Innovation Warehouse - Stories
Meridian is a resource for you to be able to share the changes that you have made to the way that you do things that have resulted in improved health outcomes for patients, a more effective way of delivering more for less, an increase in the productivity or just a different way of doing things.  Please use this space to upload the innovations that you wish to share and that others can benefit from.
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Innovation (Approved)

Overview summary:
This tool has been developed by a team at UHCW, headed up by Professor Meghana Pandit, Chief Medical Officer & Deputy CEO.

This is a digital tool that will enable tracking of all post-surgical complications / morbidity by surgeon for each patient. It will enable learning and help reduce complication rates and identify trends in complications and morbidity.
Challenge identified and actions taken :
This innovation is a surgical morbidity scorecard developed at UHCW. It allows capture of theatre details and complications from two different systems onto a scorecard. The idea being that each month, surgical teams can review their performance as a team or as individual suegons and analyse the data. The indicators include generic surgical morbidity measures such as length of stay, readmissions, heamorrhage, DVT, PE, wound infection, return to theatre and unexpected admission to ITU. With this data available for each surgeon and each patient, surgeons will be able to iddentify need for change in practice and equally will be able to counsel / consent patients before surgery with their own morbidity / complication rates. 

This information is sufficiently robust to enable identification of trends in morbidity, allow in depth review when concerns are highlighted.  Such morbidity data, when appropriately actioned can be utilised to improve quality of patient care. 

The morbidity scorecard demonstrates that it is possible to establish an automated system capable of identifying trends in outcome. Accurate recording and reporting of surgical outcomes, in particular morbidity figures, is important in maintaining and improving surgical practice and perioperative care.
Impacts / outcomes: 
This innovation has a clear benefit to patient care and to the NHS. It will improve an understanding of surgical morbidity prospectively enabling surgeons to change practice when rquired. It also enables reduction of complications through learning therby reducing cost to the NHS. Furthermore, patients will benefit from improved counselling and consenting process.
Which local or national clinical or policy priorities does this innovation address:
NHS England guidance on the review and monitoring or morbidity rates.
Supporting quote for the innovation from key stakeholders:
In Healthy Measures: A UK gynaecologist’s plan to improve hysterectomy outcomes led her to develop a Surgical Scorecard that can be used in all surgical specialties. 
Plans for the future:
In terms of the development of the system itself, we plan to increase the number of indicators on the scorecard. These will be speciality specific bespoke indicators.

We are also hoping that this may be taken up throughout the region and the wider NHS and would welcome enquiries about assisting other organisations in doing so, either licensing the materials that we have develoed here at UHCW, or passing on knowledge to enable similar systems to be developed in-house elsewhere.
Tips for adoption:
As above, we would be happy to have a discussion with you regarding implementing this in your organisation. Please see the contact details below.
Contact for further information:
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Meghana Pandit 15/07/2017 - 15:13 Approved
Overview summary:
NHS Vale & York CCG introduced Proactive Health Coaching (PHC), a unique delivery structure bringing together the CCG, private partner, hospital trust, community partners & independent evaluator.
PHC is a telephone-based health management service that improves patient health & quality of life while ensuring healthcare resources are spent as efficiently as possible.
The CCG with partners Health Navigator & York Teaching Hospital delivered a preventative strategy for identified patients delivering better care for patients & reducing stress on A&E.

Challenge identified and actions taken :
NHS Vale of York CCG identified that a large percentage of A&E contact in the area as avoidable. It resolved to tackle the issue head on through work that aligned with local sustainability and transformation plans and its system-wide collaboration with partners.
But the system context in Vale of York is complex. It has three local authorities, an acute and community provider, a mental health trust, a large voluntary sector and alliances of primary care practices working in locality groupings.
Added to that, the clinical commissioning group (CCG) is in special measures due to its challenging financial position and demand is growing across the footprint, with an unsustainable increase in emergency department visits in Vale of York.

To address these challenges, the CCG embarked on a collaborative project with Health Navigator and other partners to see whether it could support patients to self-care better. It also wanted to help patients to navigate the wide variety of care options, to reduce demand on emergency services, so improving patient outcomes and reducing cost to the system.
Impacts / outcomes: 
In partnership with Health Navigator and York Teaching Hospital NHS Foundation Trust, the CCG delivered an effective preventative strategy for identified patients that simultaneously provides better care for patients and reduces stress on A&E departments.
Using an algorithm, Proactive Health Coaching identifies patients before they become high users of urgent care services it works by supporting patients with weekly coaching calls in a randomised control trial and facilitates:
  • putting patients at the centre of care
  • patients being able to define their own goals so they can take control of their health and care journey, using services other than A&E
  • a better experience and outcomes for patients
  • commissioners, acute providers and primary care being able to work together
  • a reduction of the burden on A&E and inpatient services by reducing unnecessary attendances from some patient cohorts
  • a more efficient use of healthcare resources.
By supporting patients with weekly coaching calls, the randomised control trial is already showing high levels of improved patient experience, a reduction in attendances at A&E and fewer unplanned admissions to hospital. Patients being supported by the health coaching intervention are also reporting more confidence in the management of their conditions.

Results from an earlier NHS case study collated by York Teaching Hospital NHS Foundation Trust are currently being evaluated and published by the Nuffield Trust, an independent health charity. The patients formally contract with Health Navigator, which at present covers a relatively small patient group of 183 study participants, of which 121 patients have had the support of a health coach. At the time of evaluation, this has yielded savings per patient in the first year of the intervention of £1,034 less than the control group. This means that the service is already close to break-even in its first year, as it costs £1,200 per person for a two-year intervention.
Based on results in Sweden, it is anticipated that those receiving the service will have a further benefit in year two, equating to around 40 per cent further savings. This should mean a total saving of £1,448 per person and a net benefit to the commissioner of £248 per person over the two-year intervention.
Moreover, there are the associated operational benefits from taking activity out of the system. In particular, the intervention group has had 63 per cent fewer non-elective admissions and 60 per cent fewer A&E attendances. The number of bed days was 17 per cent less than the control group.
All of these represent the first year of the intervention only and across a small population group. The CCG recognises that results may change as study numbers increase. It is fully expected that over time, and as a greater number of patients are included within the study, the potential impact is normalised out across the population and the end result may be a slightly lower number, but the trend is clearly a positive one.
These early results mirror the significant impact that has been seen in the much larger trial in Sweden where over 12,000 patients have received similar support. Results from the Swedish trial have been published in the European Journal of Emergency Medicine in 2012 and 2015. The most recent results are showing statistical reductions of 30% in non-electives and 36% in A&E attendances.
The results also provide evidence of relevance, spread and replicability, with the initiative being easy to replicate nationally, even in financially challenged care economies. It also has the ability to be scaled up to cover a wider range of conditions.

Which local or national clinical or policy priorities does this innovation address:
NHS England’s Five Year Forward View - NHS England’s Five Year Forward View states there is a traditional divide between primary care, community services and hospitals, largely unaltered since the birth of the NHS, is increasingly a barrier to the personalised and co-ordinated health services patients need. The NHS will increasingly need to dissolve these traditional boundaries. Long term conditions are now a central task of the NHS; caring for these needs requires a partnership with patients over the long term rather than providing single, unconnected ‘episodes’ of care. Proactive Health Coaching allows for services to be integrated around the patient.
Plans for the future:
This is an exciting time for Health Navigator UK. We are encouraged by the progress we are making and are delighted to have secured a number of significant contracts to deliver new and innovative healthcare services in the UK.
Proactive Health Coaching is being delivered together with various CCG partners in England and will be evaluated by the Nuffield Trust on a yearly basis.
We are at the start of a significant growth phase but acknowledge we cannot do it alone and we are seeking additional sites in the West Midlands to work with.
If you would like to explore this opportunity please get in touch.
Tips for adoption:
Key learning:
  • Don’t underestimate how important it is to gain buy-in from partners. Time spent working together is key to success at all levels.
  • Setting up a project to meet research standards and guidelines, and gaining ethics approval, is perhaps the most time consuming part of the project.
  • It is important to understand the finance and activity relationship between this intervention and any other scheme, coding or change targeting a similar area, as this can skew the results. It is essential to ensure you are looking at like-for-like datasets.
  • Working with patients to help them understand their conditions and navigate the system effectively has a massive impact on people’s confidence to manage their own conditions. Continuity of support and time spent early on has a lasting impact on health behaviours and use of health and care resources.
Takeaway tips:
  • Agree the inclusion process and mechanisms for contacting patients as early as you can.
  • Engage widely, particularly around governance requirements of each partner organisation.
  • Organisations such as Healthwatch are invaluable in helping to support patients and encourage participation.
  • Develop appropriate contract risk shares to provide financial incentive to the provider to ensure delivery while protecting the commissioner from exposure to the full impact of any potential non-delivery.
Contact for further information:
Ravinder Sandhu
Managing Director UK
Health Navigator Ltd
T: 07717 412543
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Ravinder Sandhu 21/05/2018 - 12:17 Approved
Overview summary:
The project used existing pharmacy interventions, New Medicine Service (NMS) and Medicines Use Reviews (MURs) to improve knowledge and confidence in using the correct injectable therapies for both community pharmacy and patients. Pharmacists attended 2 training events focused on improving knowledge and consultation skills with patients with diabetes who were using injectable therapies. Pharmacists were also introduced to a consultation framework, the Five Star Diabetes Consultation, which became the framework for future patient consultations.  
Challenge identified and actions taken :
It was intended that the project would:
  • Develop an education framework for a community pharmacy consultation on injectable therapies in diabetes  
  • Develop a community pharmacy consultation framework for injectable diabetes therapies
  • Enable community pharmacists in the pilot to deliver patient support for injectable therapies for diabetes via a consultation
  • Measure outcomes to show the value of interventions  
  • Increase confidence of pharmacists in conducting consultations and improve the competence of patients using injectable therapies
  • Foster closer relationships between community pharmacy and general practice
27 community pharmacies and eight general practice surgeries in the Coventry and Rugby CCG participated in the project around the following areas: 

Pharmacy education: An initial engagement meeting was held ito communicate the project. This also provided an insight into the training needs for community pharmacy. Two pharmacy training events were delivered. 

