Medipex NHS Innovation Awards 2017
Innovative NHS staff and their collaborators from the region’s universities, charities and SMEs have been celebrated at the twelfth annual Medipex Innovation Awards and Showcase.
Innovators from around the region gathered at Cedar Court Hotel near Wakefield for a networking event and awards ceremony where five teams were crowned winners across different innovation categories: Medical Devices and Diagnostics, GP and Community Care, Mental Health and Wellbeing, Self-Management and Service Improvement.
Run by Medipex, the awards provided a platform to showcase pioneering new ideas and technologies developed by, or with, NHS staff to improve patient care and make services more efficient.
Seventy high quality entries were received this year from which fifteen teams were selected to attend the awards ceremony as finalists. Five of these teams were crowned winners, receiving their awards from BBC Yorkshire Broadcaster Harry Gration and our generous sponsors.
Medical devices and diagnostics
This category is for innovations relating to the development of a new medical device, technology, piece of equipment or diagnostic tool.
Category winner
Joel’s Bucket, a central venous catheter training device
Joel Copperthwaite, Airedale NHS Foundation Trust
Joel’s Bucket is a high-fidelity, low cost device for creating a realistic artificial circulation for the purpose of training clinicians to safely insert arterial and venous catheters. These interventions can be lifesaving, yet carry a high complication rate. High quality simulation training has been shown to improve patient outcomes by 85%. Joel’s Bucket is significantly less expensive than the market leaders whilst offering a high degree of realism. It allows the procedure to be completed fully to national guidelines, and can be adapted to reflect the abnormal clinical features often present in patients needing lines. Evaluation of the second generation model by a panel of experts scored realism as 90/100 and perceived value as a training tool of 93/100. The fourth generation is currently under development and will include pre-programmed scenarios to improve off-the-shelf usability.
Finalist
Electronic Frailty Index (eFI)
Andrew Clegg and Sarah De Biase, led by researchers from the University of Leeds based at Bradford Teaching Hospitals NHS Foundation Trust
The eFI uses routine GP data to identify and severity-grade frailty to enable evidence-based, proactive models of integrated care for older people. The eFI was developed following an internationally established framework and validated using primary care data from over 900,000 older people. The eFI enables the calculation of a frailty score; a higher score identifies older people at increased risk of care home admission, hospitalisation, and mortality. Implementation of the eFI into routine primary care practice is a major advance in the care of older people with frailty as it is enabling the development of integrated care pathways for this highly vulnerable group.
Finalist
The Intra-Abdominal Platform (IAP) for enhanced laparoscopic surgery
Pete Culmer, University of Leeds and Pd-m International Ltd
Surgeons identify inadequate retraction and poor visibility as critical issues when performing laparoscopic surgery resulting in only 48% of colorectal surgeries being carried out laparoscopically. Of these, 17% are required to be converted to open surgery, adding to the cost and risk of the procedure as well as an increased hospital stay for the patient. The IAP is a novel platform for the hands-free retraction of tissues and organs in laparoscopic abdominal surgery to provide improved access and visibility. It is inserted through a small incision, clamped in place for stability, and extends into a radial position to provide a wide platform for the retraction of tissues and organs.
Finalist
Teaching material for illiterate and innumerate families with diabetes
Emma Randle, Sheffield Children’s NHS Foundation Trust
Vulnerable families who have had little or no access to education sometimes need to manage a condition that requires safe treatment decisions to be made on a daily basis, for example type 1 diabetes. These families need support to achieve the same health outcomes as their English-speaking, literate and numerate peers. A package of attractive visual aids was developed to assist in delivering the essential education required for independent management of insulin dependent diabetes without the need to understand the English language. The resources also support families that lack the numeracy skills required to calculate insulin doses or count the carbohydrate content of foods.
Service improvement
Innovations which have potential to improve the quality, efficiency and productivity of services across the NHS.
Category winner
The York faecal calprotectin care pathway
Dr James Turvill and Victoria Hilton, York Teaching Hospital NHS Foundation Trust and Y&H AHSN Improvement Academy
Patients often see their GP because of bowel symptoms. Although these are often caused by irritable bowel syndrome (IBS), sometimes they can be caused by urgent inflammatory conditions, such as inflammatory bowel disease (IBD), which require hospital input. The symptoms are often difficult to interpret resulting in many patients being referred for unnecessary, costly, invasive investigations while for others, referral is delayed. NICE recommends that faecal calprotectin (FC) is used in primary care to differentiate between IBD and IBS, but implementation has been variable. The York Faecal Calprotectin Care Pathway was developed to help GPs effectively utilise the FC diagnostic test and identify which patients can be cared for in primary care and which should be referred to secondary care. A resource pack has been developed to support scaling up and adoption of the Pathway into other areas.
