Enhanced Ligature Awareness Training - The Use of a Ligature Cutter in Practice (#2115)

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Idea Description
Supplementary Information
Innovation 'Elevator Pitch':
A two tiered awareness training aimed at raising awareness of the risk of ligatures and hanging, what to do in ligature scenarios, and raising awareness of suicide risk.
Overview of Innovation:
(On behalf of Marie Nicholls, CWPT Lead for Clinical Risk and Suicide Prevention)

Hanging is the most prevalent suicide method for men and women in the UK. In Coventry & Warwickshire Partnership Trust, ligature related incidents have risen over the past two years.

In response to this, a two fold awareness programme has been developed around ligature/hanging risks. Firstly a basic awareness for all Trust staff (including non-mental health colleagues), which is an overall suicide prevention message; and secondly an enhanced training, which includes a film showing the use of ligature cutters in practice with staff testimonials and advice on supporting staff.

We are hoping to market this programme to other Trusts and health and social care providers. We are currently investigating methods of distribution and delivery, and whether we might be able to get this programme accredited by an organisation such as NICE. 
Stage of Development:
Evaluation stage - Representative model or prototype system developed and can be effectively evaluated
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Innovation 'Elevator Pitch':
Using Sport to Talk, targeting men by accessing local sporting events, and providing information on why it’s important to reach out about feelings. 
Overview of Innovation:
(On behalf of Marie Nicholls, Coventry and Warwickshire Partnership NHS Trust Lead for Clinical Risk and Suicide Prevention)

Suicide is the biggest killer of men under 35 in the UK. 3/4 suicide fatalities are male.
 
Suicide is complex and there is not one single cause of it, however evidence shows that men who are traditionally less likely to discuss feelings and concerns may benefit from reaching out, from talking about how they feel.
 
‘Balls to Talk’ is a project directed at men and the people who care about them, promoting that it is ok for men to reach out, to talk about how they feel, and to be a listening mate via sporting events across Coventry and Warwickshire.
 
Partners in this scheme include: WASPS rugby League Club; Coventry City Football Club; Coventry Blaze Ice Hockey; and various other local sports teams and clubs.
 
We are also working with Time to Change, Mind and the Samaritans. Large local employers who have high numbers of male staff including Jaguar – Landover and Unite the Union are also committed to the project.

Press release - https://www.covwarkpt.nhs.uk/our-news/it-takes-balls-to-talk--923 
Stage of Development:
Evaluation stage - Representative model or prototype system developed and can be effectively evaluated
WMAHSN priorities and themes addressed: 
Mental Health: recovery, crisis and prevention / Patient and medicines safety
Benefit to NHS:
Suicide has traumatic effects for everyone, not only for those personally involved, but for professionals as well.
 
Suicide touches the lives of many people, and the impact on the NHS is significant in regard to the cost of trying to prevent suicide, supporting those bereaved, and the NHS' reputation.
 
Suicide is preventable and yet investment in programmes to prevent it are not well resourced or popular. This needs to change, as it is simply not acceptable that suicide kills more men in the UK under 35 than accident, illness and injury.
 
 It is well evidenced that men don’t talk about their feelings and suicidologists have surmised that not reaching out and not talking is a significant risk factor to someone ending their life by suicide.
 
 
Large numbers of men like to attend sporting events and follow local teams (we know women do too, but larger numbers of men). We feel that these events and venues allow access to large groups of men, and that by targeting these events, we can effectively tackle the stigma and myths around mental health and wellbeing. We want to tell men that it’s ok to talk, it’s actually a sign of strength to do so, and that it can make a difference.
Benefit to WM population:
The West Midlands has the third-highest suicide mortality rate across England and Wales at 11.6 deaths per 100,000 population, and the second-highest rate of male suicide, with a rate of 18.5 deaths per 100,000 population. Moreover, the suicide rate had the biggest percentage increase between 2013 and 2014, rising from 9.8 deaths per 100,000 population to 11.6. 

Currently planned activity is centred around Coventry and Warwickshire sports teams and matches. Our initial aim is to reach out to men around the West Midlands through these matches, in order to tackle the high rates of male suicide in the area. Ideally, we are hoping the campaign will be influential and start a conversation amongst men across the West Midlands, stretching out not only to male sports fans but their friends and colleagues as well.

On 12/09/16, the Coventry and Warwickshire Partnership NHS Trust Suicide Prevention Team was interviewed about the campaign by Jo Cameron on Radio Plus, a Christian community radio station that covers Coventry. 
Current and planned activity: 
The launch of the project was International Suicide Awareness Day (10 Sept).

