Medipex NHS Innovation Awards 2011
Innovative staff members from the NHS across the Yorkshire and Humber and East Midlands regions were recognised on 22nd September 2011 at Medipex’s 2011 NHS Innovation Award Ceremony and Showcase and was attended by more than 200 people from across the NHS and Medical Technology industry.
Now in their 7th year, the awards have established themselves as Yorkshire’s premier healthcare networking event and are an integral part of Medipex’s work promoting innovation within the NHS, helping innovators from within the NHS to develop their ideas to improve patient care and helping medical technology companies to link in with clinical staff for collaborative product development and clinical trials. 25 clinical teams were shortlisted for the awards across the 5 categories from over 120 entries that were submitted.
This category is for innovations which relate to improvements in primary care including (but not limited to) pathway redesign, a book, a DVD, a training course, redesign of a service, a public health campaign, a new device or incorporation of a new technology into a service.
Fit Reds weight management programme
Alan Rouane, Prior Campus, Barnsley
Since October 2010, members of the Health Team have been part of a multi agency weight management project called Fit Reds. Criteria for enrolment include participants being male, aged over 35, consider themselves to be overweight and to be Barnsley residents!
The project is based at Barnsley football ground. It uses the 1st Team facilities including the indoor training facility, 1st Team Gym and dining room, which is a huge draw to getting the men to participate. The project is endorsed by Barnsley FC's longest serving player Bobby Hassell. Every Thursday evening over 8 weeks participants enjoy a mix of health advice and physical activity such as gym work & football sessions. Each week they fill in a food diary, are given feedback and weekly prizes. Up to date, the 50 men who have completed the Fit Reds course have lost a combined total of 36 stone 4lbs in weight and 93% of them have lowered their blood pressure as a direct result of Fit Reds.
Safe handling of medicines in social care
Sandra Sweeny and team, NHS North Yorkshire and York
A series of training resources and audit tools for the safe handling of medicines in social care. For a number of years, Sandra and the team have been developing training materials and audit tools for traditional ‘face to face’ medication training courses for staff in Care Homes. However, when care staff get back to the day job it is sometimes difficult to put everything learned in to practise. So they have developed refresher modules that don’t require staff to be released from the workplace and can be safely delivered ‘in house’ by managers. The modules target areas that can lead to unacceptable levels of error in the medicines received by care home residents - seven out of ten residents experience at least one medication error on any given day.
HEAR (Helping Establish Adolescent Rapport) DVD
Dick Churchill, Chilwell Meadows Surgery
Dick Churchill and his team from Chilwell Meadows Surgery has developed a HEAR (Helping Establish Adolescent Rapport) DVD. HEAR is an educational DVD for health professionals working with young people containing video excerpts of a series of GP consultations with 4 teenagers, presenting with different problems. However – and here comes the clever part - there are three versions of each consultation – one demonstrating a poor approach, the second illustrating improvement, and one highlighting good practise. Its purpose is to stimulate discussion about approaches rather than simply demonstrate a particular style. The original version of HEAR was produced with the benefit of a grant from the Teenage Pregnancy Unit and over 800 copies have been disseminated nationally. We are now looking at ‘HEAR 2’ - the sequel - looking at areas that young people and GPs find difficult such as mental health and sexual health problems.
Integrated care pathway for community-based management of non-alcoholic fatty liver disease (NAFLD)
George Abouda and team, Hull and East Yorkshire Hospitals NHS Trust
George Abouda and his team from Hull and East Yorkshire Hospitals NHS Trust have developed a new integrated care pathway for community-based management of non-alcoholic fatty liver disease (NAFLD). Approximately 25% of the UK population is believed to have Non Alcoholic Fatty Liver Disease, rising to 90% in people who are obese. Worryingly, its prevalence is rising in children. Currently all cases are referred to a liver specialist. However, only about 3% of people will develop complications requiring a referral. Usually in less serious cases it can be managed if people follow healthy lifestyles. A new blood test involving biomarkers has been developed by the team to determine whether a patient can be managed in primary care or whether they should be referred to a specialist. The new testing procedure is undergoing a clinical trial and if successful it is hoped that it will become the national standard. It will reduce unnecessary referrals, avoid unwarranted invasive tests and should result in a saving of £750 per patient.