Finalist
3D imaging to replace planar imaging of metastatic bone disease
Michael Hanney, Sheffield Teaching Hospitals NHS Foundation Trust
Nuclear medicine imaging is a common investigation for the evaluation of metastatic bone disease. It conventionally employs 2D, planar scanning, which has limitations in terms of determining the precise location of abnormalities and in identifying subtle lesions. Single Photon Emission Computed Tomography (SPECT) produces 3D images that offer increased clinical utility, but its routine use has been considered impracticable due to the extended acquisition time required. Shortened acquisition protocols have been developed that use recent improvements in image reconstruction techniques to enable SPECT images to be acquired in a similar time to planar views. The implementation of SPECT is expected to improve management of malignant diseases with a propensity to spread to bone, such as prostate and breast cancer.
Finalist
The Bradford diagnostic virtual ward
Dr Stefan Williams, Bradford Teaching Hospitals NHS Trust
A large number of medically fit patients are kept in hospital for a final test before discharge. For these patients, the timescale for outpatient investigation is too long, although inpatient monitoring and treatment is no longer required. Traditionally, clinicians could only ensure timely investigation by keeping the patient in hospital. The Diagnostic Virtual Ward solves the problem by allowing these patients to go home thereby freeing a hospital bed and their tests are still undertaken on an inpatient timescale. The service is co-ordinated from the hospital, and patients remain under the care of their consultant. A number of different specific Virtual Wards are envisaged, each with a simple, targeted remit. Together, they would share the aim of reducing unnecessary hospital bed days.
Mental health
This category is for innovations relating to improvements in mental health care. In particular, improving access to services and outcomes for vulnerable service users.
Category winner
Targeted TMS@NAViGO, a non-invasive brain stimulation
Colin Robertson, NAViGO
Transcranial Magnetic Stimulation (TMS) is a highly effective, safe intervention for treatment-resistant depression and other mood disorders, recognised in NICE (2015) guidance. TMS is both painless and non-invasive. NAViGO has developed a unique way of delivering TMS, using the pioneering technique of QEEG (Quantitative Electroencephalography) to map brain activity. Clinicians can then identify the exact illness and target the optimum area of the brain to treat for the best outcome. Other clinics only use TMS as a repetitive therapy to the left frontal lobe with less impressive results. NAViGO has collated data from QEEG brain wave assessments into a phenotype database which can be used for commercial development and sustainability. NAViGO is now ready to spread this innovation nationally.
Finalist
Outcome feedback technology improves the efficiency of psychological care
Jaime Delgadillo, Leeds Community Healthcare NHS Trust
Nationally, less than 50% of patients recover from their mental health problems after treatment; identifying and addressing obstacles to improvement is a key challenge. Outcome Feedback is a computer-based technology that assists psychological therapists in monitoring how their patients are responding to treatment. Each patient’s level of depression and anxiety symptoms are compared to records from hundreds of similar cases at each therapy session and feedback about treatment progress is provided in real-time. Therapists are alerted to cases showing atypical symptoms, prompting them to identify and resolve obstacles to improvement. A study of >500 patients demonstrated that the Outcome Feedback cases completed with similar levels of symptom improvement, but in a considerably shorter time. A multi-site randomised controlled trial is currently being conducted and preparations are being made to disseminate this technology across the NHS.
Finalist
The Mental Capacity Assessment Support Toolkit (MCAST)
Mark Jayes, Sheffield Teaching Hospitals NHS Foundation Trust
The MCAST toolkit has been developed to support multidisciplinary staff to carry out robust mental capacity assessments for patients who need to make decisions about their treatment or discharge arrangements. User-centred design principles were adopted to develop a prototype toolkit to help staff to prepare, carry out and document assessments in line with the requirements of the Mental Capacity Act (MCA, 2005) and to identify and support patients with communication needs during capacity assessments. The toolkit prototype has been evaluated by 21 healthcare staff, who reported that the toolkit was easy to use, increased confidence and improved capacity assessment documentation.
