Over the past year, the National Institute for Health and Care Research (NIHR) has supported the next stage of Melo’s development through the NIHR i4i FAST programme.
The project aim was to explore how Melo (originally piloted in a single clinical environment) could scale to support clinicians working with individuals with Acquired Brain Injury (ABI) across a variety of services and organisations. Twelve months later, the project has helped move Melo from an early-stage innovation toward a platform designed for real-world clinical adoption at scale.
The challenge: understanding complex behaviours
People living with acquired brain injury often experience complex behavioural changes such as agitation, aggression, impulsivity and emotional dysregulation.
Clinicians rely on structured tools like ABC charts, ABS and OAS-MNR to understand these behaviours and guide interventions. However, in many services these assessments are still recorded on paper or across multiple systems, making it difficult to identify patterns and coordinate care effectively.
Melo was developed to address this challenge by enabling clinicians to capture, analyse and share behavioural assessment data digitally in real time.
The project focus:
The NIHR FAST project focused on three key areas to prepare Melo for wider adoption.
Scaling across ABI services Working with clinicians across the brain injury pathway helped shape a more flexible platform capable of supporting neurorehabilitation wards, specialist brain injury units and multidisciplinary teams.
Strengthening governance and safety The project strengthened several important foundations for NHS adoption, including updated DCB0129 clinical safety documentation, continued Clinical Safety Officer oversight and reinforced DTAC compliance processes.
Shaping the platform with lived experience In collaboration with the NIHR Brain Injury HealthTech Research Centre, a Patient and Public Involvement (PPIE) workshop brought together ABI survivors and family carers to share perspectives on how behavioural data should be captured, used and communicated.
What comes next?
With the project complete, the focus now shifts from development to expanding adoption across healthcare services.
By working with clinicians, researchers and people with lived experience, we are building the clinical and operational evidence needed to support wider implementation.
Our goal is simple: to help clinicians make earlier sense of complex patient behaviours and support better care for people living with acquired brain injury.
We are extremely grateful to NIHR and the i4i FAST programme for supporting this work.
Innovation in healthcare rarely happens in isolation. It requires collaboration between clinicians, researchers, patients and technology teams.
This project has been a powerful example of what can happen when those groups work together. And we’re only just getting started!
What happens to behavioural assessments once they’re completed?
SDSade Demehin5 min read
A co-design workshop with the clinical team at Elysium’s Moorlands Neurological Centre, November 2023.
In specialist neurorehabilitation, recording behaviour is an essential part of care. But making sense of those records across shifts, staff and weeks can be surprisingly difficult.
On a neurorehabilitation ward, an episode of behaviour that challenges might be recorded in minutes. Understanding what that episode means alongside everything else the team has observed can take considerably longer.
By the time a clinical psychologist prepares for an MDT review, there may be dozens of assessments to examine. Each contains useful information, but the clinician still needs to establish how often particular behaviours have occurred, whether their severity has changed and what circumstances might be contributing to them.
In services relying on paper-based assessments, much of that work happens manually. Forms need to be checked, information compiled and charts prepared before the team can begin discussing what the records show.
It’s an important part of clinical practice, but it can also be enormously time-consuming.
Four questions worth asking about your service
Tap a question to see how Melo helps.
0 of 4 opened
Staff record assessments digitally at the point of care, and Melo brings the entries together in charts. Clinicians can review changes in frequency and severity without compiling each assessment by hand.
Nurses, support workers, psychologists and therapists look at one shared record. That makes it easier to see where observations agree, where questions remain and what deserves a closer look.
Specialist neurorehabilitation teams use established assessment tools to document behaviour consistently. The Overt Aggression Scale – Modified for Neurorehabilitation (OAS-MNR), for example, provides a structured approach to recording aggression after brain injury. Other tools, including the St Andrew’s Sexual Behaviour Assessment (SASBA), help clinicians assess different types of behaviour that challenges.
These assessments provide valuable information about a person’s presentation and needs. Their usefulness depends partly on what happens once staff have completed them.
Consider the questions a team might need to answer during a care review.
