Situation
Suicide is the biggest killer of under 35s in the UK. Papyrus is the national charity founded for the prevention of young suicide, providing confidential support and advice to young people struggling with thoughts of suicide, and anyone worried about a young person through its helpline, HOPELINE247.
Aware that people search online to find support for their mental health, including searching for apps, Papyrus wanted to supply a digital resource following a call to HOPELINE247, and to have available for those who do not call. But the charity understood that although there are thousands of apps to choose from, the vast majority are not safe or secure with managing personal details.
Solution
To identify the best apps across a range of challenges its service users face, and to create a platform that allows safe and secure distribution of the apps, Papyrus decided to work with the Organisation for the Review of Care and Health Apps.
Working closely with the Papyrus team, ORCHA delivered a Health App Library in Papyrus branding, featuring shortcuts to apps specifically selected to support the most common mental health challenges its users face. Papyrus built the Library into its website, so that all clients have a place where they can find trusted apps.
Alongside this self-serve solution, ORCHA also delivered a solution that enables Papyrus’ HOPELINE247 staff to be able to quickly and easily find apps, and send to them securely by email or text to a caller whilst they are on the line. ORCHA gave the HOPELINE247 team training to ensure they felt comfortable with the system and the apps they would be recommending.
The ORCHA customer success manager worked with the Papyrus project lead to create material and a plan to promote the service to young people who may be thinking about suicide, highlighting this vital new service.
Results
There are now 35 HOPELINE247 team members who are trained and recommending apps to the people they support, with 10% of these being the most active champions.
Since launching, almost 20,000 people have accessed the service.
To bring this impact to life, we share the story of one service user:
A young person contacted HOPELINE247 and explained they were feeling suicidal. Following the loss of a grandparent, they felt like everything was getting too much and was self-harming in order to cope. They also shared that they often feel anxious in school. Having different interests to most of their peers, they feel isolated and as though they don’t fit in.
The adviser explored this with the client, and reflected on why having different interests make us who we are, and suggested finding some local groups where people share those interests.
The caller shared they would like this and agreed to consider sharing their thoughts of suicide and self-harm with their Mum as well. They also agreed that some further support would be helpful, but especially at night, as that is when their thoughts are more intrusive and they struggle to stay safe from suicide.
Together, the caller and adviser created a HOPELINK safety plan which included a plan for the caller to keep safe from any plans for suicide, the reasons the caller does want to stay alive, some coping strategies and signposting.
The adviser discussed with the caller how having some different apps on their phone that only they have access to and that they can also access on the go any time day or night might be helpful, the caller agreed. The adviser then explained to the caller that there are a lot of different apps out there, and that we have an resource called Orcha that is a safe way at finding a suitable app, the adviser put the link for Orcha in the safety plan for the caller to access.
The caller shared they was able to stay safe and felt able to call us back should they need further help.
Just over a month later, the caller phoned back as they wanted to disable their suicide plan. The adviser revisited the HOPELINK safety plan with them where they asked if the caller was able to have a look at some apps. The caller shared that they had and had found this resource helpful and had helped them to stay safe since the time of their last call with HOPELINE.
Commenting on the project, Sophie Addison, HOPELINE247 Manager at PAPYRUS said: “Young people use there phones a lot, so why not use there phones to save their lives, and with ORCHA that enables our service users to find a service that they can privately have on their phones, that they have access to pretty much all the time.”
Introduction
Wellbeing Enterprises CIC is a social enterprise organisation that provides support to people who are experiencing practical, social, and emotional difficulties. Each year it supports almost 5,000 people of all ages in Halton, Knowsley, St Helens, Warrington, and Wigan to improve their wellbeing.
Specialising in person and community centered health approaches, the organization puts social prescribing at the heart of its work. People undergo holistic assessments of needs and strengths and are supported to co-create Personalised Wellbeing Plans to move forward with their lives. It connects people with a broad range of one to one and group activities that help people to build confidence, form friendships and learn new skills. This includes everything from drumming and yoga lessons, to walking clubs and wellbeing courses.
