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Protecting Workforce Mental Health Through COVID-19

posted 29 May 2020, 03:28 by Hollie O'Connell

29 May 2020 

We are delighted to announce that from an unprecedented number of applications nationally, Simple Shared Healthcare Ltd. has been selected by the UK’s innovation agency, Innovate UK to refocus their internationally recognised work with healthcare psychology to support the mental health of staff in the workplace, to improve well-being and protect productivity and thereby make a significant contribution to UK’s business recovery during and following the current COVID-19 outbreak.

Based in Stoke-on-Trent, Simple Shared Healthcare has a mature legacy in partnering with healthcare organisations to provide education, coaching and support for patients to achieve better and faster clinical outcomes than can be achieved under normal care.  Simple Shared Healthcare works with intellectual property owned by NHS Stoke-on-Trent and develops innovative services deployed as friendly personas including 'Florence' (UK & Ireland), 'Annie' (USA) and 'Nellie' (Australia) to engage directly with patients.

Phil O’Connell, Founder of Simple Shared Healthcare Ltd. and former NHS Innovator of the Year commented,
“We are immensely grateful for the foresight of Innovate UK to recognise the opportunity to leverage Simple Shared Healthcare’s mature, independent evidence base that has consistently delivered internationally-recognised economic and behavioural change in healthcare to assist businesses to cost-effectively manage and mitigate the impact of COVID-19 on staff whilst reducing the associated economic costs of lost productivity for years to come. This opportunity allows the development of a unique product that will provide a substantial catalyst to any business’s post COVID-19 recovery; and most importantly the quality of life and wellbeing of staff through and beyond this challenging time. ”

For over 10 years and founded upon business psychology, "Florence" is a digital platform used by NHS Hospitals, General Practice, Mental Health and Community teams that has been formally evaluated across hundreds of clinical conditions harnessing targeted behavioural psychology-based Smart Messaging to engage patients, change their behaviour and help them attain better and faster clinical outcomes in hundreds of clinical conditions.

Building on the capabilities of Florence, an international collaboration including ethical development company Bitjam Ltd inspired the development of our Next-Generation smart messaging system "Clara"(UK/USA) / "Nellie"(Australia).  The technologies have proven to be massively scalable and flexible and incorporates both workflow and messaging improvements learned from 10 years with Florence.

Partnering with workplace mental health and wellbeing charity Mates in Mind, this project will re-purpose Clara for use by businesses, assisting them to effectively manage the many challenges to staff wellbeing, mental health during self-isolation and sickness/absence, generated by the first and subsequent waves of the COVID-19 pandemic.

This will be achieved through evidence based smart interactive messaging to motivate staff, reduce anxiety, change thinking and associated behaviour toward forming confident healthy and productive personal and workplace habits and reduce the feelings of loneliness and isolation.  Furthermore, the service aims to create a sense of appreciation and wellbeing, whilst reducing the workload of HR departments.

Executive Chair, Innovate UK, Dr Ian Campbell, said: 
“Businesses from all over the UK have answered our call rapidly to meet the challenges we face today and in the future through the power of innovation. The ideas we have seen can truly make a significant impact on society, improve the lives of individuals, especially those in vulnerable groups and enable businesses to prosper in challenging circumstances.”

Inaugural COVID-19 rapid innovation forum

posted 22 May 2020, 01:56 by Hollie O'Connell   [ updated 22 May 2020, 04:25 ]

22 May 2020 

During the current outbreak of COVID-19, many of our community members are continuing to adapt and innovate with Flo to enable sustainable provision of high quality care to their patients under difficult circumstances.  To support our Members, we recently held our first in a series of Forum Calls.  The calls are being facilitated to provide technology-enabled care leads from the Community of Practice with the opportunity to share how Flo is being utilised during the COVID-19 outbreak within their organisations.  

Read on to find out more about the ideas shared & discussed on the first of these calls.

