Idea Description
Supplementary Information
Innovation 'Elevator Pitch':
Peezy Midstream delivers right first time urine analysis, diagnosis & treatment by reducing mixed growth from national average 18% to 1.5%. Reduces costly retesting, repeat appointments and unnecessary antibiotic prescribing. Saves time and money.
Overview of Innovation:
Peezy Midstream is new technology that guarantees midstream urine for essential tests and routine screening. It reduces the national average mixed growth rate from 18% to 1.5%; Peezy meets all the criteria for the Department of Health's Getting It Right First Time Programme.

Peezy is on the NHS Supply Chain and the National Drug Tariff, which means it can be prescribed for antenatal and elderly use, where truly accurate results are essential for mental and physical wellbeing of patients.

Urine analysis is used for myriad routine and exceptional diagnoses from chronic urinary tract infection to bladder cancer; prompt and efficient treatment brings benefits to clinicians and patients alike saving valuable time and money.
Stage of Development:
Market ready and adopted - Fully proven, commercially deployable, market ready and already adopted in some areas (in a different region or sector)
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Innovation 'Elevator Pitch':
65m urine specimens analysed annually in the UK breaks down to 250,000 every working day, of which 45,000 will be unreliable. This means 45,000 patients daily who will not be treated for urine-based infections. Peezy Midstream means they can.
Overview of Innovation:
Peezy Midstream can save the NHS £30m in reduced retesting of the most common diagnostic procedure.

It is a simple but innovative device that automatically captures clean-catch urine from men, women and children (from toddler age). It is especially valuable for the elderly and pregnant women for whom accurate urine screening is essential.

The average national mixed growth rate reaches from 0.38% to over 70%; the average is 18% - that's nearly 1 in 5 patients who will not receive accurate right-first-time treatment from their urine specimen.

Peezy Midstream reduces mixed growth rates to 1.5%, which means many more patients will be treated right-first-time, saving the NHS as a whole over £30m in direct retest costs and over £1bn indirectly through saving repeat staff and resource time.

Peezy Midstream captures urine specimens hygienically - it prevents spills and splashing, improving infection control in healthcare settings. It can be held by the tube if help needs to be given - the assistant does not risk becoming soiled either.

Dignity is implicit; easy Peezy is comfortable, quick and removes the need to start-stop-start when giving a midstream urine specimen.

There is no down-side to using Peezy Midstream. It saves lives, saves time and money and reduces unnecessary broad spectrum anitbiotic prescribing. Peezy is poised to make novel cancer urine tests more efficient too.

Each Peezy kit costs just 87p on the NHSSC; use ten for every retest. Available on the NHS Supply Chain and on the UK Drug Tariff - growing in popularity with midwives and care givers to the elderly.
Stage of Development:
Market ready and adopted - Fully proven, commercially deployable, market ready and already adopted in some areas (in a different region or sector)
WMAHSN priorities and themes addressed: 
Advanced diagnostics, genomics and precision medicine / Wellness and prevention of illness / Clinical trials and evidence / Innovation and adoption / Patient and medicines safety / Person centred care
Benefit to NHS:
Peezy Midstream delivers huge cost and efficiency savings plus clinical benefits:

(See attached WM mixed growth data and separate cost savings model)
  • Reduction of average West Midlands mixed growth rate of 17.5% to 1.5%
  • West Midlands direct savings of £307,798
  • West Midlands indirect savings of £12,339,337 (see attached WM cost savings model)
  • reduced urine specimen mixed growth from West Midlands average  to 1.5%
  • right-first-time urine analysis, diagnosis and treatment - don't see the same patient twice for the same problem
  • delivers specimen into 10ml tube that fits most automated laboratory urine analysers (no decanting in lab)
  • no soiling, dry tube, clean toilets: more hygienic for healthcare professionals
  • targeted prescribing, reducing need for broad spectrum antibiotics
  • improved infection control: no spills or splashing of urine
  • works equally for men, women and children (from toddler age)
  • excellent for pregnant women where antenatal screening must be super-accurate; they don't have to see the funnel is in place - they can feel it
  • antenatal screening accuracy for maternal diabetes, pre-eclampsia
  • excellent for the elderly prone to UTI, which can affect both wellbeing and behaviour
Initial Review Rating
4.20 (1 ratings)
Benefit to WM population:
  • West Midland Patient Savings of £90 (please see attached WM cost savings model, Patient Savings tab)
  • Accurate urine specimens mean prompt, accurate diagnoses
  • Patients will no longer need to visit their GP more than once for urine-related illnesses
  • They will receive the correct, targeted antibiotic, helping the fight against anitmicrobial resistance, encouraged by over prescribing of broad spectrums
Current and planned activity: 
  • Peezy Midstream is on the NHS Supply Chain at 87p (Peezy, tube, genital wipe)
  • It is approved by NHS Prescription Services and on the Drug Tariff for prescribing
  • Quality Improvement Audit at Barts (London) shows reduction in mixed growth from 17.5% to 1.5%
  • Quantative clinical study results pending from Stanford Medical School
  • Peezy currently part of MS Rapid Diagnostics Pilot, London
  • Prescribing growing amongst antenatal population
  • In use within some NHS departments: urology, outpatients, pre-admission, antenatal, A&E, Ambulance Services
What is the intellectual property status of your innovation?:
Patent and trademark granted:
  • UK
  • USA
  • Europe
  • China
  • Australisa
  • Asia
Return on Investment (£ Value): 
Return on Investment (Timescale): 
6-12 mon
Ease of scalability: 
Regional Scalability:
Easy; Peezy is available through the NHS Supply Chain
Forte Medical is happy to attend your location and brief staff on usage and instructions if necessary
Reduced mixed growth
Reduced retesting
Reduced repeat appointments
Cost and efficiency savings
Adoption target:
6 months
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Innovation 'Elevator Pitch':
Peezy Midstream: proven urine collection device, reducing specimen contamination from national average 22.5% to 2.5%. Collects specimen into either 30ml Universal Container or the 10ml lab-friendly Primary Tube. Cost: 87p on the NHS Catalogue.
Overview of Innovation:
Peezy Midstream is a proven urine collection device which reduces contamination risk from a national average 22.5% to 1.5-2.5%. 

