Common Approach To Children’s Health (CATCH) (#2772)

Creation
Draft
Initial
Detailed
Accepted
Adoption
Idea Description
Supplementary Information
Detailed Submission Data
Innovation 'Elevator Pitch':
Common Approach To Children’s Health (CATCH) is a free-to-users healthcare app aimed at parents/carers of children aged 0-5. The app gives users confidence to know when their child needs medical treatment or when self-care would be more appropriate.
Overview of Innovation:
The concept of a Cheshire East health app was originally borne out the council's Annual Report of the Director of Public Health, 2013/14 which among other findings determined that large numbers of young children in Cheshire East are being taken to A&E & are sent home with advice rather than treatment.

There could be many reasons why A&E attendance for children aged 0-4 in Cheshire East is higher than the national average but one explanation could be that some parents lack the confidence & knowledge to self-care when appropriate.

To remedy this Public Health Cheshire East, NHS Eastern Cheshire CCG & NHS South Cheshire CCG came together to jointly commission the CATCH app.
Users of the app create a profile for their child/ren to receive regular guidance & advice tailored to suit them as they grow. Once the child’s information is inputted to the app the Home section will provide users with NHS guidance that is highly relevant to their child’s age.

The Learn section contains a multitude of health information that is split by age, e.g. ‘0-6 months’ or ‘4-5 years’ to help parents & carers determine which information is relevant to their child. Learn also includes sections such as ‘Making your home safe’ & ‘Parents corner’.

Information about what to do in an emergency, such as if a child swallows a battery or button can be reviewed at any time, ensuring parents & carers are prepared if a health emergency were to occur. General announcements for subjects like seasonal advice, local news & health warnings can also be received.

The app contains highly localised information about healthcare services/support groups available in the region and an explorable map of local health services such as GPs, dentists & pharmacies. Users can set timely reminders about key health dates such as childhood immunisations.

The Emergency section contains information about emergency situations, such as allergic reactions, how to help a choking child & head injuries. The idea is for users to review this section when they have some free time rather than during an emergency itself, meaning they will be more confident to take action should an emergency occur.

CATCH uses NHS approved advice, better informing users on a range of conditions by providing advice from a trusted source - directly from NHS choices.

To view more information, videos and download the app for iOS or Android go to the website...
http://catchapp.co.uk

And watch the video...
https://youtu.be/G3bFBlC8l8M
Stage of Development:
Market ready and adopted - Fully proven, commercially deployable, market ready and already adopted in some areas (in a different region or sector)
Similar Content3
Overview of Innovation:

Common Approach To Children’s Health (CATCH) is a free-to-users healthcare app aimed at parents (and carers) of children aged 0-5. CATCH utilises a unique method of NHS Choices or custom information delivery that builds confidence in self-care and the knowledge to recognise when medical treatment is required.

CATCH has helped to reduce A&E attendances and GP Visits in the Cheshire East region of the UK. Cheshire East CATCH users were surveyed and a majority (52%) of participants, who required medical attention for their child, have used CATCH to self-care for their child rather than using an emergency service. Similarly, a majority (64%) reported that the app helped to treat their child at home instead of using GP services.  

Early Eastern Cheshire CCG cost findings are in line with the user survey and for the four months to 31 January 2016/17 show that the number of 0 to 5 year olds discharged from A&E with nothing but basic information and advice was 538 or 155 fewer than for the same four months in 2015/16 – before the app was launched.  The figures cover all A&E departments in which Eastern Cheshire children were seen, not just Macclesfield District General Hospital.

CATCH is ready to scale and has been taken up by the Innovation Agency and Halton CCG.  This version 2 of the app will be unique in allowing supported CCGs to have complete control over the information held by their section of the app.  The service also includes online marketing and an admin site that delivers analytics on a per postal-destrict basis that conforms to Information Governance rules. 

