"The West of England AHSN has been invaluable in supporting the real-world evaluation, and subsequently the adoption and spread of our digital health technology. They have given us a platform to connect with their member CCGs and other NHS stakeholders, and enabled us to work collaboratively to put our digital health innovation in the hands of people who can benefit most from it."
Tommy Parker, Digital Innovation Lead, KiActiv®
Overview

KiActiv® Health is a 12-week digital therapy designed to improve the self-management of long-term conditions using personalised everyday physical activity, and is clinically proven to work. The interactive software promotes authentic choice and empowers effective self-care. The programme offers guided development of self-management and goal setting skills, enabling users to create ‘ideal’ physical activity profiles in the context of their health.

In 2015, the West of England AHSN launched an m-health challenge call in diabetes, developed jointly with Diabetes UK and the regional health and care community. The purpose of the pre-procurement call was to identify established products and services and implement pilots in the local region to support and promote self-management of type 1 and 2 diabetes. KiActiv® was one of five successful services responding to the call and was selected to be a partner on the regional Diabetes Digital Coach Challenge. KiActiv® subsequently became a partner in the national Diabetes Digital Coach Test Bed, one of the seven wave one NHS Test Beds.

The Diabetes Digital Coach Challenge helped KiActiv® to refine their service offering and provided evidence to demonstrate efficacy and positive user experiences for people using their programme.

As a result, KiActiv® were commissioned by Gloucestershire CCG for self-care and prevention and were a finalist at the 2018 HSJ awards in the ‘patient digital participation’ category.

How is the AHSN involved?

Since 2016, the West of England AHSN has been working in partnership with KiActiv® on both the Diabetes Digital Coach Challenge and NHS Test Bed. These two programmes provided KiActiv® with introductions to regional clinicians and commissioners, detailed evaluation of the service, and raised the company profile through speaking opportunities at regional and national events.

On Diabetes Digital Coach Challenge, the West of England AHSN worked with KiActiv® and Gloucestershire CCG to make KiActiv® Health available to 179 people with diabetes. The purpose of the project was to evaluate uptake, engagement, and impact on clinical and patient reported outcomes, which has led to its wider commissioning within Gloucestershire.

On the national Diabetes Digital Coach Test Bed, KiActiv® was one of five digital tools offered through a single sign-on platform to promote diabetes self-management. The purpose of this Test Bed was to evaluate the benefits of a unique, multi-provider approach to promoting self-management.

Impacts / outcomes of AHSN involvement to date

Funding:

As a result of the real-world evaluation, which was funded by the West of England AHSN, Gloucestershire CCG has commissioned KiActiv® for people with diabetes and at least one co-morbidity, in deprived areas of the county.

This has safeguarded jobs and created a foundation from which to grow, and KiActiv® has subsequently created multiple opportunities within their team for placement students from the University of Bath.

The beneficial impact of KiActiv® Health has also been identified for other long-term conditions in Gloucestershire, and is currently being offered to patients in the falls prevention pathway who have declined face-to-face or group services.

Clinical impact:

On the Diabetes Digital Coach Challenge, KiActiv® Health implemented a self-management programme with 179 type 1 and type 2 diabetes patients. The programme resulted in the following outcomes:

  • Over 97% of patients increased their physical activity, with 83.9% improving in 4 or more dimensions, with average improvements of:
    • 1hr 29min reduction in sedentary time
    • 44min increase in daily moderate activity
    • 284kcal increase in calorie burn
    • 2hr 36min increase in weekly moderate bouts
    • 54min increase in weekly vigorous bouts
  • As a result of the programme, the group achieved physical activity levels that were shown to reduce HbA1c by 0.9%, which is associated with a risk reduction of 32.9% for microvascular complications.
  • Furthermore, as a result increased physical activity, patients reported experiencing a number of other quality of life benefits:
    • weight loss
    • reductions in pain
    • reductions in medications
    • improvements in mobility
    • reductions in fatigue
    • improved mood.

Health economic evaluation of the programme demonstrated a positive return on investment within a one-year, five-year and 10-year time horizon. For every £1 spent, the model demonstrates a return on investment of £2.53, £15.63 and £43.40 at the respective time horizons. Economic benefit is achieved through the improvement in health outcomes, the reduction in future costs such as medicines, complications and co-morbidities, and productivity gains. The programme also demonstrated the opportunity to evaluate the wider impact on prescribing and healthcare usage for other conditions.

“As a CCG we have had a really positive experience in working with KiActiv® from the planning of the first phase back in 2017 to three pilot practices for people with diabetes to the further rollout to an additional 500 people in most of our deprived parts of the county. The health outcomes delivered by the KiActiv® programme have been excellent, with reductions in weight and medication and increases in sustained physical activity and mental wellbeing. Communication with KiActiv® has been excellent. They take a proactive approach in planning ahead, and know this has been valued by the GP practices they have worked with to date. For this reason people with diabetes have committed to remain on the 12 week programme, as they have had confidence in the provider’s ability to deliver.” Associate Director Self Care, Prevention and Diabetes – Gloucestershire Clinical Commissioning Group

Plans / timescales for further work
  • The West of England AHSN is working in collaboration with national partners, including KiActiv®, to evaluate the opportunity to spread and commercialise the Diabetes Digital Coach Test Bed concept.
  • KiActiv® is successfully delivering its diabetes management service for the NHS in Gloucestershire and its impact has led to new pilots for falls prevention, cancer prehabilitation, lymphoedema and cardiac rehabilitation. KiActiv®continue to build the evidence for a pathway agnostic physical activity service, so that access is not a condition lottery.
  • Successful programmes with the local authority in Bath & North East Somerset for disease prevention and well-being are now being extended to pilots in Bristol and North Somerset.
Opportunities to get involved

With the support of the West of England AHSN,  KiActiv® has established outstanding real-world outcomes for their innovation that builds on clinical research and has attracted the recognition by the HSJ Awards. They continue to witness remarkable health outcomes from their NHS service and want to build on this success of by finding partners to accelerate the spread of this proven digital behaviour change therapy. The performance of KiActiv® has clearly established the opportunity to increase patient access to self-care and prevention of multiple long-term conditions for improved health outcomes.

Start and end dates

2015 – ongoing

Contact

Project contact

Rosie Brown, West of England AHSN
E: [email protected]

Company contact

Tommy Parker, Digital Innovation Lead
KiActiv®
E: [email protected]