Best For You is a new initiative from leading NHS organisations that is transforming mental health services for children and young people. The project is led by CW+, the official charity of Chelsea and Westminster Hospital NHS Foundation Trust, and is a coalition of NHS organisations including Chelsea and Westminster Hospital NHS Foundation Trust, Central North West London NHS Foundation Trust, West London NHS Trust and Imperial College.
Best For You works across the existing services provided by the partners as well as the broader health and social care and third sector to introduce new innovative models and partnerships to provide support for as much of the largest health population in the country as possible. The service uses next-generation therapeutic interventions and digital tools to provide the best possible care for patients – including the use of digitally and clinically assured digital health solutions from their ORCHA Health App Library.
This new integrated approach working across partners and the wider ecosystem is in response to the public health crisis surrounding children and young people’s need for mental health support. A survey commissioned by NHS Digital found that the number of children and young people with clinically significant mental health conditions was 50% higher post-COVID-19 than the previous survey three years earlier. New data shows that referrals to child and adolescent mental health services in March 2021 were more than double those in March 2020. Best For You helps to tackle this issue through tailored, holistic care which seamlessly integrates mental health services, physical health service, community services and partnerships and digital tools.
Best For You worked with ORCHA to develop a Health App Library designed to support children and young people struggling with their mental health, and their families and carers, to access safe, accredited health apps to support them.
The site includes thousands of assessed health apps, including around 300 mental health apps, which have been reviewed against 350+ criteria across clinical effectiveness, data security and accessibility. ORCHA’s review process for health apps incorporates nationally recognised digital health standards and regulations, including an adapted version of the NICE Evidence Standards Framework.
By including compliant digital therapies in its care pathways through the ORCHA partnership, Best For You is addressing the rising levels of children and young people facing serious mental health difficulties, while safeguarding them from any harmful digital health solutions. The Best For You ORCHA Library can be accessed at bestforyou.orcha.co.uk, and is the UK’s first dedicated App Library for children and young people in need of mental health support. The main Best For You digital platform can be viewed at bestforyou.org.uk.
The Best For You Library launched in November 2021, and has already had almost 2,000 page sessions and over 2,300 searches for apps to help with mental health conditions such as anxiety, low mood, eating disorders and sleep.
“This is something that people were looking for. Having that trusted and validated one-stop-shop for digital health tools for young people is something that clearly service users and clinicians are starting to tap into.
From our perspective at CW+ and Chelsea and Westminster, working with ORCHA was really the only option to create the kind of App Library we wanted to deliver. Ultimately, this is about keeping people as people and stopping them from becoming patients in the first place.”
Chris Chaney, Chief Executive of CW+
We are encouraged that the Government has announced it will invest £310 million over the next five years in digital health technologies to improve the health of the 2.3 million people unable to work due to long-term sickness(1).
This is a significant move towards a digitally integrated healthcare service. To realise the full potential of this opportunity, the whole NHS needs to look at how to accelerate the digitisation of mental health services plus other areas such as the NHS Health Check.
This may be a ringfenced investment targeted at just one population cohort, but the implications are much bigger. The safety, data privacy and health outcomes of the entire nation will depend on what the NHS does next.
Public expenditure will be impacted too. The right choices in digital health will ensure significant returns on investment, reducing costs and demand in both NHS and social services.
The NHS needs to consider how it can rapidly establish the core infrastructure for digital health that has long in place for medicine. The three most pivotal elements are:
£310 million sounds like a big sum, but without these core elements, the impact digital health delivers will not be realised.
With them, the health outcomes and savings seen will ensure the programme of work not only continues but lays the foundation for other services to follow.
But this isn’t virgin territory. ORCHA has already worked with Occupational Health, Musculoskeletal and Mental Health teams from across the NHS and seen real results. These practical everyday examples highlight this:
“Our elderly patients find it hard to come in for regular appointments here. So, if we can use apps on their tablets to assist in their progression, in addition to their therapy and not as a replacement for it, they don’t need to come in so often and it will help them progress.” Hannah Silcock, occupational therapist at Bolton NHS Foundation Trust.
