Amaven Exercise Medicine: Prevention and Recovery Through Exercise (#2357)

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Innovation 'Elevator Pitch':
Amaven is an online health, fitness and wellbeing profiling tool which measures, tracks and improves bio-motor abilities and prescribes evidence-based physical activity programmes to prevent and treat medical conditions and age-related diseases.
Overview of Innovation:
The Amaven programme adheres to up-to-date guidelines & best practise to deliver an effective & safe approach to caring for the wellbeing of older people. All our programmes have been designed by occupational therapists/physical activity specialists. One of our exercise programmes is based on the Otago exercise programme which has been proven to reduce falls and injuries from falls.


We follow guidelines from: CQC, DH, NICE falls guidance, Cochrane Reviews, Sherrington Effective Exercise to Prevent Falls Review, Public Health England, British Heart Foundation National Centre Research, FaME trial.

Health, fitness & wellbeing profiling tool. We use health assessments to identify risks & create an in-depth health, fitness & wellbeing profile for individuals. Assessments are simple to do & can be carried out by family members, care workers/other professionals or Amaven Health Mentors. Regular assessments produce evidence of progress or deterioration, highlight risks & can lead to prevention of damage. Information can be shared via reports with individuals & organisations involved in their care.


Person-centred wellbeing programmes. Specific scores & indicators are used to inform a personalised activity programme that can be done safely at home or in other settings, either done individually or in a group all activities prescribed promote physical, social & emotional health to positively impact an individual's life.

Individual health assessments provide practitioners with a complete picture of a person’s health helping to identify any risks & prevent potential injuries. Staff can discuss results with relevant professionals such as GPs if the person needs additional help. All information a person chooses to share is confidential unless they wish to share it further. They can log onto the Amaven platform at any time & view their wellbeing profile.

Amaven is personalised to the needs of the individual & a personalised activity plan is generated to work on areas that need greatest attention. The programme also helps to create a wellbeing community in residential homes & group activity sessions help people to be more social.

Staff will be fully trained to use the Amaven platform & receive on-going support (phone/email) if required, using the information gathered to work with the individual’s practitioners & family members to improve the delivery of care.

Visit the website & learn more about our programmes for Independent Living, In-care, Low Back Pain & Parkinson's.
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':
Exercise is the best medicine! Our Programme helps older adults stay independent for longer through safe & effective exercises that improve flexibility, aerobic health, balance & strength - exercise, socialise & have fun in every FABS class!
Overview of Innovation:
We all understand the importance of moving more and sitting less when it comes to living a healthy and fulfilling life. As we age this becomes even more important as our lives tend to become more sedentary which then leads to ‘inflammageing’ and many long-term health conditions.

The FABS Training Programme, developed by Move it or Lose it! in partnership with the Centre for Healthy Ageing Research at the University of Birmingham combines Flexibility, Aerobic, Balance and Strength exercises in every class, providing the four vital components of older adult fitness as per CMO guidelines. This is made up of exercises that are safe, enjoyable, effective and accessible to everyone whatever their ability, and can be done seated, standing with support or free standing – which is the unique aspect of this innovative training programme.



FABS classes ensure age or ability are no longer barriers to an active lifestyle. The aim of the class content is to increase strength and muscle density to reduce sarcopenia, improve balance to reduce the risk of falls, increase aerobic capacity to enable individuals to be more active and increase flexibility and mobility.

Via a blended approach of online learning and practical training, we train exercise instructors to become specialists in fitness for the over 60s enabling them to work with the fastest growing demographic in the UK. The programme launched in March 2016 and has more than 500 instructors undertaking it to date. The aim is to train 1000 instructors who can deliver FABS classes within their local communities to combat social isolation, physical inactivity and cognitive decline and provide opportunities for fun and friendship for our fastest growing demographic; older people. By training 1000 instructors the programme also generates wealth by creating small businesses with a licensing model similar to Zumba. Each instructor trained in FABS can deliver sessions in their local area spreading the Move it or Lose it mission to change the way we age!



