Northern innovation and networking event 2017

Northern Innovation and Networking Event 2017
The Adoption and Spread of Innovation

Welcome!
Richard Stubbs, CEO, Yorkshire & Humber AHSN

The Northern AHSNs and the Northern Powerhouse

Why innovation is important
A complex challenge…

AHSN Commercial Support
Mike Kenny
Associate Commercial Director
The Innovation Agency

Spread and adoption:
AHSN Commercial support
Mike Kenny,
Innovation Agency (AHSN for the NW Coast)
Mike.kenny@innovationagencynwc.nhs.uk
@innovation_mike 6

The AHSN Network
Why Health & Life Sciences SMEs?
Innovation & Transformation = New Models of care &
reimbursement
AHSN Offer for driving Adoption & Spread
Good to know before you go “all in”

AHSNs – improving health & supporting
economic growth

AHSNs: Spreading innovation, improving health,
generating economic growth
• Uniquely connect…

AHSNs: Spreading innovation, improving health,
generating economic growth
7 Words

11
• Health and Lifesciences employment >10% of UK GVA
• Aging population / rising demand = high growth
potential for employment/GVA
• Local and Regional Authorities targeting Health and Life
Sciences sector for infrastructure investment
• >60% of all employment in UK is via SMEs (0 to 249
employees)
• Over 99% of businesses are SMEs
• >85% of businesses supplying the NHS are SMEs
• NHS = £120 Bill sized Market / System
• Health & Care Market - £150 Bill in 2013…..
AHSNs, the NHS & SMEs

Northern innovation and networking event 2017

The NHS is Brilliant at Innovation….
• Traditionally slow to adopt….
• Needs new approaches to support adoption

New Models of Care Programmes are challenging existing
methods of service design and reimbursement….
• Services will remain – e.g. AF, COPD
• Technology & Innovations enable them to become
Safer, Better, Faster, Cheaper
• Implementation requires clinicians & citizens to
change behaviour
– …for which professionals expect evidence
– …and which takes time
• Evidence ‘gold standard’ - medicines, RCT’s
• Apps, PoC Innovation, Digital Health – don’t fit into
traditional commissioning /procurement/
reimbursement “boxes”
• Need new approaches to support adoption

What is the AHSN Commercial offer?
• Understanding NHS
• Door knocking
• Accessing funding
• Evaluation & evidence
• Procurement & Commissioning
• Regulatory approval(IP CE)
• Commercial tools & channels
• Positioning, presenting, pitching
• Innovation Visibility

Health & Life Sciences SME Client Journey
Market Access Journey

Potential Outcomes for the SME
Health & Life Sciences SME Client Journey

Some Tips for Engaging with AHSNs & NHS
• Funding – we are not organisations who can provide monies for product
development or commercialisation
• But we will provide support to access it
• We are not research organisations
• But we can provide access to those that are
• We are not a sales resource
• But we can help you build your NHS value proposition
• We can support access to key people – clinicians, commissioners,
procurement
We Are – a Critical Friend We Are – an Honest Broker

• Clarity – Have a clear focus– know what your “ask” is
• Understand - the Needs & Priorities of the NHS around your innovation
• Avoid the hard sell –understand what is in it for the NHS, Patients, Citizens
• Long Game – AHSNs can vastly speed up adoption by removing barriers, but
working with CCGs & Trusts requires a patient & controlled approach
• Co-create – the solution to the perceived problem you believe your
innovation solves for the NHS:
• Engage & Partner rather than Tell or Sell
• Understand through policy documents and plans/ procurement calls –
• How relevant your product is
Some Tips for Engaging with AHSNs & NHS

Some Tips for Engaging with AHSNs
and the NHS
• If you want to do business with the NHS – your local AHSN should be an
early port of call
• Before you engage with the NHS/AHSNs – conduct your own honest
appraisal of your innovative product
• Ask yourself – in the context of the NHS & Healthcare, is this product
Safer
Better
Faster
Cheaper
• The more of these boxes you can tick, the more likely your AHSN will be
able to help you

Mike Kenny
Innovation Agency
T: 01772 520279
M: 07950 857689
E: mike.kenny@innovationagencynwc.nhs.uk
W: www.innovationagencynwc.nhs.uk
:@innovation_mike
:@innovationnwc : InnovationNWC

Innovation in the NHS:
Commercialisation process for Doncaster & Bassetlaw
Teaching Hospital NHS FT’s eNOF (Electronic Pathway for Neck
of Femur Fracture) Product
Stephen Taylor-Parker
Innovation Manager
Medipex

Northern Innovation Showcase and
Networking Event 2017: Adoption and
Spread of Innovation

Stephen Taylor-Parker
Innovation Manager
Copyright © Medipex 2017

CliniciansMedipex
Business
Academics
Medipex model covers the
spectrum of development
and deployment of
innovative technologies
and services to NHS,
industry and universities

 25 current members
 5 University Teaching Hospitals - Leeds, Leicester, Sheffield,
Bradford, HYMs (Hull & York)
 Acute Hospitals
 Mental Health / Community Care Trusts
 1 Ambulance service
 Health Education Yorkshire (Doctor & Nurse training)
 1 Clinical Commissioning Group
NHS Members

Innovation Pathway

The Problem
 The recording of fractured neck of femur pathway data in A&E is traditionally based on a
paper checklist
 Recording is non-standardised leading to inaccurate recording of tests and administrative
errors
 These factors affect potential improvements in patients' care, failure to meet British
Orthopaedic Association Best Practice standards of care and reduce the opportunity to
benefit from Best Practice Tariff.
 There are clear indications that this causes delays to operations which have direct links to
increased mortality and a key early indication of patient outcomes is time from admission to
operation.
E-NOF Electronic Fractured Neck of Femur Pathway
Doncaster & Bassetlaw NHS Trust
Medipex early stage input into project:
• Regular meetings with Trust IP Manager identified
a potential electronic solution being developed by
Consultant Surgeon
• Landscape survey undertaken to identify any
similar pre-existing solutions
• Confidentiality and collaboration agreements put
in place
• Regular project meetings instigated

The Solution
An electronic application to improve compliance with Best Practice of Care
allowing real time pathway and patient care monitoring, whilst increasing the
potential for Best Practice Tariff.
E-NOF
 Allows clerking information on patient assessment at
each stage of the pathway
 Ensures that every step of the patient assessment is
carried out via prompts
 Appropriately prescribes tests (e.g. Pathology, Imaging
and AMTs) and captures results
 Tracks patients on the pathway with ability to prioritise
 Ensures that the patient is moved along the pathway
in a timely manner, via alerts
 Visualises performance in accordance with time
targets via “countdown clock”
 Records name and signature of staff undertaking tasks
 Makes sure that all staff are appropriately and
accurately contributing to clerking