Kathryn Taylor, ResusPod Ltd
Kathryn Taylor and Julie Burke have developed ResusPod, an emergency medicine kit and training programme aimed at dentists. The number of medical emergencies in dental practice is increasing due to a growing elderly population and it is the responsibility of all dentists to be able to manage medical emergencies. Kate has delivered training courses for dentists on the management of medical emergencies for over 15 years. In that time she recognised there was a desperate need for a comprehensive medical emergency kit incorporating all of the equipment and drugs required by the Resuscitation Council (UK); frustratingly, there didn’t seem to be anything available. Well – don’t worry there is a solution - ResusPod. Kate & colleagues have developed a complete managed solution, including easy to follow special algorithms, a training manual, very realistic training and the Pod itself containing all the emergency medical equipment anyone is ever likely to need. In order to achieve all of this in a sensible timescale Kate was advised to set up ResusPod Ltd which has been able to attract additional expertise and resources.
This category is for innovations which relate to improvements in acute and secondary care.
QIPP approach to Intravenous Iron administration in the community
Michelle Cooke and team, Hull and East Yorkshire Hospitals NHS Trust
People with chronic kidney disease often suffer from anaemia. Michelle is a renal nurse responsible for managing patients requiring intravenous iron infusions to maintain correct haemoglobin levels. If left uncorrected anaemia has a significant impact on quality of life and ability to function and work normally. Under the old system patients had to attend hospital as a day-case with nurse supervision and a 3-5 hours IV infusion of iron. The approach Michelle and colleagues have pioneered at Hull involves using a novel preparation of iron as an injection given in a Health Centre local to the patients home and in the future in the patient’s home by the district nurse along with other therapies. This novel therapy requires a maximum of a one hour visit in total.
Electronic alert system to identify and stage acute kidney injury (AKI)
Mark Devonal, Nottingham University Hospitals NHS Trust
Acute kidney injury is rapid deterioration in kidney function caused by conditions such as sepsis, trauma and surgery and is associated with significant mortality. A national study highlighted deficiencies in diagnosis and management of acute kidney injury. Mark and his team at Nottingham developed a fully automated, real time electronic alert system covering every aspect of potential kidney injury. The alert system has led to a significant improvement in the detection of acute kidney disease and has been of particular value to non-kidney specialties such as surgery and orthopaedics.
York Plantar Faciitis fast track education sessions
Tony Carter and team, Harrogate and District NHS Foundation Trust
Plantar fasciitis is a painful and debilitating heel condition and is one of the most common musculo-skeletal foot problems affecting the adult population. Using the traditional approach patients often waited over 6 months for an individual appointment with a podiatrist. Under the fast track scheme 10 patients at a time were invited by letter to attend a fast track clinic where they are provided with information on treatments, exercises and advice. Each clinic finished with a lively communal debate and patients would then continue with evidence based treatment at home. A clinical follow up was available for any patient who wanted one. The impact is that, patients are routinely seen within four weeks of referral with two clinicians managing the clinical care of 10 patients in a 1 hour group appointment rather than the usual 45 minute individual appointment. To date the cancellation rate for this clinic remains very low and between 85% and 90% of patients attending the fast track clinics do not seek follow up appointments.
Multifunctional bowel management mannequin
Anna Radford, Hull and East Yorkshire Hospitals NHS Trust
Children suffering from chronic constipation such as spina bifida patients as well as other inflammatory bowel disease will have often spent considerable time in hospital. The first time parents have to perform any ‘plumbing’ procedures is actually on their own child. Fear of ‘doing it wrong’ is a difficult hurdle. Anna with support from colleagues is developing a teaching aid with a fully functioning mannequin complete with ‘ileostomy’ and other features such as colonic enemas. The intention is that parents of younger children will feel confident in performing these procedures on their own children and therefore reducing reliance on medical staff in the community and in hospital. Older children will be empowered and feel able to be part of their own care so that non-compliance will be reduced therefore reducing the risk of complications and the need for additional treatment, including redo-surgery.