Framework for pharmacy consultation: The project team developed a pharmacy consultation framework, the Five Star Consultation, which provides a guide to pharmacy on how to deliver a patient consultation.

Development of an education framework: A declaration of competence was produced in order to provide a framework for pharmacists to develop and maintain skills.
Impacts / outcomes: 
Project outcomes include: 
  • A pharmacy consultation and education framework was written
  • Pharmacists who attended the training reported an increase in confidence pre- to post-training as a consequence of the training, with 77% likely to complete and NMS/MUR consultation as a result of the training.  
  • During May and June 2017, 50 consultations on injectable therapy were completed as a result of the training.
  • An improvement in pharmacists’ ability to deliver consultations for diabetes injectable medication.  
  • Pharmacist reported a significant increase in their confidence to deliver consultation for patients taking injectable diabetes therapies. Figure 1: illustrates the impact which the project has had on improving the ability of community pharmacy to deliver NMS/MUR.
  • Pharmacists felt the face to face training was excellent, ‘the best’ one the pharmacist had ever attended. 
Videos of the 2 start and 5 star consultation along with an engagement video are available upon request. 
Which local or national clinical or policy priorities does this innovation address:
Five Year Forward View and providing support to long term conditions
Supporting quote for the innovation from key stakeholders:
“As barriers are broken down across the NHS and boundaries become blurred, patient pathways for injecting become all the more important and this needs to begin with better support for Advanced people to manage their own health. 

“Much greater pharmacist support to people with long-term conditions should be the ultimate aim, but only as one element of a patient’s care and alongside measures to improve public health. It needs to be delivered in a way that is integrated both in terms of NHS and public health systems.”

Community Pharmacy Clinical Review The Kings Fund 

"Diabetes is a fast growing health threat facing our nation.  Over 3 million people are living with diabetes in England.  If their condition is managed they can live longer and fuller lives. The cost of diabetes to the NHS will continue to rise.  In order to ontrol these costs, the Department and the NHS must take significant action to improve prevention and treatment for diabetes in the next couple of years"

Diabetes United Kingdom - State of the Nation 2016
Plans for the future:
This programme highlighted the benefits of involving Community Pharmacists in supporting people with long term conditions and the future could involve a much wider cohort of conditions to support.  The Health Living Pharmacies start to underpin this approach and are evolving across the region at pace and scale. 
Tips for adoption:
Conclusions and lessons learned:
  • The project identified a lack of integration between general practice and community pharmacy, with little or no incentive to integrate community pharmacy into general practice. Figure 2 within the case study attached illustrates the current interface between general practice and community pharmacy and an envisioned process.
  • The project team had not anticipated the lack of awareness from primary care of pharmacy NMS and MUR
  • When engaging with general practice it is essential to secure a CCG sponsor who will facilitate engagement from general practice
  • Education and consultation frameworks were developed and can be used for future projects
  • Completing the data recording paperwork by pharmacists was a barrier to data collection owing to other data collection work happening at the same time. This resulted in a lower than expected data return. 
Contact for further information:
NHS England’s (NHSE) West Midlands Pharmacy Local Professional Network, the West Midlands Academic Health Science Network, Coventry and Rugby Clinical Commissioning Group (CCG) and Coventry Local Pharmaceutical Committee, Lilly UK and Novo Nordisk Limited completed a joint working project aimed at improving the outcomes of patients with diabetes who were taking injectable therapies. 

More information can be found in the attached document or by contacting: 

Lucy Chatwin 
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West Midlands Academic Health Scien... 18/01/2018 - 11:34 Approved
Overview summary:
Working in collaboration with TeleHealth platform developer Dignio, Sykehuset Østfold Hospital in Norway began the pilot project in January 2017.
This ground-breaking cancer care pilot project has produced significant results. This is the first trial in the world where patients were empowered to measure their own white blood cells in the comfort of their own home. A small-scale trial has been completed which has shown positive feedback from patients, clinicians and carers. And now the hospital is funding a larger scale clinical trial.
Challenge identified and actions taken :
The side effects of chemotherapy seriously impact cancer patients’ daily lives. Managing them effectively is a long-time concern for doctors and clinicians.
The project was initiated and managed by Sykehuset Østfold Hospital’s cancer specialists Elisabet Nilsen Holm and Andreas Stensvold. Working in collaboration with Norway based TeleHealth platform provider Dignio A/S, Sykehuset Østfold Hospital began the project in January 2017.
Dignio Prevent is a secure, off-the-shelf, cloud based device agnostic Remote Patient Monitoring and Telehealth Solution. Dignio can be deployed very quickly with no input from, or impact on, current IT structures, software or licensing services. For the project with Sykehuset Østfold Hospital Dignio provided a complete remote patient vital signs monitoring solution which included an innovative, Bluetooth enabled, home based, white blood cell monitoring device.
By combining daily Remote Patient Monitoring of vital signs with CBT and frequent home based white blood cell measurement, healthcare providers can follow the patient in real-time and quickly catch any deterioration in the patient’s health and decrease the chance of hospital re-admission. Analysis of the data improves patient outcomes, reduces treatment costs and decreases re-admissions.
Impacts / outcomes: 
“It’s clear from the pilot project that patients are happy to be monitored and managed in this way. They prefer to be at home, they feed more secure, more in control and less stressed. They begin to learn about and understand how they are responding to chemotherapy and begin to manage themselves.”
Elisabet Nilsen Holm, Cancer Specialist, Sykehuset Østfold Hospital
“I hadn’t used a tablet before, I don’t even have a smartphone, but the software is very easy to learn and use. When I was asked to join the trial I didn’t have to think twice. It’s interesting and exciting and has reassured me throughout the entire post chemotherapy period.”
Betty Helen Kristiansen, Cancer Patient
Combining Remote Patient Monitoring with CBT and home based white blood cell analysis improves patient outcomes, reduces treatment costs and decreases hospital re-admissions.

Our results which have been independently validated by the City of Oslo.
There is an English language version of their report into the effectiveness of Dignio at:
As you will see in the report the outcome of using Dignio was:
32% Less hospital admissions
42% Less outpatient consultations
39% Less hospital bed days
59% Less home nursing
Which local or national clinical or policy priorities does this innovation address:
Cancer - increasing diagnostic capacity
Supporting quote for the innovation from key stakeholders:
“The side effects of chemotherapy seriously impact cancer patients’ daily lives. Managing them effectively is a long-time concern for doctors and clinicians.
By combining daily remote monitoring of vital signs combined with frequent white blood cell measurement we can follow the patient almost in real-time and quickly catch any deterioration in the patients’ health and decrease the chance of hospital re-admission.”
Elisabet Nilsen Holm, Cancer Specialist, Sykehuset Østfold Hospital
Plans for the future:
Sykehuset Østfold Hospital is currently funding a larger scale clinical trial of Dignio Prevent for home based white blood cell monitoring for patients undergoing chemotherapy.
This chemotherapy remote patient monitoring solution is now available in the UK via the UK subsidiary Dignio Ltd.
Dignio Ltd are actively looking for opportunities to replicate, in the UK, the successful pilot project that has been completed in Norway.
Tips for adoption:
The minimum pilot size to produce meaningful results is 20 patients. The patients have to be trained (it takes about 1 hour) and the nurses have also to be trained on how to care for patients remotely and how to interpret the results. This normally takes around 1 day with ongoing support from our team in Norway (they all speak perfect English). The trial in Norway comprised of patients with the most aggressive cancers where any contra-indication or exascerbation needed very speedy detection and diagnosis.
Contact for further information:
Ken Garner
Director of Business Development
Dignio Ltd
0203 371 9358
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Ken Garner 08/01/2018 - 16:05 Approved
Overview summary:
The Long Term Conditions (LTC) Network has delivered a stream of programmes to encourage uptake of remote delivery of care for LTCs and adverse lifestyle habits. These include options for delivery of care such as Flo simple telehealth, video consultation, Closed Facebook Groups, apps and aid to diagnosis.
Challenge identified and actions taken :
Lack of clinicians’ awareness of viable options for TEC; competence and confidence in their usage:
  • good practical examples described and signposted in LTC Network bulletin to clinicians
  • publications in national journals
  • support for development & launch of national training module 
Lack of patients’ awareness of viable options for TEC;competence and confidence in their usage
  • good practical examples described for patients 
  • pilot upskilling course for patients 
  • support set up and usage of health professional supervised Closed Facebook Groups by three specialties in acute healthcare settings (and a few local Patient Participation Groups (PPGs) in practices
  • support medical students Year 5 to encourage patients to sign up to Patient Online to access their own records 
  • write article for citizen readership in the North Staffordshire Sentinel newspaper 
Confusion about universal approach to shared management of care of LTCs between providers of care and different modes of remote delivery of care:
  • Create LTC shared management website, with clinician and patient sections; 
Lack of leadership across health economies in relation to synchrony/sharing of remoted modes of delivery of care
  • create example interaction across Staffordshire in relation to videoconsultation for clinical consultations
  • shared learning of usage of TECs 
Impacts / outcomes: 
UHNM closed Facebook groups – a total of 354 members, MS (168), AF (91) and cardiac rehab (95)
Public pages – AF – 895 reach per month/498 post engagements per month; Cardiac rehab – 2099 reach per month/791 post engagements per month
Twitter: Over 97,000 accounts reached from tweets
Manage your Health App: 330 users
Flo Simple Telehealth: 652 protocols registered across the West Midlands region
Telehealth E-learning course: Since December 2016 when the RCGP CPD course went live there has been 236 registrations with 42 people having completed the course.  Users have rated the course 4.3 out of 5 stars.
‘Digital Healthcare: The essential guide’, (Authors: Chambers R, Schmid M, Birch-Jones J), 2016
‘Clinicians rise to the social media challenge’ – Primary Care Commissioning CIC
‘How video consultations can benefit patients’ – GP Online
‘How to set up a Skype consultation service’ – Medeconomics
‘GPs launch Skype to care homes project in Staffordshire’ – Fabsnhsstuff
‘How should we respond to negative comments on social media’ (Authors: Ruth Chambers, Marc Schmid):
‘How a Skype trolley saves GP time’ (Authors: Ruth Chambers, Marc Schmid)
Evaluation report, Autographer plus Flo (Authors: Sue Molesworth, Lisa Sharrock)
Stoke and North Staffordshire leading the way in hi-tech help for patients: for-patients/story-29733613-detail/story.html
‘Revamp your website to reduce demand’ (Authors: Ruth Chambers, Marc Schmid)
‘Helping the elderly take tablets’ (Authors: John Marszal, Aoife Donnelly, Ruth Chambers) 
‘Promoting best practice in COPD management’ (Authors: Rosie Piggott, Elaine Cook, Faye Foster, Alwyn Ralphs, Lucy Teece, Roger Beech)
Video: ‘COPD patient avoids A&E and acute admissions through self-management with Flo’ (Author: Ann Hughes)
The Health Foundation - The Power of People
Video: Introducing Flo: Telehealth with a human touch
E-Learning: Telehealth, telemedicine and telecare: an introduction to “TECS” (Technology Enabled Care Services)
BMJ – Link to back pain article (STarT Back Tool)
Year 5 Medical Students x 4 Patient Online Initiative – North Staffordshire & Stoke-on-Trent CCG newsletter publication –<>
WMAHSN LTC Network Newsletter – Publication commenced in January 2017 to 500+, the database has now increased to c.750.
Staffordshire Sentinel – weekly ‘Ask the Doctor’ health articles:
‘GP praises Endoscope-i’:
Person Centred Care Conference held in Birmingham on 6th May 2016 – 60 delegates
‘Making Change Happen with Simple Telehealth and Florence’ held in Stoke-on-Trent on 25th January 2017 – sharing success and best practice with breakout sessions for Acute, Community and Primary Care – 82 delegates
Which local or national clinical or policy priorities does this innovation address:
GP Forward View (New models of care/patient empowerment) Underpin delivery - clinical management of key LTCs: Asthma, COPD, diabetes, hypertension, AF
Supporting quote for the innovation from key stakeholders:
Marc Schmid – Digital Expert, Redmoor Communications:
“The programme has brought patient networks together around MS, cardiac rehab and AF and stroke, providing peer to peer support and regular information from clinicians. The introduction of video consultations has enhanced the care available as well as improving the efficiency of service delivery”.