 Identification of unmet need/problem
 Potential benefits from proposed development
 Financial – Increase BPT fee from £700 > £1,399
 Clinical – Reduce Number of aborted Operations
 Patient experience – Less time as in-patient
 Development of Business Case
 Scoping of project and management of development budget
 Landscape survey of “Patent and Prior Art”
 Created in depth market intelligence report
Involvement of Medipex at all Stages
Example based on 100 annual patient incidents (£)
Cost of manual data input 24,000.00
Annual software licence 15,000.00
Support and maintenance
@ 12.5% of licence fee 1,875.00
Cost Saving 7,125.00
Additional revenue by meeting
uplift guideline (50%) 69,995.00
Total revenue increase 77,075.00
Baseline revenue 100 x £700 70,000.00
Potential unit revenue £147,075.00

 Support for inventor and development team
 Regular Project meetings
 Advice on MedDev regulations & CE marking
 Liaison with Trust executive team on potential
commercialisation
 Support for internal testing and Proof of Concept
 Draft Non Disclosure Agreement for external discussions

Commercialisation Process
 Discussion options with Trust Exec team to agree
appropriate pathway
Trade sale
Direct sales via NHS
Licencing to 3rd party sales organisation
Partner with Medipex
 Develop Sales and Marketing Business plan

Business Plan Content
• Table of Contents
• I. EXECUTIVE SUMMARY
• II. BACKGROUND – THE PROJECT
• 1. The Electronic Neck of Femur Pathway (E-NOF)
• 2. The Team - Expertise
• III. PRODUCT
• 1. Software description
• 2. Software Platform
• 3. Intellectual Property
• 4. Development stage
• 5. Future Developments/Enhancements
• IV. MARKET – UNMET NEEDS & SAVINGS GAPS
1. Improve the management of hip fractures in frail
and older patients
• 2. Paperless NHS - An Alternative Software
Solution to replace Paper based systems
• 3. Improve data collection and data checks
• 4. Savings gaps
• V. TARGET CUSTOMERS – NHFD MONITORED
FRACTURE CLINICS
• 1. Target Customers
• 2. Making the case to the target customers
VI. COMPETITION
1. Direct competitor – Bluespier
2. Indirect competitors –
3. Improved management of patients based on
paper based systems
3. Positioning of E-NOF
VII. SALES AND MARKETING STRATEGY
1. Marketing and promotional tools
2. Support team & KOLs
3. Customer feedback/evidence of interest in
market
4. Sales Strategy
VIII. BUSINESS MODEL
1. Development and Testing Costs to date
2. Pricing
3. Sales and revenue forecast
4. Planning – Project milestones
IX. BENEFITS & RISKS OF THE PROJECT
1. Benefits
2. Risks

 Appointment of Medipex by Trust for Sales and Marketing Activity
 Draft Sales and Marketing Outsourcing Agreement
 Identify and contract with external software support organisation
Draft Support and Maintenance Contract
Draft Sales Licence
 Create targeted contact marketing database
Develop marketing collateral
Product fact sheet
Marketing brochure
Pop Up banners for exhibitions
Create product website incorporating enquiry capture and
response mechanism

Pop Up Stand
Design

Product Brochure

Product launch at
Orthopaedic Congress
Liverpool Sept 2017

 Embark on targeted email campaign to NHS contact
database
Respond to enquiries
Follow up Conference contacts
Arrange product presentations and site visits
Preparation of costed proposals
Collaboration with Software support company to
ensure smooth implementation and training of end
users
Next Steps
Turningideasintonewproductsandservices

Thank You

Cervix Visual Assessment Guide
Alison Roberts
Specialist Nurse Colposcopist
South Tees Hospitals NHS Foundation Trust
Last year’s business case winner….

Innovation and Production of A Cervix Visual
Assessment Guide
Sister Alison Roberts
Specialist Nurse Colposcopist
M.A. Grad.Dip. RGN
South Tees Hospital’s NHS Foundation Trust

CVAG Design
Assisting primary care professionals with the identification of symptoms and
(unaided) visual appearances. The CVAG is comprised of:
• A desktop booklet with multiple (unaided) images of the cervix typical of those
seen in a primary care environment.
• Clinical management and referral criteria reflecting guidelines from the
NHSCSP publication 20 (March 2016); PHE, Service Specification no.25 (2015)
and NICE
• Book and leaflet explaining use and learning outcomes
• The CVAG is designed for ease of accessibility in a clinical area and for ease
of use by the practitioners. Because of the infrequency of practitioners viewing
abnormal cervix, an unusual presentation of a normal cervix or benign condition,
may result in the patient being referred into a two week rule clinic.

Development and Objectives
• The concept was initiated and developed as project work for
MA Advancing Practice; Teesside University 2011-2014
• Designed to assist primary care health professionals with the
assessment and evaluation of the cervix
• To raise awareness of the signs, symptoms and appearance
of cervical cancer compared with the normal cervix and benign
cervical conditions
• To promote excellence in practice

Systematic way
Enabling Engaging
Evaluating
Patient
centredness
Professional accountability
Evidence base practice
Quality improvement
Outcome
Individual
Team
Organisational
Cultural Systems and
process
Governance principles
Change
Supporting
Practice development
Facilitating
Encouraging
Collaboration
Communication
Practice development: a framework for excellence in practice, McSherry & Warr, (2008)
Enlightening
Kotter’s 8 stage process of
creating major change

Innovation Scout Business Case
• £1000 Prize Competition October 2016
• Author time to update and complete CVAG v2 2017
• Application of ISBN
• Production and Printing Costs (1000 copies)
• Promotional Leaflets and Marketing through the LRI website
at: www.southteeslri.co.uk/innovation
• Educational Poster timed for official launch at BSCCP Annual
Scientific Meeting, Cardiff. (May 2017)

Sales
• Costs per unit reflect the numbers ordered ranging from
£12.00 to £20.00 per copy.
• Sales figures from May-Sept - £5,940
• Numbers sold from May-Sept – 427
• Widespread distribution: England, Scotland, Northern Ireland
and Wales
• Bulk orders received from the North East Cervical Screening
Training Centre and Northumbria University

Future Developments
• Trust and University supported evaluation project
• Application for NICE Endorsement
• NHSCSP Endorsement
• Promotional educational video
• Development of an electronic CVAG

References
• Cervical Screening Programme, England. Statistics for 2013-14 V1.0, Health and Social
Care Information Centre (Nov, 2014) http://www.hscic.gov.uk/catalaogue/PUB15968 -
Accessed 8th January 2015
• Kotter, J.P. (1996) Leading Change. Boston, Massachusetts, Harvard Business Review
Press.
• Master of Arts Advancing Practice Programme Handbook, (2011), School of Health and
Social Care: Teesside University.
• McSherry, R. and Warr, J. (2008) An Introduction to Excellence in Practice Development in
Health and Social Care. Berkshire, England, Open University Press.
• NHS Cervical Screening Programme (2016) Colposcopy and Programme Management,
Guidelines for the NHS Cervical Screening Programme, Third Edition, NHSCSP
Publication No 20, Sheffield: NHSCSP.
• NICE Clinical Guideline No.27 (2011) Referral Guidelines for Suspected Cancer
www.nice.org.uk/nicemedia/pdf/cg027niceguideline.pdf - Accessed: 15th December 2012

