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Idea Description
Supplementary Information
Innovation 'Elevator Pitch':
Teleswallowing enables poorly people to be seen more rapidly by specialists and improves staff productivity threefold
Overview of Innovation:
Teleswallowing is an approach using technology whereby a speech and language therapist can run a virtual clinic to triage, manage and review his/her patients with eating and drinking problems (dysphagia). Teleswallowing Ltd staff train the carers within residential and care settings to be able to link remotely with speech therapists to provide rapid access to specialist skills to avoid unnecessary distress, avoidable deterioration and hospital admissions. Speech and Language Therapy is a scarce resource and the waiting lists to see a specialist are long. The use of Teleswallowing technology prevents vulnerable people suffering and can be used as an out of hours/weekend cover approach.
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':
Our online workshop helps women from all backgrounds in all demographic areas to access positive, factual information to support their birth choices using evidence-based information that can be updated as and when new guidance is released.
Overview of Innovation:
The Real Birth Company’s mission statements are ‘to provide relevant, up to date, evidence based antenatal information that is delivered with a positive attitude’ and ‘to impart our knowledge with confidence to empower women and their birth partners at this very special time’.
 
We have achieved this with our RCM accredited antenatal education training programme that has been developed into an online e-learning antenatal resource for women birthing in the UK & is available in several languages. This e-learning resource is a birth physiology workshop full of important information that supports UK practice & enables women to understand the reasons behind their care, whilst supporting them to make informed choices in labour.


Antenatal education is essential to helping women form opinions & make choices in regard to their pregnancy & birth. There are various types of antenatal education. Hospital accessible antenatal education is dependant on resources, demographics & availability of staff to name a few. Lots of these classes use traditional methods of teaching with limited time to discuss at length the physiology.
 
The Real Birth online workshop is easily updated & uses evidence-based information from NICE, WHO, RCM, RCOG & others. It is holistic, culturally sensitive & can be accessed from anywhere by computer, tablet or mobile phone.
 
The innovation of creating a multi-lingual online e-learning workshop came from the positive birth results that were consistent with women & their partners who had attended a specifically designed positive birth workshop.
 
The workshop was created using techniques that help graduate students revise for exams, this learning technique has been integrated into the imparting of positive birth physiology. The use of non-threatening language & positive birth information helps to normalise birth & reduce fear. When fear is reduced in labour the benefits for both mother & baby are both psychological & physiological.
 
Barriers to effective antenatal education can include:
  • time pressures for antenatal classes
  • finding midwives who feel comfortable giving antenatal education
  • update & training costs
  • availability of classes
  • limited spaces for face to face classes
  • cost of interpreting services/availability of interpreters
  • birth terminology used
  • women being unable to attend for social or demographic reasons
Our online workshop works to address these barriers to help women from all backgrounds in all demographic areas to access positive, factual information.

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: 
Digital health / Innovation and adoption
Benefit to NHS:
The Real Birth online workshop is an easily accessible form of evidence-based antenatal education (updated as evidence changes) that is interactive, informative & fun to use.
 
The Better Births Maternity Review says that all women should have access to information to enable them to make an informed, non-bias choice.

Making Normal Birth a Reality states ‘evidence-based information for women about factors that make a normal birth with good outcomes for the mother & baby more or less likely, presented in a format which they understand so that they can plan for the kind of birth they want & make informed decisions’ is an essential part of birth preparation.

WHOs new recommendations on reducing unnecessary births by C-section recommended ‘Health education for women is an essential component of antenatal care’ by using childbirth education workshops that include partners to support women & address fear of birth with methods such as understanding birth physiology, our workshop helps to address unnecessary interventions in labour.

Women with access to antenatal education have a higher chance of normal birth & a more positive birth experience that can help in the postpartum period.
 
The workshop follows a researched learning technique. Written in a style that enables users to learn & retain the information more effectively leading to confidence & understanding of birth.
 
Accessed from 25 weeks of pregnancy via a unique coded card issued by the healthcare provider, users work through 1 module at a time before accessing the next to ensure the workshop is comprehensible. Within the modules are questions, diagrams & carefully designed non-threatening animations.
 
Each language has been translated by first language speakers to ensure the terminology is understandable & animations are culturally respectful whilst explaining a journey of birth. NICE Pregnancy & Complex Social Factors list barriers for women who speak no or little English that include lack of interpreters & knowledge of the maternity service. Our workshop helps address such barriers. NICE also say that with this group of women other methods such as online video clips & audio information should be used.