Luke Bracegirdle – Head of Digital & Business Analytics, Keele University School of Pharmacy:
“West Midlands Academic Science Network part funded a development project to extend work on the Manage Your Health app, to include additional content on long term conditions. Prof Ruth Chambers (Clinical lead Long Term Conditions Network, WMAHSN) has been very supportive and used the network to connect our development team with partners with complementary skills as well as link to further initiatives in the region to promote patient information resources in the area of Atrial Fibrillation”.

Phil O’Connell – Chairman & Chief Innovation Officer,
"The WMASHN Long Term Conditions (LTC) Network has provided invaluable support for clinical teams, helping to raise awareness of practical and pragmatic remote delivery of care options.  The LTC Network has worked with us, encouraging evidence based uptake through clinical peer to peer sharing of case studies and evaluation across traditional organisational boundaries of the techniques and methods used by our members to address LTCs and adverse lifestyle habits.
International dissemination of the learning, evaluation and case studies developed through the 'Simple Telehealth' programme of work including Florence in the UK, has been greatly assisted by the practical clinical applications and evaluation made possible by the WMAHSN.  The techniques and methods evaluated have achieved replicable positive clinical and productivity outcomes that are now being studied for implementation in Ireland, USA and Australia."

Jodie Williams – Stroke Prevention Clinical Nurse Specialist, University Hospitals of North Midlands NHS Trust:
“The AHSN has widely supported the AF Stroke Prevention Team over the last 2 years.
It has supported the provision for expert advisory for Atrial Fibrillation, its education and management throughout both Primary and Secondary Care.  It has supported the promotion of an online GP Masterclass for Atrial Fibrillation to GPs in Primary Care to continue education and evidence based management for AF patients reducing the risk of AF related stroke. The AHSN has supported the AF stroke prevention team in becoming champions within both Primary and Secondary Care enhancing self care management, reducing major disabling strokes with a positive impact to the Local Health Economy”.
Plans for the future:
  • Continue with pan-Staffordshire rollout of video-consultation option for clinician/patient follow up interaction in all healthcare settings; extend to social care settings as appropriate; share learning and urge adoption across the region
  • Promote the impact/how to overcome inertia to remote options for delivery of care at all levels of NHS across West Midlands and beyond via events, conferences (e.g. focus on CVD and diabetes 10.5.17; quality improvement 13.6.17), publications, LTC Network bulletin, Twitter, etc.
  • Evaluation of Trust-wide rollout of Flo Simple telehealth Sandwell & West Birmingham Trust; county-wide rollout of videoconsultation; use of Facebook in general practices
  • Develop online learning resources and simple course for citizens to use to enhance their confidence and competence in personal use of TEC for their own LTC(s)
  • Promote or develop online learning resources for clinicians to enhance their competence & confidence in adoption of TEC
Tips for adoption:
  1. Inertia is common in the NHS in relation to any new way of working – persist in engaging all those who are vital in making change happen.
  2. Don’t keep what you’ve learnt about the adoption of an innovation to yourself - evaluate, promote, disseminate it. 
Contact for further information:
Ruth Chambers - LTC Network Clinical Lead

Sue Wood - LTC Network Project Manager

Marc Schmid - Digital Expert, Redmoor Communications Social Media

Luke Bracegirdle - Head of Digital & Business Analytics, Keele University School of Pharmacy - Manage Your Health app

Chris Chambers - Telehealthcare Facilitator, Stoke-on-Trent and North Staffordshire CCGs - Flo telehealth
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Sue Wood 23/05/2017 - 09:29 Approved
Overview summary:
Health innovations and ideas frequently require robust research evidence to demonstrate clinical and cost efficiency, or structured real-world trials to support scale and speed of adoption. WFC provide a range of specialist support services in regulatory affairs. 

An example of the services that we can provide is illustrated through the case study of how WFC supported Electromedical Products International, Inc (EPII), to gain real world-data for the adoption of an innovative medical device at scale.
Challenge identified and actions taken :
EPII and the UK distributor The Microcurrent Site (MCS) offer the Alpha-Stim AID medical device. Alpha-Stim AID is proven to be clinically safe and effective in the alleviation of anxiety, insomnia and depression.

To enable EPII and MCS to offer the Alpha-Stim AID to patients in the NHS, research data was required to be submitted to the National Institute for Clinical Excellence (NICE) to evidence the clinical and cost effectiveness of the device when used in an NHS setting. Neither EPII nor MCS had any experience of designing and submitting research studies in the UK.

WFC took a protocol outline and developed it into a full clinical trial protocol with essential documentation following engagement with all stakeholders.

Regulatory submissions were made to the Health Research Authority (HRA) for approval (inclusive of ethical favourable opinion), to the National Institute for Health Research (NIHR) for inclusion onto their portfolio, and to an NHS Improving Access to Psychological Therapies (IAPT) service in the East Midlands.

WFC designed a site initiation training package which was attended by over 60 members of the IAPT team over 2 days to ensure successful and compliant trial delivery.

All aspects of design and delivery were undertaken on behalf of EPII and MCS who were provided with regular progress reports.
Impacts / outcomes: 
The clinical trial, which had been planned for many years, was designed and initiated in just 15 days of WFC consultancy time, enabling EPII and MCS to gather the valuable clinical and cost effectiveness data sooner than expected.

EPII and MCS were able to delegate all aspects of set-up to WFC with confidence, thus reducing the burden upon their teams.

Extensive initiation training ensured a prompt start to recruitment and rapid generation of data.

Strong working relationships with all stakeholders ensured a well-designed study which quickly processed through regulatory approvals. WFC were also able to facilitate conversations with the relevant Clinical Commissioning Groups (CCGs) and patient advocacy groups, with the result that real-world data collection is near completion and ready for submission for adoption of the device in the NHS. 
Which local or national clinical or policy priorities does this innovation address:
NHS IAPT services are committed to initiating treatment for 75% of people within 6 weeks of referral, and 95% within 18 weeks of referral, a clinical target formalised in policy framework Achieving Better Access to Mental Health Services by 2020. Alpha-Stim AID provides a maintenance therapy for people whilst on the waiting list following referral, thus enabling the target to be achieved. Additionally, a significant proportion of people using Alpha-Stim AID achieve full recovery, and so do not require further individualised treatment from NHS IAPT. This represents a considerable saving, and is in line with the NHS Mandate 2017/18 priority to balance the NHS budget and improve efficiency and productivity. WFC support clients to meet the national requirement for a technology appraisal from NICE, which is based upon clinical and economic data. The NHS is legally obliged to fund and resource treatments recommended by NICE’s technology appraisals within three months, as reflected in the NHS Constitution. As such, WFC are experts in navigating local and national priorities and processes. 
Supporting quote for the innovation from key stakeholders:
“Everything was great and highly professional”: Steve Hutchinson, MCS Managing Director. 
Plans for the future:
EPII and MCS will shortly be submitting the clinical trial data to NICE for technology appraisal. Recommmendation for use in the NHS is anticipated due to the high-quality clinical and economic data gathered, working relationships built with clinicians, NHS IAPT service managers, and Clinical Commissioning Group leads, in addition to support from patient groups.