To view more information, videos and download the app for iOS or Android go to the website...
  http://catchapp.co.uk

And watch the video...
  https://youtu.be/G3bFBlC8l8M
 
Read more
Hide details
Innovation 'Elevator Pitch':
WaitLess is an app for patients, combining A&E & MIU real-time waiting times, numbers waiting, traffic & routing helping patients make better decisions about where to go for minor emergencies. In east Kent, it reduced minor A&E attenders by 11%.
Overview of Innovation:
WaitLess is an innovative new app for patients. This reduces A&E attendances during busiy times by showing patients the quickest place to be seen, simply. It proves patients can be treated faster and closer to home by highlighting alternative services, driving activity away from busy A&Es. It's free for patients to download and was designed by patients for patients, funded by CCGs and STPs. Our charging model is 25,000 per CCG, or 3p per person based on population.

It's priced delibarately low to make WaitLess accessable to all, and can be deployed in less than two weeks. WaitLess was independently evaluated by the University of Greenwich and the Behavioural Insights Team and found to achieve an 11% reduction in minor attendances. 

Various studies undertaken since 2009 have found A&E attendance reduction schemes to be difficult to achieve. This is thought to be due to a number of factors incuding that patients find urgent care pathways confusing and hard to navigate. Various studies have identified that patients make a relatively quick decision about where to access treatment minor injuries. Once patients have arrived in A&E, evidence shows that they are committed to waiting to be seen and often reluctant to move. WaitLess applies an effective three second nudge to patients, by showing the quickest place to go and using real time routing options to help avoid traffic and overcrowding busy units during peak times. 

A reiew undertaken by encompass MCP found the following observations, which were confirmed as statistically significiant by the behavioural insights team and the University of Greenwich:
  1. Improved patient experience as patients are signposted to units with the lowest wiaiting times
  2. Reduction in A&E minors attendances by 11%
  3. An overall reduction of 5% in attendances across A&E and minors as more patients choose primary care.
  4. Quick and responsive, nudging patientstowards facilities with lowest waiting times.
  5. Takes pressure away from A&E and flattens activity
  6. Quick to deploy
Business cases for WaitLess are currently being considered across a broad range of regions, inclduing the South West, Greater Manchester, Yorkshire and the Humber, Surrey and Sussex. Given the benefits to the NHS, we are seeking to significantly accelerate this rollout across the NHS and to explore alternative uses for WaitLess (such as Primary Care). As a proven autonomous decision aid, WaitLess is a key pillar to any urgent care strategy.
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: 
Wealth creation / Digital health / Innovation and adoption / Person centred care
Benefit to NHS:
WaitLess has been independently evaluated by the University of Greenwich and the Behavioural Insights Team and found to deliver reduced activity, waiting times and save money for the NHS. The headline benefits are:
  1. Reduced minor injury attendance profile across the whole health economy. The total number ofcases (including A&E and MIU) shows a significant decrease (5% less, p=0.024).
  2. The total number of A&E cases shows a significant decrease (11% decrease, p<0.001).
  3. The proportion of cases (MIU out of (MIU+A&E) shows a significant decrease (the effect size varies by day of the week, but is approximately 3-4%, p<0.001)
  4. Reduction in A&E minors attendances by 11% within six months against an end of year target of 5%.
On days where there is significiant pressure on majors, it is  common for waiting times in minors to increase. As waiting times increase in one facility, patients choose alternative locations where waiting times are improved.  This has the net effect of spreading activity across A&E and UTC settings much more effectively.

As patients choose A&E because they are unaware of level 3 & 4  A&E units (UTC), nationally Hospitals are facing an increase of circa 5% year on year in A&E attendances. Peak attendances are predictable, occuring in the early evening and at weekends. WaitLess acts as an autonomous patient decision aid, helping to reduce pressure without impacting on surrounding UTCs. In addition to the benefits to patients, operational and performance benefits, WaitLess also saves money for Commissioners.

