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Idea Description
Supplementary Information
Innovation 'Elevator Pitch':
ChatHealth is a messaging helpline to enable service users to securely contact a healthcare professional, supporting timely, confidential access to help.
Overview of Innovation:
ChatHealth is a safe and secure text messaging service that helps families and young people get in touch with healthcare professionals. First developed by school nurses at Leicestershire Partnership NHS Trust (LPT), ChatHealth supports greater efficiencies within public health community nursing teams, with individual nurses able to provide for a greater number of service users. It is cost effective and uses technology millennials are familiar with, providing confidential and timely access to
healthcare. People who need health advice and support do not need to wait for a nurse visit and the service is completely anonymous meaning it reaches out to often seldom-heard and vulnerable groups.
  • Available to nearly two million young people in England.
  • Available to the parents/carers of nearly 80,000 new-born babies a year.
  • Increased service reach/access - delivering 100 additional contacts every month.
  • Overcomes the stigma of face-to-face discussion of sensitive issues.
  • Reaches more underserved groups - 1 in 5 male users compared to 1 in 10 in face-to-face clinics.
ChatHealth can help teams to deliver more contacts with existing resources. At any time, just one health care professional can handle all messaging enquiries from an entire population, usually only impacting around 0.5WTE capacity. At a combined cost of £10k (salary and product licensing) less than a WTE post, a single healthcare professional can support a population of 85,000 service users and deliver 50 contacts p.c.m. These low-cost additional contacts eliminate unnecessary face-to-face contact (more resource intensive, more costly to taxpayers). They say it would take four more staff to deliver the same number of additional contacts face-to-face, costing £150k.
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':
ChatHealth is a messaging helpline to enable service users to securely contact a healthcare professional, supporting timely, confidential access to help. 
Overview of Innovation:
ChatHealth is a safe and secure text messaging service that helps families and young people get in touch with healthcare professionals. First developed by school nurses at Leicestershire Partnership NHS Trust (LPT), ChatHealth supports greater efficiencies within public health community nursing teams, with individual nurses able to provide for a greater number of service users. It is cost effective and uses technology millennials are familiar with, providing confidential and timely access to healthcare. People who need health advice and support do not need to wait for a nurse visit and the service is completely anonymous meaning it reaches out to often seldom-heard and vulnerable groups.
  • Available to nearly two million young people in England.
  • Available to the parents/carers of nearly 80,000 new-born babies a year.
  • Increased service reach/access - delivering 100 additional contacts every month.
  • Overcomes the stigma of face-to-face discussion of sensitive issues.
  • Reaches more underserved groups - 1 in 5 male users compared to 1 in 10 in face-to-face clinics.
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 / Wellness and prevention of illness / Digital health / Innovation and adoption
Benefit to NHS:
  • An efficient way of working for teams that are already stretched, for example one duty nurse can support large populations of people, within existing capacity, delivering up to 100 additional contacts every month. Working in more traditional ways, it would require the appointment of two additional nurses to improve reach to the same level.
  • More contact from more new service users across a broader range of issues. This is particularly relevant for certain “hard to reach” demographics, such as adolescent males, who are more likely to ask for health advice and help by sending a message compared with traditional forms of service access.
  • ChatHealth is a sustainable solution.  Environmentally, it reduces travel, particularly in rural areas where nurses might otherwise drive up to 90 minutes to visit a particular school. 
  • Due to how ChatHealth changes the model of delivery, resources can be better allocated and promote more effective spend of taxpayers’ money.
  • Strengthens and complements the universal face to face support offered by Public Health/School Nurses and Health Visitors through a digital offer which could be integrated with other services such as CAMHS, Speech and Language Therapy, nutrition and dietetics.
  • Improved access to healthcare for more children and teenagers/parents and carers who would be reluctant to engage directly with health professionals.
 COST EFFICIENCIES EXAMPLE
With safety/security assured, nursing teams can now easily provide industrial scale messaging enquiries services delivering more contact withing existing resources.  Adopting teams usually move to a single point of access model, so just one duty nurse can handle all messaging enquiries from an entire school population, usually only impacting around 0.5WTE capacity.

In a modest example, one public health/school nursing team runs its messaging service with 0.5WTE staff from within existing capacity or a vacant post, at a combined cost (salary and product licensing) of £10k less than a WTE post.  The nurse running the service supports an entire population of up to 85,000 pupils and delivers 50 contacts p.c.m.  These low-cost additional contacts eliminate unnecessary face-to-face contact (more resource intensive, more costly to taxpayers). They say it would take four more staff to deliver the same number of additional contacts face-to-face, costing £150k. 
Initial Review Rating
5.00 (1 ratings)
Benefit to WM population:
Evidence shows that young people sometimes feel more comfortable and confident relaying sensitive issues via mobile technology rather than a face-to-face discussion with a healthcare professional whilst busy parents especially value its convenience. When ChatHealth launched in 2013, the number of reported young suicides were the highest they’d been in ten years with depression and self-harming doubling. Meanwhile one in five mothers suffer from perinatal mental health issues.