WFC are ready and available to support other users of the Meridian platform to navigate regulatory affairs issues.
Contact for further information:
Mark Terry, Senior Consultant:
Luke Brewer, Senior Consultant:
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Mark Terry 10/05/2017 - 11:32 Approved
Overview summary:
Birmingham Community Healthcare (BCHC) NHS Foundation Trust have created an interactive PDF version of the Trust Clinical Handbook for use on smart devices.

To save the recurring cost of reprinting to keep the handbook up-to-date, and to keep up with the demand of the digitally enabled workforce, this tool has now been converted to an interactive PDF that can be accessed on smart devices. Examples of procedures included in the handbook are Sepsis screening tool, Resuscitation flow chart, Urine Colour chart, and normal blood values.

Challenge identified and actions taken :
The Clinical Handbook with one-page clinical guidelines on various procedures has historically been printed in a physical hand book.  It was found that there was a large recurring cost associated with this and it was difficult to ensure that clinicians were up to date and has acess to the guidelines in a managable format. 
Impacts / outcomes: 
BCHC has seen a considerable reduction in the printing costs of producing a physical handbook.  The has been estimated in the region of £5-8000.
Which local or national clinical or policy priorities does this innovation address:
Long term sustainability of the NHS - Paperless NHS
Plans for the future:
After a 6-month period of evaluation, the need to create an App with the additional functionalities of user statistics and remote content updating will be considered.

This handbook can be tailored for use in other Trusts and we would like to share this with other organsiations.  Provided that the cost of changing the contents to fit the needs of your Trust are covered and that BCHC copy-rights are mentioned and respected we are willing to openly share this. This means that you will be permitted to use the branding of your own Trust on the handbook, alongside BCHC's logo and branding.
Contact for further information:
Hamid Zolfagharinia, BSc, MSc, MIPEM, CSci
Innovation Manager
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Hamid Zolfagharinia 30/03/2017 - 13:31 Approved
Overview summary:
FindMeALocum was created by NHS MLCSU’s Digital Innovation Unit in conjunction with a range of NHS stakeholders.

FindMeALocum is a digital solution developed by people at the sharp end of general practice: Practice Managers wanting to find high quality Locums quickly and Locum GPs wanting to work more flexibly.

It provides a low-cost, flexible, easy to use, digital solution for GP Locum Banks, Primary Care Health Professionals & Practice Managers to advertise Locum assignments.
Designed by the NHS, for the NHS and used by the NHS today.
Challenge identified and actions taken :
There are many challenges when it comes to shortages of GP’s in the NHS. This means that many GP Practices often struggle to find good Locums quickly. As a result, clinics and appointments are cancelled/rearranged leading to a range of impacts e.g:
  • further work and even greater pressure on GP Practices, re-arrangement of clinics and appointments
  • greater burden on Acute services, inappropriate attendances that are often the default position for patients when they cannot secure timely GP appointments
  • poor access for patients and disruption through lack of timely access to GP appointments
  • increased risk to patients’ health outcomes from delayed or cancelled appointment
Another driver for the creation of FindMeALocum is to encourage doctors who might otherwise leave the profession, to remain in clinical general practice e.g. through allowing them flexibility to select sessions to support their work life balance.

Other drivers for the creation of FindMeALocum are to encourage doctors who might otherwise leave the profession and retired GPs wishing to return to the profession through allowing them flexibility to select sessions to suit their needs and work life balance.  
Impacts / outcomes: 

The above identified challenges led to the Digital Innovation Unit, in conjunction with Howbeck Health Care Ltd, the North Staffordshire GP Federation and the South Cheshire and Vale Royal GP Alliance creating the FindMeALocum solution designed to help fill shortages of Locums at Practices expediently so that there were fewer cancellations to clinics etc.

For GP Practices, the solution enables the promotion of sessions to Locums in the area. Registered Locums can see what sessions are available, so that they can apply for roles that fit their schedules. Once applications have been made by professionals, GP Practices can then pick Locums who meet their requirements. The tool, therefore, has helped to stimulate the market by creating a simpler way for Locums to apply for the positions they want and for GP Practices to promote sessions.

The solution is a responsive web application with Apple/Android mobile app capability that enables a simple booking solution for Locums. The mobile app is available on both iOS and Android platforms and enables Locum GPs the ability to view and apply for sessions in a simple and hassle-free way.  Locums can ask questions of the Practice before applying and review which sessions they have been chosen for. 

The solution also removes the need to pay Locum agency fees meaning that GP Practices benefit financially and offers potential financial benefits to Locums through the broader and more transparent sessions that are available.  

Registrations of GPs to the solution entails employment checks which are in line with the latest CQC guidelines. Such checks are carried out once by the umbrella organisation (such as the Federation or PCN) on behalf of all member Practices. An electronic profile of GPs is securely accessible to Practices for reference purposes.

There are many positive impacts and outcomes that have derived from the FindMeALocum solution.

The benefits of the FindMeALocum solution are:
  • It is a digital service accessible through the web or app.
  • It’s for both Doctors and GP Practices across the UK.
  • It is quick and easy to use for both parties involved.
  • It saves time and money for GP Practices and the NHS.
  • The app is flexible and efficient.
  • It is affordable with its pricing and free upgrades are included.
  • Supports improved patient access to GP appointments
Some examples of how GP Practices have used the project:
  • Retaining clinicians on flexible terms.
  • Helping to sustain primary care.
  • Increasing the medical workforce numbers in primary care.
  • Attracting new workforce to our local health economy.
  • Adding skill mix, with standardised minimum expertise, within primary care.
  • Act in an enabling role, helping to reduce the primary care healthcare team’s workload.
For GP Locums it increases the opportunity to:
  • Work flexibly and choose what they would like to cover.
  • Select areas they would travel to and work at.
  • See the sessions available for them to work.
  • Receive alerts on mobile for urgent vacancies.
  • Use the app as a personal planner.
For GP Practices the FindMeALocum solution is quick, secure and low cost, it:
  • Takes the hassle out of filling Locum sessions, saving time.
  • Helps GP Practices to have access to accredited Locums in seconds not hours, again saving time and resources.
  • Gives a full audit trail in line with CQC recommendations.
  • Reduces the reliance on recruitment agencies.
  • Saves GP Practices money within a year.
Which local or national clinical or policy priorities does this innovation address:
The FindMeALocum solution addresses the shortage of Locums in GP Practices. The FindMeALocum solution is designed to support the National GP Retention Scheme
Supporting quote for the innovation from key stakeholders:
“FindMeALocum has taken the stress out of finding GP Locums. It’s made it easy to fill our locum sessions quickly, with experienced, knowledgeable, reliable clinicians. I highly recommend this fabulous resource to practices.”
            Kirsty Moore -Practice Manager

“FindMeALocum has become my main way of accessing locum sessions. I find it: clear, up-to-date and easy to use, I have a broader circle of practices that I am connected with, and it has helped me to stay local to the Staffordshire area without having to look elsewhere for work.”
            Dr David Weldon MRCSEd MRCGP- Locum Sessional GP

“I can honestly say FindMeALocum has been a Godsend to me, we have had an ANP leave this year and I was struggling to find a GP.  I tried the agencies but they either let me down or never came back to me.  The website is very easy to use, I have found all the GPs amazing when they have done sessions, they have been efficient and basically once I had synchronised their smartcard etc it was really easy for them to go straight into the EMIS solution. This has saved me time and money over the last 6 months.”
            Susan Pyatt, Practice Manager

I’ve found the website easy to use. Being able to see potential Locum shifts has made it easy for me to fit shifts around my availability. I’ve found the booking process easy and hassle free
            Dr Matthew Lancett, GP
Plans for the future:
There are now approximately 100 GPs registered with the solution who have fulfilled approximately 1400 vacancies over an 8-month time period[1]. However, there is still a shortage of GPs registered. Over 1800 vacancies were advertised over the same period.

Therefore, the plan for the future is to further promote the solution so that the number of shortages of GPs decreases. The more the app is advertised and known the more Locums and GP Practices would register and gain from the app’s benefits. Furthermore, this would improve the services that patients receive.

A new Nurse Bank module will be launched soon.  Further improvements such as Locum invoicing and a Practice Admin Bank are in the pipeline with an expected release in late 2019 or early 2020.
[1] As at Spring 2019
Tips for adoption:
FindMeALocum has been created to save money for GP Practices from DAY ONE

Option 1: Package including installation, full training and ongoing support

Option2: Option 1 plus one-off project management support to launch the solution

Option3: Option 2 plus ongoing project management including employment checks
For more information or to book a demo please contact: Priyantha Jayawardane ( /
Contact for further information:
If you would like to look at more information on the solution, then please visit the website where you can sign up and download user manuals:
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Sharon Ibbs 17/10/2019 - 13:11 Approved
Overview summary:
The Traffic Life Game was developed by Laura Ogi, a Lead Clinical Psychologist NHS Clinical at Birmingham Community Healthcare NHS Trust (BCH).

The Traffic Life Game is an educational board game that helps adults with learning disabilities to recognise and manage risks associated with all types of relationships. It enables health and social care professionals to discuss sensitive issues with people with learning disabilities, as well as offering a safe environment to talk about important issues, encouraging participants to support one another.
Challenge identified and actions taken :
People with learning disabilities are often excluded from family or peer conversations on issues that may occur during relationships throughout their upbringing. These conversations are normally avoided as it is assumed that they would not understand and because families feel like they should be sheltered. This may result in a lack of exposure to day to day conversations which help gradual developments of relationships. This can lead to people with learning disabilities not being able to recognise potential unsafe situations.

For adults with learning disabilities the grey areas and risks of social, friendships and romantic relationships can be difficult to spot and respond to. However, they have active social lives and relationships, so it is important that they too are supported to discuss issues that come along with all types of relationships. It is important that they can learn how to stay safe and have an enjoyable life.

