"The AHSN Network has helped the spread and adoption of S12 in numerous ways. They have given advice and guidance, supported independent evaluation work, invited us to present and pitch at events with relevant stakeholders, helped to develop our value proposition, supported us with networking and introductions. Encouraged and given us confidence to apply for programmes such as the NHS Innovation Accelerator and NHS England’s Innovation and Technology Payment.

"The NHS Innovation Accelerator (NIA) has been invaluable - the support and guidance from the NIA team, the support and learning from peers, and no longer being on the innovation journey alone. I cannot thank the team enough."
Amy Manning, Managing Director, S12 Solutions
Overview

The current paper-based method of organising a Mental Health Act (MHA) assessing team routinely delays assessments because there is no easy way for Approved Mental Health Professionals (AMHPs) to identify local, available section 12 (s.12).

The S12 Solutions app and website, developed by an AMHP, connects AMHPs with s.12 doctors, making MHA assessment set-up and claim form processes quicker, easier and more secure. S12 Solutions helps to reduce assessment delays caused by the current paper-based assessment set-up process, reducing the risk of unlawful detention. Service users are assessed sooner by the best available team, minimising potential distress and risk. S12 Solutions also gives doctors better control over their s.12 work.

The company has been adopted and scaled rapidly over the past three years in England.

S12 Solutions currently supports 4,000 users and is working with 70% of England. The average STP can expect annual financial savings from using the S12 Solutions platform to be in excess of £200,000 per annum from cost savings for services in terms of saving AMHP assessment and data entry time, administrator time, and police and place of safety resources.

The cross-AHSN and NHS Innovation Accelerator (NIA) support, training and evaluation received by the company has supported this growth and adoption of the innovation.

Challenge / problem identified

Before a person can be lawfully held under the MHA, an assessing team comprised of an Approved Mental Health Professional (AMHP) and two doctors (a registered medical practitioner and a section 12 approved doctor), must agree that detaining the person in hospital is the best way to provide their care and detained under the MHA to receive treatment for a mental health disorder.

The problem is that assessment organisation, and the process doctors use to claim payment for attending assessments in some cases, are completed using paper-based processes. AMHPs often use paper lists of doctor’s details to arrange assessment, which are not necessarily up to date or accurate. Adding to this, AMHPs may not have full access to the entire s.12 doctor network, relying instead on a small number of known doctors to contact. The paper claim form process can lead to absent, duplicate or slow payments and there are many types of form, which are not necessarily GDPR compliant.

As such, assessments are routinely delayed, leaving patients waiting potentially distressed and at risk, assessment preparation time for AMHPs is reduced, and emergency services, A&E and secure transport provider resources are obstructed during delays. For the services users this may increase anxiety, agitation and risk.

Currently, doctor approval status is not routinely checked – AMHPs and doctors may unintentionally breach human rights by unknowingly arranging unlawful detentions. Claim payments can be slow or absent, which deters doctors from undertaking s.12 work – there is little standardisation or governance supporting these processes, which can be equally difficult for administrators. These factors make services vulnerable to time-consuming, difficult and costly legal challenges and compensation claims. Inconsistent or absent data capture and reporting about this area of mental health practice makes it difficult to spot opportunities for improvement.

Amy Manning, AMHP and S12 Solutions’ founder, has developed an app and website that connects AMHPs with s.12 doctors. AMHPs can also search for doctors by criteria such as languages and specialisms. The platform facilitates a standardised, GDPR compliant claim form process, which allows AMHPs and s.12 doctors to create then submit forms to the right organisation for payment, all within the platform.

How is the AHSN involved?

S12 Solutions has grown significantly over the past year with support from many AHSNs. Specific support included:

  • Attendance at Wessex AHSN’s four-day Health Innovation Programme start-up course to develop their value proposition.
  • In 2018, both South West AHSN and the Health Innovation Network (HIN) provided an insight surgery and innovation clinic involving identifying the value proposition and advice on potential next steps along the Innovation Pathway.
  • HIN and Wessex AHSN supported S12’s preparation for their successful NHS Innovation Accelerator (NIA) and Innovation and Technology Payment (ITP) applications.
  • Kent, Surrey and Sussex AHSN have been acting as a ‘critical friend’ to S12 Solutions and supporting them with articulating their value proposition in a meaningful way to show the problem they are addressing, why and the impact of the product.
  • Both Yorkshire and Humber AHSN and HIN provided pitching opportunities for S12 solutions at their mental health digital events leading to several contract conversations. In South London the solution has been adopted by all three mental health trusts.
  • The founder of S12 solutions was successfully accepted onto the NHS Innovation Accelerator for their 2019 fellowship.
  • The company has gained traction of spread and the selection through the ITP programme with a key factor being the intensive support from South West AHSN, the lead AHSN for this ITP solution.
Impacts / outcomes of AHSN involvement to date

In 2019, the South West AHSN led, on behalf of the AHSN Network’s, the unified support for the implementation of S12 Solutions as part of the Evidence Generation Fund (EGF) subcategory of the NHS E/I led Innovation and Technology Payment (ITP) programme. NHS England are funding a total of 15 EGF sites across England.

To support conversations, the South West AHSN ran a Spread Workshop for AMHPs and commissioners as well as relevant AHSN leads and included learning from Wessex AHSN’s separate evaluation and involvement with the company.

To meet the key metrics of EGF South West AHSN developed and implemented a process to produce baseline data, which will allow any service improvement via S12 Solutions usage to be measured with input from Approved Mental Health Professionals (AMHP) to ensure added value. The South West AHSN is leading the real world evaluation of the six pilot sites under the EGF.

There is evidence that, in these areas, S12 Solutions has:

  • Created 11 new jobs and leveraged approximately £500,000 investment
  • Secured new contracts – increase in take up from three CCGs contracts to 62 CCGs signing contracts (32% of total CCGs) and 89 (46%) of the 192 have agreed to take contract but are going through sign-off.
Plans / timescales for adoption and spread

The ITP’s Generation Evidence Fund has been extended until September 2020, South West AHSN are leading the working group to share learning across the AHSN Network on S12 Solutions both in relation to ITP EGF, and through separate support for the company. Wessex AHSN are currently undertaking an independent evaluation of the innovation for Hampshire and Isle of Wight STP, due for publication in the summer of 2020.

Opportunities to get involved

S12 Solutions is seeking interested CCGs and mental health trusts who would like to use the platform for their mental health services.

Start and end dates

January 2018 ongoing.

Contacts

Project contact for further information

Lesley Soden, Programme Director – Innovation, Health Innovation Network

Lesley.soden@nhs.net

Media contact for further information

Hin.communications@nhs.net