Innovation and Technology Tariff (ITT)
The Innovation and Technology Tariff has been introduced to incentivise the adoption and spread of transformational innovation in the NHS.

Ideas (Publish, Detailed Submission)

Innovation 'Elevator Pitch':
The unique PneuX™ System monitors the endotracheal or tracheostomy tube’s seal. It measures cuff pressure and continuously adjusts itself to seal the patient’s trachea to prevent ventilator-associated pneumonia (VAP) during mechanical ventilation.
Overview of Innovation:
The PneuX™ System is for airway management in critically ill patients receiving mechanical ventilation. The system is designed to prevent ventilator-associated pneumonia (VAP) by minimising the risk of pulmonary aspiration and micro-aspiration of bacteria-contaminated subglottic secretions in patients having prolonged ventilation. The silicone material of the tube and cuff has been specifically designed to overcome the problems which cause VAP with standard endotracheal tubes, such as folds and creases in the inflatable cuff, loss of seal due to patient or tube movement and maintenance of cuff pressure. The PneuX™ System permits subglottic irrigation and drainage to remove infective material.
 
VAP - The problem
In the UK each year, 100,000 patients are admitted to critical care units for mechanical ventilation, and of these patients, 10-20% will develop ventilator associated pneumonia. Patients who develop VAP have an increased length of stay on ICU and increased mortality rate; of these 10,000 – 20,000 patients who develop VAP, between 3,000 and 6,000 per each year die in the UK with this type of pneumonia.
VAP is the leading nosocomial cause of mortality in ICU and the most common cause of VAP is aspiration of contaminated secretions from the oropharyngeal space. Aspiration occurs passed standard tubes or cuffs by three mechanisms:
  • Channels or invaginations within the inflated cuff
  • Movement of the cuff
  • Loss of cuff pressure
 
The costs of treating VAP are significant, between £10,000 and £20,000 per patient. As such, conservative estimates for prevention are savings to the NHS of over £100 million and this does not account for savings from the associated reduced length of stay.
 
The Solution
The PneuX™ System promotes patient safety through a five-pronged approach:
  • Reduced cuff leakage
  • Maintenance of cuff pressure
  • Convenient drainage and irrigation of subglottic secretions
  • Prevention of tube movement and accidental extubation
  • Potential inhibition of biofilm formation in tube lumen

The PneuX™ System is thus designed to produce an optimal seal and improve airway management to prevent VAP in ventilated patients in ICU or during prolonged major surgery.
 
The PneuX™ System attracts the Innovation and Technology Tariff (ITT), and as such is zero cost to provider Trusts to implement.  Thus, as well as improving patient safety for patients in critical care, the use of this innovation will provide a cost saving for the Trust over the life of the ITT.
Stage of Development:
Market ready and adopted - Fully proven, commercially deployable, market ready and already adopted in some areas (in a different region or sector)
WMAHSN priorities and themes addressed: 
Education, training and future workforce / Wealth creation / Innovation and adoption / Patient and medicines safety
Benefit to NHS:
Key Benefits
  • Major reduction of VAP cases within a Trust’s ITU
  • Improving patient safety and outcomes
  • Improving Patient flow - Using the PneuX™ System will likely improve the flow of patients coming to ICU (preventing VAP leads to reduced length of stay) and could enable an increase in elective surgical work.
  • Reducing Bed Stay significantly reduces the subsequent costs, treatment and hospital stay costs from anyone acquiring VAP. 
Note: There is a likely to be a small impact on the staff due to initial training requirements on the use of the PneuX™ System.  Comprehensive Training is provided by Qualitech Healthcare Limited.
 
Measuring the reduction of VAP within a Trust
To assist NHS England in assessing the impact of this innovation and its uptake there are some data collection requirements for the ITT programme (zero cost provision of the technology). These include:
  • Prevalence of VAP for the previous financial year (This is only required for the first report)
  • Prevalence of VAP during the period of reporting
  •  Number of PneuX™ tubes or other approved VAP prevention devices used on patients ventilated for 24 hours or more
 
Measuring the direct Financial Benefit
To record the impact of this innovation, Trusts engaged in the ITT programme, need to indicate the current number and cost of endotracheal tubes ordered per annum in ICU.
 
This is to establish that the PneuX™ System significantly reduces the number of endotracheal tubes being used. Whilst the current tubes may still be required, there will be a significant reduction in stock level required which will generate a cost saving. (Trusts may wish to add proposed reduction in current ETT usage)
 
The cost of the Venner TSM™ Tracheal Seal Monitor is zero to Trusts as provided on loan, with a minimum of 24 ETT’s to be ordered per year for each TSM™.
After a 2-year period the ITT will be evaluated by NHS England to determine whether it should be continued. It is recommended to use the PneuX™ System for the lifespan of the ITT.


Thus, there are key benefits to patients and Trusts through the use of Venner PneuX™ System, significantly reducing the incidence of ventilator associated pneumonia (VAP); In time, costs and administrative burden plus removing the stress from potential incident reports and investigations that may occur. In addition to ensuring the patient’s safety and quick recovery.
Initial Review Rating
4.20 (2 ratings)
Benefit to WM population:
Key Regional Benefits
  • Better West Midlands’ patient outcomes and increased patient safety
  • West Midlands’ reduced incidence of VAP
    • and significant reduction in the cost of treating subsequent infections
    • reduction in stress for patients and staff where VAP occurs
    • eradication of related paperwork recording and reporting VAP cases  
  • Reduction in length of patient stay in regional Trusts
  • Reduction in regional / Trust procurement costs of buying endotracheal or tracheostomy tubes per annum
  • Free Loan of Kit during ITT to judge the value of adoption of PneuX™ System into Trusts ICU standard operational procedures.
     
Note: As the Venner PneuX™ System attracts the Innovation and Technology Tariff, there is a zero cost-implication of introducing this device. In fact, it will generate a cost saving (from April 2017 for 2 years), as there will be a reduction in the number of current standard endotracheal tubes required.
 
Please see attached document ‘PneuX Implementation Pack v4.0’ to see how your Trust can implement the PneuX System™ under the NHS England Innovation Technology Tariff
Current and planned activity: 
Current Utilisation Studies underway:
  • Bristol Royal Infirmary
  • Manchester Royal Infirmary
  • Stepping Hill Hospital
  • Ipswich Hospital
 
Recent publication:
  • JICS Journal of Intensive Care Society 0(0) 1 – 7
    “Cost of treating ventilator-associated pneumonia post cardiac surgery in the National Health Service: Results from a propensity-matched cohort study” – Heyman Luckraz et al.
    Heart & Lung Centre, The Royal Wolverhampton NHS Trust.
    Link - http://journals.sagepub.com/doi/pdf/10.1177/1751143717740804

Planned activity
January 2018 the WMAHSN will be holding an ITT/ITP workshop for West Midlands ITU and other critical care units to hear in detail about the PneuX™ System and the NHS England ITT. See www.wmahsn.org/events/upcoming/2018/01 for more details.
 
Thus, we would like to discuss:
  • Procurement / Adoption of Venner PneuX™ System: - Interested in meeting ICU teams and others to discuss the System and its adoption via NHS England ITT.
  • Establish Utilisation Studies in West Midlands ICU’s.
What is the intellectual property status of your innovation?:
Patent protected
BSI - EN ISO 13485:2012
Class II (a)
 
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
0-6 mon
Ease of scalability: 
3
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Nicki Dill 23/11/2017 - 09:59 Publish Login or Register to post comments
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