Looking holistically at the people it supports, the team at Wellbeing Enterprises wanted to extend the range of self-help resources available.
After seeing the ORCHA product range commissioned by NHS Cheshire and Merseyside, it identified that a Digital Health Formulary of safe and effective apps across a range of health and wellbeing conditions would be a useful resource. Particularly as it provides assurance that the apps have been assessed for clinical and technical standards assurance.
The Formulary would provide its staff with a single platform where they could find the organisation’s preferred health apps across a range of conditions, and safely recommend one to a client by email or text message. Furthermore, the team knew that all apps featured would be continuously checked by ORCHA to ensure they meet standards.
This would be available to all staff, but in particular its wellbeing social prescribing team, who are well placed to recommend apps during a face to face and telephone support calls.
Solution
Wellbeing Enterprises worked with NHS Cheshire and Merseyside to create a set of folders within the Digital Health Formulary, designed just for the needs of its staff.
Informed by ORCHA’s in-depth assessments of 20,000 digital health technologies, and led by Bethany Harrison, Senior Wellbeing Link Worker, the Wellbeing Enterprises and Cheshire and Merseyside team worked with ORCHA to create a short list of preferred apps to support the common health and wellbeing concerns seen by the social enterprises’ clients.
Once selected, the apps were included within named folders in the Digital Health Formulary, to allow all social prescribing staff to quickly and accurately find the best app for every client.
Training in digital health and the ORCHA system was delivered to all staff. This ensured everyone feels confident recommending apps to clients and understands how they fit into the organisation’s client support pathways. This training was then followed by regular updates and tips.
Results
The Formulary has made a big impact on the social enterprise and its clients, especially among its core social prescribing team and clients. Its staff regularly take the top spots in ORCHA’s list of ‘most active health app advocates’ in the country.
Since its introduction in January 2023, the Formulary has seen 10,000 sessions and more than 35,000 page views.
Last month alone, nine people in its core social prescribing team recommended 83 apps to people. Given NICE evidence indicates that each downloaded app saves the NHS £93 in costs, that is a positive story.
This year so far, we estimate around 700 apps have been downloaded from the recommendations sent by the Wellbeing Enterprise Team. Based on the NICE evidence, this means a saving for NHS Cheshire and Merseyside from this team alone is in excess of £65,000.
Lynn Swift, Services Manager at Wellbeing Enterprises said “We’ve enjoyed working with the ORCHA Team to collate health and wellbeing apps into a Formulary that patients and the public tell us they want and need. The feedback has been positive. It is also reassuring to know that the apps in the Formulary are reviewed by clinicians and technical experts giving assurance of safety and quality”.
Notes
Wellbeing Enterprises is a trailblazing health and wellbeing social enterprise based in the NW of England. As one of the first Community Interest Companies (CICs) in the UK, its mission is to help everyone live happier, healthier, longer lives. It does this by educating and supporting people, mobilising assets and resources in communities and working with partners to tackle the underlying causes of poor health. www.wellbeingenterprises.org.uk
NHS Humber and North Yorkshire Integrated Care Board looks after the NHS spending and performance across a region home to 1.7million people.
One of the biggest challenges facing the Humber and North Yorkshire Health and Care Partnership is managing the growing lists of patients waiting for access to treatment and care. So as part of its Recovery in Primary Care Plan, it has been working to improve the outcomes and experience for patients with planned appointments or interventions, focusing on prevention and management of long-term conditions.
The team identified that health apps can offer convenient and effective ways for people to improve their health whilst waiting for surgery, in preparation days before surgery, then to speed recovery and improve condition management after discharge.
To uphold consistent clinical standards, the team wanted a specific set of apps for each target area. They wanted to know that ach app meets clinical, data and security standards, and decided that less complicated, low risk apps would achieve a higher recommendation rate from clinicians and adoption rate by patients.
Solution
The Board already had a working Health App Library provided by the Organisation for the Review of Care and Health Apps (ORCHA), giving its public a source of safe health apps across a wide variety of health conditions. So, it asked the team at ORCHA how this platform could be utilized to actively put the right apps in the hands of the right people at the right time. To target those waiting for surgery or for those wanting to manage and maintain their long-term health and well-being needs.
