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Innovation 'Elevator Pitch':
FebriDx® is a rapid, point of care test that uses a capillary blood sample to help identify a clinically significant immune response to acute respiratory infection and differentiate viral from bacterial aetiology.
 
Overview of Innovation:
FebriDx detects elevated levels of Myxovirus resistance A (MxA) –
an intracellular protein that becomes elevated in the presence of acute viral infection
and C-reactive protein (CRP) – an acute-phase inflammatory protein that is elevated
in the presence of bacterial infection.

•    Accurate results eliminate diagnostic uncertainty.
•    Enables GPs to make targeted and informed therapeutic decisions.
•    Supports patient discussion around the clinical pathway of viral infection.
•    Reduces unnecessary prescriptions of antibiotics.
•    Optimises costs associated with clinical management of acute respiratory infection.
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':
Catheters cause 250,000 serious infections, 3,000 deaths & up to £500m in healthcare costs a year research reports. UroShield prevents bacterial biofilm formation, increases antibiotic efficacy & decreases pain & discomfort of urinary catheter use.

Overview of Innovation:
90,000 Britons are fitted with a urinary catheter each year. Catheters are essential for a wide range of conditions that compromise the ability to empty the bladder effectively, such as prostate cancer patients and those with incontinence and neurological conditions like multiple sclerosis and spinal injury.
 
Indwelling catheters serve as an environment for bacterial attachment, biofilm formation and subsequent urinary tract infections (UTI). Biofilm formation is a thick, bacterial ‘glue’ that sticks to the surface of the catheter plastic and is highly resistant to antibiotics, making infections difficult to treat. Such catheter-acquired infections are one of the most common iatrogenic complications and may lead to increased mortality rates, extended hospital stays and increased medical costs for healthcare providers.
 
UroShield uses soundwaves to ‘shake’ away bacteria, protecting patients from painful and potentially life-threatening bladder infections. It is composed of 2 components: A disposable actuator which clips onto the external portion of the catheter and a portable battery powered driver.



The device sends out low-frequency ultrasound waves (Surface Acoustic Waves) which run longitudinally along both the inner and outer surfaces of the catheter. These surface acoustic waves prevent bacteria from docking and adhering to the catheter and subsequently prevent the formation of biofilm.
 
If there is a biofilm already present or one does form, the ultrasound waves help to break up the normally impenetrable biofilm matrix to allow access of the antibiotic to the biofilm. This increases the antibiotic efficacy by working synergistically so that patients may have a shorter course and lower dose of antibiotics.


In addition, independent studies from leading Universities have shown that the UroShield device enhances the immune systems’ ability to fight biofilm. In further studies the Uroshield device achieved a 90% reduction in the presence of common bacteria most likely to cause infection including E. coli and Staphylococcus epidermidis.
 
The action of the ultrasonic waves on the surfaces of the catheter interfere with the attachment of bacteria, prevents infections developing, reduces catheter encrustation and blockages and decreases or eliminates the need for antibiotics, reducing risk and improving patient outcomes. This in turn reduces the costs associated with indwelling catheter complications that may lead to increased medication and extended hospital stays.
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: 
Wellness and prevention of illness / Innovation and adoption
Benefit to NHS:
Reducing health care-associated infections (HCAIs) remains high on the Government’s
safety and quality agenda and in the general public’s expectations for quality of care.
 
Patients with invasive devices such as urinary catheters are at a greater risk of developing a HCAI (NICE, 2012). In addition to increased costs, each one of these infections means additional use of NHS resources, greater patient discomfort and a decrease in patient safety.
 
UroShield is a breakthrough device to prevent or treat catheter-related trauma.
 

 
Once the urinary catheter has been placed into the patient’s bladder, the actuator is clipped on the extracorporeal part of the catheter and the device is activated. UroShield harnesses the known therapeutic effects of ultrasound such as tissue healing and muscle relaxation to significantly decrease catheter-associated pain and discomfort. This is extremely easy for nurses to use and maintain, with a simple clip around the catheter to be changed monthly and disposed of in standard waste.
 
UroShield could have huge implications for reducing A&E admission rates as 224,670 admissions for UTIs were reported in 2009 and 2010 and since then numbers have continued to increase, with 43-56% of all UTIs being associated with indwelling. Between 2013/2014, the NHS spent £434 million treating 184,000 hospital admissions for a UTI.
 
UroShield could play a key role in achieving CQUIN targets for CAUTI rates and the reduction in E. coli Bloodstream Infections through the initial prevention of infection.
 
E. coli is one of the main pathogens responsible for causing UTIs and CAUTI, of which Gram-negative CAUTIs are often a source of bacteraemia. E. coli account for 55% of all BSIs and of these UTIs are responsible for 45% of E. coli BSIs. E. coli BSIs have increased by 20% over the last five years and the trend is still rising, which is of grave concern.
 
