Situation

In 2019, Humber, Coast and Vale Integrated Care System (ICS) (now Humber and North Yorkshire ICS) set out their Strategy for Digital Transformation. At the time, the population served by the ICS was 1.4 million people, with 23% of the population living in the most deprived areas of the UK, and a high proportion of this population living in extremely rural and isolated areas. 

The ICS was under a great deal of pressure. If no transformational changes took place, the Humber, Coast and Vale ICS expected a budget deficit of at least £420 million by 2020/21. 

Digital transformation was fundamental to improving the health of both citizens and the system itself. During the process of developing its digital strategy, the ICS commissioned a public survey to ensure any digital transformation was aligned with their citizens’ needs. Amongst the responses to questions on digital improvements to the patient experience were several requests for patient-related healthcare apps.

Despite the fact that the growing adoption of digital health was clear, many health and care professionals had difficulty knowing how to incorporate it into their service delivery. Staff reported it was hard to tell which of the hundreds of thousands of them available would be relevant and beneficial to the vulnerable people they support.

Solution

The Humber, Coast and Vale ORCHA Digital Health Library launched in 2019 at hcv.orcha.co.uk (now at hny.orcha.co.uk), with the intention of delivering quality-assured digital health to their population. The Library contained only apps compliant with safety standards, and provided an easy way to search for the highest rated apps across a wide range of issues. 

In 2020, the project team chose supporting healthy living and long-term condition management as key focus areas for their population, particularly with face-to-face services being halted during the COVID-19 pandemic. The team identified social prescribers as being particularly well-placed to deliver these services, and connected ORCHA’s team behind the implementation of the Library with teams such as Citizens Advice Clinic. 

Results

Social prescribers at the Citizens Advice Clinic found the inclusion of assessed digital health technologies within their work to be an incredibly valuable additional tool. 

Elaine Elsdon at the Citizens Advice Clinic was introduced to the Humber ORCHA Library in May 2020, and began using it right away. She has found that the assurance of being able to signpost people to the health technologies available, in combination with the robust review process behind their inclusion in the Library, is very reassuring to the people she supports.

The wide variety of health and care technologies (including apps) that are identified in the Library for each condition area means that she can identify support for the wide range of people supported by the Clinic. If a client presents an issue which she hasn’t previously found a solution for, she can simply search to see which assessed solutions are available, and recommend them securely to her clients.

Mainly focusing on mental health and exercise and weight management apps, Elaine has adopted the recommendation of apps to her clients, with resounding success. Many of the clients being supported by the Clinic haven’t considered using apps for their health, but may be looking for support either in addition to or as an alternative to medication and traditional therapies. As accessing services became difficult during lockdown, Citizens Advice clients have found great use for apps to support the management of their own health.

Furthermore, as many felt during the pandemic that they might be using up limited resources which would be better spent elsewhere, or that the complexities of trying to access these services was causing them stress, the instant accessibility of support provided by health apps was and remains very much preferable. As traditional services have begun to be reinstated, Elaine has found that health apps have continued to provide support to her clients, some of whom don’t wish to access helplines or face-to-face or group therapy sessions.

The ORCHA Pro functionality has also been incredibly helpful to Elaine, allowing her to keep track of which apps she has recommended to whom, and based on this, to find solutions for clients with similar health concerns. As well as being able to track previously successful apps, Elaine can find new apps, and apps for health concerns she hasn’t previously been presented with. Furthermore, through ORCHA’s Digital Health Academy, Elaine can continue to develop her understanding and use of digital health.

Elaine Elsdon, Link Worker at Citizens Advice Clinic said

“Without ORCHA, I just would not have ever considered recommending any app at all. So for me, it’s opened up a completely new world. And therefore, it’s influenced me. It’s made me a better practitioner because I have more tools available to me, and it’s opened up a wider conversation with my clients about different kinds of support that are available out there.  I think that can only be good, for me as a practitioner but also for my clients because it gives them a much broader opportunity to look into options that might be a better fit for their needs. Not everybody wants to go to a face-to-face group in the community, and something like an app might just prove to be a perfect solution for someone.”

