An online remote behavioural intervention for tics (ORBIT), from the University of Nottingham, funded by the National Institute for Health and Care Research (NIHR) Invention for Innovation (i4i) is ready to be rolled out across NHS England, following its conditional recommendation by the National Institute for Health and Care Excellence (NICE). Allowing young people aged 9 to 17 diagnosed with tics and Tourette syndrome access to effective evidence-based treatment through NHS care.
The ORBIT programme, co-led by Dr Charlotte Hall, Principal Research Fellow and Kelly-Marie Prentice, Project and Implementation Senior Manager for ORBIT, represents a major collaboration between University of Nottingham, Nottinghamshire Healthcare NHS Foundation Trust, Great Ormond Street Hospital for Children NHS Foundation Trust, Health Innovation East Midlands, Centre for Healthcare Equipment & Technology Adoption (CHEATA) and Blüm Health Ltd.
Together, the partners have transformed an evidence-based tic therapy and psychoeducation tool into a patient ready digital intervention. The first phase of implementation will launch across five NHS sites: Nottinghamshire Healthcare NHS Foundation Trust, North East London NHS Foundation Trust, Leicestershire Partnership NHS Trust, Lincolnshire Integrated Care Board (ICB), and NHS Norfolk and Suffolk ICB, with an ambition to expand nationally.
ORBIT which is based on a specialist form of cognitive behavioural therapy known as exposure and response prevention (ERP) focuses on teaching the user techniques on how to control their tics. The online intervention platform consists of 10 chapters that a young person and their parent or guardian log on to complete, supported remotely by a therapist through regular messages and feedback.
Blüm Health who developed the digital platform for ORBIT, worked closely with the project patient and public involvement group to ensure the platform is fit for purpose and user friendly. Blüm’s Co-founder, Dr Michael Watts said “by combining world-class academic research with Blüm’s cutting-edge AI and software expertise, we’re now ready to explore the implementation of ORBIT into NHS England. This collaboration continues to be a powerful example of how knowledge sharing and joint capabilities can drive meaningful change for populations in the UK and beyond."
Tics can affect up to 20% of young people, with 1% having chronic tic disorders or Tourette syndrome. Tics are involuntary vocalisations or movements that can cause physical pain, stigma and low self-esteem, leading to social isolation and poor educational achievement. Behavioural therapy is usually recommended as a first line intervention, but only 1 in 5 children and adolescents with tic disorders can access behavioural therapy due to a shortage of trained therapists. By offering therapy digitally and at scale, this programme aims to remove these barriers and ensure that young people receive timely, effective support wherever they live.
Jigna, parent to a son with tics and ORBIT patient and public involvement member said, “I believe this project is crucial to improving timely access to healthcare for young people with tics, it was a gamechanger for my son and I"
In 2025, NICE guidance conditionally recommended ORBIT stating the digital tool could reduce the severity of the symptoms of chronic tic disorders and Tourette syndrome. ORBIT is currently the only digital therapy tool recommended for these conditions. Kelly-Marie Prentice explained, "with the conditional recommendation already provided by NICE, we are optimistic that this next phase of evaluation will help secure full recommendation, ensuring sustained access to care."
ORBIT is one of six innovations using digital technologies and AI to reduce NHS waiting times, speed up access to care and make services more accessible for patients, equipping NHS staff with the latest evidence-based technology. The six innovations are backed by over £8 million in government funding through NIHR.
By backing these six digital research projects, the NIHR is helping to drive the fundamental shift from an analogue to a digital health service and deliver the government’s 10-year health plan. This important investment in AI and innovation will cut NHS waiting times, fast-tracking diagnoses and ensuring patients receive more accessible, efficient, and high-quality care. Professor Lucy Chappell, Chief Scientific Adviser to the Department of Health and Social Care and CEO of the NIHR
By backing these six digital research projects, the NIHR is helping to drive the fundamental shift from an analogue to a digital health service and deliver the government’s 10-year health plan. This important investment in AI and innovation will cut NHS waiting times, fast-tracking diagnoses and ensuring patients receive more accessible, efficient, and high-quality care.
Professor Lucy Chappell, Chief Scientific Adviser to the Department of Health and Social Care and CEO of the NIHR
Minister for Digital Government, Ian Murray said: “This is how we modernise the NHS – cutting delays, giving clinicians better tools and delivering faster care for patients wherever they live.”
Rebekah Pole Clinical Studies Officer for Leicestershire Partnership NHS Trust said "We are delighted to introduce ORBIT within Leicestershire. We are incredibly excited to be able to offer our young people access to this specialised therapy, that would not otherwise be routinely available. This initiative will significantly enhance our teams’ clinical skills and represents a truly exciting and meaningful addition to the therapeutic support we can offer our patients.”
ORBIT-UK - Institute of Mental Health
Alternatively, if you would like to be contacted by the team to hear more about or get involved in research relating to the ORBIT project complete the expression of interest form
Contact Form - ORBIT (Online Remote Behavioural Intervention for Tics)
This programme is funded by NIHR i4i Transformative and Disruptive Innovations: NIHR503712. Project began in January 2026 for the duration of 3 years.