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Singapore fact-finding mission focuses on pioneering digital care in South Lanarkshire

posted 22 May 2018, 05:56 by Hollie O'Connell

22 May 2018 

South Lanarkshire’s award-winning Telehealth team have been recognised by a Singapore fact-finding mission team for their experience and successful adoption of digital health and care.  To share experience and knowledge, the team from Singapore visited South Lanarkshire.  You can read how the visit went in this press release.

Flo showcased in #NHS70

posted 11 May 2018, 07:46 by Hollie O'Connell   [ updated 30 May 2018, 08:27 ]

11 May 2018

Fab news for Flo as she's recognised in the top NHS70 Innovations for her use in long term conditions such as COPD, asthma and diabetes.

Flo actively supports the model of patient self-care management and compliance, while also delivering productivity gains for services, enabling larger caseloads to be managed within existing resources. "  


Flo and respiratory pathways – An overview of growth and diversification

posted 1 May 2018, 03:02 by Hollie O'Connell

03 May 2018 

We’ve seen steady growth in respiratory innovation with Flo since 2012; 2017 demonstrated a 75% increase on use from 2012!  The largest growth in respiratory use continues to be within COPD patient cohorts, but asthma and pulmonary rehab usage have both more than doubled over the intervening years.  We have also seen some new innovative pathways begin to develop for bronchiectasis and interstitial lung disease.

As the largest area of use within respiratory conditions, we have seen some really positive outcomes through improved understanding, management and control of the condition and its symptoms.  Flo supports the patient to self-manage their condition at home according to their existing clinical management plan, ensuring avoidable exacerbations are minimised and that if their condition was to deteriorate, any clinical intervention can take place as early as possible to avoid the patient’s condition worsening to a point where more intensive intervention, and perhaps even an acute attendance or admission is the only option.

It’s great to hear from patients whose lives have been improved by Flo, and we are excited to share some of the success stories we have seen:
  • John Stalker, a patient from Hamilton, began using Flo to help him better manage his COPD.  John had a total of 11 hospital admissions before starting on Flo, but in the 10 months since this has significantly reduced to only one.  John had previously sung and played guitar in local clubs, and although not able to sing for long periods of time, he now can now play guitar again and he feels that this is a “vital outlet” for him.  To read about John in more detail, please look here
  • Pat is a patient whose life has been improved by using Flo to help her manage her COPD.  Similar to John, Pat was calling 999, and attending A&E and her GP surgery quite frequently due a lack of confidence in understanding the symptoms that her COPD brought on.  Pat was introduced to Flo to help her manage her condition, and Pat says that Flo has given her a new lease of life.  Read more about Pat, and watch a short film about her journey here
  • Shirley also found that using Flo could help her to improve both her control of her COPD and her quality of life.  Take a look at this video to hear Shirley’s feedback.  This video also includes Maggie Whitmore, a Practice Nurse from Furlong Medical Centre in Stoke-on-Trent, describing her experiences with Flo.  As you will hear, Flo has also helped to reduce the number of doctor’s appointments required by patients at the practice by a significant amount resulting in increased capacity delivering faster access for patients at the practice.

A common theme that emerges from patients living with COPD is the challenge of managing their symptoms; understanding what is normal, and when action needs to be taken.  This is where Flo’s gentle guidance and reassurance builds confidence to follow their clinical management plan, reducing anxiety and motivating them to take the most appropriate action should they need to, helping to ease pressure on emergency and out of hours services.

Patients with poorly controlled asthma often report that they forget to take their preventer inhaler as prescribed; therefore Flo being able to gently prompt patients is a common application proven to be very effective either as a short term intervention until the habit is formed, or for longer term use with appropriate cohorts.  Patients with asthma are also supported to more closely manage their condition according to the guidance relating to their peak flow in the patient’s action plan.  Flo’s use with asthma represents one of our most mature pathways, seeing this usage included in the NHS England Advice and Interactive Messaging (AIM) project, and also as part of the group of protocols produced in conjunction with WMAHSN.

Flo is used to support children who have asthma; often parents interact with Flo on their child’s behalf to help them to look after their healthcare needs.  This not only helps to ensure that children are taking their inhalers as prescribedbut also supports and reassures their parents as well.  You can hear a bit more about this from Dr John Alexander in this video.