The ChatHealth platform is predominantly used by community health teams supporting universal care.
The majority of enquiries relate to emotional and mental wellbeing, including adolescent self-harming and low mood and maternal mental health. Some of these kinds of contacts can be significant from the point of view of safeguarding vulnerable service users and the ChatHealth model helps to safeguard risk. Other regular types of enquiries relate to adolescent sexual health, or new parents enquiring about infant health and development.
 
Children, young people and families in the West Midlands can expect to gain the following benefits:
  • Improved and more convenient access to the specialist community public health nursing service.
  • Children & young people can contact public health/school nurses during the school holidays.
  • Improved response to need which will lead to earlier intervention.
  • Improved, quick and easy access to health advice and support for children, young people and their families.
  • Swift response to text messages within the core hours of service delivery.
  • User friendly/age appropriate resources that are localised.
  • Targeted provision for more vulnerable young people and adults that may find it difficult to access services.
  • Extends service provision to service users that may have not previously accessed the service.
  • Transcripts of the messages can be copied over to the EPR where a service user has been identified, enriching the patient record. Anonymous transcripts can be downloaded as pdf’s and stored in a secure drive.
Current and planned activity: 
Around 38 NHS Trusts and organisations have adopted ChatHealth, they receive ongoing support for their licences. We are also in discussion with several organisations who are interested in adopting ChatHealth.
What is the intellectual property status of your innovation?:
All intellectual property is held by Leicestershire Partnership NHS Trust.
Return on Investment (£ Value): 
Very high
Return on Investment (Timescale): 
0-6 mon
Ease of scalability: 
Simple
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Overview summary:
The Solihull Approach, an NHS based team of health professionals, have developed an exciting online course for parents, carers and professionals. ‘Understanding Your Child’ includes 12 modules (20 minutes each) and follows 5 other families. The focus of the course is  how our emotions affect our relationships and behaviour. It looks at brain development, play, styles of parenting, sleep, temper tantrums, communication and more and is based on the nationally and internationally acclaimed face to face course.
Challenge identified and actions taken :
Unlike antenatal support, there is a stigma around accessing parenting support.
We know a great deal about preventing mental health problems in future generations. We know that the brain develops in response to its environment and is especially sensitive to the quality of relationships with caregivers, particularly in the first three years of life.
There is “floor to ceiling” evidence that intervening early and preventatively pays both economically, emotionally, and cognitively and achieves life long impact.
A trial of universal parenting support was undertaken by the coalition government (CanParent trial 2012-15). The Solihull Approach was a provider in the trial. The range of courses on offer were very popular with those who took them but the trial reached only a fraction of the intended audience, less than 3000 out of an intended 20,000. A CanParent survey revealed that most 98% of parents would be interested in a course, but the difficulty is accessing one.
The Solihull Approach developed the online coures in response to this finding.
The Solihull Approach face to face course and online course were  the first in the country to be awarded the DfE’s Quality Mark.
The Solihull Approach is offering multi-user licences to corporates, schools, NHS trusts, local authorities, public health, and prisons.
 
Impacts / outcomes: 
Data analysed so far: 121 parents highly significant reductions in conflict and increases in closeness in the relationships between the parents and their children on the two subscales and overall score on the Child Parent Relationship Scale (Pianta, 1992).
Published research demonstrating effectiveness of face to face course:
 
  • Johnson, R., Wilson, H. (2012) Parents’ evaluation of Understanding Your Child’s Behaviour, a parenting group based on the Solihull Approach. Community Practitioner, 85: 5, 29-33.
  • Vella, L., Butterworth, R.,  Johnson, R.  and Urquhart Law, G. (2015) Parents' experiences of being in the Solihull Approach parenting group, ‘Understanding Your Child's Behaviour’: an interpretative phenomenological analysis. Child: Care, Health and Development 41:6, 882–894.
  • Baladi, R., Johnson, R., and Urquhart Law, G. (in progress) A pre, post and follow-up evaluation of Understanding Your Child’s Behaviour (UYCB): A parenting group intervention based on the Solihull Approach. Child: Care, Health and Development.
Which local or national clinical or policy priorities does this innovation address:
National Institute for Clinical Excellence (NICE) Guidelines for conduct disorder: ‘Antisocial behaviour and conduct disorders in children and young people: recognition and management’ NICE guidelines [CG158] Published date: March 2013 http://www.nice.org.uk/usingguidance/sharedlearningimplementingniceguida...
Supporting quote for the innovation from key stakeholders:
“The most amazing and immediately life changing course I have ever been on! And that’s after 5 years in childcare!” (Parent)
“Really enjoyed doing it and found it useful. Yes it made a difference. Was going to make a referral to the MAT team. Children's behaviour problematic at home, being managed at school, but a problem. Saw an improvement after the parent took the course. We could see a difference in school. Children much, much better. The mum was being more positive, a bit more confident, she seemed able to see things from their point of view, and had  changed the way she spoke to the children.” (Pastoral Lead at a Primary School)
 
Plans for the future:
To engage with corporate partners, health, education and social care. Develop implementation kits  to assist organisations to launch the course to employees and customers. Reach the whole population thereby elevating the emotional wellbeing of future generations.  
 
Tips for adoption:
Multi-user licences are available. Implementation kits are in development.
 
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