E. coli BSI are therefore a huge patient safety issue and are set to cost the NHS £2.3 billion by 2018. These contributed to over 5,500 NHS patient deaths in 2015 and there is £45 million quality premium which is incentivised by Ruth May to reduce healthcare associated Gram-negative BSIs by 50% across the NHS by 2021. The goals are to: prevent the need for antibacterial prescription, to reduce the dose or length or antibiotics as a minimum, and to reduce hospital admissions and HCAIs.
Initial Review Rating
5.00 (1 ratings)
Benefit to WM population:
Over 1 million patients a year have a catheter for a short time while in hospital & those using them at home for longer periods have them changed every 3 months & infections can be missed between changes.
 
An untreated urinary tract infection (UTI) may spread to the kidney, causing more pain & illness & lead to sepsis, a life-threatening reaction to an infection.
 
Long-term catheterisation carries a significant risk of symptomatic UTI, which can lead to serious complications such as bloodstream infections (NICE 2012). The diagnosis of a CAUTI increases the use of antibiotics which will increase the burden & development of antimicrobial resistance (DH, 2007).
 
Recurrent lower UTIs have a detrimental effect on patients quality of life. Patients experience a psychological burden because they live with the anxiety of sudden acute episodes. The resulting social handicap is known to induce feelings of self-devaluation or culpability, which can lead to clinical symptoms of depression.
 
UroShield could protect thousands of patients from painful & potentially life-threatening bladder infections reducing the psychological burden & anxiety patients experience.
 
The innovation is currently being trialled in NHS hospitals with leading urologists including a consultant & surgeon at the Royal Marsden in London describing the device as ‘game-changing’.
 
Uroshield comprises an electronic driver (8-hour battery life) weighing 5g & a disposable clip that fits around the catheter tube, the driver transmits continuous ultrasound waves to the clip via a small cable. The rechargeable device can be switched on & off & a small screen on the driver indicates power supply & battery life.
 
Clinical trials have shown the acoustic sound waves generated by the UroShield device along the urinary catheter result in a significant decrease in catheter-associated pain & discomfort.
 
Click the image below to read the full article.


 
UroShield significantly reduces bladder washouts in catheterised patients & thus could reduce visits from district nurses to generate significant cost & time savings. For example, one patient required daily bladder washouts & since UroShield no longer requires any at all. Patients can have greatly extended catheter life, reducing the frequency of catheter change & maintenance & nurse callout time associated with this. Alongside freeing time & resources, UroShield could also assist Infection Prevention Nurses in achieving CQUIN targets based on catheter-associated infection rates.
Current and planned activity: 
We are speaking with over 80 primary and secondary care sites with regards to UroShield. We currently have 6 NHS sites evaluating UroShield in small scale patient service evaluations alongside a double-blind randomised controlled trial producing positive data proving the efficacy of UroShield.
 
We are also working to provide Health Economic Data which will further support the use of UroShield across various healthcare settings. To support this we are looking to work with a NHS partner in the West Midlands to undertake a small-scale (service) real-life evaluation of UroShield to demonstrate patient and fiscal benefits of using the device.
 
UroShield can help you to support the delivery of the national ‘reducing the impact of serious infections (Antimicrobial Resistance and Sepsis’ CQUIN by creating a new, improved pattern of care for patients, reducing their risk of painful and potentially life-threatening bladder infections.
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
1 year
Ease of scalability: 
2
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Innovation 'Elevator Pitch':
The latest review from Havard Medical School is calling for action. Antiobiotic Resistance is a global crisis. A vastly modernised therapy and approach to the use of UV light to treat infections.
Overview of Innovation:
Overview of Innovation:
Biophotonic therapy (or Ultraviolet Blood Therapy) was initially used to treat a variety of infections prior to antibiotics in the 1940's & 50's.  