More recently, NHS Highlands have been using Flo to help patients to self-manage their asthma.  A consideration for NHS Highlands is the rurality of the area.  Patients sometimes have to travel quite long distances to attend asthma clinics, and should they experience severe exacerbations of their conditions then emergency support may also be quite a distance away which can be a major risk.

Kyle Mackay is a patient with asthma, who suffered a severe asthmatic attack.  Luckily for Kyle, he was staying at a friend’s house which was half an hour closer to the hospital than he would have been at home.  However, had he not been at his friends, this added distance could have had some serious consequences for him.  Following this, Kyle’s respiratory nurse recommended that he try using Flo to support him with his asthma management.  Kyle has found that using Flo has made him more aware of his condition, and he now feels that his breathing is more stable.  You can hear more from Kyle about his experiences with Flo in this video.  Corinne Clark, who is a respiratory nurse featured in this video has also written a blog about her time using Flo, which you can take a more detailed look at here.

Similar to Flo’s COPD pathways, asthma pathways help patients to become more aware and knowledgeable of their asthma, helping to improve stability and reduce severe flare-ups.  This has the potential benefit of reducing the need for emergency care and possible admissions, helping to ease some pressure on local services.

“All Together Better Sunderland” work towards improving patient’s understanding
NHS Sunderland were able to secure funding from NHS England’s New Care Models Programme to produce patient information leaflets for use with Flo.  The leaflets cover a broad range of conditions, but COPD & Asthma specific leaflets are available.  The leaflets are a resource that any member of the Simple Telehealth Community can use, to find out more, please click here.

New and emerging respiratory use 
We continue to see new and exciting Flo developments within the respiratory field, here are a few interesting examples of the developments that have been going on recently:
  • Powys Teaching Health Board (PTHB) are using Flo to give patients who are taking part in pulmonary rehab extra support and motivation during their treatment.  Flo interacts with patients for four weeks, encouraging them to complete exercises between sessions, and has demonstrated to be improving compliance and long term outcomes.  Flo also asks review questions at 3 months (exercise compliance) and 6 months (have patients had further admissions or GP appointments).  PTHB has received positive feedback from patients so far, and hopes to roll out the pathway across the whole of Powys. 
  • PTHB, Shropdoc & The Health Foundation Have been working in conjunction with Barchester Care Homes to create monitoring protocols for care home residents with COPD and asthma.  The protocols are designed so that care home staff can take readings and reply to Flo on the patient’s behalf, with Flo sending advice back to staff.  The aim of these protocols is to ensure timely and appropriate access for patients to the Specialist Respiratory team or GP, as well as providing reassurance both residents and the care home staff.

For more information on integrating Flo within respiratory services please contact lisa.taylor@simple.uk.net

East Midlands Regional Network Meeting - December 2017

posted 8 Feb 2018, 01:09 by Hollie O'Connell

Simple Shared Healthcare 

08 February 2018 

Firth Park Library played host to the December Regional Network Session dedicated to supporting the use of Flo, which enables attendees to share their experience and ideas, as well as promoting best practice in their areas. 

The day began with Lisa Taylor and Karen Moore sharing developments across the wider Simple Telehealth community, including the latest additions to www.simple.uk.net, such as example pathways, case studies & blogs and emerging outcomes from across the UK.  Lisa and Karen also highlighted the development of supported clinical networks across the community to enable the sharing of best practice regardless of geographical location; the first of these being maternity care focused with the inaugural national special interest group call set for February 2018.

Focus: Early pulmonary rehabilitation management of patients with Chronic Obstructive Pulmonary Disease following acute exacerbation in Sheffield 

Cath O’Connor, Clinical Specialist Physiotherapist in Sheffield, discussed her service evaluation of the implementation of Flo in early pulmonary rehabilitation management of patients with Chronic Obstructive Pulmonary Disease following acute exacerbation.  Cath focused on patients who had experienced acute exacerbations of COPD (AECOPD), and were taking part in Early Pulmonary Rehab (EPR).  In Sheffield, 1 in 3 patients admitted to hospital with AECOPD is readmitted, despite often being asked to participate in EPR; patients may not be receiving the support they require to successfully complete EPR, and this may be a factor in the number of readmissions.  Cath, with some support from Karen, developed a pathway supporting this cohort of patients, which focused on symptoms before and after exercise to understand how the patient felt.  Results from the evaluation showed that:
  • Patients found Flo acceptable
  • Patients felt safe, supported, motivated to exercise. 
  • Patients felt more confident about self-managing their health. 
  • Some patients developed new skills in sending text messages that they now use in other areas of their lives, reducing their isolation.