Therefore, the Traffic Life Game was created to support individuals that may find it difficult to have open conversations about relationships. The board game removes barriers that may be felt by individuals and allows them to discuss any grey areas and risks of social, friendship and romantic relationships. The game helps make right decisions without it being taught which makes it memorable.
Impacts / outcomes: 

The Traffic Life Game has had a very positive impact and has many outcomes from it. The board game is simple, entertaining and helps individuals to memorise safe and unsafe situations. The games can have 1-4 players and requires 30 minutes to play. A facilitator is also required.

The game is a traffic light risk assessment system that helps players to recognise and assess risks relating to romantic, social and family issues and situations. During the game, the players are presented with scenarios and asked short questions about how they would respond to everyday life and relationship situations. These questions and scenarios are asked by the facilitator of the game. The facilitator is usually a support worker: they lead the discussion with the players. The facilitator can help the group to talk about the risks and opportunities of the scenario presented and the answers are given points (wiser choices are given higher points). 

The players respond to questions asked by holding up a coloured card to indicate how they might respond to the situation asked.
  • Red - it is not safe
  • Amber - I am not sure
  • Green - It is ok to try
Examples of the questions and situations asked are:
  • You’re at a party and your friend makes you drink lots of alcoholic drinks. What do you do?
  • You’re on a date and your date asks for a kiss. What do you do?
  • A stranger approaches you at a party and tries to give you alcoholic drinks. What colour is this?
The participants of the game would then answer these questions with the colour coded cards (red, orange and green) and explain why they chose that card colour. This will then start a discussion between the participants that is usually guided by the facilitator and allows participants to share their thoughts on certain situations and see other people’s point of view. As the facilitator leads discussions on potential risks in each situation, it helps players to decide what the best course of action is. The facilitator then gives the participants points on how they answered, if their decisions were ‘correct’ and safe then they would be rewarded 3 points and if they gave the second safest answer they are given one point. For the wrong answer they do not receive any points.

Furthermore, the game is also not a competitive game where players play against one another- it is about personal growth and understanding. Therefore, the points that are given are to improve participants own understanding of safe and unsafe situations. The points system allows the support workers to monitor if participants are improving in their understanding of unsafe situations. One hopes that the participants would increase their total score as they play the game more times.
There is also an additional activity to the game where the player can build their own character. This is designed to help keep players engaged and interested. The players collect illustrated cards and use them to create a character. These cards consist of hair colour, style and other appearance details.

The intention of the game is to help participants to apply this risk assessment to their daily lives so that they can make safer decisions and internalise the thought process used when playing the game with the group, so they could repeat this when alone in the community. The aim of this game is ultimately to help people discuss topics that they may not have discussed before, as well as learning how to deal with issues in the real world. 

  • The game was very successful as the team have seen increased understanding when uncomfortable situations arise.
  • Relationships were getting better for participants who played the board game.
  • Participants were able to apply the game to their lives and make better decisions than they would have done before.
  • It was proven to be useful for when participants were starting to gain more independence in their own personal lives, such as moving out of their family home to supported or independent living.
  • Some participants also moved away from education into employment.
  • There were weekly sessions and the improvements in decision making were measured. They found that decision making was improving and that participants were making safer decisions.
  • The game is portable, flexible and can be used in a range of settings
Which local or national clinical or policy priorities does this innovation address:
This board game was designed to help people with learning disability understand how to form, develop and keep relationships. It helps them understand the risks of different types of relationships and what scenarios are safe and unsafe. It also gives them the chance to talk about the grey areas of relationships by normalising the conversations surrounding the scenario given. The game ensures that people with learning disabilities can process potential risky situations and make good decisions. This innovation was created at BCH.
Supporting quote for the innovation from key stakeholders:
Laura Ogi, clinical lead psychologist in learning disabilities at BCH until 2016, said:

“We started running a relationships group in 2008 to help people with learning disability understand the difference between types of relationship.

“It’s common for people with a learning disability to need support in understanding how to interact appropriately from one social setting to another.

“For example, what is meant by a hug? How do you know whether it is platonic or something else? What if a friend refuses a request for money? It’s understanding that this person can still be your friend…”

Dr Clive Thursfield Research & Innovation Director for Birmingham Community Healthcare NHS Foundation Trust (BCH) commented:

“Having watched the inception and development of the Traffic Life Game through our Innovation team we were very impressed with the focus the game places on teaching emotional and situation awareness to individuals who may otherwise be at risk of learning through experience. The Traffic Life Game is a prime example of the creative methods which we believe can really help individuals early on in their adult lives and which we are proud to support. At BCHC, we look forward to continuing to bring our staff’s insights on patient health to fruition in new and innovative ways...”

When facilitating the game with their service users, staff at Dumbarton Community Health & Care Partnership’s day centre said:

“Very easy to understand and aided in bringing up useful conversation.

“It was very effective in not only helping clients talk about risks but to look at areas we need to work on.”
Plans for the future:
The plan for the future is to promote this game further to other NHS organisations and health professions that work with individuals with learning disabilities, as it is a very useful tool in aiding individuals with making sensible decisions.
Tips for adoption:
The game has been fully developed by Focus Games and is available to buy here:
Contact for further information:
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Laura Ogi 07/08/2019 - 12:35 Approved
Overview summary:
SMARTChip is a purine biosensor which uses a finger-prick sample of blood to detect ischaemic brain events that occur during a stroke. It’s been developed to address the need for a rapid diagnostic test to help decision making in early stages of a stroke.

SMARTChip was created by Prof Nick Dale of the University of Warwick and developed in a NIHR i4i research study carried out at UHCW NHS Foundation Trust under vascular surgeon Prof Chris Imray in collaboration with stroke physician Prof Christine Roffe of UHNM NHS Trust.
Challenge identified and actions taken :
Currently, patients suspected of a stroke are taken to A&E to have a CT scan as confirmation before given thrombolysis treatment; however, the length of time it takes to recognise stroke symptoms is critical as delay in treatment leads to increased damage to the brain. Furthermore, there are no diagnostic tests to help clinicians and paramedics to identify stroke, resulting in high levels of misdiagnosis and delays in treatment.

SMARTChip was created to reduce delays by diagnosing stroke faster and better informing clinical decision making.

Research proved that, at the onset of a stroke, the brain releases a detectable quantity of purines into the blood. Purines are produced and released by cells undergoing the oxidative stress that occurs during a stroke. SMARTChip measures these purines to detect and diagnose symptoms of a stroke faster, improving patient outcomes and saving the NHS time and money.

There were many practical challenges to overcome with the first proof-of-concept device developed (SMARTCap) including difficulty experienced by nurses accurately and rapidly collecting and measuring blood samples in test tubes. This led to modification of the design and the development of SMARTChip. SMARTChip only requires a finger-prick sample of blood thereby simplifying, miniaturising and speeding up the technology.
Impacts / outcomes: 

There are several positive outcomes from the SMARTChip project:
  • The study provided an excellent example of partnership working across academia, industry and the NHS.
  • The SMARTChip study has been featured in the national media with articles in The Guardian and the National Institute for Health Research Website.
  • The time it takes for SMARTChip to make a measurement is approximately 3-5 minutes.
  • SMARTChip will be used in conjunction with the existing assessment procedures such as FAST (Face, Arms, Speech, Time) and ROSIER (Rule Out Stroke in the Emergency Room) to aid clinicians to diagnose stroke more rapidly.
  • SMARTChip is also expected to help by triaging patients and directing them to the most appropriate clinical unit.
  • SMARTChip may also be able to detect a number of other injuries including traumatic brain injury (TBI), heart attack and foetal hypoxia.
  • SMARTChip has the potential to improve patient outcomes but also can save major cost to the NHS.
  • SMARTCHIP won the MidTECH Award for Best NHS-Developed Medical Technology Innovation at the WMHASN Awards 2018.
Which local or national clinical or policy priorities does this innovation address:
National Clinical Priority: One of the key priorities of the Stroke Association and the NHS RightCare Pathway is for stroke to have a more rapid diagnosis and treatment, from a 999 call through to optimal treatment. Every year, around 110,000 people in England have a stroke, and it is the third largest cause of death, after heart disease and cancer. Earlier diagnosis of stroke can better inform clinicians, meaning that treatment can be administered earlier. This leads to fewer complications later, as every minute that a major stroke is untreated, the brain loses some 1.9 million neurons, 14 billion synapses and 7.5 miles of myelinated fibres.
Supporting quote for the innovation from key stakeholders:
Quotes from Nicholas Dale, founder of Sarissa Biomedical Ltd:
“In 10 years’ time, I’d hope that SMARTChip will be in the defibrillator boxes that enable the public to treat cardiac arrest…upgraded with Sarissa’s SMARTChip, they should become multifunctional, enabling the public to contact the health service with more complete information.

“Sarissa has developed a world beating technology that will improve the lives of stroke victims and save the NHS money. Our ambition is to create jobs and economic wealth, we see the development of our production capability as being a key factor in transforming Sarissa from an R&D company into a high value IVD manufacturer and look forward to working with Aston University to deliver our ambition.”

Quote from Norman Phillips, Patient representative:
“Having had a stroke in 2003 at the age of 55 and being treated under the then current practice I was left with hemiplegia on the left side.

“After being discharged I took an interest in stroke treatment and research serving on many bodies and taking part in research in all areas.

“During the time since my stroke I have seen the introduction of the FAST campaign and fast tracking of patients to acute stroke units where diagnosing can be carried out, but, as we know, “time is brains.” The use of thrombolysis is governed by time so speed is of the essence.

“The introduction of SMARTChip will greatly reduce the time element and mean that treatment can begin sooner. Its use would also reduce the number of false diagnoses that turn out not to be a stroke.

“In my mind, and that of other stroke survivors and medical professionals that I have spoken to, this is a major breakthrough in the early diagnosis of the onset of a stroke.”
Plans for the future:
Further research studies using SMARTChip in an emergency setting will provide evidence for it to be implemented as an early diagnosis indicator of strokes. A planned study in an ambulance setting will also allow the device to be used and tested on patients with a suspected stroke before they arrive at A&E, again saving critical time in diagnosis and treatment.