Symptom Based COVID-19 Monitoring Protocol

Based on new learning around the recovery period for COVID-19, NHS Scotland are taking a lead to develop a multi-symptom monitoring pathway with Flo to support those with a diagnosis of COVID-19.  The aim of implementing more specific monitoring of a wider set of symptoms is to enable early detection of any deterioration of the patient’s condition, thus ensuring timely and appropriate medical intervention when required.

In support of government guidance, the pathway monitors patient’s symptoms for a period of two weeks, and Flo will ask daily questions around a wider set of symptoms, including breathlessness while talking and during activity plus the presence of a cough and muscle aches/pain. Patients also have the option to take their temperature, O2 & pulse readings if clinically significant.  Flo interacts by providing clear advice and reassurance, where a patient’s symptoms or readings are of concern, Flo will flag an alert on the patient’s record, and advise them to contact 111 for further medical advice.

Staff Emotional Wellbeing

Providing additional help to those working under even greater pressure at this time is vital in ensuring that the health of frontline staff is not overlooked.  As a result, a number of community members have expressed an interest in developing pathways that support staff emotional wellbeing during what is a both psychologically, and physically tiring time.

Suggestions as to how this support will be delivered include requesting wellbeing scores, providing wellbeing support messages, and signposting to services open to staff, such as occupational therapy.   Flo’s unique ability to interact remotely with staff members also creates an opportunity to understand when, and which staff may need further support and either direct staff to step-up interventions or notify their Line Manager to facilitate personal intervention.

Increased Interest in, and Uptake of Remote Monitoring with Flo

A number of TEC leads commented on seeing a general increase in queries received around implementing Flo in various areas of clinical practice.  Due to social distancing measures, reducing clinical contact is imperative, with only the most essential face-to-face appointments going ahead.

As a result, many teams who may have been previously aware of Flo, but not actively implementing her, are now looking to develop new pathways to enable patients to monitor safely at home and receive additional advice and motivation as needed.  Examples of increased interest in implementation include pregnancy induced hypertension, sexual health, respiratory and mental health.

Royal College of Obstetricians & Gynaecologists - Flo stars in new guidance for safe home monitoring

posted 16 Apr 2020, 02:50 by Hollie O'Connell

17 April 2020 

Supporting ladies to monitor their BP safely at home for pregnancy induced hypertension is one of Flo’s most mature & evidenced uses, with numerous sites adapting existing community protocols to suit their local needs. 

This innovation continues, most recently in Nottinghamshire, where the Local Maternity Systems are engaging in a rapid role-out of BP monitoring for postnatal and antenatal ladies.  The driver to implement the pathway originates from a desire to help reduce the number of clinic appointments ladies would need to attend during the current COVID-19 outbreak, which has the added benefits of convenience for patients, but also released capacity for clinicians.

Reducing contacts is particularly important during the outbreak of COVID-19, as further outlined in a recent publication by The Royal College of Obstetricians and Gynaecologists. RCOG has published new guidance for clinicians caring for women with pregnancy induced hypertension (PIH), urging maternity services to implement safe home-monitoring for women to reduce the need for face-to-face appointments, thus reducing the risk of further spreading the virus.

In support of this new guidance, NHS England has also offered to supply blood pressure monitors free of charge to Trusts who wish to take forward plans for self-management of blood pressure in pregnancy (see guidance for details on how to apply).

The RCOG publication includes extensive guidelines for inclusion criteria (table 1) and implementation of home monitoring and includes details of support for safe home monitoring, of which we are extremely proud to share that Flo is one. 

Click image to enlarge

Click image to enlarge

Dr Kim Hinshaw at City Hospitals Sunderland was involved in a peer review of the guidance prior to publication.  Kim and his team in Sunderland have worked with Flo for anumber of years to support women with PIH, and their learning and experience has contributed greatly to the Community of Practice since the implementation of their pathway.  You can find out more by taking a look at this short video.

As part of the guidance, safe BP ranges & corresponding advice is given (depending on if women are prescribed BP medication or not).  Simple Shared Healthcare has made available a protocol that adheres to these ranges and the advice given, with the aim of maintaining high levels of patient safety during this difficult time.  