The health apps themselves have been incredibly beneficial for many clients. Mental health apps in particular had very positive effects for those who had perhaps been guided through various coping strategies, but, due to the nature of mental health illnesses, found it difficult to remember what they were supposed to do when they were struggling. By accessing mental health support on their phones, however, they found that they could practice these strategies as many times as they needed to, without feeling judged in any way, or as if they were taking up time or resources.

One mental health app in particular, an AI chatbot app called Woebot, has been very successful in supporting Citizens Advice clients, as it allows them to work through and reframe thought patterns they are struggling with, as many times as they need to. One user described it as “a friend in my back pocket 24 hours a day, seven days a week.”

Chloe, a client at Citizens Advice Clinic said

“[The app] is very good.  It helped me to change my mindset.  I can have self-destructive and negative thought patterns and it helped me to challenge those thoughts.  It’s such a shame I didn’t have this app in Lockdown.  It’s so helpful because I can just offload to the app any time of the day or night and clear my head.  I think of this as my little buddy, and I look forward to the next goal we can work on together.”

To date, the Humber Library (now relaunched as Humber and North Yorkshire, in line with changes to the ICS) has had almost 10,000 page views. There are over 100 ORCHA Pros registered to the Humber site, with the most popular apps being recommended residing within the mental health and healthy living categories, and having a particular focus on anxiety and depression, relaxation techniques, and cognitive behavioural therapy. Mental health is by far the most searched term within the Library, but searches for diabetes, fitness and weight management apps are also common.

As the weather gets nicer, we all like to spend more time outside. And we often hear about how good being outdoors is for our health – usually as we’re being hustled out of the door while the hoovering is finished. But it’s all well and good being told to “go outside”, “experience the joys of nature” and “touch grass”. Ok, you’re outside. Experiencing nature. Touching grass. Now what?

This is where the famous mindfulness comes into play. Mindfulness is talked about a lot these days. To be honest, it can seem intimidating – the idea that you have to be completely present, in a state of total calm, et cetera. But mindfulness is a skill, like anything else. You start small, and slowly but steadily improve. 

Guided mindfulness meditations are a good way to start practising, as these can help to keep your mind on track when it (inevitably) wanders. For guided meditations and help learning mindfulness techniques, there are some great health apps in your Digital Healthy Schools Library which can support you with practical techniques and reminders to practise them. Search “mindfulness” to get started – and remember that you can use the filters at the top of the page to find the best app for you.

And just to note – mindfulness isn’t for everyone. Many people find it helps them manage their day-to-day stress, but for some it just doesn’t work. You may want to try this article from Mind, for more information on whether mindfulness is right for you.

So, what is mindfulness?

Mindfulness is the act of noticing what’s happening in the present moment without judgement. This could be what’s happening in your mind, your body, or around you.

Whenever you catch your mind drifting into other thoughts, just gently bring it back, without any judgement towards your mind for doing what it does naturally: drift. Notice how thoughts come and go, and create space between them. This may help you to learn that your thoughts don’t have to define you, which might help you react more calmly to situations, and teach you to reflect before you respond.

Just paying more attention to yourself and your surroundings – noticing how you feel in this moment, looking more closely at whatever you can see, focusing on what you can smell, feel and hear – are all mindfulness exercises. You don’t have to be outdoors – but this article is titled “Getting Outside”, so we’ll stay on theme.

This leads nicely onto a great mindfulness exercise you may have already heard of: the Five Senses exercise. The goal of this exercise is to calm your mind by using your five senses to focus on your environment instead of your thoughts. This can help you to be present in the moment, keeping your mind just busy enough not to begin worrying, planning or daydreaming.