Sarissa is now working on developing SMARTChip to support wider diagnosis and treatment of Ischemic Vascular Disease (IVD), with further trials planned for traumatic brain injury, heat attack, foetal hypoxia, limb ischaemia, peripheral artery disease and neurological disorders such as epilepsy.

In the longer term, a ‘wellness’ test is planned to screen people most at risk of a stroke and prevent them occurring.
Tips for adoption:
Final research and testing is reaching its conclusion, with an SBRI funded paramedic led trial of SMARTChip in the North West, North East and West Midlands NHS ambulance trusts and led by Dr Chris Price (Newcastle). SMARTChip is expected to achieve CE marking in 2020 with the product being available commercially by the start of 2021.
Contact for further information:
If you would like more information on the SMARTChip please contact:

Further information on Sarissa Biomedical Ltd and SMARTChip is available via the following links:
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MidTECH Innovations 24/07/2019 - 13:09 Approved
Overview summary:
ETL has worked with SEL STP to refresh their Digital Strategy. The HSLI in Provider Digitisation provided the funding stream to deliver the priority changes. ETL facilitated the creation of the HSLI case over three years and the development of the PIDs Business Cases and Value for Money analysis for the initiatives. We are now supporting the delivery of priority FY18/19 projects, updating the digital strategy reflecting the ICS and NHS 10-year plans and prioritising initiatives for FY19/20.
Challenge identified and actions taken :
The existing SEL Digital Strategy was over 70 pages long, had not been updated for a while, and was not understood. The challenge was to update the strategy so that it reflected the latest thinking in the NHS and STP plans. We delivered a strategy that was a few pages long, easily understood, achievable and had STP-wide consensus.
In addition, there was a need to draft an investment case to secure 3-year HSLI in PD funding within a fixed deadline. The challenge was to get agreement on a set of initiatives that could be delivered in FY18/19 with robust benefits and outline proposals for FY19/20. These needed to be aligned to the criteria set out by NHSE as well as the STP and provider priorities.  
Having secured HSLI in PD approval, we drafted quality PIDs, Business Cases and VfM analysis documents for FY18/19 and within tight deadlines. We worked closely with NHSE Chief Digital Officer to ensure that our proposed initiatives would meet expected criteria.
With key lessons learned we have an equally challenging task to refresh the STP digital strategy so that it is aligned to the ICS and NHS 10-year plans. We need to deliver the projects that we have committed to in FY18/19, whilst also getting priority FY19/20 initiatives. Finally, we need to draft quality submissions with robust business cases by Spring 2019.
Impacts / outcomes: 
We now have a STP digital strategy that is agreed across the STP and can be communicated easily and understood by all stakeholders. It is also a strong reference point for measuring the alignment of the initiatives that the STP is pursuing to the strategy.
We have a robust HSLI in Provider Digitisation investment proposal that is agreed across the SEL STP and provider organisations. It has been approved in principle by NHSE and hailed as the standard for the whole of London to follow.
We have a set of documents - PIDs, Business Cases and Value for Money Analysis - for the initiatives that we are progressing and delivering in FY18/19. In addition, we have a template for future initiatives and lessons have been learned on how best to implement new and similar work. These lessons and good practices can now be shared readily with other STPs.
Which local or national clinical or policy priorities does this innovation address:
This innovation addresses the proposals set out by NHS Five Year Forward View, NHS Digital Priorities, Matt Hancock’s HSLI in Provider Digitisation initiatives and SEL ICS ambitions and NHS 10-year plan. It also helps significantly to improve and deliver the digital maturity in the NHS.
Supporting quote for the innovation from key stakeholders:
Quote from John-Jo Campbell the SEL CIO.
“I understand that ETL may have opportunities to undertake STP Digital work in other parts of the country. I am happy to confirm the excellent work ETL have undertaken in supporting SE London STP in updating and refreshing the Digital Strategy and roadmap in 2018 and more latterly driving the process of developing and submitting cases for HSLI digital funding.
As discussed, please share this as you see fit, I am happy to be contacted for further information or references for ETL.”
Plans for the future:
The next phase of the project includes:
  • Delivering the projects that we have committed to in FY18/19
  • Refreshing the STP digital strategy so that it is aligned with the SEL ICS ambitions and NHS 10-year plan
  • Securing SEL ICS wide consensus to priority HSLI in PD FY19/20 initiatives
  • Drafting quality submissions with robust business cases for NHSE to approve by the end of Spring 2019.
Tips for adoption:
The right type of leadership, governance and collaboration at STP and provider level are key to success. What this means is all the key stakeholders at the STP and Provider level recognising the importance of these initiatives, the commitment, collaboration and leadership that is required and the time that needs to be allocated to discuss, agree and stick to the priorities. Without that and the underpinning governance and decision-making forum would lead to initiatives that are not fully thought through and tax-payers money wasted.  We have seen this first hand and recognise the true significance of this.
It is also very important that the leadership team engage the right type of expertise to drive this requirement at the STP and ICS level. Without that it will be very challenging to secure the funding and deliver the much-needed changes underpinned by digital solutions in the NHS.
Contact for further information:
John-Jo Campbell – CIO SEL STP
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Tas Hind 22/01/2019 - 20:10 Approved
Overview summary:
The Royal Stoke Pharmacy Workforce Calculator (RSPWC) was developed at University Hospitals North Midlands NHS Trust (UHNM). It was developed to determine local clinical pharmacy staffing levels required to deliver pharmaceutical care to specific patient cohorts. Its algorithm is based on ‘activity standards’ for tasks and ‘unavailable’ staff time, which generates a resource to deliver services sustainably across a full year. It has been utilised by UHNM for a number of years as a method of responding to business case plans.
Challenge identified and actions taken :
Challenges began for the pharmacy workforce at UHNM when there was an increase bed numbers and patient cohort changes, increasing  the number of patients requiring pharmaceutical services. This had a clear impact on the pharmacy team’s ability to deliver the pharmaceutical care requirements for patients. Securing adequate resources for pharmacy service delivery was challenging. Often the pharmacy was not considered in financial calculations of associated business cases and when it was, an arbitrary value, insufficient for service needs, was allocated.

This led to the development of the RSPWC as a method to objectively identify and calculate the necessary resources to ensure adequate staffing. The calculator is now a validated tool that identifies the staffing resources required to deliver clinical pharmacy services to in-patients in acute hospital settings. It does this by using the mean time the pharmacy workforce takes to complete patient related clinical pharmacy tasks (the ‘activity standard’) and extrapolating this for a specific cohort of in-patients, using number of beds and average length of stay. This determines workforce staff and resources needed, taking into consideration the ‘unavailable time’ (annual leave, sickness, training etc.) to ensure that the service is sustainable 24/7/365.
Impacts / outcomes: 
There are many positive outcomes that have come from the RSPWC. These are discussed below:
  • The RSPWC provides an objective calculation of pharmacy staff resource, to ensure that adequate staffing in a changing health service is provided.
  • The system requires minimal data collection by users as data is readily available from the ward demographic data, which completes the process.  The resources that are needed by the pharmacy workforce are then identified and are broken down into staff groups to allow skill mixed opportunities to be identified.
  • The RSPWC has been validated through a process that included a Delphi study with a panel of national experts for application to pharmaceutical care services for acute hospital in-patients, both in  general medicine and surgery
  • For the first time, a consensus on required service components for the delivery of pharmaceutical care, across multiple hospital sites nationally in the UK has been established. .
  • Through the application of the calculator to business cases the pharmacy establishment has grown over a number of years.  It has increased staff numbers across all grades and staff groups.  This has allowed improved patient care e.g. staffing to RSPWC levels an increased number of patients can be discharged directly from the ward area (the surgical team deliver around 85% of discharges in this way.  This has reduced turnaround time for medicines required for discharge from 3 hours to 30 minutes.
  • Furthermore, there is evidence from other sites that suggests that staffing to levels suggested by the calculator has had an impact in reducing length of stay and readmission rates of patients.  
Which local or national clinical or policy priorities does this innovation address:
With the increased focus on pharmacy workforce following the Carter Report 2016, many hospitals are looking at utilisation of pharmacy staff in much greater detail. The need to expand pharmacist roles beyond the traditional ward service is increasing and the RSPWC allows pharmacy managers to understand baseline staffing requirements before addressing changes of role or scope of practice. The RSPWC has been used by other Trusts to support responses to business cases and guide service development eg. Coventry and Warwickshire NHS Trust, East Kent NHS Trust.
Supporting quote for the innovation from key stakeholders:
“In this era of standardisation, rationalisation, benchmarking and Carter it [the RSPWC] will support some agreed standardisation of pharmacy so it fits nicely in the political context.”

“I think historically capacity and demand planning have been very much feeling based, but it’s nice to have something that either backs up that feeling or completely challenges it I guess.”

“I did try it just for a ward we’ve got at the moment and one that I thought was reasonably functional and it came out with roughly what we’ve got.”