“As a practice nurse we see a lot of patients with chronic conditions. We only see them once or twice a year to review. To be able to give them something to help them manage their conditions on a daily basis is really beneficial, for example to help those with diabetes manage their blood glucose levels.” Jane Patrickson, Bradford practice nursing team.
“Digital health is becoming part of the armoury of tools that our clinicians have…Service users and clinicians are tapping into this. Ultimately, if we get this right, this is about keeping people as people and stopping them from becoming patients in the first place.” Chris Chaney, CEO of CW+, the charity of the Chelsea and Westminster Hospital Foundation Trust.
At this time when the NHS is faced with unprecedented pressure, we welcome this funding from the Spring Budget, but urge caution around the next steps.
ORCHA has created the country’s first Digital Health Formulary, to help healthcare professionals prescribe safe digital health products and health apps to patients. Learn more about how ORCHA supports health and care organisations to deliver digital healthy safely.
ORCHA provides everything a health system needs from assessing digital health technologies and providing the safe deployment, workforce development and prescription infrastructure to achieve this, which complements other system initiatives. Our cloud-based system has been designed to easily integrate with existing NHS infrastructure, including the NHS App and Electronic Patient Records (EPRs). It also places very minimal demands on existing stretched NHS IT and digital transformation resources whilst ensuring a fully governed, safe process for the deployment and activation of these tools.
(1) Source: Office for National Statistics (INAC01 SA: Economic inactivity by reason (seasonally adjusted) – Office for National Statistics (ons.gov.uk))
ORCHA (the Organisation for the Review of Care and Health Apps) has been helping healthcare professionals and the public find trusted health apps since 2015, through its digital health libraries.
Following the rapid growth of the digital health sector, healthcare professionals and citizens now have distinct and different needs from their health app libraries – and so ORCHA has created products exactly tailored for each of these two audiences.
The UK’s first Digital Health Formulary
Nearly 75 years after the publication of the first British National Formulary (BNF), the essential prescribing tool depended upon by all healthcare professionals, the UK’s first Digital Health Formulary sets up a system for prescribing safe health apps to patients.
GP Tom Micklewright, ORCHA’s medical director, said:
“The original BNF was introduced because in the first half of the 20th century doctors were faced with an increasingly complex range of drugs and influential pharmaceutical industry. They realised they needed high-quality and independent advice. We are in the same situation again now, as pressures on our healthcare systems make us look at revolutionary new ways of doing things.”
The new formulary can be integrated into existing patient record systems, such as CERNER or EPIC dashboards. It’s a single source from which to find health apps which have been pre-selected and vetted by healthcare colleagues.
Within three clicks, healthcare professionals can send a health app recommendation to a patient via a secure text or email. Recommendations and patient downloads can be tracked, ensuring good governance. The healthcare provider can also take an overview, monitoring how many apps it is prescribing and which are being downloaded and used by patients.
A safe health app library for citizens
Consumer research* has indicated that 62% of people are interested in using apps and many are finding them themselves rather than through a healthcare professional (55% had received their recommendation from a healthcare professional). This raises serious concerns about quality, as only 20% of the 320,000 health apps currently available are safe to use.**
From now, ORCHA will be developing straightforward, easy-to-use Health App Libraries in partnership with healthcare providers, which allow patients to easily find apps they can use unaided. Only consumer-friendly, over-the-counter apps which require no input from a healthcare professionals will be included on these libraries.
The App Libraries are structured on simple, pre-built layouts. They can be presented in several languages and configurations and designed to support health strategies and key health priorities of each health care provider. The Libraries can only be accessed within the geographical territory of the healthcare providers, ensuring that all the regulations for that territory area met safely and that data governance and residency requirements are met.
The reporting dashboard will enable the provider to have new population insights.
Tom Micklewright said:
“We want to get safe digital health to those who need it as safely and quickly as possible, so we’ve designed the Libraries with usability and accessibility as an absolute priority. We’re proud that our Libraries are rated AA for web content accessibility. They’re modern, responsive, and mobile first.”
These two new products are part of an expansive range of ORCHA products designed to give health and care providers everything they need to deliver digital health safely.
See a video about the new ORCHA products here.
* https://info.orchahealth.com/digital-health-attitudes-behaviours-2022-report
**ORCHA statistics