Has the frequency of physical aggression changed over the past month? Are incidents becoming less severe? Do particular behaviours occur more often during certain activities? Are there periods when the person appears consistently more settled?
Answering these questions means examining multiple records together.
Four review questions, one record
Pick a question to see how the same entries answer it.
Shows what a team can examine. It doesn’t explain why a pattern exists.Illustrative data
When assessments are held on paper or across separate documents, staff may need to transfer information into spreadsheets, calculate totals and prepare graphs themselves. The process takes time, particularly when assessments are completed frequently or a service supports several people with complex behavioural needs.
Paper OAS-MNR and SASBA forms. Each one is useful on its own; the pattern only appears when they are read together.
It also creates a practical difficulty: the information available at a review may depend on how recently someone has had time to process it.
Why timely access matters
Behaviour after acquired brain injury can fluctuate. A person may experience periods of agitation or aggression alongside times when they are comfortable, engaged and responding well to support.
Individual records provide important detail about these events. Looking across several days or weeks helps clinicians consider whether they reflect a broader pattern.
Take an increase in recorded aggression. A clinician reviewing the data might want to examine when incidents occurred, how severe they were and what was happening beforehand.
They would also need to consider whether the apparent increase reflects a change in behaviour or simply more consistent recording.
That distinction is important. Behavioural data needs clinical context, and even a well-documented pattern does not establish its cause.
Having the records readily available allows clinicians to spend more of their time examining these questions and less time preparing the information needed to answer them.
Making established assessments easier to use
Digital recording offers a practical way to reduce the manual work associated with behavioural assessments.
For clinical teams, the important consideration is whether a system supports the assessments and working practices they already rely on.
Melo supports established tools, including the OAS-MNR and SASBA, alongside other structured behavioural observations. Staff record information digitally at the point of care, and the entries are brought together in charts that clinicians can review over time.
Instruments includeOAS-MNRSASBAABCABS
This makes it easier to examine changes in the frequency and severity of recorded behaviours without manually compiling each assessment.
The same information can also be accessed by other members of the care team, supporting discussions across shifts and disciplines.
For psychologists, this can reduce the preparation involved in reviewing behavioural records. For nursing and support staff, it means their observations are available to contribute to the wider clinical picture.
The underlying clinical work remains the same. Staff still need to observe carefully, complete assessments accurately and use their professional judgement when interpreting what the information shows.
See Melo with sample data
Record an assessment and see how it shows up in the charts.
Nurses and support workers often spend the most time observing and recording behaviour during everyday care. Psychologists, therapists and other clinicians bring different expertise to understanding those observations and considering appropriate support.
Filmed with the clinical team at Elysium’s Moorlands Neurological Centre, when they were using Melo. Professor Nick Alderman, who appears in the film, has since joined Melo as clinical lead.
Bringing that information together helps the MDT work with a more consistent record.
It also makes it easier to review aspects of someone’s experience that might otherwise receive less attention.
Periods of settled behaviour, positive interactions and participation in activities can be just as relevant to understanding someone’s progress as incidents of aggression or distress.
A record focused heavily on incidents may provide an incomplete impression of a person’s day. Reviewing behavioural patterns alongside other observations gives clinicians more context when discussing their needs.
This is particularly relevant in neurorehabilitation, where progress can be gradual and changes in behaviour are not always straightforward.
A shared record won’t resolve every uncertainty. It can, however, help clinicians identify where their observations agree, where questions remain and what deserves closer examination.
Getting more value from the information teams already collect
For services considering how to improve behavioural assessment, it is worth looking closely at the work involved after an observation has been recorded.
How much time goes into compiling assessments for clinical review? Can staff readily see changes across shifts? Are positive and settled periods documented alongside incidents? And how easily can the MDT examine the evidence together?
The answers can reveal opportunities to improve the process without changing the established clinical assessments themselves.
After all, the purpose of collecting behavioural information is to support an informed understanding of the person receiving care.
The easier that information is to access, examine and discuss, the more useful it becomes to the clinicians responsible for interpreting it.
Make assessments easier to review
See how structured assessments come together for the whole team.
