PHE Innovation Fund: Welcome to Brook

Brook is delighted to have secured funding through the 2020 PHE Innovation Fund to develop a new digital tool to triage young people in our waiting rooms. Below, Director of Digital & Communications, Laura Hamzic, describes how the idea behind the project was developed.

The reality is that societal stigma still limits young people’s ability to take control of their sexual health and enjoy healthy relationships. What’s more, the commissioning environment means that due to funding cuts, Brook has to turn away 15% of the young people who come to us for help.

We have long known that the length of our clinical consultations contributes to the problem of turnaways and high wait times. We ask our young clients in excess of 40 questions to ensure we can support them appropriately and identify and safeguard the most vulnerable.

In order to tackle this problem, a group of us – including frontline clinical staff – came together for a week long Product Design Sprint to develop a tool that could drive down waiting times while still providing the highest quality support to young people.

We started by creating five personas, in order to put ourselves in the shoes of the diverse spectrum of young people we see. Our clinical colleagues used their vast experience to develop their back story, their needs and behaviours in vivid detail and explained when their in-clinic experience is positive and negative. This gave us valuable insights into our users’ needs.

We also studied our consultation questions. We identified those that a young person could answer alone, before a face-to-face consultation, and worked on the wording of them to ensure they were friendly and clear.

Our idea was to create a digital assessment that would be completed by every young person sitting in a Brook waiting room, on their phone or on a Brook tablet. It would ask 25% of our existing consultation questions, protecting valuable face-to-face time for important conversations.

We opted for a digital route because staff time is so squeezed but we also felt that this would offer young people speed, privacy and a chance to prepare for the face-to-face consultation.

The results of this work were used it to build a prototype of an online assessment.

The prototype was tested with young volunteers and the feedback was overwhelmingly positive. All felt it was easy to use and understand, the questions didn’t make them feel uncomfortable and they also felt they could be more honest. We also received great feedback from staff and our commissioners in Liverpool, Manchester and Dudley – where the tool will be piloted.

This is a simple but powerful tool that will allow us to do three important things:

1. Answers given will be fed directly into that young person’s health record.

This may sound like a boring detail but integrating with clinical record systems is essential as well as challenging. Pilots of standalone digital systems taught us that if we wanted to really save staff time, this was the nut we needed to crack. Achieving this will cut down consultation time and crucially, will allow staff to focus on those trickier safeguarding conversations.

Our aim is that this tool will support a 20% decrease in consultation time and waiting times, leading to 50% fewer walk outs and will allow us to see 4000 more young people every year.

2. It will support rapid risk profiling.

Brook safeguards 3% of the young people it sees. This means we refer them to children’s safeguarding services because we believe them to be at risk – perhaps due to self-harm, suicidal thoughts or child sexual exploitation and the time it takes to manage these cases is significant.

The answers collected by our tool will help staff to prioritise the most vulnerable, high risk young people in the waiting room and reduce the chance of them walking out before being seen. The answers will also be used to flag alternative options for the lower risk clients, such as home sampling

3. It will empower young people to self-care.

The answers given will allow us to provide each young person with an automatically generated, tailored package of advice and information to read while they wait. In the short term, this will help make best use of wasted time; helping to manage frustrations, ease nerves and curb boredom. But it also has the potential to improve contraceptive decision making, increase awareness of STIs and pregnancy choices – as well as wider lifestyle factors and risk taking behaviour.

Welcome to Brook

The funds secured from the Public Health England Innovation Fund will help us to build and launch the tool by summer 2020. Our estimate is that within a year, 17,000 young people will use it and by year two, it will benefit 50,000 young people per year.

Welcome to Brook – as we’re calling the tool – is a first important step on our journey towards what we call our Digital Front Door. Our ambition is that by 2023, the young people we support will have a suite of digital alternatives to the services we provide – wherever possible.

Crucial to that will be two things: first, curating existing products that will fulfil our needs from organisations that have perfected aspects of online service provision. This might include software for video consultations or products to support remote prescribing. Second and perhaps most crucial, we need to use our decades of experience to identify and shape the ways digital can help us to deal with the complexities of supporting the very young or the vulnerable.

When a young person steps into a Brook service, we have an invaluable opportunity to support them with some of the most intimate aspects of their lives.

Our ambition is to ensure that no one is turned away and that each young person can receive the help and support they need to enjoy better sexual health and relationships.