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Idea Description
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Innovation 'Elevator Pitch':
The FearFighter Treatment is an evidence-based online program for an Anxiety Treatment.  Brave designed for Children and Adolescents experiencing Anxiety Disorders Social & Specific Phobias - Available 24/7/365 from any computer or mobile device
Overview of Innovation:
FearFighter is an online program for the treatment of panic and phobia. It is based on the evidence based approach known as Cognitive Behavioural Therapy, or CBT for short. Thousands of people have used this programme to help them overcome their fears and lead a more normal life.

The programme teaches patients how to tackle their thoughts and challenge avoidance behaviours that characterise panic and phobia. They can print out worksheets for activities, monitor their own progress and receive emails with further tips at the end of each step. Most sessions last about 50 minutes.  It is recommended that patients do one session a week.

FearFighter has undergone extensive testing & trial pilots involving 700 patients and has received an endorsement by the NICE as being proven to be clinically & cost effective.  In the NICE Final Appraisal Determination (FAD), FearFighter has been recommended as an option for delivering CBT in the management of panic & phobia. FearFighter has since been implemented in many NHS regions as well as being adopted in other countries as a recognised standard form of treatment.
 
BraveOnline
BRAVE-ONLINE utilises the technology and learnings from  FeaFigther to design a treatment specicifically for children and adolescents who experiencs Separation Anxiety Disorders, Social and Specific Phobias and other Generalised Anxiety Disorders. The treatment can be tailored by the therapist to meet the needs of the individual young person.

Parent sessions are designed to accompany the material covered in the child and teen program. Sessions focus on strategies such as psychoeducation about child anxiety, contingency management, relaxation training, and information about cognitive restructuring, graded exposure and problem solving. As such, the parent receives training in anxiety management strategies and is empowered to help their child acquire and use the skills learned in the program, and to manage situations in which their child becomes anxious. Both mothers and fathers are able to complete the parent sessions together or independently.

FearFighter and associated programs
  • NICE approved
  • UK National Health Service (NHS) recognised as a standard form of treatment for anxiety and phobia disorders
  • Evidence-based & extensively tested
  • Available to patients 24/7/365
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':
The FearFighter Treatment is the only product endorsed by National Institute for Health and Clinical Excellence (NICE) in the UK (TA097) – for an Anxiety Treatment
Evidence-based online program - Available 24/7/365 from any computer or mobile device
Overview of Innovation:
Introduction
FearFighter is an online programme for the treatment of generalised anxiety, panic and phobia. The programme teaches users how to confront and change their thoughts and challenge avoidance behaviour that characterise panic and phobia. Users can print out worksheets for activities, monitor progress and receive emails with further tips at the end of each step. Most sessions last about 50 minutes. One session a week is the current recommended treatment regime.
 
FearFighter is an online program for the treatment of panic and phobia. It is based on the evidence based approach known as Cognitive Behavioural Therapy, or CBT for short. Thousands of people have used this programme to help them overcome their fears and lead a more normal life.
The programme teaches patients how to tackle their thoughts and challenge avoidance behaviours that characterise panic and phobia. They can print out worksheets for activities, monitor their own progress and receive emails with further tips at the end of each step. Most sessions last about 50 minutes.  It is recommended that patients do one session a week.
Between certain steps, FearFighter sets activities to complete. These help them build on topics covered in sessions & are essential to make progress. FearFighter consists of 9 steps that need to be worked through one by one in order to obtain the greatest benefits. It guides users through CBT as much as a therapist does.
FearFighter has undergone extensive testing & trial pilots involving 700 patients and has received an endorsement by the NICE as being proven to be clinically & cost effective.  In the NICE Final Appraisal Determination (FAD), FearFighter has been recommended as an option for delivering CBT in the management of panic & phobia. FearFighter has since been implemented in many NHS regions as well as being adopted in other countries as a recognised standard form of treatment.
 
