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Idea Description
Supplementary Information
Innovation 'Elevator Pitch':
The i-THRIVE programme aims to improve children and young people’s mental health outcomes by working with 30 sites across the country to implement the THRIVE framework.
Overview of Innovation:
i-THRIVE is national programme of innovation and improvement in child and adolescent mental health. It is an NHS Innovation Accelerator and is currently being implemented in national accelerator sites across the country. It is delivered by supporting localities to implement the THRIVE Framework through their CAMHS transformation and service improvement programmes.

i-THRIVE Community of Practice 
More than 30 sites make up the i-THRIVE Community of Practice. The Community of Practice includes organisations that are using the THRIVE framework as the basis of their CAMHS transformation and improvement programmes who then share learning about the implementation of THRIVE and how it can be adopted to fit with their local plans for service redesign. Nearly 25% of the young people in England live within a locality that is a member of the i-THRIVE Community of Practice.

THRIVE
THRIVE Elaborated (Wolpert et al, 2015) can be downloaded here: THRIVE Elaborated

i-THRIVE
i-THRIVE is the implementation of the THRIVE conceptual framework, translating the THRIVE core principles into models of care that fit local contexts. Key to this process is the use of evidence based approaches to implementation.
 
i-THRIVE supports the provision of services using a whole-system, or place-based, approach to the delivery of child mental health services. This involves taking a population approach to delivery of care; enabling integration across health, care, education and third sectors, and a central focus on delivering improved outcomes for children and young people.
 
Choice and personalisation of care are core values and these are delivered in part through systematic implementation of shared decision making. To support this, a range of validated measures, tools and educational programmes have been developed by partners and are included in the i-THRIVE Implementation Toolkit, including the CollaboRATE measure, Option Grids and shared decision making training through the i-THRIVE Academy.

i-THRIVE Partnership Organisations
i-THRIVE is delivered through a partnership between the Anna Freud National Centre for Children and Families, the Tavistock and Portman NHS Foundation Trust, the Dartmouth Centre for Healthcare Delivery Science and UCLPartners.

Further Information
Further information about i-THRIVE and examples of successful implementation in sites can be found at http://www.implementingthrive.org/. For the latest news and updates you can also follow us on Twitter: @iTHRIVEinfo.
Stage of Development:
Trial stage - Trial stage to prove that the idea actually works as intended
Similar Content2
Innovation 'Elevator Pitch':
This project aims to improve patient knowledge and confidence in the correct use of injectable therapies via pharmacy intervention with New Medicines Service (NMS) and Medicines Use Review (MUR). 
Overview of Innovation:
It is intended that this work will develop:
  • A framework for both the NMS and MUR consultation for community pharmacists on injectable therapies in diabetes. To include safe administration, safety, including appropriate quantities of insulin adn adherence. 
  • Pharma outcomes will be used to support framework and implementation of project. This will also enable commissioners to understand the quality of the interactions from pharmacy. 
  • Develop an education framework for pharmacists to deliver injectable therapy NMS and MUR.
  • Upskill community pharmacists around the pilot site to deliver patient support for injectable therapies via NMS and MUR.
  • Process map current and future state for MUR service.
  • Measure outcomes to show the value of interventions.
Stage of Development:
Evaluation stage - Representative model or prototype system developed and can be effectively evaluated
WMAHSN priorities and themes addressed: 
Long term conditions: a whole system, person-centred approach / Wellness and prevention of illness / Education, training and future workforce / Patient and medicines safety / Person centred care
Benefit to NHS:
  • Reduce medicines wastage.
  • Reduce hospital admissions due to adverse events from medicines.
  • Lead to increased Yellow Card reporting of adverse reactions to medicines by pharmacists and patients, thereby supporting improved pharmacovigilance.
  • Pharmacist's intervention receives positive assessment from patients.
  • Improve the evidence base on the effectiveness of the service.
  • Support the development of outcome and/or quality measures for community pharmacy.
This project will develop resources which in turn can be used to replicate this work - to include the following:
  • Consultation framework to be adopted for NMS and MUR in Pharma Outcomes.
  • Integration of pharmacist care in line with the 5 Year Forward View.
  • Improvement of pharmacist skills around injectable therapies through NMS and MUR. 
Initial Review Rating
5.00 (1 ratings)
Benefit to WM population:
Patient benefits will be those expected from the NMS and MUR service, which are:
  1. Improve patient adherence which will generally lead to better health outcomes
  2. Increase patient engagement with their condition and medicines, supporting patients in making decisions about their treatment and self-management.
  3. Improve patients' understanding of their medicines
  4. Highlight problematic side effects and propose solutions where appropriate
  5. Improve adherence
  6. Reduce medicines stock piling adn safety but encouraging patients only to order the medicines they require
Current and planned activity: 
A Joint Working Agreement is being established between the West Midlands AHSN, Sat Kotecha, Chair of Local Professional Network, NHS England, Mark Galloway, Head of Medicines Management, Coventry and Rugby CCG, Novo Nordisk, Eli Lilly and Sanofi. 