When used properly, UV light acts on blood in unique ways to produce some very positive therapeutic effects.A more modern approach and re-invention of the devices used are described below.
The primary purpose of the UltraLux UV device is to reduce signs and symptoms of diseases caused by infection with viruses or bacteria or characterized by excessive inflammation, when other treatment options have proven insufficiently effective.
Although the UltraLux UV devices may be successful as a primary treatment option, available data reviewed indicates use as a concomitant, secondary or tertiary treatment to:
  • reduce viral load
  • reduce bacterial load
  • reduce inflammation
In general, it has great potential to quiet the cytokine storm in sepsis and effectively treat some of the ESKAPE pathogens.The mechanism of action involves the UV light interacting with components of the blood (proteins and cells). It is likely that many different blood components are affected – monocytes, lymphocytes, erythrocytes, dendritic cells, neutrophils, and even proteins such as lipoproteins and immunoglobulins may be affected. The net result is that there is a significant decrease in inflammation (important for patients with sepsis and inflammatory conditions) and the natural antimicrobial activity of the host cells is markedly increased.
Ultraviolet Blood Therapy has had a history of safety.  Side effects have been minimal and are more associated with the drawing and returning of the blood as to the actual action of the light in the blood. The experience of over 200,000 human treatments has yet to uncover any serious adverse effects.  The therapy has been in continual use for the last 50 years.
As we now reach a global crisis in antibiotic resistance any alternative or additional treatments for infections are gladly welcome and should be utilised.
Stage of Development:
Close to market - Prototype near completion and final form may require additional validation/evaluation and all CE marking and regulatory requirements are in place
WMAHSN priorities and themes addressed: 
Clinical trials and evidence / Innovation and adoption / Patient and medicines safety
Benefit to NHS:
An alternative to antibiotic use, 
Initial Review Rating
4.20 (1 ratings)
Benefit to WM population:
An alternative to antibiotic use
Current and planned activity: 
Currently trying to enage Primary Investigators for efficacy studies
What is the intellectual property status of your innovation?:
Patent in US ,Would be first to market in UK
Return on Investment (£ Value): 
medium
Return on Investment (Timescale): 
1 year
Ease of scalability: 
3
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Innovation 'Elevator Pitch':
Evaluation of near patient testing within community pharmacy to help reduce inappropriate antibiotic prescribing associated with respiratory and urinary tract infections.
Overview of Innovation:
Inappropriate antibiotic prescribing can lead to higher rates of antimicrobial resistance. Taking steps to reduce the number of inappropriate antibiotics prescribed will help delay the emergence of resistant organisms and prevent harm by reducing the incidents of Clostridium Difficile. 

GP practices are often the first port of call for infections such as such as sore throats. It is estimated that 50-95% of sore throats in adults and 70% in children are caused by respiratory viruses which could potentially be managed safely within community pharmacy without the need for antibiotics.

Patients presenting with sore throats to GP practices fall into three groups namely, those with clear bacterial infection, those with viral infection and those where there is a degree of diagnostic uncertainty. In the latter group, a near patient test to aid diagnosis may help reduce diagnostic uncertainty and may prevent inappropriate antibiotic prescribing. 

Near patient testing is well established in general practice e.g. urine test strips for urinary tract infections. Recently, other devices have been introduced which look at CRP, Strep A, RSV, Flu.  These devices have been shown to aid diagnosis rates. 

However, conducting near patient tests in GP practice does not help address the current workload and capacity issues experienced by GPs. It is therefore proposed that such tests could be conducted in the Community Pharmacy.

Patients with diagnostic uncertainty could be referred by the GP to their community pharmacist to have a diagnostic test and dependent upon the results have the most appropriate treatment dispensed. Community pharmacists could supply antibiotics in line with local formularies if the test results were positive or self advice / over the counter medicines if the results were negative. 

By developing and evaluating this care pathway, we aim to evaluate whether this helps reduce overall antibiotic prescribing in primary care. We would also evaluate patient satisfaction, the impact of GP workload as well as pharmacy satisfaction with near patient testing. 

Initially we would like to evaluate one device but this patient pathway could be applied to other near patient tests. If successful, ear patient tests could be incorporated in common ailment schemes whereby patients approach their "pharmacy first" rather than their GP practice for sore throats or urinary tract infections. This would help reduce demand on GP services.  



 
Stage of Development:
Trial stage - Trial stage to prove that the idea actually works as intended
WMAHSN priorities and themes addressed: 
Long term conditions: a whole system, person-centred approach / Advanced diagnostics, genomics and precision medicine / Wellness and prevention of illness / Education, training and future workforce / Patient and medicines safety / Person centred care
Benefit to NHS:
The NHS would benefit on a number of fronts. 

1. Reduce inappropriate antibiotic volume. This will help delay the emergence of of antimicrobial resistance which in turn help prevent incidents of C Difficile and related multi-resistant infections in the future. 

2. A reduction of unplanned admissions associated with C Diff will help reduce pressure of the acute sector. Similarly, any reduction in hospital admissions will help the NHS save money. 

3. Introduction of a new care pathway involving near patient testing within community pharmacy will help reduce workload pressure on GP practices. A recent survey of GP surgeries has shown that GP waiting times have increased from an average of 9 days in April 2014  to 13 days in APril 2015. Near patient tests can take from a couple of minutes to 10 minutes. By doing these tests during a  GP consultation will add time which could be potentially be avoided if done elsewhere.

4. New ways of working between GPs and community pharmacists are part of the Five Year Forward View. A clear and robust pathway will help utilise existing capacity in community pharmacy to support other primary acre contractors such as GPs. This also strengths the links between community pharmacy and GP practices and will foster closer working between the two primary care contractors. 


 
Return on Investment (£ Value): 
N/A
Return on Investment (Timescale): 
N/A
Ease of scalability: 
N/A
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