The FearFighter Program
  • FearFighter is NICE approved
  • UK National Health Service (NHS) and other nations recognise FearFighter as a standard form of treatment for anxiety and phobia disorders
  • Evidence-based & extensively tested
  • Online programme available to patients 24/7/365 from any computer or mobile device
  • Allows patients to learn how to confront and change their thoughts
  • Challenges avoidance behaviours that characterize panic and phobia
  • Print worksheets for activities, monitor progress & receive emails with further tips at the end of each step
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 / Wellness and prevention of illness / Wealth creation / Digital health / Innovation and adoption / Person centred care
Benefit to NHS:
  • Our latest data shows recovery rates of 48.2% this compares to the national recovery rate in 2015 of 38.4%
  • Research from trials shows dropout rates are not significantly different to face to face therapy.
  • Trials showed that clinician time per patient was reduced by 73%
  • The NICE Endorsement was for clinical and cost effectiveness with financial savings up to 70% compared to conventional therapy
  • The programme is available on desktop and mobile compliant devices and are available 24/7 thereby making access easier for a patient.
  • Reporting analytics are compatible with NHS requirements and the back office is simple to use

Quote from Mary ‘To date I’ve travelled on the underground train without a twinge of anxiety – I still can’t believe it! FearFighter has surpassed all my expectations’.
Initial Review Rating
5.00 (1 ratings)
Benefit to WM population:
NHS Benefits
Reduction in the demand on therapist time means more patients can be treated with improved recovery rates and reduced waiting lists
  • It provides greater choice of treatment to both the clinician and patient.
  • Evidence proves that the treatments work.
  • The product should provide direct financial savings.

Patients Benefits
Patients are able to self-manage their condition and thus not have to rely on or need psychological interventions and can also reduce or remove the dependence on medication.
The programmes help people to understand themselves better and to recognise and change unhelpful habits and thinking patterns.
The tracking system helps users review their progress throughout the programme using simple, scientifically validated questionnaires.

Company
A wider adoption of our CCBT technology and FearFighter would allow our West Midlands based company to expand its activities within the UK and overseas and thus take on additional staff to support clinicians and users / patients.
It would also facilitate us to develop a broad portfolio of treatments we have in the pipeline.
Current and planned activity: 
Birmingham and Solihull Mental Health NHS FT has been our client since May 2013 to date during which time that have used our FearFighter, MoodCalmer and OCFighter programmes and they are currently piloting both our Shade (Drug & Alcohol addiction) and Restore (Insomnia & Sleep disorders) programmes
 
Dudley and Walsall Mental Health Partnership NHS Trust currently in discussion with the trust to adopt our platform for are evidence based programmes for people with anxiety (FearFighter™), depression (MoodCalmer™), OCD (OCFighter™), addiction (SHADE™), sleep disorders (RESTORE™)

Required
  • Procurement / Adoption of: -  Require increased sales and access to market our products to CCGs and Trusts Mental Health teams.
  • Awareness / Profile Raising Greater awareness of our products and the conditions it can address
  • Project Assistance required - We are interested in locating possible clinical / academic collaborators and pilot sites for new Online mental health tools.
What is the intellectual property status of your innovation?:
All IP is owned by CCBT Ltd.

All our products are NHS information Governance Toolkit (IGT) and Interoperability Toolkit (ITK) compliant and our secure socket layer (SSL) and database encryption technologies have been enhanced to keep up with the ever changing requirements for web security and NHS informational governance standards and is integrated with IAPTUS and PCMIS. IE11, Chrome or Firefox are recommended
 
 
Return on Investment (£ Value): 
Very high
Return on Investment (Timescale): 
6-12 mon
Ease of scalability: 
Simple
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Innovation 'Elevator Pitch':
Ieso Digital Health delivers NICE recommended cognitive behavioural therapy (CBT) one-to-one between patients and IAPT trained therapists via online (live) typed conversation. Appointments are available when suit patients on any web enabled device.
Overview of Innovation:
Ieso Digital Health (“Ieso”) provides NICE recommended cognitive behavioural therapy (CBT) through our proprietary 'ThinkWell' web-based platform. Both Step 2 and Step 3 therapy is delivered one-to-one between a patient and an IAPT-trained PWP or a BABCP-accredited high intensity therapist online through typed conversation, supported by offline messaging in-between sessions; treating all IAPT-applicable conditions:
  • depression
  • generalised anxiety disorder
  • social anxiety disorder
  • panic disorder
  • agoraphobia obsessive-compulsive disorder (OCD)
  • specific phobias (such as heights or small animals)
  • PTSD
  • health anxiety (hypochondriasis)
  • body dysmorphic disorder
Ieso’s fully-managed service has been developed in association with, and operating within, the NHS IAPT services since 2011. We have steadily built up our customer base and are now commissioned in over 65 CCG areas across England, either working directly with the CCGs or as sub-contractors to NHS Trusts and independent healthcare providers. To date Ieso have treated in excess of 43,000 patients and conducted over 210,000 hours of therapy within the IAPT programme.

