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 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:
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

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.

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.

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. 

• 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