Idea Description
Supplementary Information
Detailed Submission Data
Innovation 'Elevator Pitch':
A journey onto the hills and into recovery.
Overview of Innovation:
The Shropshire Wild Teams utilises Shropshire's amazing landscapes to engage with some of the county's most marginalised and isolated people, the majority of whom are experiencing mental health problems and/or have learning disabilities. The project works with statutory mental health services and other health and care agencies, alongside environmental conservation services; to provide holistic health promotion and learning opportunities for participants that is based on research evidence of eco-therapy.
Each week, four separate teams located across the county visit a different location, to carry out conservation tasks for a variety of environmental partners. The teams are active all year round. The work carried out by the teams is exactly the same as that carried out by environmental professionals and has real value for the wide variety of habitats and the people that visit them, and of course the volunteers themselves. As well as conservation work, the teams also learnt bush craft, navigation and map reading skills and wildlife surveys.
The project is co-ordinated by two members of staff; one from an environmental background and the other from a mental health background. The programme is client centred and individual volunteers receive support to develop skills and confidence to achieve their personal goals.
Stage of Development:
Evaluation stage - Representative model or prototype system developed and can be effectively evaluated
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Innovation 'Elevator Pitch':
HeadGym coaching is a one to one flexible service providing innovative self help techniqes for adults and children that enable clients with mental health challenges to develop mental resilience and manage their own mental health. 
Overview of Innovation:
HeadGym services are preventative and for those experiencing crisis; we believe in helping the client to help themselves. Many clients we see have undertaken short term interventions over many years which have been inaffective in the long term, creating a revolving door of services and/or becoming dependent on medication.
We address this issue and provide a long term flexible service built around a goals framework, it is about the client having the ability to take control of their own mind and body and finding the solutions to do so. The coach ensures clients are supported in developing their own goals and steps to achieving them meaning that aspirations are built around what the client wants and not a service providers desired outcomes. The ownership of these goals has shown to make a huge difference in clients motivation and success rates are high, inevitably service providers desired outcomes are met anyway. We provide clients with some simple tools, techniques and strategies based around the findings of neuroplasticy using Neuro Linguistic Programming, Cognitive Behaviour Therapy  and other methods. Areas of progress have been: self esteem, mental health, self confidence, self worth, weight loss, nutrition, exercise, career, addictions, volunteering, coming off benefits and re-engaging with education.  A Coach is encouraging and guiding throughout the process, they highlight the positive achievements in an individual’s progress. HeadGym helps a person to identify strengths and provides long term support to enable people to make positive changes. Appointments can go from fortnightly to 3,6, or 12 monthly or longer with the option for a person to alter the regularity of sessions and return to more frequent appointments should their needs change. Sessions can be held face to face, via email, facetime, Skype, Google hangouts and other platforms, this enables us to reach out to more isolated people and to be very flexible and is particular popular with young people.
Using this mechanism people have progressed to manage their mental health and in turn make progress in other areas of life, such as gaining employment, losing weight, starting volunteer work. We have been monitored by referring agents, case studies have been conducted independetly and WEMWEB self assessments have been completed by clients, all of which validate the HeadGym approach.
Due to the proven success of our project we now want to train more Headgym coaches and reach more people.
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 / Education, training and future workforce / Innovation and adoption
Benefit to NHS:
Due to our long term more flexible approach we have seen that as HeadGym begin appointments other service provider interventions drop off; this varies from client to client, however the lessening dependency upon other services clearly has a benefit to the NHS in terms of cost and time. Clients are no longer repeating short term interventions over and over and start to make progress in all areas of their life, for example relationships, family, work, education and physical health.
Some of the outcomes that we have seen are improved diet, less GP appointments, reduction of dependencies (prescribed medication, alcohol, drugs etc) and therfore reduces the cost of future interventions and treatments.
Psycological interventions for issues such as suicide attempts, self harm, eating disorders are also avoided as clients build mental resiliance. Our approach also recognises the impact on the whole family and potential future generational problems, we have developed techniques for all age groups from age 3 upwards, this negates future requirement for intervention across whole families and generations. The cost saving is difficult to measure and potentialy could be huge not just for the NHS but also for social services, police, probation, courts, schools etc. 