Ieso summary information sheet is attached for review.
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 / Digital health / Innovation and adoption
Benefit to NHS:
With growing demand for psychological therapies, traditional services can struggle to maintain NHS service standards relating to access, waiting times and recovery. As a result, services from around the NHS need to consider how to extend their care to patients without increasing their costs; including delivering digital interventions for appropriate cohort of patients. Although our service utilises the same human resources for the therapy itself, we have no additional overheads with regards to room hire, travel costs or other traditional overheads seen within the NHS.

Ieso's financial model is focused around patient treatment with no limit on session numbers. Pricing is based upon per episode of care, meaning a certain number of patients will be treated as part of allocated budget rather than assumed therapist capacity. 
 
Analysis of that data (Jan-Dec 2017) shows that Ieso delivers:
  • 22% better outcomes than the national average
  • 48% more patients’ complete treatment than the national average
  • 96.5% accessing treatment within 6 weeks, compared to 93.7% nationally, but with no waits for subsequent appointments.
In addition, Ieso’s “patient experience questionnaire” data shows that 82% of patients rate Ieso as good or excellent, and 66% of patients’ treatment is conducted outside of normal office hours.
 
The benefits of our innovation are not limited to quick and flexible access to treatment and better outcomes for patients. Our unique position of having access to extensive patient data can be used in clinical research to develop improvements in mental health care:
• Catarino, A. et al. (2018) Demographic and clinical predictors of response to internet-enabled cognitive–behavioural therapy for depression and anxiety. BJPsych Open (attached.
• Ewbank, M. et al (2019) Quantifying the Association Between Psychotherapy Content and Clinical Outcomes Using Deep Learning (attached)
Initial Review Rating
5.00 (1 ratings)
Benefit to WM population:
Patients are able to access clinically validated, NICE-approved, one-to-one typed CBT with an IAPT-trained PWP or BABCP-accredited high intensity therapist from the comfort of their own home using nothing more than their smartphone, tablet or computer to access our ThinkWell platform via a reliable internet connection.

With appointments available 24/7, traditional CBT can be conducted at a time and place that suits the patient. This means that those who are time poor, struggle to access traditional services due to geography, physical difficulties or personal boundaties are able to access the treatment that's right for them.

Approximately 66% of Ieso’s therapy sessions happen outside the traditional Monday-Friday 9-5 window,
with the majority taking place on week day evenings; in addition, Ieso’s “patient experience questionnaire” data shows that 82% of patients rate Ieso as 'good' or 'excellent'.

You can view an Ieso explainer video here:
https://www.youtube.com/watch?v=H5cID-JGSXU

As well as a 'people' video showing some of the people behind Ieso Digital Health here:
https://www.youtube.com/watch?v=ryIFZNBVkhk

We have also attached a patient case study.
Current and planned activity: 
Ieso manages IAPT contracts with large footprints, such as in Surrey, where we treat approximately 20% of the total number of patients accessing IAPT across the five CCGs within the AQP contract. In addition to Surrey, Ieso holds 26 IAPT contracts delivering a Primary Care Psychological Therapies Services. These contract areas are listed below;
•        Bolton
•        Bromley
•        Camden
•        Cambridgeshire and Peterborough
•        Derbyshire
•        Devon
•        Dorset
•        Dudley
•        East Riding of Yorkshire
•        Gloucestershire
•        Buckinghamshire
•        Herefordshire
•        Islington
•        Lancashire
•        Leeds
•        Medway
•        Merton
•        Norfolk
•        Nottinghamshire
•        Salford
•        Southampton
•        Southwark
•        Suffolk
•        Sussex
•        Wandsworth
•        West Kent

We continue to expand enabling more and more people to access clinically-validated CBT at a time and place that suits them.
What is the intellectual property status of your innovation?:
All IP is owned by Ieso Digital Health.

Ieso is ISO9001 and ISO27001 compliant and our IG Toolkit for 2017-18 (v14.1) had an overall score of
95%.

Ieso is fully operable with all major patient management systems (IAPTus, PCMIS).
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
6-12 mon
Ease of scalability: 
Simple
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Innovation 'Elevator Pitch':
Big White Wall provides accessible, evidence based online therapy via a secure platform. Sessions are available 7 days a week between 7am and 11pm, providing enhanced accessibility. KPI's are fully reportable and the service is CQC regulated. 
Overview of Innovation:
Big White Wall (BWW) is a digital mental health support service which has been operating since 2007 and has supported 150,000 members in distress.