• First notice five things you can see. Try to look for things that you wouldn’t usually notice.
• Second, notice four things you can feel. Your clothing, the ground under your feet, the breeze, any four things.
• Next, notice three things that you can hear. Bring your attention to sounds in the background that you don’t usually pick up on, like nearby traffic, or birds singing.
• Next, notice two things that you can smell – whether they’re nice or not-so-nice.
• Last, notice one thing you can taste – whether it’s the last thing you ate, a sip of a drink, or your morning breath. Without judgement.

Nature has a scientifically proven positive effect on our mental health. Green and blue spaces (parks or woodlands and beaches or canals) are great – but trees planted along a street, plants in pots and even watching nature documentaries are all shown to be good for our mental health. In the section below, there are some great apps to help you get started with mindfulness and getting outdoors – you can search them in your Digital Healthy Schools Library to see exactly what support they provide and view some screenshots from within the apps to check that they feel right for you. If these apps aren’t quite what you need, try searching “mindfulness” to find the best app for you.

So get outside. Stare at the sky. Touch grass. Just pay attention while you’re doing it.

Good sleep is one of those things we’d all love to have a little more control over. Children and young people need more sleep than adults to function – but unfortunately, there are a lot of things that can impact our ability to get the amount of rest we need.

Whether it’s stress, illness, screen time, too little physical activity or too much caffeine, it doesn’t take much to throw our sleeping habits out of whack. Poor sleep can have a huge impact on our mental and physical health – and vice versa. If we’re struggling with our wellbeing, it’s often very difficult to sleep well, which then has a negative effect on our health. Most people will have difficulty with their sleep at some point, but ongoing or severe sleep problems need to be addressed. Lack of sleep can negatively affect our mood, concentration, weight, our ability to cope with stress and even how many spots and pimples we get. 

Neurodiversity, such as attention deficit hyperactivity disorder (ADHD) can also impact sleep. If your sleep problems carry on for a long time and trying different sleep-inducing habits doesn’t work, or there’s no obvious reason why you can’t sleep, you may wish to talk to your GP, as this could impact your learning and overall wellbeing.

Clearly, general health has a massive part to play in getting enough rest. There are hundreds of health apps in your Digital Healthy Schools Library to help with improving sleep, making sure you’re getting enough exercise, building healthy habits and more – and you can use the filters at the top of the search page to make sure you find the best app for you.

So, how do we improve our sleep? There are a number of ways we can help ourselves sleep better – the first is to try to identify why we’re having trouble sleeping. For instance, energy drinks or several hours of staring at a screen right before bed are very likely to cause difficulties falling or staying asleep. Similarly, lying in bed going over and over our worries or stresses doesn’t allow our brains to enter the state of rest needed for sleep. 

A good sleep routine is key. This is called “sleep hygiene” (which doesn’t just mean clean bedding – although that definitely helps!). Essentially, it’s about creating a bedtime routine which helps us to wind down before bed. Creating a pattern to follow before going to bed helps your body and brain recognise that it’s time for sleep, and to settle into a restful state more easily. 

First, identify a realistic bedtime which will allow you to get 8-10 hours of sleep. Stick to this bedtime as closely as you can – even on weekends. Set a time period before this time, between 30 minutes and two hours, you should avoid sugar, caffeine, heavy exercise and screens. Before this, you could set a blue light filter on your screens, as this light tends to stimulate our brains. If you often find yourself laying in bed worrying, you might use this time period to make sure you’ve done everything you need to do for tomorrow, and maybe create a to-do list for the following day, which could help you feel more in control of your outstanding tasks. 

You may also want to try guided meditations, wind-down exercises or sleep story audios. There are loads of apps in your Digital Healthy Schools Library designed to help with sleep, try searching “sleep” or downloading one of our three top-rated sleep apps below. 

*Please note: these are the three top-rated apps with specific sleep improvement functions that do not require a subscription by an organisation or service.