The programme has been used within the NHS commissioned by Birmingham and Solihull CCG for patients with COPD and/or frailty and is being trialled as a measure to reduce the risk of falls across the area. 
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
Benefit to NHS:
The consequences of physical inactivity as we age are not just associated with movement problems and ill health, but also social issues. This often leads to feeling isolated resulting in depression which can lead people into a downward spiral and consequently their loss of independence.

Professor Janet Lord, Director of the Centre for Healthy Ageing Research at University of Birmingham and adviser for the recent BBC One Programme ‘How to Stay Young’ says, “Exercise is the best medicine. We can reduce our risk of heart disease, some cancers, diabetes, obesity, arthritis and osteoporosis by up to 50% by simply getting people to move more and sit less.”



The programme has been recognised by the NHS and is commissioned by Birmingham and Solihull CCG as an exercise and education programme for patients with COPD. More than 300 patients have benefited from the programme, improving physical and mental wellbeing. This in turn will keep patients away from GP surgeries and hospitals for longer periods, thus reducing, or even preventing treatment costs.

Education of self-management techniques which is part of the programme will also contribute to this. The programme helped Move it or Lose it become Highly Commended by WMAHSN for Excellence in Wellness and the Prevention of Illness, as well as winning an award from WMAHSN’s Long Term Conditions Network.
Initial Review Rating
5.00 (1 ratings)
Benefit to WM population:
The class members benefit from improvements in their health, reducing their risk of heart disease, some cancers, diabetes, obesity, arthritis and osteoporosis.

Move it or Lose it! assists with the development of practical solutions to improve levels of physical activity in older people. This increase in activity has an economic impact for the NHS by improving physical and mental health, the cost of treatment needed for conditions associated with declines in health such as sarcopenia, osteoporosis and arthritis will be reduced.



The FABS Training Programme provides job opportunities in the West Midlands. FABS Instructors will benefit from using an established brand in Move it or Lose it! that will help them to build their own business of exercise provision to the over 60s.
Current and planned activity: 
We are currently engaged in a 12-week trial, providing exercise as an intervention for patients identified to be at risk of falling with Birmingham & Solihull CCG in Northfield & West Heath areas. We are collaborating with ROSPA & Northfield library as well as the CCG providing our book, DVD & a resistance band free of charge to promote activity & signposting people to our community classes in the area. The trial is being evaluated using the QTUG by Kinesis.

We are looking to expand our team of inspirational instructors & trainers so they can get everyone experiencing the benefits of Move it or Lose it! & FABS across the UK! Instructors receive continual support through The Exercise Network, aiding their knowledge & delivery. By building this network of instructors Move it or Lose it! are helping older people & those with disabilities across the UK to get active to help them age well. If you are passionate about helping older people to live life to the full then find out more here.
 
What is the intellectual property status of your innovation?:
The FABS logo is registered trademarked. Content relating to FABS and its materials are copyrighted.
Return on Investment (£ Value): 
N/A
Return on Investment (Timescale): 
N/A
Ease of scalability: 
Simple
Regional Scalability:
The FABS Training Programme is highly scalable due to eLearning platform, allowing many people to undertake the programme simultaneously. We can then offer multiple practical assessments dates at a central Birmingham location (as well as other venues nationally) for 20 instructors at a time. This would allow for rapid expansion of the programme in the West Midlands area.  The model that has been developed is a sustainable business model which ensures that income is generated from licensing, training and ongoing support.
Measures:
The aim of The FABS Training Programme innovation is to train 1000 specialist exercise instructors to the over 60s. The success of the innovation will be measured against achieving this goal.

The quality of The FABS Training Programme is measured through its recognition by industry regulators such as CIMSPA, EMD UK and Active IQ. This is also ensured via the company’s Quality Assurance Policy.