Funding gained from:
Coventry MIND
Coventry Samaritans
Unite the Union


Events planned for the week 8-16 October (World Mental Health Day, 10 Oct):
Matches

We have gained access to Coventry City Football Club and WASPS matches. We have pages in the programmes of both to promote 'Balls to Talk''. We expect that the CCFC / WASPS / Blaze games will reach approx. 20,000 men.
Coventry City Football Club
Nuneaton Borough
Leamington RFC
Coventry Blaze Ice Hockey
WASPS
(and numerous other local matches)

Other
Design of Infinity Cards (50,000 ordered)
Posters
T shirts
Volunteers from CWPT to hand out information at games
Linking in with IAPT (CWPT)
Time to Change to provide volunteer training and evaluation of the project.
Packs made up for other sporting clubs to distribute among fans / team.
Possible stakeholder event at Ricoh Arena on 10 October (well known sporting name linked with mental health and wellbeing to be in attendance)
What is the intellectual property status of your innovation?:
Website addresses regarding 'Balls to Talk' purchased. 
Return on Investment (£ Value): 
medium
Return on Investment (Timescale): 
N/A
Ease of scalability: 
Simple
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Innovation 'Elevator Pitch':
Edu Pod is an affordable and accessible digital solution which enables schools to create a whole school approach to mental health. 
Overview of Innovation:
Due to an increase in demand for our service we can no longer meet demand
with our current face to face delivery model. This means that schools cannot access our content that will aid them to create a whole school approach to mental health. 

This is disruptive within the field of mental health in education as the
current available online platforms do not offer a full service from audit to
intervention and user experience has been described as boring and dull. Our
approach is innovative and disruptive hence why we are now in a position we
can no longer meet service demand. This is because we are talented at
partnership working and bring in innovation to enhance user experience. 

The vision
Our vision is to create an online tool to support schools to deliver an innovative 'whole school approach' to mental health' to enable students and staff access support. 

This project is innovative because:
Scale: We are responding to every local authority's and multi academy trusts pain point. They cannot find a quality mental health service that can industrialise their work to support the schools in their geographical patch. The technology and the content we are creating does not exist on the scale we are envisaging. This technology will also open national and global implementation opportunities.

Clinical Expertise: As a team of clinical psychologists, we are using our clinical experience to create a digital platform that will transform mental health in education. This is a true partnership between schools and health practitioners to devise a product that meets the needs of educational providers, students and parents. This is a rare combination in world of heath and ed tech.
 
Transferability:The digital platform can be used in different industries and content can be adapted to meet the end users’ needs. This enables scaling and pivoting to occur. 
 
Technology disruption: We are using technology to innovate our currently
model of offering and also disrupt how online training is delivered. We will include gamification, machine learning and create a social network to increase engagement experience.
 
Stage of Development:
Ideas stage - Early concept and ideas stage
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 / Education, training and future workforce / Digital health / Person centred care
Benefit to NHS:
Working in collaboration with education – The healthcare and education sector have difficulties with working together therefore therapeutic recommendations are not always implemented within the educational environment, and educational staff feel frustrated because they are not aware of the treatment plan delivered by national services such as CAMHS. The Whole School Approach will enable educational staff to become more psychologically minded and informed about how they can work in collaboration with the NHS. This approach is supported by the Green Paper, Health Education England and Department for Education. 

Cost Effectiveness- Mental illness represents the single largest cause of disability. It is estimated that better mental health support in the workplace could save UK businesses up to £8 billion a year. Total non-inpatient costs for children are projected to rise to £233 million by 2026 (Kings Fund). Edu Pod will enable people to access early help and be in an environment that is supportive of their mental health which prevent a deterioration in mental health and support children to learn how to live with their mental health difficulties. Failure to address poor mental health and conduct disorder in childhood results in higher risk of suicide, substance misuse, self-harm, lower educational and employment achievement.We measure our value for money by calculating Social Return on Investment (SROI). For example, At Young People's Academy school we achieved a total of £104,081 social return on investment of £23,400. Every £1 of funding generated £4.10 SROI.

NHS seen as innovators - There is a current campaign in in government to ensure health care professionals work in collaboration with the education sector. This has been challenging to implement due to staffing shortages and it is costly to deliver this is continuing to deliver the ‘standard’ NHS service. Edu Pod will enable individuals to access content from a Multi-disciplinary team and seek consultation from professionals at an affordable cost. 
 
Initial Review Rating
4.20 (1 ratings)
Benefit to WM population:
Mental health costs the West Midlands region £12 billion a year and affects around 70,000 people (West Midlands Combined Authority). Poor mental health results in enormous distress for individuals, greater pressure on public services and reduced economic productivity. In the West Midlands there are approximately 4000 schools. In Birmingham, there are over 400 schools and Birmingham Educational Partnership have identified that they are unable to deliver scalable solutions to create a whole school approach. 
Current and planned activity: 
Since 2016, we Innovating Minds is working across 45 schools across London, Birmingham, Staffordshire and Coventry and Warwickshire. We have contracts with two local authorities and are contracted to deliver early help interventions for Coventry and Warwickshire NHS. 
 