As part of its big update at the start of 2023, knowing a Health App Library needs to be as relevant to an audience as possible, ORCHA enabled the Library to be highly configurable. One such feature is its ability to easily add a dedicated campaign landing page to the Library that drives targeted health app adoption. Designed to a health provider’s specific needs, the page feature images, copy, video and specific apps to address the needs of a specific patient cohort.
Working closely with Humber and North Yorkshire Board, ORCHA created a Waiting Well and Beyond campaign. This included:
Results
Since the campaign was launched in August 2023, we have seen over 6500 page visits, and approximately 32% of those who visited the campaign download a health app resulting in 2096 on page downloads.
Based on NICE evidence, each download helps to save the NHS £93 in costs. And so, this campaign not only helped provide support to people when they needed it, improving their health, but so far has also helped to save the NHS approximately £194,928.
Commenting on the campaign, Carrie Cranston, Strategic Digital Programme Support Manager, Humber and North Yorkshire Health and Care Partnership said:
“Our ICB were looking at how we could maximise our elective care recovery programme, to reduce the capacity in demand for local services across Humber and North Yorkshire.
ORCHA have supported us in promoting the use of self-care apps within our local population and this campaign has allowed us to begin the wholesale adoption of digital health within our local communities.”
We are delighted that the Government has accepted most of the recommendations from the Health and Social Care Select Committee. However, we are surprised by their decision to reject what we consider a straightforward recommendation – introducing an accreditation scheme for third-party healthcare apps verified by the NHS.
This is a crucial step that could significantly benefit the NHS and people’s health, and it’s something that could be easily put into practice.
The demand for these healthcare technologies is clear. A significant 68% of people express their desire to use an NHS-verified app as part of their healthcare, and a remarkable 93% of health and care professionals believe in the potential of health apps to have a positive impact.
Moreover, countless technologies are readily available to meet this demand, thanks to significant investments from the NHS, clinicians, and the digital health industry.
To ensure that these apps maintain high standards in clinical, privacy, security, and usability aspects, much like medicines, we require a quality-check scheme. The NHS Digital Technology Assessment Criteria already serves this purpose.
To ensure safe distribution, continuous assessment, and a unified platform for healthcare professionals to safely prescribe these apps to patients, ORCHA, founded by clinicians and supported by the NHS National Innovator Accelerator Programme, possesses the necessary technology. We have assessed 24,000 technologies to date, providing Health App Libraries for the public and Digital Health Formularies for professionals in 70% of regions.
All the necessary components are in place, yet without government support, they remain disconnected. The crucial element of trust that would come with a central accreditation scheme is currently missing.
So, what’s the impact of this decision?
Well, despite the lack of UK regulation or NHS involvement, half of the UK public already chooses to use health apps. Our assessments have revealed that 80% of apps available in app stores fall short of quality standards, putting the UK public at risk.
Without a centralised system, app assessment and distribution are constrained, fragmented, and duplicated. Consequently, the NHS leverages digital health in only a small fraction of its potential applications.
For instance, just 2% of individuals with COPD currently use health apps, despite clinical studies confirming that the right apps can enhance outcomes and reduce the need for frequent medical appointments. Imagine the potential relief on our healthcare system during the Winter Pressures if primary care had access to the right set of digital tools.
In England, 7.19 million people are waiting for routine operations like hip or knee replacements. Integrating digital health into this pathway could significantly reduce deterioration while awaiting surgery, optimise health, and improve recovery outcomes.
This presents a substantial opportunity to enhance efficiency in prevention, urgent care, treatment, and discharge processes.
While it’s promising that the Government plans to introduce a new app, it’s important to recognize that a single app cannot cater to the diverse healthcare needs of our population. After all, there are 70,000 medicines listed in the BNF. Why should we assume that one app can meet everyone’s needs?
The NHS is under immense pressure, and Digital Health presents a practical and effective solution. However, for it to reach its full potential, a centralised system is essential.
We sincerely hope that the Government will reconsider its decision.