Leicester Ambulatory Pulmonary Embolism Service
Catherine Free and team, University Hospitals of Leicester NHS Trust
Pulmonary embolism (PE) and suspected PE are a major cause of admission to hospital. The symptoms of PE include chest pain and Shortness of Breath which commonly have other causes which, if PE was excluded, would not necessitate admission to hospital. Traditionally, PE has required admission to hospital for investigation and treatment. A nurse-led ambulatory PE service was commenced in June 2010 whereby patients referred with suspected PE are assessed using a clinical probability score and D-dimer levels. Patients with a low clinical probability of PE and normal D-dimers can be discharged without further investigation. In those with elevated D-dimer levels or a high clinical probability of PE, further imaging, either with VQ scan or CTPA, is arranged. If the investigation cannot be performed on the same day, the patient is discharged on low molecular weight heparin (LMWH) to return the following day. If PE is excluded an alternative diagnosis for the symptoms is sought and the patient is discharged back to the GP. If a PE is confirmed, the patient is commenced on warfarin and allowed home. The service has received 417 referrals in the last 12 months and saved 386 hospital admissions, leading to a saving of £130,000 and freeing up beds for more acutely ill patients and relieving pressure on the Clinical Decisions Unit. Patients are also better supported as the specialist nurse is able to provide telephone support and advice for those who need it.
This category is for innovations which relate to improvements in mental health care including (but not limited to) pathway redesign, a book, a DVD, a training course, redesign of a service, a public health campaign, a new device or incorporation of a new technology into a service.
Ian Colpitts, Lincolnshire Partnership NHS Foundation Trust
SMILES is a therapeutic package designed for young children, aimed at preventing mental health issues. Experience has shown that being creative and injecting fun into therapy dramatically improves things and gets better outcomes. The children learn a variety of techniques and skills in order to equip them for future life stresses. SMILES is intended as both a prevention to service need, as well as supporting those who do require further therapeutic input. Ian said that “As with all public sector services, our service is struggling with funding cutbacks, the SMILES programme, for a relatively minimal financial outlay, allows for a therapeutic intervention to be delivered to a significant number of young people.”
Outcome-orientated child and adolescent mental health service
Sami Timimi and team, Lincolnshire Partnership NHS Foundation Trust
Sami Timimi and team have develop an outcome-orientated child and adolescent mental health service. This is a new approach that focuses on improving outcomes for treatment of mental health problems in the young. By incorporating extra therapeutic factors it has demonstrated a 25% reduction in non-attendance rates, high levels of satisfaction and engagement from service users and a 10% cost saving. The major benefit is that it is producing a positive change for young people and reduces the chances of 'getting stuck in the system'.
Evidence-based recovery service to empower over 65’s with mental health issues
Petra Baldwin and team, Leicestership Partnership NHS Trust
Petra Baldwin and her team have developed an evidence-based recovery service to empower over 65’s with mental health issues to take control over their own recovery after discharge from the programme. Petra with her colleagues adopted an evidence based approach to devise a pathway for older people focusing on leading a meaningful life & avoiding relapse. The work is intended to be individual and based on each person's skills, needs and wishes, whilst it is still early days it does seem to be showing promising results.
Improvements to end-of-life care for people with learning difficulties
Gemma del Toro and Claire Henley, Nottinghamshire Healthcare NHS Trust
The End of life pathway for people with learning disabilities links to the existing Nottinghamshire Pathway that allows access to tools, service directories and documents relating to learning disabilities. It provides easy to understand information to the person, it links to the persons Personal Health File and Health Action Plan and is supported by a DVD to raise awareness of how to support someone with a learning disability as they approach end of life. Support staff in residential units feel supported to provide care to an individual with a learning disability during End of Life, therefore reducing inappropriate use of health services.
Antenatal screening midwifery training programme
Ian Rothera and Margaret Oate, East Midlands Perinatal Mental Health Clinical Network
This is an e-learning training programme covering all community midwives that is being implemented by the East Midlands Perinatal Mental Health Clinical Network. The new e-learning module has been shown to deliver benefits to both staff and patients as midwives are more effectively detecting women at increased risk of developing a serious post natal mental illness and those women most likely to suffer from a serious mental illness following childbirth are identified and appropriate actions taken before birth and before significant illness develops. This has led to a number of Productivity Benefits such as reduction in inappropriate referrals and a reduction in overall costs of the service.