Diffusion and Adoption of Innovation:
International perspectives on theory and practice
Dr Yasser Bhatti
Research Fellow in Frugal Innovation
Institute of Global Health Innovation
Imperial College London / Helix Centre

Diffusion and adoption of innovation:
International perspectives on theory
and practice
12 Oct 2017
Yasser.Bhatti@imperial.ac.uk

Dr Greg Parston
Dr Matthew Harris
Dr Yasser Bhatti
Dr Matthew Prime
Jacqueline del Castillo
Nikitha Reddy
Hamdi Issa
Matthew Quinn
Kavian Kulasabanathan
Ibtehal Attaelmanan
Seema Yalamanchali

NEED IDEATIO
N
KNOWLE
DGE
PERSU
ASION
ADAPTI
ON
ADOPTI
ON
SCALIN
G
EVALUA
TION
Investigatin
g what
constitutes
a reverse
innovation
and
developing
a typology.
Investigatin
g, to what
extent
reverse
innovation
as a
construct
challenges
current
institutions
and
narratives.
Investigating whether
cognitive biases and
prejudices exist against
research or innovations
from low income countries.
Evaluating International
health partnerships, and
volunteers knowledge of
innovation in partnership
countries and its translation
in the UK.
WISH showcase – an
annual competition
which captures and
features underexposed
healthcare innovations
from around the world to
global experts.
Evaluating
the spread
and
diffusion of
reverse
innovation
by
analysing
the Center
for Health
Market
Innovation
s
database.
GDHI Phase
1 -
Investigated
the enablers
and frontline
behaviours
necessary for
successful
diffusion of
healthcare
innovations
through in-
depth
interviews
with
healthcare
experts and
a large scale
survey of
HCPs and
IPs.
GDHI Phase 2 -
Investigated eight
successful examples of
rapid
innovation diffusion around
the world to better
understand the facilitators
and enablers of healthcare
innovations.
GDHI Phase 3 –
Investigating curator
organisations and how
relevant the innovations
found are to peoples needs.
Exploring how grassroots
innovation, as a source of
frugal innovation, can be
directed at prevention and
wellness-oriented
outcomes.
The
developme
nt and
diffusion of
surgical
frugal
Innovation
s –
Lessons
for the
NHS
Impact of
research
source on
evidence
interpretatio
n – an
individual,
randomised
, controlled,
blinded trial
CWF:
Translating
Frugal
Innovation
s to the US
By
Identifying
and
evaluating
frugal and
reverse
innovations
in
healthcare
Social
movements
in
healthcare
and the
NHS
Co-design
and Open
innovation
for end of
life care

Big questions
• Sources (who, where)
– Who innovates?
– Where to find it?
• Process (how)
– How does it happen and diffuse?
• Outcomes (what).
– What does it do?
57

GDHI 2015
Innovation
Phase 1
Create a climate
for change
Phase 2
Engage and enable
organisations to
implement change
Phase 3
Embed and sustain
the change
Transformation
Specific agent
for change
ICT
incentives
and Rewards
Specific
funding for
diffusion
Vision
strategy and
leadership
Transparency
of research
and data
Communication
channels
Standards
and
Protocols
Time and
space for
learning
Identify
champions
Delayering
Improving
the next
journey
Adapt to
local context
Engaging
patients and
the public
Address
concerns of
professionals
EnablersFrontlinebehaviours
Accelerating the journey: building organisational capacity for change

60
2013 & 2015 GDHI findings about frontline
Making time
and space
for learning
and adopting
new ways of
working
Engaging the
public to
create social
demand for
innovation

Learning new ways in innovation
• Open Innovation
• Grassroots Innovation
• Reverse Innovation
61

Closedinnovation
Openinnovation

From Closed to Open innovation
Closedinnovation
Openinnovation

Bhatti © 2014
66
Flow of innovation
Reverse flow of innovation

Bhatti © 2014
67
Flow of innovation
Reverse flow of innovation

$10K vs $1000
https://www.youtube.com/watch?v=yB47wx-b6sY

A: Typical Direction for innovation diffusion
B: Reverse / Frugal Innovation diffusion?
Reverse diffusion
Rogers Diffusion of Innovation Curve

73
Literature
FHW &
Leaders
Top-down
hierarchical sourcing
Low – High
income
country
sourcing
High – Low
income
country
sourcing
Internal
sourcing
Bottom-up
hierarchical sourcing
External
sourcing
Reverse
innovation
Grassroots
innovation
Open
innovation

Open innovation
FHWs most often
source ideas close to
home from colleagues
and patients .

Own clinical specialty
dominates as a source of
innovation.
FHWs are influenced too by
disciplines outside their own
sphere.

Although own
organization remains
the main source, a
high proportion of
FHWs are sourcing
ideas from practice
outside their own
organization.

Grassroots
FHWs see themselves
mostly responsible

Reverse
Very little reverse innovation
appears to be taking place. Only
10 percent of FHWs report that
they source ideas from practice in
other countries.

“Insanity is doing the
same thing over and over
again and expecting
different results.”
Albert Einstein

Make time
and space
for learning
and adopting
new ways of
working

UK Key findings
• While concerns about quality and safety are relatively
low in England, FHWs cite challenges surrounding
the delivery of care and patient experience; particularly
integration between levels of care and the complexity
of the patient journey.
• Leaders also recognise these challenges, however
finances are the leading concern.
• FHWs in England tend to source new ideas from other
organizations in England, with only a small proportion
looking to other countries.
• FHWs in England almost exclusively name other HICs as
useful sources of innovation. They tend to look to
these countries due to their perceived similarities.

Vote for your favourite poster in each region using Slido…
https://www.sli.do/
#InnovationChampion
Poster competition

Teleswallowing
Veronica Southern
Speech and Language Therapist
Blackpool Teaching Hospitals NHS Foundation Trust

Status: ConfidentialIssue Date: 2-Mar-17
As well as the above, I’m…
- Speech and Language Therapist
- Clinical Lead in Telesolutions Blackpool
Teaching Hospitals NHS Foundation
Trust
- Digital Leader at NW STP
- Consultant to New Care Models
Programme
- Director Veronica Southern Telerehab
Ltd/ Teleswallowing Ltd
- Ideas generator and
implementer
- Proud dog owner
vstr.mybiz.org.uk
Who’s this??
Veronica Southern MA BSc MRCSLT

People Centred Positive Compassion Excellence
‘The Workplace of the Future:
it’s not where you go
but what you do’Hugh Bradlow, Chief Technology Officer, Telstra, Sept 2011
Winner: Clinician in
Informatics 2016
Veronica Southern MA BSc MRCSLT

Status: ConfidentialIssue Date: 28-Aug-17
1
0

Status: Confidential
…swallowing difficulties are prevalent among elderly…
Swallowing difficulties are prevalent among the elderly, are a
frequent corollary of neurological disease and are a predictor of
poor rehabilitation, increased hospital stay and poor outcome.
• 426,000 elderly and disabled people in residential care
• 50-75% of nursing home residents have dysphagia
• as population ages the NHS resources needed to provide early
identification, assessment and management will escalate.
National Clinical Guidelines for good practice already supports
early identification, assessment and management of dysphagia
Issue Date: 28-Aug-17
1
0