  
 
Our workshop is factually based giving true & correct information & techniques to practice for labour along with the best positions & why. It addresses subjects like the reasoning behind recommendations for skin to skin & looks at how this can help aid mental health for both parents in the postnatal period.
Initial Review Rating
5.00 (1 ratings)
Benefit to WM population:
Antenatal education has a role to play in improving knowledge of, and preparation for parenthood and can lead parents to be, to adopt a range of healthy behaviours that affect pregnancy and birth, improving outcomes and the mother’s experience of birth.
 
The Real Birth Company is committed to supporting all women to access up to date and evidence-based information relating to their birth. We believe that all women should have access to this information and have produced the e-learning modules in several languages to help tackle health inequalities.
 
Tackling health inequalities in infant mortality and infant and maternal health, will not just improve health outcomes today, but lay the foundations for sustainable, long-term improvements in health.
 
At 5.5 deaths per 1,000 live births, the West Midlands has the poorest infant mortality rate in England [2014 data].  The infant mortality rate takes into account the total number of live births and so provides a more accurate indication of trends than just analysing the number of deaths in infancy over time. The West Midlands rates are significantly higher than the England average. (source)
 
Poorer mothers-to-be often do not attend antenatal classes. Almost three-quarters of pregnant women on low incomes do not attend antenatal classes according to new figures. Nearly half are not even offered them on the NHS. (source)
 
The Real Birth Workshop was created because we believe that all expectant parents should have access to positive birth information. It is beneficial for pregnant mums and their birth partners to have positive help with their birth preparation. We support all birthing choices because we believe in empowering women with the right information when they need it.
 
A report by the National Childbirth Trust (NCT) Preparing for birth and parenthood report surveyed 928 expectant parents (first-time mothers and fathers) attending antenatal courses. The research found that while only 3% of women said they felt confident about birth before attending an antenatal course, afterwards 98% said they felt confident or fairly confident. Similarly, among fathers-to-be surveyed, just 1% said they felt confident about birth before their course; afterward 97% felt confident or fairly confident.
 
The Real Birth Online Workshop provides parents to be with the education they need to manage and reduce maternal anxiety leading to improved coping strategies, greater partner support and a better birth experience.
Current and planned activity: 
We believe the workshop shows decreased admission in the latent phase, decreased use of analgesia & an increase in women having a positive birth experience.

We need champions who can apply for NIHR funding with us to pilot The Real Birth Online Workshop with women using their NHS maternity services.  
 
A number of languages are currently active, we want to include more to help all women access valuable antenatal education. Being able to access our online workshop provides antenatal education to women who may otherwise be unable to attend classes for various reasons including social, cultural & demographic.
 
Many proactive measures are being taken to address perinatal mental health. We believe a positive birth experience doesn't depend on mode of birth but choice, understanding & involvement in decision making & empowerment in pregnancy & labour.
 