The ideas for Edu Pod as received positive feedback and an advisory board has developed. This will enable the platform to be built based on feedback from individuals that will be using the platform and professional that will be creating content.   
 
The non-executive board included Dr Pooky Knightsmith, a major influencer within the field of early intervention and mental health. Dr Pooky Knightsmith has input into policies at a governmental national and international level which has enabled us to understand the challenges. 
What is the intellectual property status of your innovation?:
‘Innovating Minds’ and ‘Mind Space’ are trade marked. 
‘Edu Pod’ is in the process of being trade marked. 
 
The platform will be based on a subscription model therefore licensing agreements will be drawn up to enable users access the platform and content. 
 
Discussions regarding IP for coding have taken place with the external companies that may be contracted to build the platform. 
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
2 years
Ease of scalability: 
2
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Innovation 'Elevator Pitch':
A comprehensive package of training and development on safegaurding adults, mental capacity, deprivation of liberty safeguards and Prevent delivered through training DVDs, e-learning packages, patient stories, face-to-face training and webinars. 
Overview of Innovation:
Safeguarding Adults, Mental Capacity and Deprivation of Liberty Safeguards are mandatory training for all staff working with vulnerable adults across the health and social care economy. As this inevitably requires large numbers of staff, organisations are constantly being challenged with meeting the training compliance needed. This training is also required every 3 years.

This flexible training package is designed to meet the training needs of various organisations who have statutory obligations in this area. The training package includes:

- Safeguarding adults level 1 raising awareness 
- Safeguarding adults level 2 alerter/referrer 
- Safeguarding adults level 3 section 42 enquiries/case conference 
- Mental Capacity Act introduction
- Mental Capacity Act in practice
- Deprivation of Liberty introduction
- Deprivation of Liberty in practice
- Prevent
- Specialist modules on
    * self-neglect
    * modern day slavery and human trafficking
    * Female genital mutilation (FGM)
    * Domestic violence

These training modules can be delivered via:

- E-learning package including anonymised real patient story videos developed by the Trust
- Face-to-face for more advanced training
- Webinars
- Bespoke training individually costed
- Educational material such as booklets, posters, leaflets

All educational and training material can be customised to include the receiving organisation's branding and logo.

More bespoke services include:
- Organisational Review of existing safeguarding processes ,policies and procedures
- Develop safeguarding plan based on gap analysis
- Policy Development
- Risk Assessment, Care planning, report writing , Court reports
- Individual management reviews for SAR’s Domestic Homicide reviews
- Audit Evaluation and Implementation Plan
- Organisational preparation for CQC Inspections
- Organisational quality, risk and governance assurance
Stage of Development:
Close to market - Prototype near completion and final form may require additional validation/evaluation and all CE marking and regulatory requirements are in place
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 / Education, training and future workforce / Wealth creation / Innovation and adoption / Patient and medicines safety / Person centred care
Benefit to NHS:
- Flexible learning packages to meet mandatory training requirements for NHS organisations who do not have the capacity to provide the training in-house
- Improving the knowledge and skills of the workforce which will improve the safeguarding of patients
- Reduce organisational risk
- Improve outcomes for patients and carers
- Reduces demands on clinical time by way of providing training through e-learning
- Access to the most up-to-date contents as our team are constantly updating the training material
Online Discussion Rating
4.00 (1 ratings)
Initial Review Rating
3.80 (2 ratings)
Benefit to WM population:
The safeguarding of vulnerable adults is now statutory under the Care Act 2014. As such, its implementation is required locally, regionally and nationally.

According to the editorial of Journal of Adult Protection Vol 18, No 2, 2016: "Across West Midlands, local authorities are struggling with the effects of austerity measures, unprotected social care budgets, restructuring, under-valued care workers, redundancies and more generally on the rising demands associated with an ageing society". Following re-organisation, many of the local authorities are struggling with a younger and less-experienced workforce with less intellectual memory and too many agency staff. This will be even more so in West Midlands following the councils' devolution plan delivery. This calls for increased training and support for staff delivering front-line services where demands have risen and resourses have dwindled. 
Current and planned activity: 
Currently we provide training to BCHCFT workforce which comprises over 5,000 members of staff. In addition, we provide training to limited number of NHS Trusts and a wider workforce in hospice care, special schools and some private and commissioning groups. All of this has been achieved through recommendations rather than utilising any marketing strategies.
What is the intellectual property status of your innovation?:
Training material need to be protected.
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
1 year
Ease of scalability: 
Simple
Regional Scalability:
The service can be provided across the West Midlands Health Authority region.
Measures:
- Provides the organisation across the health and social care with the mandatory training for staff dealing with vulnerable adults
- Knowledge assessment at the end of the training to ascertain the competences acquired by the individuals
Adoption target:
Health and social care organisations and private sector
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