…and poses a challenge.
Assessment of care home residents’ swallowing by SLT requires:
• domiciliary visits by SLT which are an inefficient use of NHS time & resources
• attendance at out-patient clinics which require carer supervision, hospital
transport, inconvenience and stress for elderly and infirm patients and missed
appointments waste considerable NHS SLT time
Delays in the identification, assessment and management of
dysphagia due to staff shortages, work patterns and waiting lists may
cause:
• the deterioration of a care home resident’s health
• subsequent hospital admission
1
0

The journey…….
Veronica Southern
30 years experience NHS
MA in Health Research
Innovation bids and development of
remote access for communication
disorders
the problem
1
0
Liz Boaden
29 years experience NHS
PhD: improving the
identification and
management of aspiration
the problem
A rapid, cost-effective identification, assessment and
management of dysphagia

The Teleswallowing solution…
1
0

…an innovative use of technology that
significantly enhances the use of limited
NHS resources by reducing costs, saving
time, improving productivity and
increasing capacity while enhancing the
quality of care experienced by the
patient ...
The Teleswallowing video
tells the story…please tap my app
http://vstr.mybiz.org.uk

“I like the fast track. It
minimises the delay
of assessment and
implements a plan to
reduce distress to
patients and
residents”
Nurse
“Nursing Home staff have
increased knowledge
when they discuss clients
on the phone.
They are more
knowledgeable and
this makes the case
discussions
more effective and less
risky”
Speech and Language Therapist
“We thought there would
be a lack of personal
touch but we found that
this was not the case.”
Speech and Language
Therapist

Benefits realised from teleswallowing evaluation…
Removed the need for patients to receive a care home visit and none were
admitted to hospital
100% diagnostic accuracy for diet and fluid modification compared to bedside
assessment
79.5% reduction in cost per patient compared to home visits
98.5% reduction in cost per patient where early assessment and treatment by
Teleswallowing prevents deterioration in patient health and subsequent
admittance to hospital
66% reduction in time taken to assess each patient vs to home visits
50% reduction in time taken to assess each patient compared to bedside
assessment in hospital
Improved response time to referrals
Improved quality of service for patients and care homes
1
0

It’s a clinical tool adding tangible value
Enabling faster access to patients before they deteriorate and require
costly hospital admission – reduce costly 999 calls from care homes
Triage and review tool which can monitor 3 people vs 1 home visit
Enables nurses in care homes to become more skilled in rehabilitating
their patients, e.g. positioning/feeding patients, improving resilience in
care homes
Reduction in home visits, increase in productivity - easier to slot in a 30
minute remote assessment than a 90 minute home visit
Reduce waiting lists
Remote training tool as well as a clinical tool (delivering programme of
dysphagia management and awareness)
Linking specialists to junior staff in the community
1
0

Money, money, money…
1
1
Cost of one home visit: £47.60 clinician
time + £21.15 travel time + £7.28 travel
cost = £76.03 vs one Teleswallowing
assessment = £15.87.
£60.16 saving per assessment
e.g. The saving from 500
Teleswallowing assessments (via a team
of different therapists increasing
patient throughput at the same
clinician rate of pay) =
£30,080 saving

London Speech and Language
Therapy and University College
London
Workforce Scoping Project
Phase 2:
modelling workforce
transformation example
Results:
The Teleswallowing model could
free up a total of 10.38 weeks SLT
time in one year, and 1.9 weeks
of care home staff time.
1
1
1

1
1
New Care Models
Teleswallowing Ltd has been
successful in a bid to NHS
England New Care Models
Programme; Harnessing
Technology Investment Fund
Teleswallowing training is being
delivered in 100+ care homes in
the Fylde Coast Vanguard: Care
Home Connect
Also being used at Blackpool Teaching
Hospitals and Central Cheshire Integrated
Partnership

Remote Dysphagia training…starting the conversation…from this…
1
1

1
1
To this…a Digital Practitioner

1
1
5
A Digital Practitioner prescribing digital solutions
www.healios.org.uk
Reimagining
psychological therapies
using technology
www.Salaso.com
Promoting self
management and
independence through an
online app
patient
Hands-on
Remote teaching
A Digital Practitioner prescribing digital solutions
Apps
Therapy software

Contact me now on my Digital Business Card!
Issue Date: 2-Mar-17
Open the web browser on your
phone and type the following web
address into the top field.
vstr.mybiz.org.uk
You can then save my card to your home screen as a button for
instant phone, text or email contact in the future.
Please contact me!

Using Technology to Improve Patient
Experience
Mark Simpson
Project Support Officer
Leeds Community
Healthcare NHS Trust
Iona Taylor
Dietetic Clinical Lead
Leeds Community
Healthcare NHS Trust
Mike Odling-Smee
Technical Director
Aire Logic

Mark Simpson & Iona Taylor
© Leeds Community Healthcare NHS Trust September 2017

Our work with the AHSN
 After presenting at this event last year, the AHSN have worked with us on
our Oral Nutritional Supplement Passport, providing guidance and
expertise.
 The AHSN were working with AireLogic who were looking for a test case
for an electronic tool they had developed, and the AHSN put us in
contact.

The IBS Cohort
 We originally looked at using this new tool with the Passport, but
Passport holders are largely over 65 years old and we knew this was
probably not the right demographic to test an electronic innovation.
 So instead we discussed using their ‘Forms4Health’ tool with our IBS
cohort to see if we could improve patient care and save clinical time. The
IBS cohort is predominantly female, and new diagnosis in people over 50
is 25% less than under 50’s1, making this a cohort much more likely to
engage in this test.
1 US National Institutes of Health study 2014 © Leeds Community Healthcare NHS Trust September 2017

Functional Gut Disorder Form
 The Function Gut Disorder (FGD) Form is used by our
team as standard practice for tracking symptoms.
 Our team report that its use in consultations can be
lengthy, sometimes taking more than half an
appointment (20 mins) to complete with a patient.
 AireLogic used the Forms4Health tool to create an
electronic version that can be sent to patients to
complete before the appointment, and be on their
medical record before they attend.

What Forms4Health did
 Took the form and made it look engaging:
 Buttons & Skip logic mean the patients can put exactly what the need to, the
form guides them to the answers
 An interactive Bristol Stool chart to help patients identify their grading
 Allows better data capture:
 Form goes onto patient record quickly
 Captures data in a way we can manipulate later
 Allows us to make edits to the form
 All while being straightforward and easy for the patient

The Electronic Form – Benefits
Saves time & a more patient centred consultation
The clinician knows the patient’s specific problems before the consultation starts, and can spend more time
addressing them.
Greater patient engagement
The form is easy to use and looks great. Patients can use any device & have a whole new way of communicating
with us
More Responsive
We are contacting the patient and gathering information much earlier than normal, so the patient feels their
care is already making progress
Patient Self-Care
The patient is in control of their symptom monitoring, in line with the NHS 5 Year Forward View

The Patient Experience
 An IBS Patient is referred to the team. They are flagged as IBS at triage, a
flag which stays with them until their appointment is booked.
 When admin send reminder texts the week before the appointment they
can also send the link to the form, asking the patient to fill it.
 Patient fills the form in and sends it back
 Admin can add to the record

Considerations/Problems
 Patient Engagement – when triaged, patients have the form and its
benefits explained
 IG & Systems – AireLogic have worked closely with Leeds Community
Healthcare to ensure all IG systems are compliant
 The ‘Tech Averse’ – some patients will just not want to do an electronic
form.
 ‘Tech Averse’ staff….