BWW provides Live Therapy, which is face to face therapy via the secure platform. Our clients, can complete sessions via video, audio only or text only. We provide NICE guided, evidence based interventions for common mental health disorders, such as OCD, Social Phobias, PTSD, Panic, Depression, GAD, Health Anxiety and Specific Phobias.

Many of our existing commissioners are IAPT services and we are fully IAPT compliant in our delivery including the sessional collection and reporting of the minimum dataset (MDS). Performance data can be submitted by the referrer themselves, either by collecting and inputting data from our platform or through the IAPTus PRISM integration, which feeds session data (clinical notes, attendance data and MDS) directly into the referring IAPT service's own IAPTus system. Or BWW can also submit data through the BWW IAPTus system which allows us to report data directly via an N3 connection, into NHS Digital under the appropriate service code.

We provide both NICE guided evidence based CBT and Counselling interventions and all of our Counsellors are additionally trained in Counselling for Depression. We also have a team of Long Term Conditions specialists (IAPT LTC Top Up trained) who can provide specialised interventions for those experiencing physical health issues. All of our therapists are professionally accredited and are experienced with at least 2 years post-accreditation.

We are CQC registered for our Live Therapy provision and remain the only digital service to have received this registered status. Our governance systems are therefore acknowledged to be safe and robust. We are included in the NHS Apps Library, requiring stringent assurance that we meet national standards, regulations and industry best practice.
 
Live Therapy at BWW is available between the hours of 7am and 11pm, seven days a week. We are able to meet an accessibility standard that many IAPT services are unable to achieve.

We are able to scale up or scale down provision according to demand and our waiting times to assessment / first therapy session are often measured in days rather than weeks or months. We are able to implement new contracts at pace. 

We also provide clinically moderated peer support on the platform 24/7, which can augment patient self-management and provide intersession and pre . post treatment support.

 
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 / Wellness and prevention of illness / Digital health / Innovation and adoption / Person centred care
Benefit to NHS:
The benefits to the NHS of using BWW to deliver services include;

a) Eliminating unwarranted variations in health indicators and the outcomes of care - through the utilisation of national standardised measures and KPIs.

b) Improving and increasing equitable access as outlined in the Five Year Forward View for Mental Health, by providing digital interventions, not reliant on geographical location, not limited by affordability or complexity of transport. Available nationally online to all, removing socio economic barriers, with hours of service availability outside the scope of normal IAPT service provision. Clients can access high quality support from the comfort and safety of their homes.  

c) Giving the best possible experience for patients and carers by providing a high level of customer support and service satisfaction. Measured by standardised Patient Experience Questionnaires (PEQs) and survey data.  

d) More cost-effectively integrating care and resources around the needs of patients and populations though specialist LTC interventions.

e) Reducing healthcare utilisation costs (survey data reveals usage of BWW (peer support network) reduces GP / acute service usage across populations).

f) Reducing social isolation, stigma and associated costs in decreased in wellbeing, and increases in physical health decline and frailty

g) Population based access to BWW, provides early and easy access to mental health support, which aids the prevention and early identification of MH issues.

h) Use of BWW to provide services improves patient choice. Members can choose to remain within the sphere of clinically moderated peer support and self-manage using resources and self-directed courses or can engage with Live Therapy and can select a modality and mode of treatment.


i) Provides an embedded, scalable, evidence based solution which is cost effective, high quality and safe.

 
Initial Review Rating
4.60 (1 ratings)
Benefit to WM population:
Benefits to the WM population as outlined for the NHS
Current and planned activity: 
BWW provides services for several CCG's, Local Authorities and NHS Trusts, augmenting IAPT service provision. BWW has recntly completed a successful single point of access pilot for a London CCG, which allowed for population based self-referral into BWW Live Therapy. BWW submitted monthly data to NHS Digital and reported monthly recovery rates as high as 68% against a nationally set target of 50%. 

BWW is contracted by the MOD and the Home Office to provide Support Network peer support services and is currently commissioned by over 70 UK Universities. BWW is also comissioned by governement in Canada (Ontario Telemedicine Network) and New Zealand to provide Support Network access. OTN video linked here; https://youtu.be/OLG_OMHU4-s

BWW continues to grow and use technology for good and is currently undergoing a refresh of the platform - which  will enable an enhanced user expereince as well as improve the capability to innovate, scale and incorporate new technologies which augment care. 
 
What is the intellectual property status of your innovation?:
Intellectual Property is owned by BWW.
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
0-6 mon
Ease of scalability: 
Simple
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