Our programme can have a positive effect on women’s birth experiences & her birth partners & assist with informed choice & understanding of birth.  
What is the intellectual property status of your innovation?:
100% IPO The Real Birth Company Limited
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
N/A
Ease of scalability: 
Simple
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Overview summary:
Capitalising on a successful e-learning programme, we are developing SCRIPT for nurses. SCRIPT is a suite of 15 modules aimed at developing and maintaining professional knowledge and competence relating to medicines. The platform is generating a significant amount of interest and support.
Challenge identified and actions taken :
Medicines are the most common intervention in the NHS, but evidence suggests that the use of medicines in the NHS is often sub-optimal. Medication errors account for 10–20% of all adverse events in the NHS and preventable harm from medicines costs more than £750 million each year. Ten days after starting a new medicine, nearly a third of patients are non-adherent. To address the training needs relating to medicines management/optimisation, SCRIPT is an established suite of web-based e-learning 15 modules, aimed at developing and maintaining professional knowledge and competence relating to medicines. The modules, agreed as a result of feedback at WMAHSN events, have been authored by specialist physicians, nurses and pharmacists in the region and six modules are currently in final production ready for launch. Planned outcomes were a suite of modules to develop and maintain the professional knowledge and competence of qualified nursing staff relating to the safer use of medicines. This work builds on the established SCRIPT e-learning programme available for junior doctors (www.safeprescriber.org). The modules were scoped and developed as part of a collaboration between Coventry and Warwickshire NHS Partnership Trust, the University of Birmingham and OCB Media. 
Impacts / outcomes: 
  • The scale of delivery has already increased from the original proposal, from nine modules to 15 module categories finalised
  • Specialist physicians, nurses and pharmacists in the region have been involved in the authoring of modules
  • Six modules have been launched (UK Medicines Policy, Evidence-Based Practice, Introduction to Pain Management, Pharmacological Pain Management, and Adverse Drug Reactions, Anticoagulation Part 1)
  • Two modules are currently undergoing final edit (Anticoagulation Part 2 and Medicines Management in Care Homes)
  • One module with author for final review (Respiratory)
  • Two modules currently undergoing edit (Dosing and Calculation and Advanced Pain Management)
  • Nursing SCRIPT User Guide drafted
  • The e-learning platform is available online at www.saferuseofmedicines.org
  • As this e-learning will be available to all nurses across the healthcare sector, it is generating a significant amount of interest and support. In addition, interest is being received from academic institutions in the West Midlands that train nurses at undergraduate level as they are keen to ensure that nursing competencies with regards to medication administration are gained prior to entry in clinical practice
  • Working in collaboration with a number of authors from various backgrounds and trusts across the region, SCRIPT has not only built a network of clients but a wider regional interest in drug safety.
Which local or national clinical or policy priorities does this innovation address:
From the NHS Five Year Forward View: • As the ‘stock’ of population health risk gets worse, the ‘flow’ of costly NHS treatments increases as a consequence • Future models will expand the leadership of primary care to include nurses, therapists and other community based professionals. It could also offer some care in fundamentally different ways, making fuller use of digital technologies, new skills and roles, and offering greater convenience for patients • access to GPs or nurses working from community bases equipped to provide a much greater range of tests and treatments. In partnership with local authority social services departments, and using the opportunity created by the establishment of the Better Care Fund, we will work with the NHS locally and the care home sector to develop new shared models of in-reach support, including medical reviews, medication reviews and rehab services. NICE guidance on medicines management, adherence and optimisation.
Supporting quote for the innovation from key stakeholders:
Dr Jamie Coleman, Professor of Clinical Pharmacology and Medical Education, University of Birmingham: “The administration of medicines occurs in all areas of health and social care, many of which are given by nurses and professional carers. Errors that occur at the administration stage are often not intercepted by others, unless the patient notices an error, and therefore this is an important focus for education and training. The SCRIPT project team are excited to be working on new e-learning modules to provide for the Safer Use of Medicines for the region.” 
Plans for the future:
  • Completion of remaining modules
  • The e-learning platform will be promoted regionally in the first instance, with the ability to expand the scope nationally
  • The first six modules will be officially launched by March 2016.
Contact for further information:
Prof Jamie Coleman 
j.j.coleman@bham.ac.uk 
0121 414 3778
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Innovation 'Elevator Pitch':
We develop board games that engage and educate frontline staff. 
They improve care delivery and patient safety by giving staff the knowledge, skills and confidence to make beneficial changes.
Overview of Innovation:
Since 2004 we have been developing board games that improve learning and development by making face-to-face engagement easier and more effective. They bring staff together and encourage them to discuss new ways of working. They get people talking and sharing; players learn from each other.
 
Our games improve performance by delivering the knowledge, skills and confidence that staff need to change the way they work, communicate and behave. Games encourage players to relax and have fun making them more receptive to new ideas and more willing to discuss difficult subjects. While the games are delivering structured and engaging learning it doesn't feel like formal learning. This is very important for unqualified support staff (bands 1-4) who may have fear of formal classroom learning for a variety of reasons.

Our games are designed to be extremely flexible and can be played in the workplace without a specialist facilitator or as part of a more structured formal training programme or workshop. This is intentional and is designed to bridge the gap between solitary learning such as eLearning (which may not be engaging or effective) and formal instructor lead training (which can be effective but expensive and scarce).

We have developed over 40 games and most of them are specifically for use in health and social care settings to address specific clinical and organisational issues. Many of the games are designed to reduce avoidable harm and improve patient safety by encouraging continuous improvement among frontline staff. Games cover a range of issues including:
  • Medication errors
  • Sepsis management
  • Pressure ulcer prevention
  • Malnutrition & dehydration
  • Dysphagia management
  • Stroke pathway
  • Communication skills
  • Team working in health and social care
  • Information governance
  • Genomics
  • Cystic Fibrosis (for children with CF)
All of our games are developed in partnership with leading academics, clinical practitioners, educators and frontline staff. We have formal agreements and partnerships with a range of national and local NHS organisations including NHS England, Health Education England, NHS Improvement, NHS Scotland, and NHS Education for Scotland.

We have formal partnerships with a range of organisations in the Midlands including City University Birmingham, Birmingham Community Healthcare NHS FT, Health Education West Midlands, Coventry & Warwickshire Partnership NHS Trust.

Our biggest challenge is publicising our games. This is why we would like funding from the SME Innovation Fund.

