Key learnings

Time scales
While the project is on track to be completed within the predicted time frame, certain activities took longer than expected and there has been a shift in terms of when different activities have to be conducted. For example, ensuring data protection and quality of service was a top priority and led to an additional unexpected activity (such as applying for ORCHA certification) – this took longer than had we not applied. Additionally, when receiving advice from WAHSN on effective implementation and evaluation of the pilot, we realised we should customise the app to create an area-specific token system in order for us to understand a user’s journey within a specific community while keeping sensitive information anonymous (this would also help us collect more nuanced data for our analysis). Any changes to the app come with extra time and all of these small improvements led to a later roll out date for prescribing the app to patients.

Roles and boundaries
One of the project’s initial intentions was to create a triaging system which would communicate details about a patient’s case with participating trusts. This was unfeasible for a number of reasons. For one, it would involve a much more rigorous data security review, additionally, the pilot has now grown to include 12 NHS Trusts and the practicality of setting up this type of communication within each individual system would be too arduous to fit within the scope and timeline of this project. Finally, we wanted to be clear that LatchAid is not a medical device and should not be used in lieu of emergency or healthcare support; instead the app should be seen as a source of information to supplement medical support. Understanding partner roles and the boundaries of what these partnerships could entail was key in creating an achievable project plan.

Evaluation
Part of the delay to rolling out the prescription model was the need to get the evaluation and survey checkpoints agreed. We secured support from WAHSN and University of Exeter which meant this was a more comprehensive activity, but one that is truly worthwhile to help us accurately measure the project’s success.

Learnings for others 

Be open to adaptation and learning along the journey
Understanding that this is a pilot and something that has never been done, all partners have been really open to adapting areas of the project as and when needed. It is a true collaborative effort where all participating partners are learning along the way and with that comes a need for flexibility. We have also been offered different support throughout our journey, which may slow activities down slightly, but are always in the project’s best interest.

If your intention is to scale up, keep it in mind throughout
We have always hoped that with the success of this pilot, we would be able to roll out a licensing scheme whereby NHS trusts can license the LatchAid app to prescribe it for free to their new mothers. With this in mind, we have worked on meeting a higher level of data protections than required for this pilot, we have co-developed business cases for what this partnership would look like beyond the Q Exchange funding and pilot programme and have worked to build senior level buy-in across the board from the outset. If this pilot is successful, we want to ensure that level of care is available to mothers long beyond its end date.

Implementation planning is not to be overlooked
The original plan was to send flyers to healthcare professionals looking to prescribe the LatchAid app to new parents. It is important to consider the nuance of that process. For example, how are professionals made aware of the app, when exactly are they prescribing it in a mother’s journey, how do mothers sign up for free and how do we track that the app is prescribed. We have spent a great deal of time working across the project’s partners to agree to a very detailed implementation plan to ensure that those frontline professionals who are already very busy, have everything they need to effectively champion this service without hassle.

Keep the technology development process agile 
During the implementation framework development, we have pivoted from a per-user token system to a per-region token system based on the valuable feedback from the pilot partners. The additional software development takes time but is worthwhile to increase the pilot take-up rates and ease the roll-out process. This highlights the needs and benefits of the agile development process to continually communicate with end users and make sure that the technology / solutions developed are what they want and need.

What is working well

We have expanded the project from 3 NHS trusts to 12 NHS which has been encouraging in helping us understand that this service is needed and wanted.
We have a strong project team that are in regular communication and have kept things flowing smoothly.
Because of delays in rolling the prescription model out, we have had more time to input recommendations from LatchAid’s beta study, conducted in March 2021, which means quality has been further improved.
All of the implementing partners have shown the same passion for the project as the project team, which is very rewarding and encouraging.

Challenges

Summer! Because capacity is tight during the summer, we further delayed the roll out, however there are benefits to this as well (such as further app developments).
Despite the grant from Q Exchange, which has been extremely beneficial, we have needed to seek out additional funding to ensure app development could be speedy and could provide the crucial customisations.
It has been difficult to set up necessary processes to ensure smooth transition into a licensing framework post-pilot. Evidence is integral, however evidence of effectiveness won’t be available until quite late towards the end of the project. This means there will inevitably be a lag where some mothers are not given the app for free.

What are the next steps?

4 October 2021
Implementation of the prescription model where mothers are given premium versions of the LatchAid app for free.
15 November 2021
Analysis of the project’s effectiveness against local benchmarks begins.
27 December 2021
Produce mid-pilot evaluation report and a social media package for knowledge sharing.
24 January 2022
Design and conduct workshops and shared-learning events.
4 February 2022
Project implementation ends.
7 February 2022
Planning partners for deploying & scaling up LatchAid to wider NHS trusts.

How can the community get involved?

Guidance with knowledge sharing activity
Feedback on evaluation and feasibility of future similar work
Scaling up support