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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 Content3
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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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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Innovation 'Elevator Pitch':
Using  a person centred approach to create socially useful data. Demonstrating outcomes in terms of national policy allows data to be aggregated for social benefit. Data can describe the communities we live in and help to co-produce services.
 
Overview of Innovation:
We produce a number of open source tools to help manage clients and demonstrate outcomes. Our tools support organisations to get a rapid understanding of the full range of issues a person wants help and support with. Using a simple, whole person, assessment process we help organsiations to take a person centred approach which wraps services around the invidual. 

Our tools provide a secure and easy way to share information across services but also gathers anonymised data on a population level. Our approach to gathering data on clinical and social need provides a basis for area based commissioning by describing communities and neighbourhoods.

Out two main tools are Risk Tracker, a case management and outcome measurement tool and Referral Tool, a system that quickly links people to local services. We provide fully managed and hosted solutions to organisations on our secure cloud servers. Our hosted solutions allow data to be anonymously aggregated across organisations to provide live data on clinical and social need. 

Our systems are linked to a database that collates policy from National Outcome Frameworks, Government Strategies and best practice from NICE. This allows services to report the impact they have in relation to the outcomes that their funding organisations and commissioners are accountable for. As policy and outcome frameworks change, we reflect those changes in organisational reports. 

All of our software is available under an open license to ensure sustainability and allow integtration with existing bespoke systems. 

The Inside Outcomes approach to case management and making referrals have been designed to support anyone that works in a community navigation role, or within social prescribing and general face to face prevention services. 

 
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: 
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:
Health is influenced by a range of social, environmental and economic factors which are beyond the remit of the health sector.
 
Health services, social care and housing are all focused on delivering better outcomes at lower cost to the public purse and finding ways of improving the effectiveness and better understanding the value of preventative services.
 
Risk Tracker measures the impact of organisations against national outcome frameworks, supporting them to translate the things they do into the outcomes that commissioning bodies are measured against. Referral Tool makes the referral process between organisation more efficient and promotes better service integration.
 
Commissioners need to identify what services are required to deliver improvements in the prevention, diagnosis and treatment of physical and mental illness in their local population, Risk Tracker provides important data to identify top priorities and opportunities for transformation.
 
It helps commissioners to identify subgroups within their population and consider service requirements across the system, creating the person-centred services patients want and need.
 
Our tools allow a simple method to analyse population data and identify those who would gain most from the services and interventions, commissioners then use this information to plan, deliver and monitor services for their local population.
 
When contracting for services, commissioners are looking for positive social outcomes, which have a lasting impact; with benefits for patients that can be clearly demonstrated.
 
With Risk Tracker, information is used to improve services and influence commissioning decisions. For example, the crossover in issues that the clients present to substance misuse services, mental health services and housing associations mean that data can be aggregated together.

As all data is stored in a single, secure, compartmentalised system we can create aggregated, anonymised maps of social need. The live data that can be produced records social need and is an essential tool in commissioning services against evidenced social need.
 
Investing in prevention and better health outcomes can be part of the solution to the challenges of increasing levels of need along with shrinking budgets. Effective preventative interventions can reduce health and social care costs and the need for welfare benefits. Better health can also enhance resilience, employment and social outcomes.
 
 
 
Initial Review Rating
4.60 (2 ratings)
Benefit to WM population:
Risk Tracker helps commissioners to plan services which meet national standards and local ambitions, by combining knowledge of existing service performance and population needs. Referral Tool provides a way for services to integrate around an individual, creating a person-centred approach whilst collecting minimal information. 
 
Commissioners traditionally do not have access to live local data. Having the ability to extract accurate data on health and wellbeing needs for a particular area supports a flexible approach to commissioning against need. Open data on social and clinical need also creates a basis for the co-production of services that match the needs of communities. 
 
The methodology that underpins our system encourages services to carry out a whole person assessment.  This means exploring the range of issues that might be present in an individual’s life. Through identifying a range of interdependent issues, services can integrate how they work with an individual and improve their outcomes.
 
An important component of planning for transformation is recognising where services may
need to be decommissioned. Risk Tracker can help to identify where less effective approaches to service delivery are to be found. With a good understanding of how a service is currently operating, commissioners can identify potential opportunities for innovation and improvement. Our method of mapping and recording referrals also can identify where services are not linked up providing an opportunity to increase efficiency and reduce costs. 
 
Risk Tracker and Referral Tool support commissioners to develop service specifications that focus on paying for services which produce improved outcomes for their patients, rather than reimbursing providers for activity.
 
All of our tools provide commissioners with the information they need to develop a vision of future service provision that will improve the health & wellbeing of individuals and communities in the West Midlands.
 
We provide hosted and managed solutions for a range of organisations. Our cloud servers provide a scalable solution that is secure and dynamically allocates resources to meet to demand. All of our software is also provided under an open license in order to promote sustainability and integration with other systems. 
 
Current and planned activity: 
Our Risk Tracker system is currently being used across Birmingham in GP surgeries as part of a contract with Citizens' Advice. It is also being used to support Health Trainers, Pregnancy Outreach Workers and Pre-Diabetes Group work. We also support Social Prescribing Projects in Birmingham and Oldham. 

Referral Tool is being used across Sandwell and is available for use by any organisation in Sandwell. 

We have recently received a number of grants for a range of outcome work.

We make this application to the SME Fund in order to get working capital to finish off software development of Risk Tracker, achieve NHS IT security accreditation, develop network mapping capabilities in Referral Tool and supplement marketing activities. 
 
What is the intellectual property status of your innovation?:
The intellectual property for all software is owned by Inside Outcome CIC. Our software is released under an open license. 
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
6-12 mon
Ease of scalability: 
Simple
Regional Scalability:
Both Risk Tracker and Referral Tool have been built to scale across large areas. The aim of the apps is to generate population level data on social and clinical need. Consistent data across large geographical areas. 

The key areas where we are looking at scale is to extend the use of Referral Tool. At present it’s operating across Sandwell Metropolitan Borough Council. We are seeking to extend this across the West Midlands Combined Authority by developing capacity to map organisational relationships and generate sustainable directories of services. 

Risk Tracker is operational across Birmingham generates data to support commissioning. We need to invest in development of the app in order to better manage organisations that work together. This will increase the ability to scale across neighbourhoods. 

Both Risk Tracker and Referral Tool are designed to operate sympathetically, to capture data from organisations that need a client management tool and those that want to manage data.
Measures:
We are working to achieve a number of outcomes in our short term plan. We will achieve compliance with the NHS Data Security and Protection (DSP) Toolkit. We will complete our pilot data generation project in the Northfield district and use that data to work with Birmingham City Council to design services. 

We will be able to demonstrate outcomes, in relation to services and areas, from the NHS, Adult Social Care, Public Health, Social Jusitce and Social Prescribing Outcome Frameworks. 
Adoption target:
We have achieved minimum viability through commercial sales to date. We are looking to progress pilot projects, in partnership with the NHS, to demonstrate how we can generate data on a larger scale. In the coming year we are looking to expand the use of Referral Tool from Sandwell into the West Midlands Combined Authority area and Staffordshire. 
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