflection reinforce and consolidate learning.
 
It is an HTML5 web app that works on any mobile device or PC. When offered to all clinical staff in an organisation, it can reduce the incidence of workplace stress across the organisation. Deploying Working Stress is fast and efficient and the benefits are realised rapidly. Working Stress is a cost-effective way for the NHS to reduce workplace stress and its consequences. 

The benefits for individual clinicians are clear, the benefits for employers and local health economies are potentially significant; healthy employees are more productive and provide a better and safer quality of care. 
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 / Digital health / Innovation and adoption
Benefit to NHS:
Work related stress accounted for 43% of all lost working days in 2014/2015 (Buckley, 2015; Beheshtifar & Nazarian, 2013). 37% of National Health Service (NHS) staff reported feeling unwell due to stress and pressure at work (The Picker Institute & National Health Service, 2015). Moreover, Goodwin et al. (2013) meta-analysis revealed a much higher percentage of health care professionals and NHS staff were suffering from a common mental disorder (psychiatric morbidity; 32%) compared with general population (19.1%).

Poor occupational health in the NHS is costly and puts patient safety at risk. For example, Boorman (2009) calculated that better staff health might be associated with up to a million extra working days a year and could save approximately £13.7 million a year to NHS as a whole. The cost of sickness absence alone has been estimated at £2.4 billion a year.

80% of NHS staff admit that their state of health has an impact on a patient’s care (Boorman, 2009). A number of systematic reviews and meta-analyses showed that occupational health is negatively linked to a patient’s care, satisfaction and safety outcomes (Boorman, 2009; Edwards, Burnard, Park, MPhil, & Edwards, 2003; Hall, Johnson, Watt, Tsipa, & O’Connor, 2016; Nahrgang, Morgeson, & Hofmann, 2011), leads to lower job satisfaction, poorer performance, work-life imbalance (Edwards et al., 2003), intention to leave an organisation and earlier retirement (Buckley, 2015; Taylor et al., 2007).

Our academic partners, Dr Caroline Kamau and Asta Medisauskaite, published Prevalence of oncologists in distress: Systematic review and meta‐analysis assessing occupational distress among oncologists. Their analyses showed that:
  • Up to 69% feel stressed at work
  • Up to 51% positive for depression
  • Up to 44% have sleep problems
  • 32% have a high level of burnout
  • 27% have psychiatric morbidity
In response to their own research Kamau & Medisauskaite designed 3 simple online interventions to help reduce levels of occupational distress and burnout. These interventions were tested with a Randomised Control Trial (RCT) Occupational Distress in Doctors: The Effect of an Induction Programme. The participating doctors (n=227) came from a range of specialities and seniority, including consultants. The Working Stress app has been built around these 3 interventions. The potential benefits are clear.
Initial Review Rating
5.00 (2 ratings)
Benefit to WM population:
The impact of occupational health for the wider NHS and its patients have been investigated and documented. The potential benefits of improving occupational health for the wider NHS are clear. It can be assumed that the WM would derive identical benefits if Working Stress were offered to NHS clinical staff in the WM.

A number of systematic reviews and meta-analyses showed that occupational health is negatively linked to a patient’s care, satisfaction and safety outcomes (Boorman, 2009; Edwards, Burnard, Park, MPhil, & Edwards, 2003; Hall, Johnson, Watt, Tsipa, & O’Connor, 2016; Nahrgang, Morgeson, & Hofmann, 2011), leads to lower job satisfaction, poorer performance, work-life imbalance (Edwards et al., 2003), intention to leave an organisation and earlier retirement (Buckley, 2015; Taylor et al., 2007).

Poor occupational health in the NHS is costly. For example, Boorman (2009) calculated that better staff health might be associated with up to a million extra working days a year and could save approximately £13.7 million a year to NHS as a whole. The cost of sickness absence alone has been estimated at £2.4 billion a year.
Current and planned activity: 
Discussions about the Working Stress app are ongoing with NHS England, NHS Innovation, NHS Employers, NHS Resolution, MIND and a growing number of individual NHS trusts.

Working Stress is being offered to the clinical, occupational health and finance leadership within targeted NHS trusts. The intention is to create ongoing commercial relationships with NHS trusts whereby Working Stress is offered to all frontline doctors and nurses in a single programme to address immediate issues. Working Stress would then be added to formal inductions for all new staff members and also for existing staff who are facing a significant change their professional personal circumstances. Long-term sustained cultural change is the objective.