It is common for Urgent Care Centres to have much ower waiting times than A&E departments. By using real time data, WaitLess influences patients to choose the facility that willsee them fastest, giving improved overallexperiencefor patients and encouraging more competition among providers of urgent treatment services.

With many UTCs commissioned on block arrangements, overheads are already paid for. In these scenarios, each A&E attendance saved is equivalent to 85.00 per episode saved. Where UTCs are commissioned on PbR, the standard tariff is 65.00 per episode. in thesecases, WaitLess saves 20.00 per episode. The PbR savings alone equate to 100,000.00 per CCG. 
Initial Review Rating
5.00 (1 ratings)
Benefit to WM population:
Activity analysis has highlighted over the years that A&E is seen as a  trust brand by patients. Commissioning of alternative facilities with different names, such as MIU / UTC / Minor Injury Cinic / MIIU has created a significant confusion among patients about which services are  available and what they offer. A number of self help apps have been developed to support patients, however these have nationally had a limited impact on emergency attendances to A&E. Since 2004, the UK has seen A&E attendances grow by 5% year on year. A&E Departments are now widely reported to suffer from overcrowding, leading to sub-optimal conditions both for clinicians and patients. The majority of A&E attendances are from patients who choose to self present to Hospital, most with Ambulatory and more minor conditions. As an ex Urgent Care Commisisoner and General Manager for A&E and Acute Medicine, I knew prior to the build of an app that patients make a quick decision about where to access urgent care services, which was recognised by the behavioural insights team in 2015. In many other parts of healthcare planning, autonomous patient decision aids have been found to be highly effective in terms of both influencing behaviour and flattening demand. This can be seen in the NHS rightcare guides. WaitLess provides this for Urgent Care services. It helps the local population in the following ways:
  1. Encouraging people to access care services closer to home
  2. Reducing avoidable A&E attendances
  3. Improving the patient experience
  4. Empowering patients to mae a better decision about where to go to be seen
  5. Reducing pressure on overstretched A&E departments
  6. Savng money for the local health economy to re-invest in pathway changes that are sorely needed to improve urgent care flow.
Current and planned activity: 
We are currently enagaged in discussions around WaitLess with Nene and Corby CCGs, Yorkshire and the Humber and Greater Manachester. As part of the National Innovation Accelerator, we have ensured WaitLess is built on a platform that is simply scaled. Patient feedback has highlighted a need to provide WaitLess at scaleas patients commute for work and leisure and come to rely on the information. Our diffusion plan is outlined in a 12 week programme per CCG which can run in parralel with up to 26 CCGs per cycle. As WaitLess technology is bespoke, it has been built with scaling in mind. Our 12 week programme can be accelerated to 2 weeks, depending on each health economies informtion capabilities and appetite.
What is the intellectual property status of your innovation?:
As a developed and deployed product, we have IP rights  to our innovation
Return on Investment (£ Value): 
Very high
Return on Investment (Timescale): 
0-6 mon
Ease of scalability: 
Simple
Read more
Hide details
Overview summary:
Brush DJ is an app designed to motivate children to have an effective oral hygiene routine by making tooth-brushing fun! The main feature of the app is a timer, which plays 2 minutes of music taken at random from the user’s device or cloud. The app also contains the evidence-based oral health information given in the Public Health England document ‘Delivering Better Oral Health’.  Reminders can be set to prompt at least twice a day brushing, when to change toothbrushes and visit the dentist.   
Challenge identified and actions taken :
Approx 26,000 children are admitted to hospital each year (England) to have decayed teeth extracted under general anaesthetic, the most common reason for children between 5 & 9 to be admitted to hospital. At least 50% of NHS dental budget is spent on treatment of preventable disease c.£1-1.5bn p.a. (England) with £30m spent on hospital tooth extraction for children aged under 18, these costs don’t include loss of income/productivity for parents/carers & lost school hours or the psychological cost of treatment to all involved.
 