This category relates to an idea for, or development of a new medical device, piece of equipment or diagnostic by a member of NHS staff either working as part of a team with other NHS staff members, in collaboration with a company or in collaboration with a University.
A novel blood test for bowel cancer detection and screening
Mr Muhammad Imran Aslam and team, University Hospitals of Leicester NHS Trust
About one in 20 people in the UK will develop bowel cancer during their lifetime (Cancer Research UK, 2005). The current strategy for bowel cancer screening is based on a Faecal Occult Blood Test but it is inaccurate and has led to misdiagnoses and unnecessary invasive investigations. The national screening programme offers screening every 2 years for 6 million people between the ages of 60 and 69 years and costs £76m per year. If the screening age is extended to cover 50 to 70 year olds there will be up to 10 million people in the screening programme. The team based at University Hospital Leicester have successfully developed a novel blood assay based on micro RNA that offers better accuracy of detection and can result in big cost savings. The initial work has been validated with a high degree of accuracy on 100 patients. They are now looking to produce a diagnostic kit with software that should have the results within 6-8 hours. The potential for such a test is immense not just in the UK but world wide.
Novel Carbon Black wheelchair
Avril McCarthy, Sheffield Teaching Hospitals NHS Foundation Trust
Carbon Black is an exciting advance in wheelchair design aimed at the active independent user. Wheelchair design has changed very little in the last twenty five years. Carbon Black uses Formula One racing car expertise in its carbon fibre construction making it light weight, highly manouverable and has a host of other highly desirable features. Andrew Slorance has been a wheelchair user since breaking his back in 1983 aged fourteen. He was frustrated with the old design of wheelchair which was limiting in performance and style and Andrew has made it his mission to radically improve things. Over the last four years Andrew has personally invested considerable amount of time and money in Carbon Black based on his own experience. Devices for Dignity and Andrew would like to see his wheelchair become the desirable wheelchair to own. Carbon Black is designed to empower the user not overpower the user.
Non-contact respiratory rate monitoring device
Heather Elphick, Sheffield Children's NHS Foundation Trust
For children admitted to casualty at Sheffield Childrens Hospital one of the most important measurements needed is an accurate assessment of respiratory rate. Changes in respiratory rate are known to be an early indicator of deterioration in a patient’s condition. If the child is young and very agitated it can be very difficult for the staff and distressing for the child and parents to try and obtain a direct measurement. There is currently no portable device for accurately measuring respiratory rate. The Childrens Hospital in conjunction with Sheffield Hallam University have set out to develop what they believe to be the first portable non contact device. The device has a facility to trigger an alarm when the respiratory rate falls outside a set range and has potential to be further developed. It can be used in the emergency department, primary care, wards, ambulances and at home and a patent application has been filed.
Peripheral field test for upper eyelid malposition
Joyce Burns, University Hospitals of Leicester NHS Trust
In the NHS, cosmetic procedures are not routinely supported. There is currently debate about the impact of over-hanging eyelids and drooping upper eyelid. However, up until recently there hasn’t been a test readily available that could demonstrate the physical impairment suffered by such patients in an objective, cost effective and repeatable manner. The team at Leicester Royal Infirmary modified an existing test and since 2006 they have used the new Leicester Test on all patients referred to them for both eye conditions. Results have been published in an international peer reviewed journal and they are using the results to make an objective assessment whether surgical intervention can be justified. The test can readily be spread to other hospital sites with the same equipment. Future developments will introduce greater efficiencies and patient benefits.
High performance inhaler mouthpiece/nasalpiece
Andrew Copestak, Swedish Biomimetics 3000 Ltd
Andrew Copestake at Swedish Biomimetics 3000 Ltd has been working with a team based at Leeds University and Leeds Teaching Hospitals NHS Trust to develop a high performance inhaler mouthpiece/nasalpiece. They are working on a research programme to develop an ‘intelligent’ asthma inhaler and the associated mouthpiece or spacer. The design of the mouthpiece is as important as the therapeutic drug because data suggests that up to 90% of the drug may not actually enter the body at all but is trapped in the mouthpiece and wasted. The improved mouthpiece design suggests that dosing levels [and thereby costs] can be reduced by up to 90%. These gains are particularly valuable for modern drugs, which are both more expensive and very potent.