 
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 / Advanced diagnostics, genomics and precision medicine / Wellness and prevention of illness / Education, training and future workforce / Innovation and adoption / Patient and medicines safety / Person centred care
Benefit to NHS:
Patient safety and avoidable harm are huge problems for the health and social care systems and for wider society. Many of the changes needed to improve safety are relatively simple and can be carried out by frontline staff without the need for new equipment or complex system or process changes. But these changes cannot happen without effective training and support. Without them frontline staff cannot improve their performance. While evidence based medicine is practiced it is not supported by evidence based training and we believe that within health and social care training is either absent or has no evidence to support its efficacy.

The widespread adoption of eLearning and other remote learning resources are appealing to the organisation because they appear cost effective but can be isolating and unpopular with frontline staff. It's easy to conclude that if these methods of delivering training were effective then the incidence of avoidable harm and patient safety incidents would have decreased or disappeared. They have not.

We believe that the most effective way of engaging and training frontline staff is face-to-face in groups where staff members learn from each other. If this happens it often involves a slide show or lecture and neither of these engage the learners in any discussion nor challenges them to process new information and ideas.

We develop board games to achieve these levels of engagement. A simple board game based on recognisable games such as Snakes & Ladders are very simple to play, widely recognised and have cross cultural and generational appeal. Our games don't require any structured facilitation and can be played by anyone anywhere. Within minutes players are laughing and joking while focussing intently on discussing the questions and scenarios presented within the game.

Independent university and NHS studies strongly suggest that our games are very effective for knowledge transfer, knowledge retention and developing the confidence players need to implement what they've learned during the game. There are also clear indications, from within the NHS and care homes, that playing games can have a measurable effect on patient safety and avoidable harm but this needs more investigation to confirm. 

Any reductions in avoidable harm and improvements in patient safety will have a significant benefit on finances across the system and of course the benefit to patients and carers is clear. Staff morale can also be improved.
Initial Review Rating
4.60 (1 ratings)
Benefit to WM population:
As described earlier in this submission we have contractual and commercial relationships with several organisations in the West Midlands. The sale of our games generates revenue for these organisations that can be reinvested by them to improve the services that they deliver to the residents of the WM. We anticipate more of these commercial relationships as our company grows so our games would be creating wealth within the WM economy.

The direct benefits to patients and carers of less avoidable harm and improved patient safety is clear and the financial implications for the WM economy could also be significant.

The reputational benefits for service providers should not be ignored and the improvements in staff morale could also be a beneficial side-effect.
Current and planned activity: 
We have formal agreements and partnerships with a range of national and local NHS organisations including NHS England, Health Education England, NHS Improvement, NHS Scotland, and NHS Education for Scotland.

We have formal partnerships with a range of organisations in the West Midlands including City University Birmingham, Birmingham Community Healthcare NHS FT, Health Education West Midlands, Coventry & Warwickshire Partnership NHS Trust.

We also have relationships with a range of Royal Colleges, charities and patient groups including Royal College of Nursing, Royal College of Midwives, The Patients Association, UK Sepsis Trust, Chest, Heart & Stroke Scotland and the British Dietetic Association.

We cannot develop our games without the support of subject matter experts from these organisations and we will continue to strengthen these relations and create new ones.
 
What is the intellectual property status of your innovation?:
In most instances we entirely own the IP related to our games. In some instances the IP is owned, or partly owned, by our partners and we sell the games under licence from them. We recently had an IP Audit carried out on all of our games and associated commercial agreements and partnerships. When this report is finalised we would be willing to share it with the SME Innovation Fund.
Return on Investment (£ Value): 
medium
Return on Investment (Timescale): 
1 year
Ease of scalability: 
Simple
Regional Scalability:
In terms of scalability many thousands of existing games are already being used in hospitals, universities and care homes across the UK and overseas. The WM is well-represented in terms of games already in use. Funding from the SME Innovation Fund would be used to broaden the scope of existing activities and ensure that more games are sold and used in the WM and elsewhere.
Measures:
Because this submission is related to the promotion of a range of products success will be measured in numbers of additional games sold. However, individual games are assessed for their efficacy in knowledge transfer, knowledge retention and confidence levels of players to make changes to care delivery and behaviours. Independent studies carried out by universities and NHS employees all conclude that the games are effective. We assume that more games being used by frontline staff will translate into improved care delivery.
Adoption target:
The company is currently viable. The loan would help generate extra sales and this revenue will be used to further grow the business. Existing games cover almost the entire health and social care sector and so potential buyers and users in the WM could be any NHS trust, university, care home or other service-provider.
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