If you would like to find out more about the pathway, & how Flo can support pregnant women during COVID-19, please contact Hannah.Mountford@simple.uk.net 

COVID-19; Digital Health response for the UK and Australia

posted 25 Mar 2020, 09:56 by Hollie O'Connell   [ updated 25 Mar 2020, 10:05 ]

25 March 2020 

During the current outbreak of COVID-19, adherence to official national guidance1 is a primary determinant of the effectiveness of any precautionary steps that members of the public take.  There is currently a wealth of advice shared from various sources, including the NHS and Government around self-isolation, social distancing and other preventative measures. 

However, people may be overwhelmed with the deluge of official information and updates, and confused by misinformation spread via word of mouth and social media.  This is a particular problem for vulnerable groups and serves to exacerbate anxiety.

While concerns about COVID-19 are raised globally, for at risk groups (e.g. the elderly and those with pre-existing conditions such as respiratory or heart diseases), the outbreak is even more concerning as the consequences of contracting the virus are more severe. 

At the time of writing, Simple Shared Healthcare are collaborating with NHS organisations on pathways to help patients self-isolating and social-distancing at home.  The collaboration has created a bank of advice messages and structured protocols based on official NHS and Government guidance that can be integrated into pathways with Flo, covering all manner of topics from symptom tracking, hygiene, loneliness and isolation, to advice for parents.

Flo’s gentle prompts are also designed to encourage subtle behaviour-change over time.  This is particularly crucial for those self-isolating or social-distancing to ensure guidelines are followed to reduce the likelihood of contracting or further spreading COVID-19.

Building on Flo’s considerable capability, her ‘Next- Gen’ cousins Clara and Nellie, who’ve been working for over 2 years in Australia, USA and UK, offer a service specifically designed for a rapid public health response.  The foresight of NHS Stoke-on-Trent inspired us to add a layer of functionality to Clara we called self- subscribe.

This enables healthcare workers to ‘prescribe’ Clara for a patient.  The healthcare worker simply advises the patient to text a keyword to a specific mobile number and that’s it!

In the case of COVID-19, this may be as simple as a general self/household isolation protocol which provides a trusted source of information and advice; thus reducing anxiety, increasing adherence and directing patients on the appropriate use of NHS resources at any particular time during self-isolation or just helping vulnerable patients to manage pre-existing conditions.  Clara engages patients with a rich dialogue and updates to guidance provided to patients can be done on the fly, hot off the press.

Most importantly for patients using either Flo or Clara, they feel that they have a ‘human’ connection to their healthcare provider, making them feel that they are not facing this alone, helping to mitigate the mental health issues that self-isolation may cause in many patients.

If you would like to discuss how Flo could potentially support patients during this testing time or are interested in self-subscribe with Clara, please contact us via our website and a member of the team will get back to you.

TEC Lanarkshire Celebrate over 10,000 Patients Supported by Flo

posted 10 Mar 2020, 04:51 by Hollie O'Connell

10 March 2020 

Kerry Fletcher, Lesley Aitken & Morag Hearty

TEC Lanarkshire Team attending the Digital Health & Care Scotland Awards in February

We are delighted to share that in February 2020, over 300 new patients in Lanarkshire started to self-manage their health with Flo’s unique support, taking the total number of patients that Flo has helped in Lanarkshire alone to over 10,000 patients across a broad range of conditions.

The award-winning team in NHS Lanarkshire worked passionately to support the introduction of Scotland’s National Florence hypertension pathways, including the integration of Flo into hypertension diagnosis and hypertension monitoring pathways, alongside medication titration for those patients whose hypertension is newly diagnosed or uncontrolled.  This has proven to avoid the need for some non-value added appointments, thereby allowing remote blood pressure monitoring to increase practice capacity and reduce patient travel costs.