The Brush DJ app is free (no in-app purchases or adverts). Videos showing how to effectively use a manual toothbrush, floss & interdental brush can be watched for free on YouTube. Using an app to raise awareness of evidence-based oral health information has financial advantages over methods such as leaflets as there is no printing, storage, distribution cost associated with an app. Apps are instantly scalable & updatable with the cost of producing one app being the same as any multiple, unlike a physical product. Because an app can use local reminders generated by the app itself they have an advantage over text message reminders, which have been used to motivate better oral health.  
Impacts / outcomes: 
The Brush DJ app has been already been downloaded in 193 countries on to 246,000 devices and received mainly 5 star reviews in the app stores https://itunes.apple.com/us/app/brush-dj/id475739913?mt=8 https://play.google.com/store/apps/details?id=uk.co.appware.brushdj&hl=en .  Diffusion of the app can be measured by the number of downloads it achieves.

The main measure of success of the Brush DJ app at a population level will be if there is a fall in the number of decayed, missing or filled teeth reported in the Nation Dental Epidemiology Programme for England, oral health survey of five-year-old children and a reduction in the number of children attending hospital for tooth extraction under general anaesthesia.

The information given in the app comes from the Public Health England document ‘Delivering Better Oral Health – an evidence-based toolkit for prevention’ https://www.gov.uk/government/publications/delivering-better-oral-health-an-evidence-based-toolkit-for-prevention . PHE have reviewed the app and have no concerns.

The next step in the development of the app will be to include software to measure when users open the app, how long they stay on each screen and if they uninstall the app. The data obtained from this would be used to improve the user experience.

Research is soon to begin to measure the effectiveness and cost effectiveness of the app in comparison to traditional methods to motivate an evidence-based oral hygiene routine in children. This will involve a randomised control trial comparing the app to traditional methods by monitoring levels of plaque on children’s teeth in the short and long-term.
Which local or national clinical or policy priorities does this innovation address:
Wellness and prevention of illness.
Supporting quote for the innovation from key stakeholders:
The City of York council has started to promote the app in children’s centres and reception classes. http://www.yorkpress.co.uk/news/14306759.Free_dental_packs_for_York_children__as_city_tries_to_tackle_shocking_child_tooth_decay_figures/?ref=fbshr
Plans for the future:
The next step in the development of the app will be to include software to measure when users open the app, how long they stay on each screen and if they uninstall the app. The data obtained from this would be used to improve the user experience.
 
The main barrier to scaling the app is lack of awareness – this could be reduced by all those involved in health in the WMAHSN region actively promoting the app at every contact with patients and the public who would benefit from using it - making every contact count.
 
I have recently been appointed as one of the inaugural NHS Innovation Accelerator fellows http://www.england.nhs.uk/ourwork/innovation/nia/ to try to get the app adopted at a scale and pace in the NHS. With the programme comes a bursary which is being used to improve the app and raise awareness.  To make the app sustainable in the future funding will be needed to cover the cost promoting and maintaining the app.
 
Research is soon to begin to measure the effectiveness and cost effectiveness of the app in comparison to traditional methods to motivate an evidence-based oral hygiene routine in children. This will involve a randomised control trial comparing the app to traditional methods by monitoring levels of plaque on children’s teeth in the short and long-term. 
 
The main measure of success of the Brush DJ app at a population level will be if there is a fall in the number of decayed, missing or filled teeth reported in the Nation Dental Epidemiology Programme for England, oral health survey of five-year-old children and a reduction in the number of children attending hospital for tooth extraction under general anaesthesia.
Tips for adoption:
The City of York council has started to promote the app in children’s centres and reception classes. http://www.yorkpress.co.uk/news/14306759.Free_dental_packs_for_York_children__as_city_tries_to_tackle_shocking_child_tooth_decay_figures/?ref=fbshr
Contact for further information:
Ben Underwood - ben@brushdj.com
Read more
Hide details
0
0
Votes
-99999

Created by

Co-Authors:

Share and Follow