The trial now
 Soft-launched to the staff
 Followed by a whole cohort engagement campaign – our main focus is to
make the form standard practice and ensure good uptake
 With the support of AireLogic we will continue the trial and once we have
enough data will begin comparisons and evaluations
 Patients described the form as “Well put together” and “Easy to use”.

Evaluation
 Using our health records we can track how many of the forms are sent back,
by whom and how frequently, and collect feedback from these users.
 Feedback from staff about time freed up in appointments
 The Dietetic service see standard IBS patients, and offer a specialist
‘FODMAP’2 service for patients it could help. We now have 2 identical forms
with different names (IBS & FODMAP). This means we can;
 Compare IBS vs FODMAP Therapy Outcome Measure results
 Building evidence for business case to extend our FODMAP service
2 Fermentable Oligosaccharides,
Disaccharides, Monosaccharides and Polyols © Leeds Community Healthcare NHS Trust September 2017

forms4health
Patient and clinician facing
smart digital forms

Established in 2007 – three main streams of
business, Consultancy, Development and
Product (forms4health) year on year growth
Involved in the definition of the national
interoperability approach, inc GP Connect,
Care Connect and Spine 2
Developed the recognised agile healthcare
enterprise architecture method EA Light, to
support organisations reviewing their ICT
and deliver an organisational ICT roadmap
for the future
forms4health now being used from Leeds to
the US
ABOUT AIRE LOGIC

Clinical electronic forms platform
capturing, presenting and graphing clinical
data
Nursing assessments, EoL care plan,
discharge summary, patient facing forms
and many more
Contain pre-population capability, skip
logic, calculations, lightweight decision
making support, input validation, business
logic
Building block approach to form
development, rapid design and
deployment – easy to replicate, proving
cheaper to deliver
THE forms4health SOLUTION

Structured data for business intelligence,
monitor, evaluate and report on the data
Working across a range of devices, iPad,
smartphone, android tablets
Scalable, small numbers of forms to EPR
Users can develop, edit and ‘withdraw’
forms
Can ‘gap fill’ for other solutions –
provision of solutions for existing system
gaps and full integration with existing
solutions
THE forms4health SOLUTION

A case study
LTHT – 13,000 users; 215,000+ forms
per month
40,000 handover documents preventing
accidental loss, and delivering
consistency of process and time for shift
handovers ‘markedly reduced’
90,000+ National Early Warning System,
e-obs forms per month – meeting
national standards
Primary Care Access Line – eForm
saves 4,000 pieces of paper per month
and removed fax referrals
forms4health IN NUMBERS

A case study
50-100 integrations achieved per
annum, from patient information
between systems to specialist
information to regional providers
Massive cost savings, the LCR efficiency
benefits alone were over £3 million
Unplanned patient list – forms4health
allowed £150k cost improvement,
reducing calls, faxes and administrative
time
Paper and ink saving £15,000 per month
forms4health IN NUMBERS

CONTACT US
Gill Smith
gill.smith@airelogic.com
07557 882616
Mike Odling-Smee
mike.odling-smee@airelogic.com
07946 512754
www.airelogic.com
@AireLogic
1 Aire Street, Leeds, LS1 4PR, UK
Tel: 0113 468 8527

Vote for your favourite poster in each region using Slido…
https://www.sli.do/
#InnovationChampion
Lunch

ePAQ
Electronic Personal Assessment
Questionnaire
Stephen Radley
Consultant Gynaecologist
Sheffield Teaching Hospitals NHS Foundation Trust

ePAQ
electronic Personal Assessment Questionnaire
Supporting healthcare with web-based instruments
12th October 2017, Leeds
Y&H AHSN Showcase
Stephen.Radley@sth.nhs.uk
Gynaecologist & Director of Research
Jessop Wing, Sheffield Teaching Hospitals NHS FT
Director of R&D, ePAQ Systems Ltd
An STH, NHS spin-out technology company

80.4
71.4
59.3 58.4
39.0
11.1
0%
20%
40%
60%
80%
100%
would
recommend
would
undergo
again
subjective
improvement
or cure
no GSI normal
urodynamic
study
subjective
cure
The ‘Science’ of Outcomes Assessment

Bristol female urinary
tract symptoms - Q
Birmingham
bowel & urinary
tract - Q
Sheffield prolapse
symptoms - Q
Female sexual
function index
ICS
Male
Pelvic Floor
Assessment (PAQ)
Questionnaires
Developing a web-based ‘Virtual Clinic’ in Urogynaecology

Radley S et al. Development & validation of a questionnaire for the
assessment of bowel symptoms in women. BJOG 2002
Radley SC et al. Computer interviewing in urogynaecology. BJOG 2006

Why an electronic
personal assessment
questionnaire (ePAQ)?
 Burden
 Value (interactive, simple & easy, help pages)

ePAQ – Pelvic Floor
A questionnaire for clinical use

Linking Internet & N3 networks
N3
(NHS)
Personalised
Name, DoB, NHS number,
WWW
(Internet)
Anonymous
Unique Voucher code
& DoB
EPR

ePAQ – Pelvic Floor
Structure
• Introductory pages
• Questionnaire dimensions (up to 120 items)
Urinary
Bowel
Vaginal
Sexual
• Analysis, summary, printed report
Interactive &
optional
dimensions

Routine use…
• Urinalysis
• Bladder diary
• Urodynamics
• Questionnaire?

Benefits of questionnaires in practice
• Embedded outcome measures (PROMs & PREMs) 1
• Avoiding clinician bias 2
• Engagement, enablement, empowerment 3
• Disclosure, discussion & shared decision making 4
1. Black et al Relationship between patient reported experience (PREMs) and
patient reported outcomes (PROMs) in elective surgery. BMJ 2013
2. Black et al. Impact of surgery for stress incontinence on morbidity: cohort study.
BMJ 1997
3. Dua et al: Understanding women’s experiences of electronic interviewing during
the clinical episode in urogynaecology: A qualitative study. IUGA Journal 2013
4. Schussler-Fiorenza et al. Using an electronic pelvic floor questionnaire to increase
discussion rates of urinary incontinence in primary care: an RCT. JWH 2015

Questionnaires to improve discussion & disclosure
Prevalence of coital incontinence in urogynaecology clinics
Author(s) Number Outcome measure Prevalence
Moran et al, 1999 2153 Interview 10.6%
Serati et al, 2008 132 Interview 11.6%
Madhu et al, 2015 11689 Interview 11.8%
Monsterrat et al, 2008 633 Questionnaire 36.2%
Bekker et al, 2009 136 Questionnaire 56%
El Azab, 2011 90 Questionnaire 66%
Jha et al, 2012 480 Questionnaire (ePAQ) 60%
Gray et al, 2016 2312 Questionnaire (ePAQ) 47%

