The ever-increasing pressure on primary care services in England has been well documented in recent times. NHS Bedfordshire, Luton and Milton Keynes Integrated Care Board (BLMK ICB) recognised this issue and wanted a solution that could help to manage the wellbeing of this vital element of the healthcare workforce.
A collaboration between BLMK ICB, NHS digital transformation experts, Arden & GEM, and evidence-based mental health tool developers ShinyMind, resulted in the Shine Programme. This initiative has improved both the wellbeing and resilience of the primary care workforce while simultaneously enabling patients to better self-manage their mental health.
The challenge
The NHS Fuller Stocktake report recognises an urgent need to address the increasing demand upon primary care services to provide proactive and personalised care. It also highlighted that “primary care teams are stretched beyond capacity, with staff morale at a record low” – a challenge BLMK ICB was keen to address.
In addition, with mental health issues affecting 1 in 4 people, BLMK ICB also recognised the need to invest more in mental health prevention and support for its local population. This was particularly prudent in supporting people with long term conditions – given that poor mental health is the most common co-morbidity for this cohort of patients.
The overall aim of the project was to simultaneously support the primary care workforce’s wellbeing while helping BLMK’s patients to better self-manage their health. This was achieved via the Shine Programme – a unique solution that utilises an evidence-based mental health digital tool, ShinyMind.
Our approach
The Shine Programme was designed in partnership with BLMK ICB as a wellbeing initiative for both patients and primary care staff and includes three key elements; the ShinyMind app, a customised ‘prescribing’ portal and a training programme for ‘prescribers’.
The ShinyMind app, which was originally developed for and co-created with NHS staff, blends science and research to offer users interactive exercises, advice and resources that improve wellbeing and resilience. Each practice taking part in the programme was given licences for their staff in addition to 500 annual patient licences.
Practices were also asked to select three ‘prescribers’ to attend a series of five virtual training sessions covering:
- The power of narratives
- Self and others
- Assertiveness and voice
- Motivational interviewing
- Empowerment.
A train the trainer model supported those who attended the sessions to share the programme and its materials with their colleagues, improving the resilience and wellbeing of the whole staff group. Trained staff were then able to prescribe ShinyMind as a wellbeing resource for patients utilising the unique portal which enables both one to one and one to many (population level) prescribing.
The programme targeted citizens aged over-18, including those experiencing anxiety and depression, living with long-term conditions or facing the greatest health inequalities. This included access to specific ‘LifePacks’ (e.g. coping with anxiety and mental wellness) matched to the needs of patients to personalise support and enable better self-management of health conditions.
The outcomes
The first phase of the programme, which launched in 2021, has been successful with feedback from both patients and staff collected through completion of a confidential research questionnaire.
It has addressed multiple objectives of the NHS Fuller Stocktake report including streamlining access to care and advice, providing more proactive personalised for those with multiple long-term conditions, helping people to stay well for longer through prevention and utilising digital solutions to drive population health management.
The programme has widened access to primary care services by expanding the workforce able to prescribe support to those suffering with poor mental health who aren’t at the threshold to receive traditional mental health support.
Staff findings and feedback:
- 91% improvement in wellbeing
- 73% increase in productivity at work
- 64% greater likelihood to continue working in primary care
- 73% increase in job satisfaction
- 64% increase in feeling their work makes a difference.
"Very beneficial not only for patients but for myself"
"Really excited to implement this wonderful programme"
Patient findings and feedback:
- 60% thought the app helped them feel at least a little bit better and would like to keep the app
- 83% said they felt it would benefit other patients
- 28% improvement in life satisfaction scores after 6 weeks
- 17% improvement in anxiety scores (GAD) after 6 weeks
- Significantly fewer days feeling anxious or worrying.
"I go on here when I am anxious and makes me feel like I've dropped lots of weight off my shoulders – love, love this app"
"Using this anywhere is helpful, it has made me feel less alone in dealing with stuff, and when I'm stressed it’s like a go to dealing with it. I have been surprised how much it has helped me"
"For me it’s shown me the right path of the start of a new life"
ShinyMind also offers increased effectiveness and value for money compared to alternatives such as NHS talking therapies. Research across a wide range of NHS services suggests a 33% greater benefit at around 1.2% of the cost (£12), while also avoiding waiting times.
Next steps
Phase one of the Shine Programme has empowered patients to keep healthy, both mentally and physically, while also improving the wellbeing of the practice staff who care for them.
As a result, BLMK ICB has already created a business case for wider system adoption to take the Shine Programme forward on a greater scale across 30 GP practices from autumn 2022.