The pathways have standardised and streamlined Lanarkshire primary care hypertension pathways, ensuring that patients receive best-practice care & freeing up time for busy clinicians with Flo acting as a catalyst to move responsibility away from healthcare professionals to patients, thus increasing the effectiveness of interventions. Read more here.

To date, over 5,000 patients have received Flo’s friendly messages to motivate, engage and educate them specifically with their hypertension, which is a fantastic achievement.  Well done to all of the team at TEC Lanarkshire for their forward-thinking and innovative approach with Flo to engage & motivate patients & achieve better and faster outcomes!

Simple Shared Healthcare join the AHSN Network at Arab Health 2020

posted 27 Jan 2020, 06:45 by Hollie O'Connell

28 January 2020 

This week thousands of delegates will be congregating in Dubai for four days of Arab Health 2020.  The AHSN Network, following the success of their visit last year, are returning again to support a small group of innovative UK Healthtech companies including Simple Shared Healthcare, at the Association of British HealthTech Industries UK Pavilion.

With delegates travelling from all over the world, Phil and Lisa are representing Simple Shared Healthcare at the event and are excited to have the opportunity to share how Flo and her international cousins Nellie and Annie have utilised the NHS owned “Simple Telehealth” methodology to deliver better and faster clinical outcomes by improving patients’ motivation, engagement and adherence to their best practice healthcare regime.  

You can find out more about the event here.

Journal of Psycho-Oncology; Supporting cancer patients with mindfulness-based CBT

posted 18 Dec 2019, 01:37 by Hollie O'Connell

18 December 2019 

We are excited to share with you that members of the Community of Practice from the Clinical Psychology Cancer Service Team at Sherwood Forest Hospital Foundation Trust, have recently published their proof of concept evaluation of using Flo to support cancer patients undertaking mindfulness-based CBT in the open-access Psycho-Oncology journal.   In addition to the work being published, the cancer support pathway was also shortlisted as a finalist for this years’ HSJ Awards, and has received a commendation in the category for mental health innovation at the Health Business Awards 2019.

A relatively new service, the Clinical Psychology Cancer Service was set up in 2014 to provide support to adults affected by cancer and were recently awarded a Macmillan Professionals Excellence Award for Integration Excellence.  Despite the team having high levels of clinical effectiveness, the drop out rates for psychological therapies were found to be quite high, especially amongst cancer patients, who have three times the risk of developing depression and anxiety.

Dr Sam Malins and the Clinical Psychology Cancer Service Team were looking for a low-cost digital solution to develop a blended approach of face to face and remote therapy sessions, with supportive messaging between clinical contacts.  In collaboration with Nottinghamshire University, their local Florence administration team and some additional support from Simple Shared Healthcare, the team developed pathways with Flo to reduce drop-out rates, encourage ongoing engagement throughout the course of treatment to achieve better mental health outcomes and improve relapse prevention.

The resulting protocols are unique & innovative with some of the responses Flo sends being fully personalised, written collaboratively by the patient and their healthcare professional.  During treatment, patients receive additional support and advice between their scheduled appointments, alongside messages to reinforce learning from their most recent sessions.  Whilst under the care of the team and also beyond discharge, patients are also regularly prompted to return a wellbeing score, to which they receive their personalised messages based on the work completed with their clinician.
Integration of Flo into the pathway has had some fantastic results, including:
  • Patients supported by Flo were eight times more likely to complete their treatment programme when compared to those not supported by Flo.
  • Patients supported by Flo also reported a greater improvement in depression over the course of the programme.
  • Interviews with patients suggested that they found Flo’s messages to be motivating reminders to practice techniques, and also acted as a personal connection.
Patient comments included:
I thought they were good, [Flo] sort of motivated you and was a gentle reminder really.... I thought that that was a good idea
If you found yourself getting lost they were good reminders to put you back on track
When you got it you felt “oh somebody is thinking about me.” Even though it was just a text message
You felt like - I mean, I know they [Flo’s messages] were automated, but in a silly way it felt like somebody was motivating you. I enjoyed them actually.” 
Florence seems to text me exactly when I need it the most. Always helps me. Overall amazing ” 