The Virtual
Clinic
Name Tel Time
Anna Smith AS1234 078212344 14:00
Beryl Jones BJ8765 0114 3098909 14:10
Connie Lewis CL2345 0114 3897890 14:20
Diane Cole DC4567 07989997654 14:30
Edna Rose ER3847 07635668234 14:49
Fiona Groves FG2783 0114 3897890 14:50
Greta Holmes GH1783 0114 3897890 15:00
Heidi Hill HY7896 0114 3897890 15:10
Ida France TA1256 0114 3897890 15:20
Joanne Davies JD3456 0114 3897890 15:30
Kay Somers KS2365 07885668234 15:40
Lisa Tandy LY5698 0757 3897890 16:00
Margaret Smith MS3452 0114 3897890 16:10
Nora Bates NB2344 0114 3897890 16:20
Orla Charles OC3567 07835668234 16:30
Penelope Roper PR5702 07835668234 16:40
Rose Doyle RD5098 07835668234 16:50
Selena Bird SB8090 07835668234 17:00
Tina Moores TM3409 07835668234 17:10
Ursula King PL0987 07835668234 17:20
Violet Bonnett VB0934 07735668239 17:30

‘The questionnaire helped with communication’
%

Patient comments…
I preferred answering embarrassing questions via the questionnaire
Helped focus on urgent and relevant problem
Made me realise the extent of my problem
Helped talk at ease about my problems
It was really easy to use
Not having to worry about childcare
Not being examined

Evaluating the impact of a ‘virtual clinic’ on the quality and cost of patient care in
urogynaecology: An RCT
Jones GL, Radley SR, Jacques RM, Wood HJ, Brennan V, Dixon S.
195 Women: New patient referrals to urogynaecology clinic
Mean difference between groups (95% CI) for post consultation Patient Experience (PEQ) score

Resource
Cost per patient
(Intervention) (£)
N = 27
Cost per patient
(control) (£)
N = 30
Mean Difference
(£)
95% CI
Lower
95% CI
Upper
P-value
Cost of
Consultations
Consultation cost1 29.35 69.52 -40.17 - - -
Cost of software 2.40 2.40 0 - - -
Cost of computer N/A 0.25 -.25 - - -
Total consultation
costs per pt 31.75 72.17 £40 (56%) - - -
Direct costs 6/12
GP Visits 41.22 35.33 5.89 -25.29 37.06 .654
Practice nurse 0.94 2.13 -1.18 -3.77 1.41 .063
Appointments 251 188 62.67 -87.02 212.36 .405
Surgery 330 286 44.88 -353.35 442.97 .822
Other professionals
Physio 5 5 .05 -7.58 7.68 .989
Nurse 4.5 2 2.49 -5.48 10.45 .534
Consultant 8 14 -6.35 -23.22 10.51 .454
Total direct costs 641 532 108.37 -346.93 563.67 .635
Indirect costs 6/12
Personal
expenditure (£)
24 16 7.9 -6.04 21.84 .261
Loss of productivity 443 481 -37.81 -847.04 771.42 .926
Total indirect costs 467 497 -29.91 -839.47 779.66 .946
Total costs per pt 1,140 1102 38.04 -1119.34 1196.03 .948
RCT: New patient referrals in urogynaecology

New instruments
• Menstrual Connor / Gray
• Vulva Palmer / Tidy
• Knee Sutton
• Vascular Michaels / Jones
• Cardiac Briffa
• Penile Ca Braney
• GTD Tidy / Ireson
• Pre Op Andrzejowski / Goodhart

• To develop and validate a novel electronic
instrument for pre-operative assessment: ePAQ-PO.
• The study was approved by the South Yorkshire
Regional Ethics Committee (REC 09/H1308/127)
• £50K Grant from Sheffield Hospitals Charity
– Full time nurse for a year

STH Implementation
0
50
100
150
200
250
300
350
400
450
500
Sep-15
Oct-15
Nov-15
Dec-15
Jan-16
Feb-16
Mar-16
Apr-16
May-16
Jun-16
Jul-16
Aug-16
Sep-16
Oct-16
Nov-16
Dec-16
Jan-17
Feb-17
Mar-17
Apr-17
May-17
Jun-17
Number of patients completing ePAQ-PO

Walk-in Pre Operative Assessment
• 2 sites (NGH & RHH)
• 12 touchscreens
• Support worker
• POA nurse
• 5 long day service…

Improving pathways
Without ePAQ: 57.7 days
With ePAQ: 43.6 days
14.1 days less on average PER PATIENT

Summary
2 x B6 WTE
nurse time
saved
12
2 weeks

Standardisation
Clinical governance
Appraisal, revalidation, accreditation
Research, Audit, Service evaluation
Quality
Efficiency
Web-based assessment
Supporting patient-centred, effective & efficient healthcare
Communication
Assessment
Diagnosis
Decision-making
Monitoring

Integrated care pathways
N3 + www
1o care
2o care
3o care
Web-based
assessment

Conclusion…
e-assessment will be routine in healthcare,
patients will be…
Well-prepared
Well-informed
Have optimal communication tools & access
Engaged and responsible for their healthcare
Making best, informed decisions for themselves
Right place, right time, right clinician

Users
Manchester
Liverpool
Sheffield
Birmingham
Newcastle
South Tees
Southport
Ormskirk
Macclesfield
Calderdale
Italy (Milan)
Australia
100,000+
Colorectal, Urology, Physiotherapy,
Urogynaecology, Nurse Specialists

Thank you
ePAQ-Pre Op workshop
Friday 20th October, 1pm – 5pm
Royal Hallamshire Hospital Sheffield
Meetings coordinator Robert.Rumsey@sth.nhs.uk
www.epaq.co.uk
stephen.radley@sth.nhs.uk

3D Printing
Rob Cooper
Consultant Cardiologist
Liverpool Heart and Chest Hospital

3D PRINTING IN CARDIOLOGY –
AN AID TO PERSONALISED
STRUCTURAL INTERVENTION?
Rob Cooper
Consultant Cardiologist
Liverpool Heart and Chest Hospital

 Patient education
 Closing holes in the heart
 Atrial septal defects
 Innovation agency
 Planning operations for patients with
hypertrophic cardiomyopathy
3D Cardiac printing at LHCH

Patient (and colleague!) education

 Cardio - myo - pathy
 Heart - muscle - problem
 Hypertrophic – thickened / overdeveloped
 “Is my heart enlarged?”
 “What does hypertrophic mean?”
 “You’re going to do what to my heart?!”
Patient education

Hypertrophic Cardiomyopathy
LV
RA
LA
RV
LV
RA
LA
RV

Hypertrophic Obstructive Cardiomyopathy

 Mike has helped to educate:
 2 years worth of HCM patients at LHCH
 Junior doctors
 Ward nurses
 Nurse specialists
 GPs
 Geneticists
 Radiographers
 Echocardiographers
 Consultant cardiologists
 Why stop there?
Education