Move it or Lose it also has a Safety Policy and Equality and Diversity Policy to ensure the people training with us, the tutors and customers are kept safe and are treated with respect. 

Adoption target:
We would like to implement FABS classes within CCGs giving GPs the opportunity for physical activity and social prescription within their own practice to treat conditions such as COPD, diabetes and more.  The AHSN Network could provide crucial links to CCGs to raise the profile of FABS within local communities and Local Commissioning Networks.
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Innovation 'Elevator Pitch':
Providing GPs with a practical solution to help patients identified with mild/moderate frailty through a specialist exercise intervention delivered in the GP surgery.
Overview of Innovation:
Move it or Lose it delivers a specialist exercise programme which includes the cornerstones for healthy ageing - flexibility, aerobic, balance and strength (FABS). Evaluations of the FABS programme have shown improvements in functional mobility, levels of independence, high adherence levels and long-term behaviour change.
 
As collaborating partners with The MRC-ARUK Centre for Musculoskeletal Ageing Research at University of Birmingham, this brings together academic research translated into practical application. It is far more than just an exercise intervention as participants are supported to increase physical activity levels with home-based exercises away from the class setting along with motivational instructors to help frailer older adults to overcome barriers.
 
In England, 12% of the over 65s are living with moderate frailty and 35% with mild frailty. These individuals are frequent users of services across health and social care with higher levels of unplanned hospital admission or care home admission. However evidence shows these adverse outcomes could be avoided through early identification and intervention to reduce frailty levels. (Mytton et al, 2012)
 
GPs may be able to identify frailty but then need to offer a solution. As appointment time is limited, being able to offer an evidence-based programme to improve mobility, strength and balance – and one that is delivered on site – provides a cost-effective and convenient solution for busy doctors.
 
The FABS Training Programme has proven to be successful for COPD patients and has been commissioned by Birmingham CrossCity CCG. Evaluations show:
  • improved functional mobility to within normal age-related range with a reduction in physical frailty from ‘mildly frail’ to ‘managing well’
  • increased leg strength to within normal community dwelling range which is associated with health-related quality of life
  • adherence levels of 66% (traditional pulmonary rehab 50%)
  • high levels of enjoyment and self-reported long-term behaviour change
Also an independent evaluation by Royal Voluntary Service for their ‘Active Moves’ pilot showed a shift from poor to moderate function with 22% reported feeling less lonely after a twelve-week intervention.

The programme is ideally suited for frailty and with a network of specialist teachers, is also ready to scale.
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 / Wealth creation / Clinical trials and evidence / Person centred care
Benefit to NHS:
By encouraging people to be more active and reduce their risk of illness, falls and frailty, the FABS intervention has proved to be cost-effective and appeals to those who normally avoid exercise. At each session, Instructors ask for patient feedback either as anecdotal evidence captured in a notebook or by identifying how they feel physically and mentally using a simple traffic light metric.
 
Patients reported feeling “better/happier/more active” which can also be seen in this video showing the positive health outcomes the FABS intervention had on patients from GP surgeries across Birmingham. (filmed at Woodgate Surgery, Birmingham)
 
This video shows Dr Ciaran Woodman, GP in the Northfield Alliance (Northfield Medical Centre, Birmingham) explaining why they chose the FABS programme ensuring it was commissioned by Birmingham Cross City CCG.
 
Patients reported requiring less medication (e.g. exacerbation packs, steroids) during the 12 week programme. The education & support sessions also gave opportunities for peer support, sharing tips & advice for healthy lifestyle choices in terms of smoking cessation, nutrition, sedentary behaviour etc.
 
Bringing 10-12 patients together at one time allows practice nurses to give flu jabs in a time-saving and cost efficient way.
 
The Cuppa routine shows 4 easy exercises that can be done in the time it takes to make a cup of tea in their own home.
 
Reducing  frailty through resistance & balance training leads to a lower incidences of falls, allowing older people to live more independently, potentially delaying admission to nursing or residential care & reducing emergency hospital admissions.
 