From the clinician’s perspective, implementing Flo has a number of benefits such as:
  • Prevention of re-referral.
  • Increased therapeutic capacity, with more patients successfully treated in each group.
  • Simple & easy for clinicians to implement with a low input and time cost.
The full journal article is open-access and available here, or if you would like to learn more about the pathway and the team’s journey, you can contact Sam at Sam.Malins@nottshc.nhs.uk

Scotland’s Scale-Up team scoop three top awards with Florence

posted 6 Dec 2019, 01:19 by Hollie O'Connell

06 December 2019 

Scotland’s largest health and social care conference ‘Digital Health and Care Fest’ was held on 20th and 21st November 2019 at the University of Strathclyde Technology and Innovation Centre in Glasgow in partnership with Scottish Government, NHS and the Coalition of Care and Support Providers in Scotland (CCPS).  The two day event showcased the very best of digital innovation in health and social care encouraging strong debate amongst key national digital strategy colleagues from Scottish Government, the NHS, academia, industry and the care and support sector. 

We were delighted to see the trend continue from the last few years, with a significant number of Flo enabled showcases at the event, ranging from innovative evaluation studies through to deployment of digital health (Flo) at scale across multiple Healthboards and diverse teams. 

We were delighted to see that amongst the shortlisted evaluation case studies to be judged by the event panel, 25% were based on Flo’s unique abilities to enable the attainment of better and faster outcomes.  The abundance of robust, independent evidence of clinical acceptance, improved patient outcomes, improved access to care and improved patient engagement and adherence with self management speaks for itself.

Special congratulations to winner, Mary Paterson, who on behalf of the Scale-Up BP Team accepted the winning accolade with their presentation of the impact across 3200 patients from ‘Introducing Telemonitoring for Blood Pressure into Routine General Practice at Scale: An Implementation Study in collaboration with the University of Edinburgh. The results described how, compared with the previous year, the participating practices:
  • made 18.9% fewer face-to-face appointments for any reason
  • patients mean systolic BP fell by 6.55mmHg
  • patients mean diastolic BP fell by 4.23mmHg
  • patients whose baseline systolic was >135mmHg had a mean fall in BP of 15.1mmHg

The evidence from this study contributed to the Scottish Government’s recent £1.2million commitment to support Scottish Health Boards to move to large scale deployment and mainstream the delivery of remote patient monitoring within primary care services with Florence, read more here.

Scale-Up BP is part of the wider Technology Enabled Care (TEC) Programme established in Scotland in 2015/16 and to date, more than 150 practices recruited Flo to support their patients requiring blood pressure monitoring either to diagnose hypertension, monitor BP or titrate medication, with over 10,000 patients benefiting.

A notable point on the use of Flo’s unique psychological techniques, is the very low dropout rate, which was less than 9% over the length of the study, something we’ve found simply isn’t achievable when using other methods or apps.
  • Other shortlisted Florence based studies included;
  • Cost avoidance achieved with Hypertension monitoring
  • Using lifestyle interventions to lower blood pressure
  • Highest success rate in Scotland for Beating the Blues CBT completion

The prestigious UK General Practice Awards were held on 29th November 2019 at the Park Plaza Westminster Bridge, London.  The awards are held to recognise the very best of general practice and we are again delighted to share that the ‘Clinical Improvement Award: Public Health and Prevention’ was won on the night by the Scale-Up BP Team led by Prof Brian McKinstry.  This fabulous at scale achievement in digital healthcare with Florence was a well deserved recognition for all involved.

The sixth annual Scottish Public Service Awards took place on 4th December 2019 celebrating excellence within Scotland’s public services, and showcasing some of the most innovative and outstanding work being achieved.  We are excited to share that the winners of the ‘Digital Public Services Award’ were the NSS Integration Team, with their work on ‘Remote Blood Pressure Monitoring’.  We worked with the NSS Integration Team to implement Flo’s GDPR compliant APIs to allow routine blood pressure data from individual GP Practices to be extracted and analysed in the NSS safe Haven.