NHS Practitioner Health Programme has confirmed a formal partnership and is working with Focus Games Ltd to develop a face-to-face group intervention to complement the Working Stress app. This is a board game.
What is the intellectual property status of your innovation?:
Intellectual property is wholly owned by Focus Games Ltd, Dr Caroline Kamau and Asta Medisauskaite.
Return on Investment (£ Value): 
medium
Return on Investment (Timescale): 
0-6 mon
Ease of scalability: 
Simple
Regional Scalability:
The app is very easy for an NHS organisation to deploy. The process for offering Working Stress to all clinical staff is simple:
  1. Purchase an access package based on the number of clinicians in your organisation
  2. Focus Games Ltd customises Working Stress with your trust logo and welcome messages
  3. We load your ‘edition’ of the app onto our secure server
  4. You invite clinical staff to use the Working Stress app via a secure website where they create individual user accounts
  5. Staff complete Working Stress whenever is convenient. It only takes 15-30 minutes of their valuable time
  6. Users can give anonymous feedback about their experience which we share with clients
  7. We also give you regular reports about the number of registrations and completions.
The app is also available to individual clinicians at a cost of £15 (inc VAT).
Measures:
'Although the overall cost of sickness absence is estimated at £2.4bn even small reductions in sickness absence can have a large impact across the NHS. If we reduced sickness absence by 1 day per person per year then the NHS would save around £150m, equivalent to around 6,000 full time staff. These financial savings do not even take into account the reduced use of agency staff or the costs of recruitment to tackle staff retention issues and so are most likely to understate the overall impact on NHS finances.' (NHS England NHS staff health & wellbeing: CQUIN Supplementary guidance, 2016)

The benefits to the wider NHS, and to individual Trusts, of a healthier workforce are clear:

 
  • improved patient safety and experience
  • improved staff retention and experience
  • reinforced public health promotion and prevention initiatives
  • reduced costs of sickness absence and staff turnover to the NHS

National CQUIN 1a
In addition to the savings resulting from reducing the negative effects of work-related stress NHS trusts also have a direct financial incentive to improve the health and wellbeing of staff via the National CQUIN 1a (Improvement of health and wellbeing of NHS staff). The NHS Staff Survey is used as the measure of a trust's success that triggers staged payments. CQUIN 1a represents a small but significant additional income for NHS trusts.

How, or if, trusts will measure this is not yet known to us. We are including a questionnaire for users to complete when they have completed Working Stress and this will provide limited qualitative feedback. We are not including more formal pre and post intervention questionnaires because they would make the intervention unwieldy for users. Working Stress already has reliable and credible evidence from a 2017 Randomised Controlled Trial with 227 NHS doctors that proves it is effective with NHS clinical staff.
Adoption target:
There are 28 NHS trusts in the WM employing 68,500 professionally qualified clinical staff (HEE March 2017). 

10% adoption in WM NHS generates £68,500 of nett revenue.

A 10% adoption rate in the WM is achievable and viable. Working Stress is being promoted to all NHS trusts in the UK and overseas. 
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Innovation 'Elevator Pitch':
My Possible Self is the first of its kind in the UK: a personalised digital self-help programme with exclusive content that is clinically proven to reduce stress, anxiety and mild-to-moderate depression after just eight weeks.
Overview of Innovation:
My Possible Self, which has been delivering emotional health and wellbeing services since 2009, is launching a digital self-help programme, using content which is clinically proven to reduce stress, anxiety and mild-to-moderate depression after just eight weeks. 

The application uses clinically proven content adapted from the myCompass online programme developed by the internationally recognised, Black Dog Institute (BDI) in Australia, linked with the University of New South Wales. The institute is globally renowned as a pioneer in the identification, prevention and treatment of mental illness and the promotion of wellbeing. 
The BDI content has been clinically proven to reduce depression, stress and anxiety in just eight weeks, based on the Australian equivalent of the PHQ and GAD-7 questionnaires. This outcome supports the objectives of the Future in Mind, Five Year Forward View for Mental Health and Mental Health System Strategy Board (Birmingham) ‘Getting it Right, First Time: Prevention of Mental Illness’ strategies, which together aim to improve resilience, mental ill-health prevention, early intervention and accessibility.  
The application supports real-time self-monitoring of mental health symptoms across three core areas – problem thoughts, feelings and behaviours – and provides 24/7 access to evidence-based, skill-building modules and other self-help resources.  These are made up of cognitive behavioural therapy, interpersonal therapy, problem-solving therapy and positive psychology tools. The user journey is personalised according to the responses. 
It will be launched into the App Store, Google Play and online in September 2017.
We gave a demonstration of the prototype to Norman Lamb MP, the former health and care minister and prominent mental health campaigner. He said: “Digital innovations in mental health care have massive potential, and this is an app that uses clinically proven forms of therapy. I am confident that My Possible Self can help people to improve their mental wellbeing, come through difficult times, and improve their overall quality of life. It could also help to reduce reliance on NHS services which we all know are under strain. It is exactly the sort of preventive measure we should be looking at.”
My Possible Self can help prevent the development of mental health problems and get help earlier for young people, adults and older adults starting to suffer poor mental wellbeing. 
 