An incident report doesn’t give the MDT the whole picture
SDSade Demehin5 min read
Recording a behavioural assessment at the bedside.
On a busy neurorehabilitation ward, behavioural incidents may be documented without a corresponding structured assessment. What does that mean for the clinicians trying to understand what’s happening?
When a patient becomes distressed or aggressive during care, staff have immediate priorities. They need to keep everyone safe, respond to the person’s needs and document what happened.
The event might be recorded in clinical notes, discussed at handover or entered into an incident reporting system.
But when the MDT meets to review that person’s behaviour, the information available may not answer the questions clinicians need to ask.
Was there a recognisable trigger? Has the behaviour occurred before? Is it becoming more frequent? What happened afterwards, and how did the person respond?
An incident report may contain some of these details. It won’t necessarily provide the consistent information needed to examine behaviour over time.
For people recovering from an acquired brain injury, where behavioural changes can be complex and fluctuate throughout their rehabilitation, those gaps matter.
What can the MDT answer?
Switch between the two records to see which questions each one is built to answer.
Not every incident needs an ABC chart. This compares what each record is designed to capture.
On this page
Why incident reporting isn’t enough
Incident reporting and behavioural assessment have different purposes.
An incident report documents an event, particularly where there are concerns about safety, harm or risk. Structured behavioural assessments help clinicians build a more detailed understanding of a person’s presentation.
Antecedent, Behaviour and Consequence (ABC) charts record what happened before a behaviour, the behaviour itself and what followed. The Agitated Behaviour Scale (ABS) provides a standardised way to assess agitation following brain injury.
Both can contribute important information to clinical review.
Yet completing these assessments consistently can be difficult in practice. Staff are already balancing direct patient care, clinical documentation, handovers and numerous other responsibilities.
Behaviour may be discussed during a shift without a structured assessment being completed. An incident could be documented in detail, but the information may not be organised in a way that allows the MDT to compare it with previous observations.
Not every incident requires an ABC chart, of course. The concern is whether the team is collecting enough relevant information to understand the behaviours affecting a person’s care.
What happens when that information is missing?
An early evaluation of Melo in inpatient neurorehabilitation highlighted this challenge.
A review of historical ward records found that adverse incidents had been documented, but structured behavioural assessments were relatively limited.
Researchers also surveyed MDT members about their experience of preparing for and discussing behaviour that challenges. Some reported feeling inadequately prepared, with time lost during meetings because relevant information was unavailable.
What the early evaluation found
Two inpatient neurorehabilitation wards, 2023 to 2024.
ABS charts
Before, on paper (6 months)0
During the pilot (7 months)261
ABC charts
Before, on paper (6 months)9
During the pilot (7 months)51
In the six months before the pilot, 13 adverse incidents were documented on the wards, alongside 9 ABC charts and no ABS charts.
5 of 10 MDT members surveyed did not feel well prepared for meetings about behaviour that challenges.
9 of 10 lost at least 5 minutes per meeting because information about the behaviour was missing.
A research assistant joined during the pilot and working practices changed, so the rise in assessments can’t be put down to Melo alone. The survey is small (10 people, July 2023).
Source: Melo pilot on two neurorehabilitation wards at Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, August 2023 to February 2024. Read the evaluation report
The findings came from a small evaluation, but the underlying problem is recognisable.
Clinicians may be familiar with someone’s behaviour through day-to-day experience, yet lack a consistent record of how that behaviour has changed. Different team members may have observed different things, with no straightforward way to compare their accounts.
That makes it harder to examine whether a particular approach is helping, identify areas that need further assessment or explain the evidence behind a proposed care plan.
Are teams recording the behaviours that matter?
One of the more interesting findings from Melo’s early evaluation concerned how staff understood behaviour that challenges.
As clinicians discussed and documented behaviours more frequently, they reported becoming more aware of what should be considered relevant.
Aggression may be an obvious concern, but other behaviours can have significant implications for care. Pulling at medical equipment, repeatedly refusing essential care or becoming distressed during routine activities may all warrant closer assessment.
Less severe episodes can also be important when they occur repeatedly or suggest a change in someone’s presentation.