Florence and the strangest secret of self care

posted 19 Sep 2019, 06:58 by Hollie O'Connell

19 September 2019 

The use of digital technologies in healthcare is a fast growing industry with a whole host of technology start-ups offering solutions using online video conferencing, apps and AI.  Within this crowded market, many come with a promise from the vendor of a clinically effective and sustainable service but all too often we see these solutions struggle to live up to the salesman's promise.  Healthcare by its nature of course is a tricky area for digital technology, with the need to provide independent evidence of a direct causal clinical effect and improved efficiency for healthcare providers.  This is particularly tricky within the requirements of rapid change driven by new advances in care but anchored in long established methods of care delivery.

Flo is now in her 9th year of supporting patients towards better and faster clinical outcomes and helping them to manage their own health conditions better.  Along the way the evidence from Flo’s use has enabled the introduction of her US and Australian cousins (Annie and Nellie) and although these locations are very different, Flo, Annie and Nellie have all continued to demonstrate the same positive and sustainable outcomes. 

So what makes Flo, Annie and Nellie different to other digital technologies and what’s the evidence?

In this short webinar Phil O’Connell, our founder, talks through our unique methodology and how the secret to self-care has little to do with digital technologies, and everything to do with human behaviour. 

Home and Mobile Health Monitoring Evaluation - Economic case studies

posted 13 Sep 2019, 03:15 by Hollie O'Connell   [ updated 3 Oct 2019, 05:12 ]

13 September 2019 

We are delighted to announce another exciting publication, Home and Mobile Health Monitoring Evaluation - Economic Case studies” by Digital Health & Care Scotland, who have previously published their National 3-year evaluation "Towards Scaling Up Home and Mobile Health Monitoring 2015-2018".   This report provides us with a detailed analysis of the considerable cost savings across three varying locations in Scotland; Ayrshire and Arran, Lanarkshire and the Western Isles, where the substantial outcomes were fundamental in the decision to Scale Up with Flo. 

The aim of this report was to look at the return on investment when using HMHM (Flo) to support patients with Hypertension and COPD, and explore the “monetary equivalent of capacity released, the monetary equivalent of reduction in resource demands, the cost of HMHM compared to baseline costs, and the number of cases that would need to be implemented to break-even.”

When looking at COPD patients supported by HMHM (Flo) key findings were:
  • HMHM is cost effective - Using Net Present Value, savings over a 10 year period per 100 patients:
    • Ayrshire & Arran £26 - £28 million
    • West Dunbartonshire £496k - £1.4 million
    • Highland approximately £23 million
  • Fewer NHS24, ambulance call outs and emergency admission bed days
  • The number of items prescribed increased (due to more appropriate prescribing)

Key findings when using HMHM (Flo) to support patients with Hypertension:
  • HMHM is cost effective - Using Net Present Value, savings over a 10 year period per 100 patients:
    • Ayrshire & Arran £52 - £73k
    • Lanarkshire £15 - £67k
    • Western Isles £62 - £85k
  • Capacity is released. Comparing costs and benefits shows that to break even:
    • Ayrshire & Arran need 56-76 patients to use HMHM (Flo)
    • Lanarkshire need 42-68 patients to use HMHM (Flo)
    • Western Isles need 13-18 patients to use HMHM (Flo)
  • Patient travelling time is avoided, 33 - 50 hours were saved per 100 patients
  • Productivity is increased - estimated that £1,800 in loss of earning is avoided per 100 patients by having their BP monitored remotely
  • Savings can be increased by recycling of BP monitors
“ Despite considerable local variation between the partners providing data for these case studies, all of the scenarios modelled were shown to be cost effective over a 10 year period.  Although most of the benefits are non-cash releasing, aspects such as avoided appointments do create additional capacity for staff working across primary and secondary care, many of whom work under considerable pressure. “

You can read the full report and evidence towards these savings by clicking here.

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