Focus: Community Neurology Team – Improving adherence to physiotherapy in Stroke, MS, Parkinson's Disease and Head Trauma

Following on from Cath, Ed Rimmer, a Physiotherapist within the Community Neurology Team at Nottinghamshire Healthcare Foundation Trust, discussed his plans for a project integrating Flo across several pathways.  The team currently manages patients with a wide variety of conditions, including stroke, MS, Parkinson's Disease and head trauma.  Given the range of conditions and the varied demographic of their patients, a diverse multidisciplinary team of healthcare professionals has developed.  The team recognise that their patients can experience condition led challenges to adhere to prescribed medication and rehabilitation, noting the adverse effect that this reduced adherence has on the recovery of their patients. 

Therefore, Ed is leading the development of pathways aimed to support an improvement in both motivation and adherence to treatment.  Ed hopes that Flo will also help patients to improve their confidence and ability to self-manage, reducing reliance on the team.  The plan is to recruit a minimum of 20 patients over the course of 6 months, and then evaluate with both staff and patients with results informing the recruitment of more patients going forward.
Focus: Virtual Wards in Sheffield

The session was led by Rebekah Matthews, Integrated Pathway Manager, who gave an overview of Sheffield Teaching Hospitals implementation of Virtual Wards and the “Okay to Stay” plan.  The Virtual Wards demonstrated a decrease in admissions over winter months in 2015/16, leading to a pilot project being launched during winter 2016/17 aiming to improve the integration of health and social care, as well as reduce the number of inappropriate admissions.  Patients over the age of 65 who scored the highest on the frailty index were targeted, and through the combined use of a person-centred care plan, the “Okay to Stay” plan & Virtual Wards unnecessary admission were again avoided.  Patients on Virtual Wards are typically offered Flo to support awareness, both to the patient and clinicians of vital signs.  The combination of being able to monitor patients remotely, and Flo’s prompt advice motivates patients to seek appropriate intervention at the right time, and that any admission that occur are necessary and appropriate.

NHS England: Stoke-on-Trent rated Outstanding for diabetes services with Flo

posted 6 Feb 2018, 02:30 by Philip O'Connell   [ updated 6 Feb 2018, 02:34 ]

NHS Stoke-on-Trent 
Clinical Commissioning Group 

5 February 2018 


Flo cited in latest "Outstanding" rating by NHS England for Services for patients with diabetes in Stoke-on-Trent.

“Because lifestyle is key to control of most adult diabetes it is a real partnership between clinicians and each patient. Education is vital, as a patient who is properly informed about their condition can more effectively take control and manage it.”

Stoke-on-Trent and North Staffordshire are recognised as leaders in the way new technology is being used to help patients monitor and control a number of conditions including diabetes.

Florence (or Flo) is a locally developed mobile phone based platform. It allows clinicians to communicate securely with patients to remind them to monitor their readings and take medication. It can issue advice and raise the alarm if a patient’s condition deteriorates.  It can reduce the number of unnecessary appointments for patients whose conditions are stable, leaving more time for clinicians to focus on those who are struggling.

Successfully scaling innovation in the NHS - Flo

posted 29 Jan 2018, 00:40 by Hollie O'Connell   [ updated 30 Jan 2018, 01:23 by Philip O'Connell ]

30 January 2018 


Innovation Unit and The Health Foundation have come together in the "Against the Odds" research project and identified 10 UK innovations which have demonstrated "successful scaling", one of which is Florence.  From these case studies, they were able to highlight eight key enablers for scalability of new innovations within the NHS.  

Peered alongside other respected innovations such as Dose Adjustment for Normal Eating (DAFNE), Enhanced Recovery After Surgery (ERAS) , Implantable Cardioverter-Defibrillators (ICDs), Improving Access to Psychological Therapies (IAPT) and Rapid Assessment Intervention and Discharge (RAID) the report teases out key insights into Flo's adoption and spread. 