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 / Digital health / Innovation and adoption / Person centred care
Benefit to NHS:
My Possible Self is based on content that is clinically proven to reduce stress, anxiety and mild-to-moderate depression after just eight weeks. As such, it can support the range of initiatives at a national, regional and local levels to improve mental health and wellbeing.

Importantly, My Possible Self can ease pressure on short-term Improving Access to Psychological Services (IAPT) services. 

The Five Year Forward View for Mental Health notes the NHS needs a far more proactive and preventative approach to reduce the long-term impact for people experiencing mental health problems and for their families, and to reduce costs for the NHS and emergency services. My Possible Self offers NHS commissioners and service providers the opportunity to deploy at scale an accessible and personalised digital self-help programme to increase resilience, prevention and early intervention. 

The Future in Mind strategy aims to provide better support for young people experiencing mental health problems. My Possible Self is based on content for those aged 18 and over. The company would be delighted to have the opportunity to work with commissioners service providers, education and other organisations working with children and young people in the West Midlands to co-design an application for younger groups.  

The West Midlands Academic Health Science Network’s April 2017 report on the prevention of mental illness calls for a model of care that is measurable, effective, scalable and achievable. My Possible Self meets this challenge with a tried-and-tested and personalised digital self-help tool. 

My Possible Self will help the NHS to use its limited resources more effectively, allowing commissioners and service providers to focus their efforts on people who need help the most. It can also be a useful asset for NHS employers to support the wellbeing of staff and contractors. 
Initial Review Rating
4.60 (1 ratings)
Benefit to WM population:
The West Midlands population suffers worse-than-average mental health. The National Psychiatric Morbidity Survey identified 23.8 per cent of all adults in the region with some kind of mental health problem, compared with 23 per cent in England.

According to the University of Birmingham, as well as the social cost of poor mental health, there is an economic price to be paid. Mental health problems cost the region an aggregate of £12.6bn in 2015.

Research has shown that mental health issues costs UK employers nearly £26bn per year - or just over £1,000 for every employee in the workforce. Giving staff access to MPS could improve staff productivity, reduce absenteeism and lower staff turnover.

My Possible Self can offer hope and practical help to those suffering from anxiety, stress and mild-to-moderate depression, by providing a personalised digital self-help programme based on content that is clinically proven to improve conditions within eight weeks. 

Investing in My Possible Self will generate social and economic returns for communities in the West Midlands. 
 
Current and planned activity: 
My Possible Self is preparing to launch its digital self-help programme via mobile app and browser experience in September 2017.  The company is keen to work with NHS commissioners, service providers, education, third sector organisations and employers of all shapes and sizes in the West Midlands to establish My Possible Self as a force for good in the region.

It was founded in 2009 by Joanne Wilkinson whose daughters Hana and Fleur have now joined the business.  They are passionate about helping as many people as possible. 
What is the intellectual property status of your innovation?:
We have licensed the BDI's MyCompass programme and have developed this programme into our own web/phone app, in which we own the branding and the copyright we have created in creating the website/app.
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
0-6 mon
Ease of scalability: 
Simple
Read more
Hide details
Innovation 'Elevator Pitch':

