75% of children attending for healthcare procedures experience significant anxiety. This leads to worse patient experiences (e.g. use of restraint, post-anaesthetic emergence delirium) and mental and physical outcomes (e.g. increased reporting of post-operative pain and behavioural disorders including bed-wetting, separation anxiety and nightmares). Peri-procedural anxiety also results in adverse financial implications for the NHS, such as increased pre-medication use (£22 per benzodiazepine dose), unplanned admissions (approximately £1900 per patient) and on-the-day cancellations (approximately £1200 per patient).
Little Journey is a digital eSupport platform designed to reduce peri-procedural anxiety in children. It consists of a patient-facing smartphone app and a hospital-accessed web portal. The app delivers engaging and interactive content tailored to the age of child, procedure type and local hospital. This includes virtual tours, explaining what will happen and who they will meet in hospital, relaxation animations aiding development of positive coping strategies and therapeutic/distraction games. A parent section includes information articles (delivered at specifics times according to date of procedure), checklists, hospital contact details and fasting guidelines. The web portal enables hospitals to customise content to local patient pathways and policies, ensuring the provision of up-to-date and relevant information.
Little Journey is currently configured to over 50 NHS organisations; the app has had over 37,000 historic users to date (97% satisfaction rating on the app store). Early trials indicate approximately 30% reduction in anxiety plus improved quality of life through return to normal function post-surgery (1.74% Quality Adjusted Life Year improvement). In 2019, an independent health economic evaluation of an early version, supporting children undergoing elective operations, demonstrated cost benefit evidence of £3.50 for every £1 invested plus a further £6 in social benefits. This was achieved through 30% faster recovery times and a 42% reduction in on-the-day cancellations. The analysis modeled that introduction of Little Journey to 145 (50%) NHS hospitals in England would lead to approximately £12million cost benefit to healthcare and society.