GP and community care
Innovations relating to improvements in primary care. For example; assisting independent living, reducing hospitals admissions, improvement of prescribing and remote management of patients.
Category winner
CARE-VIEW, an app to reconnect isolated citizens
Jonathan Hindley, Public Health-West, Leeds City Council
CARE-VIEW is a simple to use, downloadable app which helps to locate and reconnect the socially isolated with their communities and the services they require to improve and maintain their health and wellbeing. It is designed for use by non-health professionals who are frequently out and about on the street for example police officers, postal delivery staff, council cleansing staff, delivery personnel etc. Upon detecting signs of neglect e.g. dwelling in disrepair, post piling up or an unkempt garden that may indicate the presence of a socially isolated resident, users can quickly and simply log a concern. Outreach teams can then target key individuals and areas by leafleting and door knocking to help residents access services. It is completely confidential and involves no expectation of contact or intervention in the first instance.
Finalist
Dialysis closer to home: a community based partnership
James Burton and Richard Baines, University Hospitals of Leicester NHS Trust
Haemodialysis is a life sustaining treatment for patients with kidney failure. Currently there are 22,000 users in the UK and demand is increasing across the globe. Hospital based dialysis can be inflexible and inconvenient but home based dialysis is not suitable for all patients. An innovative partnership between the University Hospitals of Leicester, Heath Lane Surgery and their patient participation groups has seen the development of a minimal care community dialysis centre, believed to be the first of its kind in the UK. A single patient, six-month pilot of the scheme has been completed and will be expanded to accommodate more patients at Heath Lane and further afield, fulfilling our vision of better dialysis closer to home.
Finalist
The campaign to reduce opioid prescribing
Sarah Alderson, Leeds Institute of Health Sciences
Opioid medicines, such as codeine or morphine, work well for short-lived pain (e.g. following injury) and cancer pain. They may not work and can even be harmful in treating chronic non-cancer pain. There is concern that patients with chronic pain are being given more and stronger opioids without first trying other, less harmful options and that opioid prescribing can be driven by GP habits rather than patient need. The Campaign to Reduce Opioid Prescribing was launched with 10 Clinical Commissioning Groups in West Yorkshire, initially running from April 2016 to March 2017. All 330 practices now receive bimonthly enhanced feedback reports on their opioid prescribing which show trends and compare prescribing to that of other practices as well as helpful hints to reduce prescribing.
Self-management
Innovations related to improving the self-management of long term conditions. For example; promotion of healthy lifestyle, increasing access and understanding of key disease indicators, educational materials, improving remote access for patients.
Category winner
Proactive health coaching
Fiona Bell, NHS Vale of York Clinical Commissioning Group
In response to rising non-elective healthcare consumption and costs, Vale of York CCG implemented Proactive Health Coaching, a telephone-based, nurse-led health management service that educates patients and helps them to plan their care. This addresses a pressing need for a practical, sustainable patient-centred solution which promotes self-care and ensures local and individual needs are met. This intervention is most suitable for patients with a high, but avoidable, risk of care requirement. The programme aims to improve patients’ quality of life while reducing unplanned care admissions and focuses on strengthening patients’ ability to self-manage and navigate the healthcare system. The intervention has been running successfully with 400 patients in the Vale of York for 12 months.
Finalist
The digital bladder diary
Professor Paul O’Brien, Elaros
The Digital Bladder Diary is the first in a series of CE marked clinical patient diaries to manage and monitor long term health conditions through clinically led partnerships. Patients record their bladder activity using an app on a locked down smart phone. The data is uploaded securely and automatically to a server where it is analysed using an algorithm, providing immediate, accurate, simple and intuitive clinical direction (based upon NICE guidelines) back to the clinician. The system is clinically more accurate than existing paper-based practice (100% v 58%), but its real benefits are derived from the fact that it enables patients to take greater control of the monitoring and management of their own health and lives.
Finalist
Teaching material for illiterate and innumerate families with diabetes
Emma Randle, Sheffield Children’s NHS Foundation Trust
Vulnerable families who have had little or no access to education sometimes need to manage a condition that requires safe treatment decisions to be made on a daily basis, for example type 1 diabetes. These families need support to achieve the same health outcomes as their English-speaking, literate and numerate peers. A package of attractive visual aids was developed to assist in delivering the essential education required for independent management of insulin dependent diabetes without the need to understand the English language. The resources also support families that lack the numeracy skills required to calculate insulin doses or count the carbohydrate content of foods.