  • "The flexibility of the platform and capability support model enables adoption in a wide variety of contexts, as well as co-production of the way in which Florence is adopted in each site with clinicians and patients."
  • "The input of clinical perspectives has been a cornerstone of the design and development process of Florence."
  • "Florence’s central team invest in organisations for the long term, supporting them to implement the system by providing unlimited support to build protocols and adapt the structure and messaging of Florence to fit their specific clinical focus areas." 
  • "The business model is explicitly not-for-profit, and has a strong narrative that focuses on a desire to satisfy the goals that clinicians are passionate about: better patient outcomes and effective use of NHS resources."
  • "The Florence team highlight the importance of gathering evidence on how Florence is used in a particular context, or with a focus on a particular cohort and their clinical outcomes."

You can read the full report here.  Look out for Florence starts on pages 50, 51, 52, 53.


Improving Patient’s Understanding: A Contribution from "All Together Better Sunderland"

posted 22 Jan 2018, 02:47 by Hollie O'Connell

NHS Sunderland 
Clinical Commissioning Group


Rachael Forbister 
TECS Programme Manager and Florence Enthusiast 

26 January 2018 

Supporting our patients confidence to access tools aimed at improving their self-management is paramount as a vital first step toward patient engagement and health literacy.  At NHS Sunderland we have developed a number of resources and we are now delighted to be able to share them with the Simple Telehealth Community.

In 2017 we were able to access NHS England’s New Care Models Programme funding, and chose Flo as the ideal subject matter given the progress we have already had in Sunderland.  This funding facilitated the production of patient leaflets that have been designed to be used with, and are applicable to, a multitude of patients and conditions.  It is with great delight that "All Together Better Sunderland" is able to share this resource for use within the Simple Telehealth Community.  

Please feel free to adopt and use these leaflets to support your patients, we hope that you all get great benefit out of them and a big thank you goes to Hannah Mountford at Simple Shared Healthcare for the fantastic content.  

The King's Fund; “Florence is a low-cost, low-risk innovation with a strong track record.”

posted 18 Jan 2018, 09:19 by Hollie O'Connell   [ updated 19 Jan 2018, 05:31 ]

 Adoption and spread of innovation in the NHS 
 16 January 2018 

This latest independent publication by Ben Collins of The King's Fund discusses the challenges of innovation adoption in the NHS and draws on “eight examples of successful spread of innovation”. We’re delighted that our own Simple Telehealth Community of Practice including, ‘Florence’ and ‘Annie’ have been selected as one of the eight examples.

Some of our favourite quotes from the study; 
  • “Florence is a low-cost, low-risk innovation with a strong track record.”
    • The benefits Florence can deliver are wide ranging
    • Florence is an enabler rather than a solution for clinicians and their patients.
    • Its greatest strength is offering a simple, adaptable framework for clinicians to work more effectively with patients and for patients to take a greater role in managing their conditions, without the need for costly investments
    • “Florence can contribute to a dramatic improvement in quality of life for patients with long-term conditions”
    • “It fits within and can be adapted for existing work processes rather than requiring substantial redesign.  It doesn’t require staff to develop new skills or very different ways of working.”

    Click to read the full publication or the Florence case study.

    NHS England's "Challenging Health Inequality" report cites Flo as 'Soft Tool' for intervention

    posted 20 Dec 2017, 07:54 by Hollie O'Connell

      Flo identified as tool to reduce health inequality in England through self-management

    The "Challenging Health Inequalities" October 2017 report compares emergency admissions and unplanned hospitalisation inequality throughout England, and has identified Flo as a successful intervention tool in supporting the reduction of health inequality.  

    # TotallyUnique

    NHS Western Isles take top QuDoS Accolade

    posted 14 Nov 2017, 07:41 by Hollie O'Connell

    Congratulations to
    QuDoS in MS special award WINNER Rachel Morrison of the NHS Western Isles MS Service.  We're all thrilled that Rachel's good work has been recognised with such a prestigious national accolade and we're proud to support the NHS Western Isles MS service with Florence.

    #NHS Western Isles #TotallyUnique 

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