This project will focus on the community pharmacists surrounding specific surgeries within Coventry and Rugby CCG and is to prove the solution before wider scale adoption.  It interfaces with a number of other pieces of work:-
  1. Coventry and Rugby Programme Board for service improvement in diabetes.
  2. Reducing variability and improving diabetes care project with UHCW and specialist input into improving the care in 8 practices in Coventry.
  3. Coventry diabetes community service is looking at compliance with diabetes medications.
  4. There is closer working between Coventry and Rugby CCG and North Warwickshire CCG. 
What is the intellectual property status of your innovation?:
Support from MidTECH in identifying the potential for IP to fall out of this piece of work would be appreciated. 
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
2 years
Ease of scalability: 
3
Co-Authors:
Regional Scalability:
This is the proof of solution and will provide the framework for how this could be scaled across the region. Having the LPN Chair leading on this piece of work alongside the CCG Head of Medicines Management means that wider adoption is a key predictor of success for this programme. 
Measures:
Measures are currently being developed with the core team in further detail. However the high level outcomes and measurements currently identified are: 
Outcomes
Patient confidence for use of injectable therapies
Community pharmacist confidence in delivery of NMS and MUR on injectable therapies.
Delivery of NMS and MUR on injectable therapy

Measurements
Community pharmacists engaged with the project to measure via PROM – to be developed as part of the project.
Measure pre and post education and at 3 months post.
Measure baseline of chosen pharmacist and end point of NMS+ and MUR+.
Adoption target:
Fully implemented across Coventry and Rugby CCG
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Overview of Innovation:
StepUp! is a digital service that integrates with CAMHS pathways. It allows young people, supported by professionals and parents to assess their needs, set goals, develop plans and strategies to self-help and measure how their mental health is changing via an app.
 
The referral is assessed and triaged and an invitation to join StepUp! is sent via a linked clinical platform to the individual who accepts and installs the app.  An introduction, preliminary resources, strategies and self-help material can be pushed by the clinician or selected by the user prior to the first appointment.
 
The content and look of the service has been designed by service users through a range of workshops. Content includes:- Questionnaires: the user responds to questionnaires which produce PROMs for the clinician; How to Help: captures what helps the user, things they find difficult, what makes things worse – information that the user writes about themselves and their condition that they can choose to share with other people; Goals: make and store plans for what the user needs help with and record progress; Notes: records things that the user wants to remember about the issues they need help with and appointments they have; Resources and Strategies: set of trusted and evidence-based digital tools targeted to help users self-care.
 
The clinician can check progress in the clinical portal. The app returns data analytics which can be reviewed pre-appointment to improve the effectiveness and efficiency of the consultation time and post-appointment to monitor outcomes.  StepUp! enables personalised care plans to be constructed using evidence-based resources and approaches for a young person and their family.
 
The service is currently in the trial phase across CAMHS in Leeds Community Healthcare NHS Trust, and is showing the potential to deliver significant improvement in the effectiveness and efficiency of service delivery.
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