This category relates to the development or deployment of a new piece of software or a telehealth service by a member of NHS staff either working as part of a team with other NHS staff members, working with a company or in collaboration with a University.
Telewound management service
Kathryn Vowden, Bradford Teaching Hospitals NHS Foundation Trust and Brenda King, Sheffield Teaching Hospitals NHS Foundation Trust
Chronic wounds are poorly diagnosed, managed and treated particularly in community and care home settings and this is made worse by a lack of access to skilled tissue viability nurses. This idea is to use readily available equipment such as digital pen and paper technology and a mobile phone with camera to securely capture and transmit images and information about the patients wound to a remote wound care expert who would offer support to the local staff. A clinical trial is underway with 32 nursing homes in Bradford and Sheffield. Trial data is not yet available however early case examples suggest that the remote TeleWound system is allowing earlier wound care interventions offering the potential for savings in dressing costs, nursing time and improved healing times. It has already prevented unnecessary patient admissions to hospital. Feedback from the nursing homes has been very positive and they have identified a number of benefits to the system including the linked educational input and the potential for the system to improve the patient’s quality of life.
Clinical Workflow Manager for the Rheumatology Clinic
Steven Wood and team, Sheffield Teaching Hospitals NHS Foundation Trust
Out-patients attending a busy clinic at any major city centre hospital can find it an extremely confusing place, dealing with check ins, making sure they don’t miss their turn and additional hospital staff are usually required to chaperone patients. Whereas the project brief was to design a more efficient check in kiosk for the Rheumatology clinic, what they actually delivered was a complete integrated patient pathway system that manages the patient journey from the moment they set foot in the clinic to the moment they leave. The impact has been huge in terms of the way the department operates. Significantly patient time spent in clinic has been cut from 54 minutes to 32 minutes, bottle necks have been eliminated, the need for patient chaperones reduced and they have been inundated with requests from other departments to introduce a similar system.
Howard Last, Oakley Medical Practice in Leeds
Howard Last from Oakley Medical Practice has developed an Asthma Webapp to promote self-management of asthma by patients and to increase their understanding of their treatment. In the UK, asthma affects 5 million people. Emergency hospital admissions cost the NHS £61 million each year. It is estimated that 75% of hospital admissions with asthma are preventable. The asthma webapp has been developed to address the needs of patients with asthma and to enable healthcare professionals to deliver best practice in asthma care. Initial feedback has been positive, the web app has been well received. There is a need to undertake more formal evaluation in terms of patient benefits, user acceptability and health economic benefits.
Alaina Challans and team, Doncaster and Bassetlaw NHS Foundation Trust
It has been claimed (Daily Telegraph Feb 2011) that up to half of the beds in the NHS are occupied by people who could be discharged home or in to nursing homes. Whilst this might be wild speculation any system that can speed up discharge is worth looking in to. At Doncaster & Bassetlaw Hospital they have come up with an impressive system i-Tracker, that promises to significantly improves the discharge planning process for the patient, the GP and other community services who are all kept fully informed of what’s happening with specific patients as they get close to discharge. The benefits within the hospital are obvious but significantly and for the first time GPs and community colleagues can access live data regarding their patients, and their current discharge status, whilst still in hospital. This replaces the old process where the GP would often receive a letter informing of discharge after the patient was back at home.
999 alternative for telecare alarm services and patients
Cathryn James, Yorkshire Ambulance Service
Last year Yorkshire Ambulance answered over 700,000 emergency calls as well as making a further 1 million non urgent patient journeys. Looking to see how they could improve their services they noticed that a high number of emergency calls were coming from telecare monitoring organisations who would routinely called 999 particularly for patients who fall. YAS worked with 2 local organisations who both have thousands of customers with alarm pendants who typically were calling 999 around 600 times each month. They jointly developed new clinically based guidelines for the staff to use when deciding whether a 999 call is needed. There is an option to direct the call to a YAS clinical advisor who speaks directly to the person who has pressed the alarm and agree an appropriate response. During a 3 month pilot, direct 999 calls from monitoring services were reduced by 30%, on average, with the majority of the remaining calls being referred to the YAS clinical advisors who were able to assist 2 out of 3 callers without the need for a blue light emergency.