Please see the link to a video of a client explaining her experience of HeadGym the sound quality is poor but the content is useful
Online Discussion Rating
5.76 (33 ratings)
Initial Review Rating
3.00 (1 ratings)
Benefit to WM population:
The benefits to the WM population will be huge, we intend to roll out the HeadGym programme across the whole of the WM as an 'accessible to all' service by a variety of platforms using SKYPE, Google, email and welcome any innovative future platforms that may come along making access easier.

We recognise that mental health difficulties are not exclusive to people claiming benefits, we also recognise that many of the existing short term services are provided in the day when people may be working and are free only to benefits claimants. HeadGym want our service open to all. We are also advocates of a well being at work policy and provide mental health awareness training days for professional organisations, as well as 'in work' coaching for those experiencing mental health difficulties. This would also be encouraged across organisations, companies and statutory bodies throughout the WM area.

The HeadGym philosophy is to work with body and mind as one; therefore as people improve mental health they improve physical health and visa versa. This has an impact on the people around them and creates positive role models within families and for future parents.

Using the HeadGym goals process people using our existing service have made progress with education, volunteer work career development and peer support, in turn this has helped improve self esteem, confidence and creates a sense of purpose within the local area. I believe that replicating our success on a larger scale will have a positive impact upon the WM population. 
Current and planned activity: 
HeadGym currently work closely with the local authority, also  many of our clients have attended CAMHS support or psycological services provided by Hillcrest Hospital, we are in discussion with the CCG and will be providing HeadGym through the new well being hub.

We have integrated a webinar into our website to provide online training and discussions for coaches and are developing a series of  quick and easy videos to help clients. (see link)

We have a young persons peer support group in the early stages of development, which will also have a online group.

All HeadGym coaches have professional support/supervison and feedback sessions to evaluate and improve the service.
At present we are using WEMWEB and case studies to evaluate the service and would welcome any alternative evaluation tools. 
We would benefit from:
Financial investment to set up and create a sustainable business model.
Assistance with evaluation on social return.
What is the intellectual property status of your innovation?:
HeadGym does not have intellectual property status or trademark, we operate as a limited company.
Return on Investment (£ Value): 
Very high
Return on Investment (Timescale): 
1 year
Ease of scalability: 
Regional Scalability:
We intend to scale up in the same way we have done in Redditch and Bromsgrove. With our licensing model and online service we feel we could expand one area at a time taking care to retain quality of service. The model we have developed is a sustainable business model which ensures that income is generated from licensing training and ongoing coaching and expansion of existing income streams as previously mentioned.
We will ensure that we are following the NICE guidelines as well as following the policies and procedures we have already adopted such as safeguarding CPD and DBS. With funding we will engage an independent evaluation and research agency who will provide full ongoing evaluation of the economic impact we are making and ensure a high quality of service in line with NICE guidance. We aim to have a sustainable business model that continues to achieve the outcomes we have made in the past and improve on them having independent evaluations and case studies.
Adoption target:
We aim to take a phased approach by licensing to operate our service one area at a time, rolling out across the West Midlands over the next 3 years, until fully adopted. We feel that retaining the quality of service is paramount to the success  therefore a well structured phased approach will enable thorough monitoring and evaluation.
Rejection Reason:
Further development required
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Innovation 'Elevator Pitch':
Technology to assist older people living independently with declining cognition, who are at risk of hypothermia, dehydration, malnutrition and unattended falls.
Overview of Innovation:
Many older people want to live independently for as long as possible, causing anxiety for family and friends.  They are often in denial of their declining capacity, proud and won’t wear pendants. Especially with impaired cognition, many suffer from hypothermia, dehydration, malnutrition or unattended falls.  They are admitted to hospital needing longer treatment for poorer health outcomes and greater risk of transfer into a care home. 
To make sure that service users are warm, drinking, eating and moving around as normal, Kemuri checks every hour and provides actionable information and alerts for the families and carers.  It increases peace of mind in addition to better outcomes and reduced costs for services users, families and the public sector.
Kemuri looks like a Familiar Power Socket to the service user; no changes to life style, plug in kettle and microwave, not stigmatising, not intrusive and tamperproof.