The ‘Stay on your Feet Programme’ in New South Wales, Australia showed the following benefits:
  • 22% lower incidence of self-reported falls in intervention area compared to control community.
  • 20% decrease in fall-related hospitalisations
In UK falls cost NHS £2billion pa for patients hospitalised as a result of a fall. If a 20% reduction could be achieved in fall-related hospitalization across the NHS that would result in a cost saving of up to £9billion over the next 15 years (this doesn’t include associate benefits such as preventing nursing home or residential care admissions)



Patient teaimonials
 
Online Discussion Rating
5.50 (2 ratings)
Initial Review Rating
5.00 (1 ratings)
Benefit to WM population:
The Chartered Society of Physiotherapy calculates benefits of offering preventative physiotherapy for older people with cost savings for a selection of CCGs as follows:
 
Recognising that the FABS programme is not physiotherapy per se, research demonstrates that the programme could deliver similar benefits. E.g. both aerobic and resistance training target specific components of frailty and trials combining these 2 modalities have demonstrated the most promising outcomes treating frailty. At the molecular level, exercise reduces frailty by decreasing muscle inflammation, increasing anabolism, and increasing muscle protein synthesis.
 
Based on available studies, an individualised multicomponent exercise programme that includes aerobic activity, strength exercises and flexibility is recommended to treat frailty. 1
 
In NHS Birmingham CrossCity CCG preventative physiotherapy for older people could lead to:
1,399 fewer falls
£2,345,124 cost savings
(without intervention, projected 12.4% more care home admissions due to falls by 2020).
 
NHS Birmingham South and Central CCG preventative physiotherapy for older people could lead to:
354 fewer falls
£582,405 cost savings
(without intervention, projected 14.5% more care home admissions due to falls by 2020).
 
NHS Solihull CCG preventative physiotherapy for older people could lead to:
599 fewer falls
£980,053 cost savings
(without intervention, projected 15.8% more care home admissions due to falls by 2020)
 
NHS Sandwell and West Birmingham CCG preventative physiotherapy for older people could lead to:
875 fewer falls
£1,435,743 cost savings
(without intervention, projected 16.4% more care home admissions due to falls by 2020)
 
NHS Dudley CCG preventative physiotherapy for older people could lead to:
860 fewer falls
£1,369,521 cost savings
(without intervention, 17.7% more care home admissions due to falls by 2020)
 
Ref: 1 Interventions for Frailty
Fielding RA, Sieber C, Vellas B (eds): Frailty: Pathophysiology, Phenotype and Patient Care.
Nestlé Nutr Inst Workshop Ser, vol 83, pp 83–92, (DOI: 10.1159/000382065)
Current and planned activity: 
Current: Engaged with the NHS through our tried & tested COPD programme. Initial discussions began with Dr Woodman and Dr Saunders from Northfield Alliance. Since spoken to Dr Sarin at Kingstanding LCG and Mrs Hargun, ACE Practice Manager for the North East Network, Birmingham.
 
Following a successful pilot study our FABS exercise programme has been commissioned by Birmingham Cross City CCG across the region and has already seen uptake for use across 49 GP practices. The classes have so far been adopted in 13 hub practices which also bring together patients from nearby practices. 

Planned: Seeking an innovative and receptive GP to pilot the FABS exercise This would further validate the use of FABS as a part of a frailty toolkit and a simple and practical solution for GPs. We wish to demonstrate the benefits of our services to CCGs to scale adoption.
 
Our service is tried, tested and successful for COPD and we are now looking to replicate the model for another high cost LTHC – frailty
 
What is the intellectual property status of your innovation?:
FABS is a registered trademark of Move it or Lose it Limited. 
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
0-6 mon
Ease of scalability: 
2
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Innovation 'Elevator Pitch':
Yecco is a fully digital telehealth & telecare self-management platform for monitoring all aspects of a person’s past & real-time health status. Our products also allow environmental monitoring & home automation to enable full remote care & support.
Overview of Innovation:
Yecco brings new & exciting ways of data sharing as the trend moves towards patients managing their health & taking control of their health data.