The evaluation found that greater discussion of behaviour, alongside the use of structured assessment tools, encouraged staff to consider these details more carefully.
This raises a useful question for ward teams:
Are staff clear about which behaviours need documenting, or does structured recording happen mainly when an incident is serious enough to escalate?
Agreeing what to record, and why, is an important part of making behavioural assessments more consistent.
Making behavioural recording part of everyday care
Asking staff to complete more assessments is unlikely to help if the process adds significantly to their workload.
The recording process needs to be practical, with clear expectations about who completes assessments and when.
This was an important consideration during Melo’s early development and evaluation.
Discovery workshops with clinicians from Salford Royal Hospital’s neurorehabilitation wards, 2022 to 2023.
Melo supports digital ABC charts and ABS assessments, allowing staff to record structured observations and make them available for clinical review. The information can be examined through charts, helping clinicians assess frequency, severity and changes over time.
During the historical evaluation, the number of structured assessments recorded increased considerably. However, the project also involved dedicated research support and changes to working practices, so the increase cannot be attributed to Melo alone.
That distinction is useful for any service considering digital behavioural recording.
Technology can make assessments easier to complete and review. It still needs to be introduced alongside appropriate training, clinical leadership and agreement about how the information will be used.
Staff need to understand the value of recording behaviours consistently, and they need to see that their observations contribute to clinical discussions.
See how Melo records ABC and ABS assessments
Structured observations from the ward, ready for the MDT to review.
A behavioural record becomes particularly valuable when clinicians can examine observations made by different staff members over time.
Rather than relying principally on recollections or isolated reports, the MDT can review recorded patterns, consider the circumstances surrounding behaviours and identify questions requiring further investigation.
That information may support discussions about behavioural support plans, therapeutic activities and the level of assistance a person needs.
It can also help staff recognise periods when someone is settled or engaging positively with their care, providing context alongside episodes of distress or agitation.
None of this removes the need for clinical interpretation. A pattern does not necessarily explain why a behaviour occurs, and a change in recording frequency can affect what the data appears to show.
What matters is having sufficiently consistent information for clinicians to examine those possibilities.
Is your ward collecting the information it needs?
For ward managers and clinical leads, improving behavioural recording starts with a few practical questions.
Which behaviours are staff expected to assess? Is there a consistent approach across shifts? Can staff complete assessments without unnecessary duplication? And when the MDT meets, is the recorded information detailed enough to support a meaningful discussion?
If the answers are unclear, introducing a new recording system will only address part of the problem.
Clear expectations, manageable processes and regular feedback to staff are equally important.
Because when a clinical team is trying to understand someone’s behaviour, the quality of the discussion depends in part on what has been recorded.
Give your MDT something meaningful to review
See how Melo supports structured behavioural observations and helps teams review patterns over time.
CareTech has made a strategic investment in Melo, alongside follow-on investment from PXN Ventures and matched funding from Innovate UK. The funding will support Melo’s continued development, validation and growth.
CareTech has made a strategic investment in Decently, the company behind Melo.
PXN Ventures has also made a follow-on investment through the GMC Life Sciences Fund. Together, the two investments helped secure matched funding through Innovate UK’s Investor Partnerships programme.
The funding will support the next stage of Melo’s development, validation and growth, helping more clinical teams make better use of behavioural information in everyday care.
On this page
Why behavioural information is hard to use
Clinical teams already record a significant amount of information about behaviour, across observation charts, clinical notes and electronic records.
The problem is often what happens next.
When observations are recorded inconsistently or without enough structure, it becomes difficult to compare what is happening across shifts, recognise patterns and triggers, or show whether a change in care is making a difference.
Decisions about observation levels, care planning and discharge can then end up relying heavily on the most recent handover rather than the fuller picture over time.
The latest handover, or the fuller picture
Switch views to see what one handover tells the team, and what four weeks of records show.
Care plan changed
Wk 1Wk 2Wk 3Wk 4
Episodes recorded each day for one person. Shows what a team can see, not why it happened.Illustrative data
Melo gives teams a structured way to record behavioural observations at the point of care and bring that information together over time, so clinicians can see patterns and use them alongside their own judgement and multidisciplinary discussion.