The Peezy is key for the pre-analytical diagnostic phase because:
  • The clean collection of Urine is a key component of laboratory medicine, drug and substance testing.
  • Pre-analytical specimen integrity is just as critical to the result reported by the laboratory. Drug testing and clinical laboratories must ensure processes are in place to ensure specimen collection is clean and free of contamination.
  • Contaminates and mixed growth can lead to corrupted or rejected samples.
The Peezy is the only device that provides a clean-catch mid-stream urine, it voids the initial stream into the toilet, removing the need to start-stop-start, it significantly reduces asymptomatic bacteriuria, it is hygienic and has been designed for use in drug testing.

- ISO 15189 / Laboratory Standards
  • Using the Peezy improves ISO 15189 reporting and quality measurements

Adopting the Peezy as the standard model for all urine collection allows laboratories to measure the number of urine samples received in the laboratory uncontaminated and to compare this to the number of contaminated urine samples received as a % of all urine samples processed, a key quality measure of the pre-analytical phase.

Peezy Midstream addresses an overlooked area of diagnostic medicine, delivers accuracy, hygiene and dignity. For those who are elderly or otherwise unable to position the device themselves, help can be hygiencially given with the carer holding the tube in place by the tube. This can be done over the toilet, a commode or bedpan.
Stage of Development:
Market ready and adopted - Fully proven, commercially deployable, market ready and already adopted in some areas (in a different region or sector)
WMAHSN priorities and themes addressed: 
Advanced diagnostics, genomics and precision medicine / Wellness and prevention of illness / Wealth creation / Clinical trials and evidence / Innovation and adoption / Patient and medicines safety / Person centred care
Benefit to NHS:
Peezy Midstream delivers right-first-time analysis, diagnosis and treatment.

It reduces retesting leading to fewer second and third urinanalysis episodes; use 10 x Peezy kits for the cost of one retest. It promotes right-first-time analysis, diagnosis and treatment and reduced antibiotic prescribing, because the root cause of infection is correctly identified first-time.

Peezy Midstream is hygienic to use, eliminates spills and splashing, results in dry collection tube and dry patient (hands and legs); simply, it promotes infection control.

Peezy meets PHE Microbiology Standars for the Investigation of Urine and WHO standards around the collection of specimens. It meets all available NHS Trust guidelines for midstream urine collection as the recommended standard for urineanalysis. 

Peezy Midstream is easy to use: see our IFU Animation:
Initial Review Rating
4.20 (1 ratings)
Benefit to WM population:
Reduced retesting leads to:
  • First time analysis diagnosis and treatment benefits clinician and patient
  • Fewer repeat appointments allowing clinicians to focus on first-time conditions or presentations
  • Reduced  retesting, leads to faster first-time lab analysis on new specimens
  • Convenience to the patient with prompt treatment and reduced repeat appointments
Current and planned activity: 
Peezy Midstream is on the NHS Supply Chain at 87p; the kit includes Peezy funnel, collection tube (choice of 10ml or 30ml) and hygienic wipe for use prior to specimen collection; this will remove surface genital bacteria and debris, which can exacerbate specimen contamination. Ten Peezy kits can be used for the price of one laboratory analysis at the average DH/NHS tariff rate of £8.86.
What is the intellectual property status of your innovation?:
Full patent granted in most global territories; Peezy name and logo are trademarked.
Return on Investment (£ Value): 
Return on Investment (Timescale): 
0-6 mon
Ease of scalability: 
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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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