Our solutions facilitate self-management of chronic conditions & can help to reduce emergency readmissions to hospital. In 2012-13 more than 1 million emergency readmissions within 30 days of discharge cost an estimated £2.4 billion.* Yecco can be used to support hospital discharge as it monitors the safety & health of a person living when back in their own home. 



View our video & see how Yecco can support a patient with Diabetes & COPD – https://www.youtube.com/watch?v=vMBFoaKy--g

Yecco’s own private, social network allows its patients, health & care professionals to share medical & device information with any connection they wish, enabling consumers, health & care professionals to share real-time medical & device data. It can be used at home, work, care settings, medical & care facilities.

Features include:
  • Share medical data with chosen family, friends & clinicians
  • Ability for another person to manage your profile
  • Create & send group messages & on your timeline
  • Keep a check on your health in real time using the Yecco medical devices or add readings manually
  • Add thresholds to alert chosen connections 
  • Store personal, medical & medication information
  • Built in calendar & reminder support
  • Video to stay in contact/facilitate remote consultations
  • Message facility
  • Task planner
  • Group connection
  • Educational content
  • Response questionnaires    
Yecco medical devices can measure vital signs with accuracy & precision using Bluetooth to automatically connect to an iOS or Android device(s) using the Yecco App for a simple & effortless measurement in real time.

The Yecco multi-function sensor offers power & flexibility that’s not been available before in a home sensor. Paired with the Yecco App & through the use of the Yecco Docking Station it can automatically detect abnormalities in physiological data, alerting chosen connections on the Yecco network.
 
The multi-function sensor can connect directly to the WIFI network. Features include the ability to activate the camera on the mobile device to investigate alerts.

  • Motion detection
  • Door & window open or closed status
  • Smoke detection
  • Carbon monoxide detection
  • Temperature & humidity
  • Add separately & plug in:
    • Bed occupancy sensing pad
    • Enuresis pad (to detect for moisture in a bed or chair)
    • Rechargeable battery
There is the option to keep a check on your health using the Yecco Wearable Watch.
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
Benefit to NHS:
Rising demand for services, combined with restricted or reduced funding, is putting pressure on the capacity of local health and social care systems.
 
The NHS spends around £820 million a year treating older patients who no longer need to be there.
 
(Source: https://www.nao.org.uk/wp-content/uploads/2015/12/Discharging-older-patients-from-hospital-Summary.pdf)
 
Yecco Pro App
 
Yecco Pro is a licensed cloud-based interface that enables organisations to remotely monitor multiple patients.
 
Yecco Pro gives medical professionals multi patient monitoring with real time data for early intervention. Powerful threshold and notification options assist all professionals to give improved patient outcomes and increased safety.


Features include:
  • Receives real time data for early intervention
  • Interface for clinician to patient communication
  • Set thresholds to assist in disease management and early intervention for improved patient outcomes and safety
  • Set alerts / notifications
  • Group patients
  • Filter and create reports (CSV)
  • Video conference calling
This modular platform enables Yecco to add other 3rd party modules or interface to Electronic Patient Record system or data contextualisation platforms that enable intelligent triage and diagnosis across a range of data sources


Yecco's product are currently being used by Surrey and Boarder Partnership testbed that is monitoring the health and wellbeing of patients that have mild o moderate levels of dementia. The aim of the project is to assist clients in monitoring and reduce the burden on front line NHS services. (GP’s appointments, health work home visit and hospital re-admissions). The health and wellbeing reading take form the Yecco devices is being monitor in partnership with the KSSAHSN/University of Surrey. http://www.sabp.nhs.uk/tihm/partnership. Currently awaiting health economics stats and data from project.
Online Discussion Rating
4.00 (2 ratings)
Initial Review Rating
5.00 (1 ratings)
Benefit to WM population:
The past few decades have seen significant improvements in life expectancy, however, rising longevity brings increasingly complex & chronic health conditions, placing substantial demands on health & social care services.
 