My Possible Self is a digital self-help programme with exclusive content that is clinically proven to reduce stress, anxiety and mild-to-moderate depression after just eight weeks.
Overview of Innovation:
My Possible Self, which has been delivering emotional health and wellbeing services since 2009, is launching a digital self-help programme, using content which is clinically proven to reduce stress, anxiety and mild-to-moderate depression after just eight weeks. 
The application uses clinically proven content adapted from the myCompass online programme developed by the internationally recognised, Black Dog Institute (BDI) in Australia, linked with the University of New South Wales. The institute is globally renowned as a pioneer in the identification, prevention and treatment of mental illness and the promotion of wellbeing. 
The BDI content has been clinically proven to reduce depression, stress and anxiety in just eight weeks, based on the Australian equivalent of the PHQ and GAD-7 questionnaires. This outcome supports the objectives of the Future in Mind, Five Year Forward View for Mental Health and Mental Health System Strategy Board (Birmingham) ‘Getting it Right, First Time: Prevention of Mental Illness’ strategies, which together aim to improve resilience, mental ill-health prevention, early intervention and accessibility.  
The application supports real-time self-monitoring of mental health symptoms across three core areas – problem thoughts, feelings and behaviours – and provides 24/7 access to evidence-based, skill-building modules and other self-help resources.  These are made up of cognitive behavioural therapy, interpersonal therapy, problem-solving therapy and positive psychology tools. The user journey is personalised according to the responses. 
It will be launched into the App Store, Google Play and online in September 2017.
We gave a demonstration of the prototype to Norman Lamb MP, the former health and care minister. He said: “Digital innovations in mental health care have massive potential, and this is an app that uses clinically proven forms of therapy. I am confident that My Possible Self can help people to improve their mental wellbeing, come through difficult times, and improve their overall quality of life. It could also help to reduce reliance on NHS services which we all know are under strain. It is exactly the sort of preventive measure we should be looking at.”
My Possible Self can help prevent the development of mental health problems and get help earlier for young people, adults and older adults starting to suffer poor mental wellbeing. 
 
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 / Digital health / Person centred care
Benefit to NHS:

My Possible Self is based on content that is clinically proven to reduce stress, anxiety and mild-to-moderate depression after just eight weeks. As such, it can support the range of initiatives at a national, regional and local levels to improve mental health and wellbeing.

Importantly, My Possible Self can ease pressure on short-term Improving Access to Psychological Services (IAPT) services. 

The Five Year Forward View for Mental Health notes the NHS needs a far more proactive and preventative approach to reduce the long-term impact for people experiencing mental health problems and for their families, and to reduce costs for the NHS and emergency services. My Possible Self offers NHS commissioners and service providers the opportunity to deploy at scale an accessible and personalised digital self-help programme to increase resilience, prevention and early intervention. 

The Future in Mind strategy aims to provide better support for young people experiencing mental health problems. My Possible Self is based on content for those aged 18 and over. The company would be delighted to have the opportunity to work with commissioners service providers, education and other organisations working with children and young people in the West Midlands to co-design an application for younger groups.  

The West Midlands Academic Health Science Network’s April 2017 report on the prevention of mental illness calls for a model of care that is measurable, effective, scalable and achievable. My Possible Self meets this challenge with a tried-and-tested and personalised digital self-help tool. 

My Possible Self will help the NHS to use its limited resources more effectively, allowing commissioners and service providers to focus their efforts on people who need help the most. It can also be a useful asset for NHS employers to support the wellbeing of staff and contractors. 
 
Initial Review Rating
4.20 (1 ratings)
Benefit to WM population:

The West Midlands population suffers worse-than-average mental health. The National Psychiatric Morbidity Survey identified 23.8 per cent of all adults in the region with some kind of mental health problem, compared with 23 per cent in England.

According to the University of Birmingham, as well as the social cost of poor mental health, there is an economic price to be paid. Mental health problems cost the region an aggregate of £12.6bn in 2015.

Research has shown that mental health issues costs UK employers nearly £26bn per year - or just over £1,000 for every employee in the workforce. Giving staff access to MPS could improve staff productivity, reduce absenteeism and lower staff turnover.

My Possible Self can offer hope and practical help to those suffering from anxiety, stress and mild-to-moderate depression, by providing a personalised digital self-help programme based on content that is clinically proven to improve conditions within eight weeks. 

Investing in My Possible Self will generate social and economic returns for communities in the West Midlands. 
Current and planned activity: 

My Possible Self is preparing to launch its digital self-help programme via mobile app and browser experience in September 2017.  The company is keen to work with NHS commissioners, service providers, education, third sector organisations and employers of all shapes and sizes in the West Midlands to establish My Possible Self as a force for good in the region.

It was founded in 2009 by Joanne Wilkinson whose daughters Hana and Fleur have now joined the business.  They are passionate about helping as many people as possible. 
 
What is the intellectual property status of your innovation?:
My Possible Self has exclusive licence of the Black Dog Institute's underlying research materials (in which the BDI own the intellectual property) and has developed its own web/phone app, in which it owns the branding and the copyright.
 


 
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
0-6 mon
Ease of scalability: 
Simple
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