Technically it is mains-powered, continuously monitoring five sensors and sending data via a mobile phone connection to the Internet.  It has internal battery back-up to report power loss. 
The Wellbeing Monitor App is designed for the families and carers of older vulnerable people who:
  • Want to live independently
  • Reject or forget pendant alarms
  • Deny declining capacity
  • Show symptoms of dementia
  • Remove things they don’t understand
  • Need daily monitoring
Predictive analytics check every hour for changes to patterns of motion and power usage.  If there are many changes, then alerts may be sent to families, carers or 24/7 response centres.
As stated by a Commissioning Manager at a County Council, “ ... this is a unique product ….  I think there’s potential here for both self funder and LA funding as a potential option that fills a gap that conventional telecare does not.”
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 / Clinical trials and evidence / Digital health / Innovation and adoption / Person centred care
Benefit to NHS:
The Kemuri Wellbeing Monitor is used the context of the care of older people living alone who are losing their ability to undertake Activities of Daily Living (ADL).  Research by the Institute of Ageing shows the range of pathways that people take before they are unable to live independently

Kemuri is effective when people are less mobile, possibly showing early symptoms of dementia.  They do not need, or welcome, daily contact and cannot, or will not, use pendant alarm systems.  They can be encouraged to continue living as actively as possible and maintain a reasonable quality of life for more years.  If people stay in the right hand side of the curve, average saving is £1900 per year.  People on the left hand side cost an extra £15,500 per year.

Kemuri’s hourly analysis of multiple sensor data enables people to gain insight into the risk of hypothermia, dehydration, malnutrition, unattended falls and power loss.  It is preventive telecare; unlike alarms that are reactive telecare.

The most common telecare service is the provision of pendant alarms.  Out of 1.6 million issued, 32% are never worn, only 8% are worn all the time, as prescribed.  These 500,000 unworn pendant alarms are ineffective for identifying falls, strokes or coma.  This wastes as much as £80 million per year.  Kemuri is passive telecare that continuously monitors ambient conditions and use of electrical devices e.g. kettles and microwaves.  

After an emergency admission into hospital, discharge to a residential care home is 2.5 times longer than discharge to independent living at home.