“I put some figures through it last week due to the Trust opening more beds and have so far got a positive response from finance which has led to getting in two locums based on the figures."
Plans for the future:
Future development plans include:
  • Developing and validating versions of the calculator for application to specialist areas.  At UHNM we have started developing a Renal version of the tool.  This speciality has long had a n accepted patient/pharmacist ratio for guiding staffing however the advantage of the RSPWC is the inclusion of technician and non-registered workforce staff groups, essential for service delivery but not included in the national benchmark.  Early approaches have been made for developing a mental health version of the tool, but this will require substantial research in-put and would be available as an MSc project for an interested candidate.
  • Generating outcome data to demonstrate the patient care benefits that staffing to this level will deliver – it is hoped to pilot this through the winter of 18/19.
  • Reviewing the model to consider the impact of pharmacist prescribing on the activity standard – this is an additional role but there will be some overlap of activity and this is not yet understood, but will have implications for staffing levels and skill mix.
Tips for adoption:
If your NHS Trust would like to adopt the RSPWC we have developed, it has been shared on the NHS platform “Kahootz” which is accessible to Chief Pharmacists. All the information you need on how to adopt the system is available on there.
Contact for further information:
If you would like more information on the Pharmacy Workforce Calculator then contact Ruth Bednall via email:
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Ruth Bednall 19/12/2018 - 17:18 Approved
Overview summary:
Carole Owen of Birmingham Community Healthcare NHS Foundation Trust (BCHC) has been collaborating with Dr Sarahjane Jones from Birmingham City University to explore the potential clinical benefits of a device called ‘Step Right ’, which aims to reduce the risk of falls in walking frame users.
The original idea for the Step Right Buddy device came from rehabilitation assistant, Carole Owen, at BCHC, who recognised the need to address the issue of poor posture, falls and the poor technique used by patients when using their walking frames.

Challenge identified and actions taken :
Falls are prevalent in older adults, one third of adults over 65 fall each year. A walking frame is a common device given to older adults whose poor mobility or balance places them at risk of falls.
Incorrect use of the walking frame is common practice, which in itself presents a risk of falls. Patients often step too far into the frame, making the frame unstable and likely to tip, leading to falls.
This led to the invention of the Step Right buddy – an attachment to a standard walking frame, aiming to teach correct use of the frame. It is an elasticated band secured across the top of the back legs of the walking frame, designed to make patients aware that they have stepped far enough into the frame, to stop them stepping any further.  It also prevents patients from falling backwards due to holding the frame too close. The device is designed to provide walking frame users with sensory and visual feedback on how far to step into the frame thus lessening risk of falls.
The research team which included Carole Owen, Sarahjane Jones, Faye Dimmock and Helen McEwan undertook a pilot study of the device. The aim of the study was to gain insight into the user’s experience of using the device after trialling it for one week. The study was also used to identify whether any new risks were introduced with use of the device.
Impacts / outcomes: 
  • The pilot study assessed the acceptability and safety of the device on 17 walking frame users who had been identified as using the frame incorrectly.
    • Users reported positive experiences from using the device
    • Users reported the Step Right Buddy corrected their posture and that the concept has great potential.
    • No serious adverse events occurred, however two incidents of unsafe and incorrect use of the device were identified.
    • Alongside the research project, the university also provided training and development opportunities for staff at the Trust, in the design, development and delivery of research.
    • Wider patient and public involvement was sought in both design and analysis of the study using an afternoon tea party group discussion format.
    • The study has highlighted that the Step Right Buddy is acceptable for patient use and the need for further research.
  • An application for funding from the Health Foundation is being considered and manufacturing sought.
  • The Step Right Buddy was also awarded a cash fund after being shortlisted for the MidTECH prize for best NHS-developed Medical Technology Innovation at the annual West Midlands Academic Health Science Network Awards.
Which local or national clinical or policy priorities does this innovation address:
The Step Right Buddy is a simple accessory that can be added to a walking frame to guide patients who have experienced difficulties using a frame. This device’s priority therefore is to help prevent patient falls when using a walking frame.
Supporting quote for the innovation from key stakeholders:
Rehabilitation assistant at Birmingham Community Healthcare NHS Foundation Trust Carole Owen:
“It was a ‘light bulb’ moment and initially, I just used a pair of tights… then I went home and ran up a simple flexible strap for 40p. I never imagined at that stage that it would develop the way it has.”
Senior research fellow at Birmingham City University Dr Sarahjane Jones:
“It’s a brilliantly simple concept because it acts as both sensory and visual aid”
“We’ve been very pleased to partner with BCHC on this and support Carole. This funding will help us develop and produce a batch of up to around 200 Buddies, taking forward the concept into a larger trial.”
The project was also aided by the feedback of former physiotherapy service patient John Fancote:
“I’d had such wonderful support from the physios so I said I’d like to give something back and I was very pleased to be able to offer a patient’s view and support the development of such a simple but effective idea.”
Innovation Manager at of Birmingham Community Healthcare NHS Foundation Trust Hamid Zolfagharinia:
“Carole is a shining example of what we can achieve by working with colleagues to take their great ideas from clinical practice and develop them.”
Plans for the future:
Funding awarded from MidTECH will help the team further develop the device Step Right Buddy and will aid to produce a batch of 200 buddies, which will take the concept forward into larger trials. A larger scale study will aim to identify the effectiveness of the device on frame users who are fallers and those at risk of falls. The team are currently in the consultation phase with a designer to formulate a design specification of the device in readiness of getting the product to a manufacture.
Tips for adoption:
At this time, the Step Right Buddy isn’t available for adoption into practice, however, if organisations would like to learn more, or be a partner site in the recruitment of patients to a larger trial, please do get in touch.
Contact for further information:
If you like more information on Step Right Buddy contact Carole Owen: 
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Hamid Zolfagharinia 13/11/2018 - 13:54 Approved
Overview summary:
NICE recommend Intermittent Pneumatic Compression (IPC) to reduce Venous Thromboembolism (VTE) risk in acute stroke patients. However around 30% of patients cannot be prescribed this modality. To serve this unmet need The Royal Stoke University Hospital has introduced a new VTE pathway which included neuromuscular electrical stimulation of the peroneal nerve using the NICE approved geko™ device (Firstkind Ltd UK). This pathway change also increased patient surveillance of both IPC & the geko™ device so to maximise the anti-stasis intervention.
Challenge identified and actions taken :
VTE prevention strategies available to high risk stroke patients are limited. NICE recommend IPC as the primary method of VTE prevention because the risk of symptomatic intracerebral haemorrhage with routine anticoagulation (including low molecular weight heparin) outweighs any potential benefit. Furthermore anti-embolism stockings are not recommended.

IPC reduces VTE risk by increasing venous return and preventing venous stasis in the veins of the calf. This modality, alongside standard measures of hydration, mobilisation and aspirin represents standard UK VTE prevention for high risk immobile acute stroke patients. The VTE consequence of no IPC intervention in this cohort was recorded in the CLOTS-3 study which showed a high resulting VTE incidence rate of 8.69%.

The geko™ device is an alternative anti-stasis device for use on patients who cannot be prescribed or tolerate IPC. The Royal Stoke University Hospital has recently introduced the device into the stroke pathway for patients who were either contraindicated or became intolerant to IPC and would otherwise have had no anti-stasis intervention.

Furthermore, nursing practice was amended to increase patient surveillance and maximise compliance for both IPC and the geko™ device. The objective was to maximise the anti-stasis intervention in this population.
Impacts / outcomes: 
Blood clots, or venous thromboembolism (VTE), are a major risk to hospitalised patients. VTE leads to pain, swelling and potential death. While the full scale of the problem is not known, it is estimated that hospital-associated VTE leads to about 40,000 deaths in England per year, 25,000 of which may be preventable through proper risk management and care. This is about five times as many healthcare-associated deaths as from methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile combined. There is a strong quality and financial imperative for hospitals to prioritise VTE prevention.
National Institute for Health and Clinical Excellence (NICE) guidelines set out the preventative measures that should be implemented to reduce this risk. In 2014, new guidelines recommended the use of the geko™ device for use in people who have a high risk of venous thromboembolism and for whom other mechanical and pharmacological methods of prophylaxis are impractical or contraindicated.
The size of a wrist watch and worn at the knee, the easy-to-use geko™ device is a neuromuscular electro-stimulation (NMES) medical device that gently stimulates the common peroneal nerve (a nerve adjacent to the knee) activating the calf and foot muscle pumps. The device creates a painless contraction of these muscles every second resulting in the prevention of “venous stasis” or static blood in the deep veins of the calf.

The risk of venous thromboembolism (VTE) after stroke is increased in patients with restricted mobility and associated increase in venous stasis. The alteration in blood flow in weakened limbs may lead to vessel wall injury, whilst there is also an abnormal tendency for the blood to clot more after stroke. The results from the Royal Stoke University Hospital show that introducing the geko™ device into this pathway lowered the overall incidence rate of symptomatic VTE. The geko™ is as effective as IPC at reducing DVT, the device was well tolerated and offered an alternative prophylaxis strategy to IPC, ensuring that all patients received VTE prophylaxis, where previously no prophylaxis could be given.

A clinical audit reviewed 1,000 patients admitted to the acute stroke unit at Royal Stoke University Hospital between 1st Nov 2016 and 3rd March 2018.