Behaviour over time in Melo.
See how Melo brings observations together
Structured observations from the point of care, reviewed as a pattern over time.
Melo has been evaluated across four separate care settings. The findings below come from service evaluations, workflow modelling and staff feedback within those settings.
Four findings, four kinds of evidence
Pick a finding to see what was measured, where, and how far it goes.
Modelled
84% less
time per standard behavioural assessment
On paper11 min 8 s
Using Melo1 min 46 s
At around 384 assessments a week, that equated to roughly 59 hours of staff time released each week.
SettingOne high-volume specialist neuro service. Workflow modelling, January 2025.
How far it goesModelled from the service’s own assessment volumes, not timed over a period of use.
Observed
57% to 100%
documentation accuracy within fifteen days of going live
Days 1 to 357%
Days 11 to 15100%
A year later, 90% of staff were still actively using Melo.
SettingA specialist neurorehabilitation hospital. Implementation study and one-year follow-up.
How far it goesOne hospital. Accuracy was audited during the first fifteen days; active use comes from platform data.
Self-reported
78%
of staff rated Melo much faster than their existing electronic record for recording behaviour
Much faster78%
Slower0%
None rated Melo slower than the electronic patient record (EPR) they already used.
SettingThe same specialist neurorehabilitation hospital. Initial efficiency trial, November 2024.
How far it goesStaff ratings, not a timed comparison, from a single hospital.
Observed, one ward
43% lower
night-time bank spend associated with enhanced observations
Before100
After57
Spend shown as an index, with before set at 100. The team used Melo to review behavioural risk more promptly.
SettingOne NHS acute ward.
How far it goesA single ward. Other changes on the ward may also have played a part.
These results come from specific settings, and some are based on staff feedback, so they won’t apply in the same way everywhere. We describe the benefits as staff time released and reduced reliance on enhanced observations, not as cash savings.
The investment will support further development and validation of Melo as its use grows across NHS and independent care.
Melo is currently used across acute NHS wards, specialist neurorehabilitation hospitals and independent complex care services, supporting people living with dementia, acquired brain injury, neuro-disability and behaviours that challenge.
As part of the partnership, CareTech Business Development Director Zak Sheikh has also joined the Decently Board.
“Our decision to invest in Decently was driven by what we saw in Melo itself. The platform is already demonstrating measurable benefits for clinical teams through improved efficiency, stronger documentation and better visibility of behavioural information.”
Haroon Sheikh and Farouq SheikhGroup CEO and Group Executive Chairman, CareTech
“Information that helps teams understand complex behaviour is recorded inconsistently, lacks structure, and is rarely turned into meaningful action. Melo enables frontline teams to capture clinically meaningful observations of challenging and positive behaviours at the point of care, using gold-standard measures, and translate them into clear, actionable insight the whole team can act on.”
“CareTech’s investment will help us accelerate this mission: empowering more teams to deliver evidence-led, person-centred support and advancing our ambition to reach 10 million patients, families and clinicians worldwide over the next decade.”
James BurchCo-founder, Decently
What happens next
We’re building Melo for the whole sector, across NHS trusts and independent providers.
The funding gives us more capacity to develop and validate the product as we work with clinical teams in different care settings. We’ll share more of that work, and the evidence behind it, as it develops.
If you already use Melo and have questions about what the investment means for your service, speak to your usual Melo contact.
See where Melo could fit in your service
How teams record observations at the point of care and review the pattern together.
Melo presents at NR-SIG-WFNR and INS 2026 with the Royal Hospital for Neuro-disability
SDSade Demehin4 min read
James Chapman presenting the RHN service evaluation at NR-SIG-WFNR in Belfast, July 2026.
Our co-founders, James Burch and James Chapman, and Dr Natali Farran of the Royal Hospital for Neuro-disability took a one-year service evaluation of Melo to NR-SIG-WFNR in Belfast and INS 2026 in Dublin.
Two conferences, one evaluation
Pick a conference to see where, when and what was presented.