Including cost of stabilisation, treatment and excess bed days, this costs an average of £5000 more per non-elective hospital stay.  Preventive telecare with a wellbeing monitor and family intervention will help to minimise the number of patients suffering from hypothermia, dehydration, malnutrition and unattended falls.  People admitted in a healthier state are less complex to treat, have improved health outcomes and less likely to be readmitted.  
Kemuri is specifically designed for a cohort of older people who are often in denial of their declining ability.  Typically they won’t use their pendant alarms, reject wearable devices, have memory lapses and resist any changes to their normal routine.  Some may show other symptoms of the onset of dementia.  Many will be over 85 years old and not receiving regular visits from family or friends.
Initial Review Rating
2.80 (2 ratings)
Benefit to WM population:
West Midlands has a population of 5.6 million people covering an area of more than 5,000 square miles.  It is a region full of contrasts and diversity.  It includes the second largest urban area in the country (Birmingham, Solihull and the Black Country) yet over 80% of the area is rural.  It is the second most ethnically diverse region in the country after London.  There are probably 40,000 older people who might be suitable for passive wellbeing monitoring.  Many of these are admitted to hospital and may not be able to return to their own homes. 
Kemuri wellbeing monitoring can extend the period that older people can continue to live independently at home.  It avoids the stigma of wearables and unfamiliar sensors that can be damaged or removed.  A power socket is a very familiar device and installation does not require changes in patterns of normal behaviour.  They are easily installed into kitchens of sheltered accommodation.  Wardens or housing scheme managers can easily check wellbeing daily and avoid some of the tragic outcomes of unattended falls. 
Peace of mind is the greatest value for many families.  They can check daily, or even hourly, that people are living normally, fitting in with their own daily routines, from anywhere in the world.  They can be alerted if there are lots of changes that may give them concern.  Alerts can also be directed to 24/7 response centres.  They can confirm that domiciliary carers have provided drinks and meals at the time they were ordered.
Families spread over the world can be part of an older person’s care plan.  Social contact with the older person can be more directed and appear less intrusive.  You can ask if somebody had a nice day in the garden or slept well, in the full knowledge of activity in the kitchen at that time of day. 
Caring for older people is very time consuming and costly if professionals are used.  However, there are probably four times as many unpaid carers providing care on a voluntary basis.  There are also examples of people who have to give up their jobs in order to care for their vulnerable parents, this represents a loss to the local economy and taxable income.  Regular checks with the Kemuri well-being monitor could allow people to have more time for paid employment.  
Current and planned activity: 
After the completion of the Proof of Concept, Kemuri is now scaling up manufacture for B2B sales through accredited telecare service companies.  The first is Welbeing (Wealden and Eastbourne Lifeline), which has the telecare service contract for Staffordshire.  They have the capacity to install Kemuri anywhere in the Region.  Welbeing provides telecare for statutory bodies and self-funders.  The latter are increasing in number as many local authorities are reducing budgets for adult social care.
We are building batches of 100 units.  Many of the first batches can be made available for trials by health and social care clients.  Trials are necessary to collect evidence that preventive wellbeing monitoring does actually improve health outcomes and reduce time until discharge.   
What is the intellectual property status of your innovation?:
Kemuri has patents pending; GB1417259.7, effective date of 30 September 2014 and PCT/GB2015/000275, International Filing Date of 30 September 2015. 
Note that the patent applies to more devices than a power socket.  It covers the internal electronics and components, which could be incorporated into any equipment consuming significant amounts of power. 
Kemuri and KemuriSense are registered trademarks.  
Return on Investment (£ Value): 
Return on Investment (Timescale): 
2 years
Ease of scalability: 
Regulatory Approvals:
The product has been prototyped and progressing through the Certification process. EMC compliance has been achieved and final Safety report for CE certification is expected in Feb 2016. 
It is not a medical device since it only measures ambient conditions.
Regional Scalability:
The production of smart power sockets is scalable from batches of 100 to 1000 per month in the production facilities in Woking.  Larger volumes could be obtained by second sourcing the manufacturer in the UK or overseas.
The Web technology is cloud-based and can be very rapidly scaled by commissioning more servers and storage at very short notice. 
The installation can be performed by our telecare service partner, Welbeing.  They are a growing company with over 60,000 service users in NHS Trusts, Social Services, sheltered housing and care agencies throughout the UK, including the West Midlands.   They offer a nationwide telecare service with 24/7/365 monitoring facilities in a TSA accredited contact centre.  
Kemuri is building up the operations support as it is recruiting more engineering and IT staff.
In co-operation with an academic research partner, we expect to plan the following measures:
  • Continuous reliable operation
  • Avoidance of false alerts
  • Recognising unattended falls, strokes or other episodes that result in a carer taking action that saved time and cost for medical intervention.
  • Peace of mind achieved for families and carers
  • Identifying trends that indicate the risk of hypothermia, dehydration and malnutrition.
  • Identifying activity at unusual times of day that lead to helpful family or medical intervention
  • Electrical safety of products after installation in kitchens.
  • Security of personal data and avoidance of data loss.
  • The cost target is £2500 for each older person involved in the trial.  This would include the costs of selection, installation, monitoring, service support and questioning families throughout the trial.  Note that this includes detailed data analysis, medical services, the final report and communications.
  • The final operational cost target is £2 per day, to include installation, Web services, smartphone apps, technical support and reseller profit margin.   
The target group for research is a cohort that has these attributes:
  • Reject pendant alarms
  • Deny declining capacity
  • Want to live independently
  • Show symptoms of dementia
  • Need daily monitoring
A percentage will be used as a control group who are not included in the Trial. Finding these people may require the inspection of medical and social care records, which will need approval by an Ethics Committee.  
Adoption target:
Assuming that there are 500,000 unused pendants in the UK, there are approximately 30,000 candidates for Kemuri wellbeing monitoring in a West Midlands population of 5 million.   
The reasonable viable number is 300 (1% of WM total) – with an expectation to grow to 12,000 service users within 5 years (20% of WM total).  
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