Key impacts:
  • 188 patients were sufficiently mobile and did not require any form of VTE prophylaxis.
  • 125 were assessed and deemed suitable for anti-coagulant drug to reduce VTE risk
  • 687 patients were assessed as immobile and at high risk of VTE, were unsuitable for drug and required an anti-stasis intervention.
  • 21/687 patients refused any kind of anti-stasis VTE preventative treatment
  • Therefore 666 patients received an anti-stasis intervention in addition to standard measures.
  • 544/666 were initially prescribed IPC to reduce their VTE risk
  • 122/666 patients were immediately contraindicated to IPC and were prescribed the geko™ device.
  • 81 patients who were initially prescribed IPC but became intolerant to it and were switched to the geko™ device.
  • Accordingly, 203/687 or 29.5% of patients represented the unmet need as described above and required an alternative anti-stasis and were therefore served by the geko™ device.
  • The geko™ was used for a mean of 9 days/patient.
  • The geko™ device was well tolerated by patients.
Key outcomes:
This audit also reviewed the VTE (DVT or PE) incidence at 90 days post discharge for the 687 patients who needed an anti-stasis intervention.
  • 11 VTE occurred in patients treated with IPC
  • 1 VTE occurred in the group who were initially prescribed IPC but who were switched to the geko™ device.
  • 1 VTE occurred in the group who refused any form of anti-stasis intervention
  • There was no incidence of VTE in patients prescribed the geko™ device.
The above new VTE pathway in acute stroke patients, which increased patient surveillance and included IPC and the geko™ device to maximise the prescribed anti-stasis intervention, resulted in a low overall incidence of symptomatic VTE. The incidence in high risk immobile patients requiring an anti-stasis intervention was 1.9% (13/687), which is lower than the 6.6% in a comparable patient population in the CLOTS-3 study.
Which local or national clinical or policy priorities does this innovation address:
National Institute for Health and Clinical Excellence (NICE) guidelines set out the preventative measures that should be implemented to reduce the risk of blood clots, or venous thromboembolism (VTE). In 2014, new guidelines recommended the use of the geko™ device for use in people who have a high risk of venous thromboembolism and for whom other mechanical and pharmacological methods of prophylaxis are impractical or contraindicated.
Supporting quote for the innovation from key stakeholders:
‘Following the positive results of our clinical audit within our acute stroke unit, the geko™ device is now in routine use and has marked a significant change to our nursing practice. The audit has shown a need to use the geko™ when other VTE prophylaxis strategies are contraindicated or impractical. This pathway enhancement ensures that all acute stroke patients now have another VTE prophylactic intervention option where previously patients would have had no other intervention available to them’.  
Dr. Indira Natarajan FRCP (UK)
Consultant Stroke Physician
Clinical Director Neurosciences
The Royal Stoke University Hospital

Plans for the future:
Whilst the above data has proven sufficient for the geko™ device to be adopted specifically to meet this unmet need, this audit will be extended as will the ongoing collation of associated quantitative & qualitative data.
Further support will be given to multiple trusts to further validate the use of the geko™ device to serve this large and meaningful unmet need in acute stroke patients
A publication strategy will also be formulated with the aim to present this data as appropriate.
Tips for adoption:
Firstkind are determined to remove any administration obstacles to accelerate the adoption process whilst fully respecting due process. We can assist the adoption process by offering the following:
  • The team at Royal Stoke Hospital are receptive to assist where possible in terms of process and sharing of experience
  • The sharing of all the relevant “committee” forms that allow for a new device to be considered and used within a trust. This common approach has created efficiency.
  • In terms of any device audit that has been conducted to quantify the size of any unmet need the audit collection forms have been shared between trusts to the reduce administrative burden.
  • Created a cross trust partnership approach to delivering patient benefit.
Adopting this approach has fast-tracked the implementation of this new technology into the stroke pathway in several centres across the U.K.

Contact for further information:
Firstkind Ltd
Hawk House
Peregrine Business Park
Gomm Road
High Wycombe
HP13 7DL


T: +44 (0)845 2222 920 (Orders)
T: +44 (0)845 2222 921 (Enquiries)
F: +44 (0)845 2222 820
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Tony Humphrey 31/10/2018 - 12:52 Approved
Overview summary:
There is a wide disparity between the emphasis on breastfeeding in culture and the support for mothers attempting to breastfeed for the first time.
Funding for Health Visitor run baby groups & drop-ins throughout the UK have been cut in past 2 years due to budget constraints, leading to increasing social isolation of new mothers.
Young mothers in particular may not have ever encountered another breastfeeding mother, given that the last generation was largely encouraged to bottle-feed.
Challenge identified and actions taken :
Our target - Mothers who may not have access to current research and/or may be unduly influenced by cultural barriers to breastfeeding.
c 700,000 newborn babies born in UK each year. A high proportion will be to new mothers with no experience or understanding of breastfeeding.
Funded by ACE from 2017-18, ‘Holding Time’ a series of photographic portraits of mothers breastfeeding was shown at Fabrica Gallery, ONCA Gallery and Royal Brompton Hospital in London, in print, video and installation formats, accompanied by talks and workshops. ONCA featured a Breastfeeding Hub where comfortable seating encouraged mothers to stay longer and talk with other mothers.

A project website (, and YouTube channel promoted 5 min Podcast interviews with participating mothers from the photographic series. A BLOG written by Dr Newell explored issues surrounding the cultural barriers to breastfeeding. Facebook promotions and postcard campaigns at GP surgeries drew visitors to the website and exhibitions.
Impacts / outcomes: 
Findings / Outcomes:
  1. Exhibition audience was more mixed in gender and age than anticipated
  2. Workshops and talks were attended by many academic, medical and health researchers/practitioners
  3. The ‘Holding Time’ slideshow drew audience to the Youtube channel
  4. YouTube recommendations helped to attract many thousands of visitors to the channel.
  5. The Breastfeeding Hub resulted in longer visits to exhibition
  6. Interviews/talks/workshops revealed structural barriers within health practice where policy and practice are not meeting.
Exhibitions x 10 days/ 435 visitors
Website: 1,000 users/ +67%
Talks x 2: 70 attendees
Facebook fans 303 posts/+91 fans/ +695 engagement
YouTube Analytics: 36,400 Views/ +6,710/60 Likes/+179 Subscribers
Which local or national clinical or policy priorities does this innovation address:
Public Health England - Health matters: giving every child the best start in life; Public Health England Commissioning Infant Feeding Guidance; NHS Start4Life; UNICEF; Every child matters
Supporting quote for the innovation from key stakeholders:
National Strategy:
Include actions to promote, protect and support breastfeeding in all policy areas where breastfeeding has an impact. This includes: obesity, diabetes and cancer reduction; emotional attachment and subsequent school readiness; improved maternal and child mental health; wellbeing in the workplace; and environmental sustainability.

Good practice guidance identifies that breast milk is considered the physiological norm of nutrition for infants and can provide wider benefits to further promote the bond between mother and baby. Some of the key evidence based benefits of breastfeeding are summarised below:

• Children who are breastfed for longer periods have lower infectious morbidity (including diarrhoea and vomiting) and lower risk of infant mortality
• Less risk of constipation
• Reduced likelihood of becoming obese or developing type 2 diabetes or other obesity related conditions later in life

• Reduced risk of developing breast and ovarian cancer
• Reduced risk of diabetes
• Develops stronger relationship bonds through skin touch between mother and baby
• It is a free resource and readily available
To gain the maximum benefits of breastfeeding the World Health Organization recommends an exclusive breastfeeding period for the first six months of life and continuing to breastfeed for at least two years.

West Midlands
• Breastfeeding initiation is significantly lower in the West Midlands compared to the England averages between 2010 and 2015
• Initiation rates between Local Authorities within West Midlands range from 48% to 77% out of all maternities during 2014/15

Key risks of lower breastfeeding uptake:
• Younger age of mother with those aged under 20 years the least likely to breastfeed.
• Mothers who are from a white ethnic background.
• Mothers who have never worked or employed in a routine or manual occupation (classified as lower socio-economic status).
• Younger age left full time education with mothers who left at or before 16 years least likely to breastfeed.
• Mothers in the most deprived quintile of society (classified as being in quintile 1 of the Index of Multiple Deprivation IMD calculation).

Patterns and associations of breastfeeding prevalence:
• Breastfeeding prevalence rates in England in 2010 were higher for each risk factor group compared to 2005 data for each reported period from time of birth to nine months.
• Breastfeeding prevalence dropped at an increased rate after two weeks from birth for all key risk indicator groups. At six months, roughly one third of mothers were still breastfeeding.
• The largest difference in breastfeeding prevalence is associated with age of the mother followed by age the mother left full time education and then socio-economic status and deprivation respectively.

Awareness of health benefits of breastfeeding:
• An inverse association is demonstrated between awareness of the health benefits of breastfeeding and younger age of mother, mothers classified as Asian or black, those in a lower socio-economic status and mothers who were intending to only formula feed or who had not yet made a decision.
• Mothers from a white ethnic background reported the most awareness but are the highest ethnic risk group to not breastfeed.

Information sharing:
• The groups least likely to receive information about the health benefits of breastfeeding include mothers aged under 20 years and those who have never worked.
• There is no significant difference between ethnicity and receipt of breastfeeding information.
• For all groups there are a low proportion of women who reported attending antenatal classes where infant feeding was discussed.

Please see
A film made by rb&hArts – the Charitable trust an partner at Royal Brompton Hospital.
Plans for the future:
A three year campaign of exhibitions/web content creation/printed book to stimulate and curate conversations around breastfeeding between the public and medical professions addressing the discrepancy between research and practice in order to inform research communities and the general public.

  • 10 new exhibitions of Holding Time at community, health and art centres, birthing units and hospitals across the country.
  • 10 x Postcard campaigns of 1000- 1500 (e.g. 25 cards x 50 surgeries per exhibition) leading public to online content
  • 20 mother stories Podcasts
  • Expansion of Mother Stories section of website
  • Transcripts/closed caption subtitles for all Podcasts
  • 20 guest BLOG posts: Academics/medical researchers to write on subjects raised by women in workshops and interviews e.g. the struggle to feed in the early stages, the establishment of lactation, post partum care, expressing, breastfeeding in public, looking at how current research can help parents make informed choices in these areas.
  • 10 Podcasts with Academics/medical researchers/health professionals
  •  Facebook Q&A sessions with guest researchers/practitioners and participating mothers
  • Breastfeeding Hubs/workshops/talks where possible/appropriate delivered by Dr Lucila Newell and Lisa Creagh
  • Facebook/Instagram channels to promote the above.
A limited edition book featuring Holding Time with an introduction by Dr Debra Bick, essay by Ruth Stirton/Lucila Newell/Erin Barnett. Schilt publishers have confirmed they will produce and distribute this book across Europe and North America using their existing channels.
Tips for adoption:
Any Community health space can host the exhibition, promote the exhibition using the tested method of GPs surgeries locally and linking to the online content. They can also suggest researchers and mothers to interview or write BLOG posts. I have applied to Wellcome for a budget to cover ten exhibitions in areas with low breastfeeding rates nationally.
Contact for further information:
For more information please contact Lisa Creagh
Project Web:
Artist site:
Tel: 07816 577140
See additional 'Links' document attached
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Lisa Creagh 13/09/2018 - 09:00 Approved

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