ConferenceNR-SIG-WFNR, 23rd conference
When and where19 and 20 July 2026, Hilton Belfast
FormatTwo datablitz sessions
From Data Burden to Clinical Insight: A One-Year Service Evaluation of Melo in Specialist NeurorehabilitationPresented by James Chapman, Melo co-founder
Service Development in Practice: Successfully Implementing Melo in a Specialist Neuro-behavioural Inpatient ServicePresented by Dr Natali Farran, Clinical Psychologist, RHN
ConferenceInternational Neuropsychological Society 2026 Mid-Year Meeting
When and where22 to 24 July 2026, Trinity Business School, Dublin
FormatBoth pieces of work as posters
From Data Burden to Clinical InsightPoster, presented by James Burch and Dr Natali Farran
Service Development in PracticePoster, presented by James Burch and Dr Natali Farran
From Data Burden to Clinical Insight: A One-Year Service Evaluation of Melo in Specialist Neurorehabilitation, presented by our co-founder James Chapman.
Service Development in Practice: Successfully Implementing Melo in a Specialist Neuro-behavioural Inpatient Service, presented by Dr Natali Farran, Clinical Psychologist at RHN.
RHN’s neuro-behavioural team (Goodman House) has been using Melo since early 2025 and has now completed more than 5,000 assessments digitally.
The International Neuropsychological Society brought its 2026 Mid-Year Meeting to Trinity Business School in Dublin, from 22 to 24 July. Co-founder James Burch and Dr Farran presented both pieces of work as posters on the Friday afternoon.
Dr Natali Farran, Clinical Psychologist at the Royal Hospital for Neuro-disability, with Melo co-founder James Burch at INS 2026 in Dublin.
Working with the Royal Hospital for Neuro-disability
Both posters carry RHN’s name alongside ours. Dr Farran and her colleagues implemented Melo on Wellesley Ward, RHN’s specialist neuro-behavioural inpatient service, and then evaluated it over a year.
On that ward, clinicians regularly have to evidence the need for 1:1 support to the Integrated Care Board, and those decisions determine whether funding continues. Ward managers used Melo’s behavioural charts to support one of those cases for the first time this year.
“Melo is such an important, useful and exciting development in the world of managing behaviour that challenges. Melo is a straightforward and clear app to track behaviour that challenges after brain injury. This will help us improve the data collection and how we utilise the data on our wards.”
Dr Alex RoseConsultant Clinical Psychologist and Neurobehavioural Programme Lead, RHN
Open the poster full size →Poster: From Data Burden to Clinical Insight, a one-year service evaluation of Melo in specialist neurorehabilitation.
Missed us in Belfast or Dublin?
Here’s the short version. Melo puts behavioural observations and assessments like the OAS-MNR and SASBA in one place, so the whole ward sees patterns early.
See what that looks like on your own ward
Start with the assessments your team already runs, the OAS-MNR and SASBA included.
Melo awarded funding through STFC’s NHS Fit for the Future Missions R&D Accelerator, in partnership with University Hospitals of Liverpool Group
MMelo team3 min read
R&D Missions Accelerator Programme
NHS Fit for the Future
University Hospitals of Liverpool GroupScience and Technology Facilities CouncilMelo
We’re incredibly proud to share that our work with NHS University Hospitals of Liverpool Group (UHLG) has been awarded funding through the STFC NHS Fit for the Future Missions R&D Accelerator.
On this page
What the funding supports
The accelerator is part of the wider UKRI NHS Fit for the Future R&D Missions Dementia Programme, and the UK’s national drive to transform dementia diagnosis, care and outcomes through:
Improving early detection and ongoing understanding of dementia
Accelerating adoption of proven innovations across the NHS
Ensuring patients receive faster, more personalised care
Together with UHLG and partners, this project will enable us to expand real-world evaluation, strengthen the evidence base for behavioural-led care in dementia settings, and support wider NHS adoption.
Our work with NHS UHLG
Over the past year, we’ve partnered closely with clinical teams across UHLG to embed Melo across 13 wards spanning Aintree, Royal Liverpool and Broadgreen hospitals, supporting teams to better understand and respond to patient behaviours.