At the same time services are experiencing significant financial pressure & need to find ways of lowering costs while maintaining or improving the quality of care provided.
 
This requires new ways of working in order to meet increasing demand & deliver care that is safe & cost‑effective while reducing reliance on hospital & institutional based care.
 
Technology can help to support these new ways of working.
 
When hospital discharge goes wrong it comes at significant cost both to individuals & to the health and social care system. In 2012-13 there were more than 1 million emergency readmissions within 30 days of discharge costing an estimated £2.4 billion. Source: http://bit.ly/2sKBn1p


The number of older people in England is increasing rapidly, by 20% between 2004 & 2014 & with a projected increase of 20% over the decade to 2024. Hospitals have also experienced increases in the number of emergency admissions of older patients, by 18% between 2010-11 & 2014-15. Older patients now account for 62% of total bed days spent in hospital.
 
The relative growth in numbers of older people is important. The number of older people with an emergency admission to hospital increased by 18% between 2010-2011 & 2014-15 (compared with a 12% increase overall).
 
While NHS spending has grown by 5% in real terms between 2010--11 & 2014-15, local authority spending on adult social care has reduced by 10% in real terms since 2009-10.  Source: http://bit.ly/2tuy9we
 
Yecco is an innovative solution that monitors the safety & health of a person living in their own home or in a care setting.  This combined telehealth & telecare solution can enable health & care providers to meet the health & social care needs of individuals in their charge.
 
By using Yecco technology to monitor if a person is physically safe, for example that they have not left the cooker on or had a fall, as well as critical indicators such as blood pressure or blood oxygen levels to indicate that they are not medically at risk can improve user’s quality of life & reduce long-term health care costs.

Yecco can help to keep people safe in their own home & reduce the number of unnecessary hospital visits, increase confidence in users to manage their own health & alleviate the pressures & concerns of caregivers.
 
Current and planned activity: 
We wish to work with regional health & care providers & WMAHSN's Patient Safety Collaborative & Care Home Network. We also wish to explore if our technology can be used to support Mental Health Services, possibly to monitor & support patients coming off medication.
 
Our products are being used by Surrey & Boarder Partnership testbed to monitor the health & wellbeing of patients with mild to moderate levels of dementia. The project's aim is to assist clients in monitoring & reduce the burden on front line NHS services (GP appts, health work home visit & hospital re-admission). The health & wellbeing readings taken from Yecco devices is being monitored in partnership with KSSAHSN/University of Surrey.
 
We previously demonstrated our products & services to EMAHSN & are currently involved in the Falls Prevention tender (EMAHSN led). Yecco products & services have been purchased by Neath & Port Talbot Borough Council to monitor & support regional LD clients (awaiting deployment date).       
What is the intellectual property status of your innovation?:
Yecco has developed its software and applications and retains the IP to this. It also owns IP in some of the hardware products developed in-house (sensors and IoT gateways). Some 3rd party integrated products (such as generic medical devices for vital sign monitoring are not Yecco IP). These products are in the process of being further protected. 

Yecco is currently in use in the NHS England IoT testbed with Surrey and also within other local authorities. Our products comply with the required data model, structure, coding and security requirements that have been dictated. We are also working with established telecare and telehealth organisations where compliance is required / requested to various standards and integration with 3rd party alarm management systems.
 
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
1 year
Ease of scalability: 
2
Measures:
Yecco are currently involved in Surrey and boarder partnership NHS foundation trust testbed programme for monitoring patients with mild to moderate dementia. The project is currently ongoing. yecco have requested information relating to the impatch of the project and health economic details. As soon as this information has been published yecco willl add this information into the meridian system 

    
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