Moving on to normal
Muscle print
Blood volume print

 Born with abnormal plumbing or unhelpful
holes in the heart.
 Operated on usually in neonatal period
 Complex operations (variation on a theme)
 Then years of use
 End result is complex adult hearts!
Adult congenital heart disease

Transposition of the great arteries
RV
To lungs
RV
To bodyTo body
LV
To lungs
LV
Normal Abnormal

Atrial septal defects
Normal Atrial septal defect

 From education to treatment
 Atrial septal defects (hole in the heart) predispose to heart
failure and stroke in adulthood
 Often not diagnosed in childhood
 In some cases closure of the hole is indicated
 Can be done surgically
 Can be ‘keyhole’
Closing holes in the heart

Atrial septal defect
LV
RA
LA
RV
LV
RA
LA
RV

 Funding from Innovation agency to print 15
successive ASD models
 Site non-sterile devices in the defect the week
before
 Hypothesis:
 Siting a closure device in a 3D model before ASD
closure will reduce complications and wastage during
the procedure.
 Understanding of the cardiac anatomy will improve
patients understanding of the procedure and ease
associated anxiety
ASD printing project

Planning operations for patients with
hypertrophic cardiomyopathy

 Surgical myectomy has a long history in
treatment of obstruction out of the heart
Surgery

Questions?
Patients head
Left main stem
RCA/right coronary cusp

CT896510
The surgical view
Offending connection

 Attempts to build this in to NHS models and tariffs
 Anecdotal evidence so far
 Not a great currency to take to your finance officers
 Approaching charities / local philanthropists to
support a formal project
 ?Reduce surgical operation times
 ?Reduce complications
 Save money anywhere to squeeze a model in to the
operation cost!
Personalised model for myectomy

 Patient education
 ASD percutaneous (keyhole) closure guidance
 Myectomy operation guidance
3D printing in Liverpool

Zilico – The Story So Far…
Sameer Kothari
CEO
Zilico

October 2017 Northern Innovation, AHSN

April 2010 208September 2009 Commercial in ConfidenceOctober 2008 Commercial in Confidence 208
October 17 Commercial in confidence 208

The current practice falls short of an effective diagnostic standard
 Current diagnostic techniques rely on visual indicators
 Visual indicators are non-specific, highly variable, subjective and
labour-intensive
 Some disease lacks the usual visual indicators making it very challenging
to identify
Therefore causing
 Poor performance - high number of false positives
 High false positive rate leads to overtreatment of patients and
increased cost of care
 Unnecessary multiple diagnostic biopsies
 1 in 4 treatment excisions are negative
Problems with Current Diagnostic Approach

How EIS Technology Works
 Defined cell layers
 Close packing of cells.
 High electrical
impedance.
 Disorganized with no
defined cell layers.
 Increased extracellular
space.
 Increased nuclear
cytoplasmic ratio.
 Low electrical
impedance.
HealthyCervicalEpithelium
CIN3CervicalEpithelium
Electrical
Current
The electrical impedance of
cells is measured across a
range of frequencies. This
generates a tissue specific
spectrum. Therefore
changes in the spectrum
can be related to changes in
the underlying nature of the
tissue – depicted in the
spectra below.
Squamous
High grade (CIN2-3)
Low grade (CIN1)
Immature metaplasia
Columnar

Executive Summary
 Zilico Ltd. manufactures next generation cancer diagnostic devices
 Remove subjectivity and increase accuracy of results
 Reduce costs and better target resources in screening programmes
 Platform Technology based on Electrical Impedance Spectroscopy (EIS)
 Differentiates normal, pre-cancer and cancer cells in real time
 Patents granted in Europe, USA, Canada, Australia, Japan, India. Filed in Brazil
 Lead product ZedScan for cervical cancer
 Immediate addressable market opportunity of $500m ($700m including emerging markets)
 Superior solution: Offers more accurate diagnosis in real-time, detecting additional disease
 Helps clinicians to better manage patients
 Already in routine use in the NHS
 5 clinical trials completed & presented in peer-reviewed journals
 Certification: CE marked (Sept 2013) cleared for EU launch. FDA expected in 2020
 NICE (UK) has published a Medtech Innovation Briefing note on ZedScan
 Significant growth opportunity as technology platform can be applied to a range of cancers, allowing for
product extensions

1998
Applications for
cervical cancer:
Prof. J. Tidy & Prof.
B. Brown
2000
1st trial -
publication in
Lancet
2003
Founders receive
NEAT grant from
NHS
2006
UoS & NHS
form Zilico
2009/11
EU Multi-centre
trial completed
2005
3 further trials
2013
ZedScan
awarded CE
Mark
Evolution of ZedScan
£1m grant funding £6m equity investment
2014
ZedScan – 1st
commercial
order
Proof Of Concept
Technology
Optimisation /
HW
Development
Clinical
Evidence

STH - Medical Device Innovation
 Support the academic research
 Electronic and Mechanical design and development
 Device production and labelling
 Design and production to meet regulatory standards e.g. BS 60601
– Electrical safety +
 Medical device risk management
 Technical file production to support MHRA clinical trial applications
 Clinical trial support – verification and validation activities in
respects of data accrued.
 ZedScan QA as ongoing validation

The latest Multi Frequency Impedance Meter
devices

Clinical pathway - ZedScan
Referral - 2-6 weeks
-ve+ve
+ve Results within 2 weeks
+ve -ve
Pap/LBC smear test
High
Grade
Low Grade
Borderline
Colposcopy
Dx Biopsy
< Low grade
precancer
High grade
precancer
Cancer
Another smear/colposcopy
within 6 months
LLETZ (excision)Treatment - Laser ablation,
Radiotherapy, Chemotherapy
ZedScan+

+ ZedScan
The Future…mature healthcare markets
Referral - 2-6 weeks
-ve+ve
+ve
+ve -ve
HPV Test
HPV infection is
essential but
only 10% leads
to disease
Colposcopy
Dx Biopsy
< CIN 1CIN 2/3Cancer
Another smear/colposcopy
within 6 months
LLETZ (excision)Treatment - Laser ablation,
Radiotherapy, Chemotherapy
+ Cytology ?
“Conclusions The major concern with switching from cytology to more sensitive
HPV screening is management of the many HPV-positive women, including those
with still non-visible ≥CIN2 lesions. Our data support the need for a non-visual
diagnostic method to guide management and treatment of HPV-positive
women."
Schiffman et al 2011
“Conclusions: Human papillomavirus type 16 is related to more clear visual
acetowhite changes in the epithelium. Therefore, we should expect a
reduction of the performance of VIA for cervical cancer screening to identify
women with CIN2+, and reduction of the performance of colposcopy
to diagnose CIN2+, in vaccinated populations."
Jeronimo et al 2015

Real World Data – 1570 women
 Detect more disease
 An additional 13.25% of high-grade disease was identified.
 50% increase in women with low grade abnormalities
 Average biopsy rate was lower – 285 fewer biopsies
 Colposcopy failed to identify 14.1% of all high-grade histology whereas ZedScan only failed to identify 3.8% of
all high-grade histology.
 The ‘See and Treat’ rate has increased from 36-39% in previous years to 68% high-grade disease was
confirmed in 94.2% of the case exceeding the value of 90% PPV indicated by the national guidelines.
 There has been a decline of >40% (302 appointments) in the number of follow up appointments since the
introduction of ZedScan.