13wards across Aintree, Royal Liverpool and Broadgreen
Traditional ABC (Antecedent, Behaviour, Consequence) frameworks are widely used in practice to capture complex behaviours. ABC+ builds on this foundation, inspired by approaches like Dementia Care Mapping (DCM), to broaden the focus beyond complex behaviour and provide a more holistic picture of the patient experience.
What each record captures
Switch between a traditional ABC chart and ABC+ to see what it adds.
AAntecedentWhat happened before the behaviour.
BBehaviourWhat the behaviour was.
CConsequenceWhat followed it.
+Positive behavioursWhat’s going well and should be reinforced.
+Sleep insightsA critical but often overlooked driver of behaviour.
+Context-rich observationsEnabling deeper, more meaningful analysis.
ABC+ is inspired by approaches like Dementia Care Mapping (DCM).
This shift aligns closely with the principles of person-centred care, helping teams move beyond observation alone, towards understanding, insight and proactive care, while recognising that behaviour is often a form of communication.
This milestone reflects true collaboration, between clinicians, innovators and healthcare systems.
Thank you to everyone across UKRI/STFC and UHLG for making this possible. We’re looking forward to continuing our work and progressing with the project together.
See how Melo records ABC charts and more
Structured observations from the ward, reviewed as a pattern over time.
How NIHR helped advance Melo for acquired brain injury services
MMelo team3 min read
Over the past year, the National Institute for Health and Care Research (NIHR) has supported the next stage of Melo’s development through the NIHR i4i FAST programme.
The project aim was to explore how Melo (originally piloted in a single clinical environment) could scale to support clinicians working with individuals with acquired brain injury (ABI) across a variety of services and organisations. Twelve months later, the project has helped move Melo from an early-stage innovation toward a platform designed for real-world clinical adoption at scale.
On this page
The challenge of understanding complex behaviours
People living with acquired brain injury often experience complex behavioural changes such as agitation, aggression, impulsivity and emotional dysregulation.
Clinicians rely on structured tools like ABC charts, ABS and OAS-MNR to understand these behaviours and guide interventions. However, in many services these assessments are still recorded on paper or across multiple systems, making it difficult to identify patterns and coordinate care effectively.
Melo was developed to address this challenge by enabling clinicians to capture, analyse and share behavioural assessment data digitally in real time.
See how Melo records ABC, ABS and OAS-MNR assessments
Structured assessments captured digitally and shared with the whole team.
The NIHR FAST project focused on three key areas to prepare Melo for wider adoption.
Three areas of work
Pick one to read what the project did.
Working with clinicians across the brain injury pathway helped shape a more flexible platform capable of supporting neurorehabilitation wards, specialist brain injury units and multidisciplinary teams.
Neurorehabilitation wardsSpecialist brain injury unitsMultidisciplinary teams
The project strengthened several important foundations for NHS adoption, including updated DCB0129 clinical safety documentation, continued Clinical Safety Officer oversight and reinforced DTAC compliance processes.
DCB0129Clinical Safety OfficerDTAC
In collaboration with the NIHR Brain Injury HealthTech Research Centre, a Patient and Public Involvement (PPIE) workshop brought together ABI survivors and family carers to share perspectives on how behavioural data should be captured, used and communicated.
ABI survivorsFamily carersNIHR Brain Injury HealthTech Research Centre
What comes next?
With the project complete, the focus now shifts from development to expanding adoption across healthcare services.
By working with clinicians, researchers and people with lived experience, we are building the clinical and operational evidence needed to support wider implementation.
Our goal is simple: to help clinicians understand complex patient behaviours sooner and support better care for people living with acquired brain injury.
We are extremely grateful to NIHR and the i4i FAST programme for supporting this work.
Innovation in healthcare rarely happens in isolation. It requires collaboration between clinicians, researchers, patients and technology teams.
This project has been a powerful example of what can happen when those groups work together. And we’re only just getting started!
See where Melo fits in an ABI service
How teams record, review and share behavioural assessments.