1 p=0.0171
2 p=0.0001
Visual
Non
visual
Equates to
ca. 10,000
additional
women
detected
with HG CIN
- UK
- 800 patients case study

Health Economics
1000
New patients pa
Colposcopy
HHH
HH H
£ £ £ £ £ £ £
£ £ £ £
Colposcopy &
ZedScan
£ £ £ £ £ £ £
£ £
Biopsies
Appointments
& follow ups
 £210K net savings
 1443 clinic appointments released
3 Years3 Years
HHH
H
6015 4572
3078
£0.85M
2008
£1.06M
-24%
-20%
-35%

Are you 1o HPV Ready?
 England moving to 1o HPV in 2019 replacing smears
 6 centre sentinel study
 60% increase in referrals
 HPV +ve Cytology –ve women
 CSW meeting last month
 70% increase in referrals
 Need technology to manage this capacity time bomb!

Mobilise the NHS
Sarah Thew
Innovation Manager
Health Innovation Manchester
Chris Chapman
Salford Royal Foundation Trust

Click to edit Master title
Problems that Matter
Codesign Partnerships between the
NHS and Digital SMEs
Sarah Thew
Health Innovation Manchester
Chris Chapman
Salford Royal Foundation Trust

Great design
depends upon a
deep understanding
of the problem

A
Juicy Salif
Philippe Starck for Alessi

A
UK Motorway Sign
Photo Credit: www.kitchen-kraft.co.uk

How do we enable
great design in the
NHS?

A
#MobiliseTheNHS

Mobilise the NHS
9Partnerships
Creative Partnerships between Clinicians and SMEs
3 Ongoing
CollaborationsPhysiotherapy
Teenage Diabetic
Support
Metabolic Disorders
Ongoing medical
education
Emergency Stoke Care
Anti-microbial
management
Diagnosis of autism
In-patient
communication support
Rheumatoid Arthritis
2015 Bolton FT
2016/16 Salford
Royal and the
NorthWest
Ambulance
Service
5
SMEs continue to
work with the NHS
More post-it notes
and cake that you
can imagine…!

What next?
User Research to
Identify and Drive
Informatics Projects
Community building

Thanks for Listening
Sarah.Thew@healthinnovationmanchester.org
@Sarri
Chris.Chapman@srft.nhs.uk

The Innovation Pathway in an Acute Trust
Charlotte Fox
Innovation Manager
City Hospitals Sunderland NHS Foundation Trust

The Innovation Pathway in an Acute Trust
Charlotte Fox, Innovation Manager
City Hospitals Sunderland NHS Foundation Trust
@charlottefox22@SunderlandRoyal

• CHSFT Innovation Journey
• Importance of structure
• Developing a pathway
• Networking to support the
pathway
• Case Studies

Our Innovation Journey
• Innovation at CHSFT was
launched in January 2015
• Using AHSN funding
appointed an Innovation
Manager and
Administrative Assistant
• As well as….
https://www.pinterest.com/explore/life-journey-quotes/

CHSFT Innovation Scouts
https://www.empireonline.com/movies/fantastic-four/review/

Director of Research &
Development
Research & Development
Business Manager
Manager
Senior Research Nurse
3x Research Nurses
Clinical Trials Officer
Officer
Data Manager
Admin Assistant
Research & Development at CHSFT pre
Innovation

Director of Research &
Innovation
Research & Innovation
Business Manager
Research Manager
Research & Admin
Assistant
Innovation Scouts
x4
Innovation
Admin Assistant
Deputy Director of
Innovation Device &
Digital
Deputy Director of
Innovation
Clinical Pathways & POCT
Deputy Director of
Research
Innovation Manager
Data Managers
x3
Research Nurses
(Generic)
x7
Research
Administration
Officer
Current Research &
Innovation
Structure at CHSFT
Innovation
Management
Trainee

Bright Ideas Pathway at CHSFT
• Capture
• Assess- protect & assign
• Develop a plan- key
milestones
• Evaluate
• Implement

Networking
• Find Opportunities
• Benefitted the organisational
reputation
• Built trusted relationships
• Plugs gaps in knowledge
“What you pay forward will
pay back in the future”
http://www.cyclonelife.net/2017/03/how-to-spend-your-spring-break-at-home/networking-meme/

Organisations we work with
“Bright Ideas” Awards

Examples of Innovation at CHSFT

The Tookie Vest
Dr. Saeed Ahmed
(Sid) Consultant
Kidney Specialist

Unmet need: Accidental line
fall out of Central Venous
Catheter
Occurs in ~20% of patients
Each line re-instatement costs
the NHS approximately
£3,000.00
https://www.cancer.gov/publications/dictionaries/cancer-terms?cdrid=45962
Connect

Solution: Adapting the Tookie
Paediatric Oncology Vest for
Renal patients to secure the
catheter
Tookie ethos is
#ALifeMoreNormal
Improving patient safety &
experience

• Medconnect North with City Hospitals Sunderland and Tookie
facilitated patient workshops to develop the vest
• The vest is now being manufactured
• It will be evaluated as part of a multicentre clinical trial

All About Me Boards
Debbie Hindmarsh
Ward Manager
Acute Stroke Unit

Communication problems are very common after stroke, around one
third of stroke survivors have problems with speaking, reading,
writing and understanding what other people say to them
When we communicate, our brain has to complete a series of tasks.
Different parts of the brain are responsible for each of these tasks. If
one of these parts is damaged by a stroke, it can cause problems
with communication
Unmet need: Communication

In response to a complaint from a different area in the Trust, a
patient who had previously had a stroke struggled to articulate his
nursing needs which resulted in distress for both the patient and his
relatives
As an organisation we listen to our patients and relatives and we
responded and acted upon comments from real time feedback about
them not being involved in their loved ones care and decision making
Using Lessons Learnt

Next steps
All about me...
Patient, family & friends: Please feel free to share information, pictures etc....
I prefer to
be called
You might be surprised
to know....
My favourite things:
activities, food, movies, games,
books, music, TV, etc,).....
Items that comfort me.....
Today's news...
Things I may need help with
(include fears)...

CHS Shoulder Bench
Developed by: Ala Mohammed, ED Consultant. City Hospitals Sunderland NHS
Foundation Trust
Multidisciplinary Training
Sessions
Online Training Video
Putting Research into
Practice
Shared learning and
innovation
Direct access from ED to new
Shoulder Dislocation Clinic
41% Less Procedural
Sedations Required
34% Reduction in Time to
Successful Treatment
29% Reduction in Time to
Discharge
6 week Reduction in Time to
specialist follow up

Next Steps & Poster Competition Winners
Juliette Kumar
Associate Director of Education and Improvement
The Innovation Agency

Northern innovation and networking event 2017

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