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Idea Description
Supplementary Information
Detailed Submission Data
Innovation 'Elevator Pitch':
NATROX® Oxygen Wound Therapy is a medical device designed to heal complex non-healing wounds to improve healing outcomes and quality of life, optimise clinical and economic resources, and reduce diabetic foot related amputation rates.
Overview of Innovation:
NATROX® Oxygen Wound Therapy is a portable, lightweight and easy to use patient-friendly device, designed to topically deliver continuous pure humidified oxygen to the wound bed. The device was developed in order to help improve healing outcomes in wounds which traditionally remain static due to wound hypoxia (oxygen starvation), a common symptom of diabetic and vascular issues.

The NATROX® system is comprised of an Oxygen Generator, 2 rechargeable batteries and a single-use disposable Oxygen Delivery System. The therapy is designed to be used 24/7 and as an adjunct to standard of care, such as absorbent wound dressings, with an average therapy length of 12 weeks. The product is supported by a growing portfolio of clinical evidence, including RCT-level data, which has demonstrated a significant increase in the healing rates of complex and non-healing wounds, compared to standard of care alone (90% healing with NATROX® vs 30% for standard of care).
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':
Woundex is a innovative breakthrough discovery, the only product in the world which efficiently works on all types skin ulcerations, and is one of the best treatments available.
Overview of Innovation:
Diabetic foot problems, such as ulcerations, infections, and gangrene, are the most common cause of hospitalization among diabetic patients. Routine ulcer care, treatment of infections, amputations, and hospitalizations cost billions of pounds every year and place a tremendous burden on the health care system.
 
This therapy will help save the psychological distress people go through when they have amputations. This treatment will reduce the monetary burden on the national health care system. It has shown good results, even on the severe cases of ulcerations.

It has no side reactions. This product can be used in all types of skin ulcerations , open wounds, burns, gangrene  and diabetic ulcers. Patients would be saved from having an amputation.
This product on application helps increase blood circulation around the wound area .It also increases and promotes tissue growth this in turn helps to heal the wound speedily.

 if it is cut, however, in some people with diabetes the skin on the feet does not heal so well and is prone to developing ulcer. This can be even after a mild injury such as stepping on a small stone in your bare feet.
There is reduced sensation of the skin on your feet. Your nerves may not work as well as normal because even a slightly high blood sugar level can, overtime damage some of your nerves. This is a complication of diabetes called peripheral neuropathy of diabetes.
Diabetic ulcers can lead to gangrene , amputation making the patient immobile.
This causes great psychological distress for the patient.
 
Diabetic foot ulcer places a big budgetary burden on the healthcare authorities. Along with treatment of foot ulcers, amputation  the cost are substantial.
The healthcare authorities have to employ multidisciplinary foot care services led by healthcare professionals, and this consist of specialists with skills in the following areas: Diabetology, Podiatry, Diabetes specialist nursing, Orthopaedic surgery, Biomechanics and orthoses, Interventional radiology, Casting and Wound care-putting an even greater financial strain on the heathcare provider.
 
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: 
Mental Health: recovery, crisis and prevention / Long term conditions: a whole system, person-centred approach / Advanced diagnostics, genomics and precision medicine / Wellness and prevention of illness / Clinical trials and evidence / Innovation and adoption / Person centred care
Benefit to NHS:
Diabetes ulcer and amputations cost £1 in every £150 spent in the NHS budget. Around 15 % of all diabetes patients will suffer from diabetic ulcer and at a advanced stage amputations have to be carried out.  There are currently 150 amputations performed every week in the UK.  Patients who  have diabetic ulcers are given antibiotics as treatment to control the ulcer. These are given over many years. As you may be aware of there is a big problem of antibiotic resistance.
There will be big benefit to the NHS if they use this treatment.
Benefit to WM population:
This Treatment will benefit the WM population in big way and will eleviate the suffering diabetic ulcer patients go through.
Current and planned activity: 
The medicine is a phyto chemical spirit based solution and has to be imported from India. This medicines ingredients can only be grown in India. At the present time this product is being licenced in India
What is the intellectual property status of your innovation?:
At this stage no status
Return on Investment (£ Value): 
Very high
Return on Investment (Timescale): 
0-6 mon
Ease of scalability: 
Simple
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Innovation 'Elevator Pitch':
Neurocare’s™ muscle stimulation  therapy is safe, comfortable, non-invasive and clinically proven to accelerate  wound healing and musculoskeletal  rehabilitation which enables major treatment  cost reduction with  significant increases in HRQoL.
Overview of Innovation:
Neurocare™are seeking to promote the adoption in the UK of their muscle stimulation device and its comprehensive treatment protocols .
 
Neuromuscular electronic stimulation therapy is well established in many countries in the world particularly in the U.S.A. and with six FDA indications has a strong clinical trial evidence base in most of its  applications.  The Canadian and American Health Authorities have recommended its use in healing pressure ulcers as did the EPUAP/NPUAP collaboration in work published in 2009.
 
Patient compliance is potentially a challenge particularly where adherence to a treatment programme over a period of time is necessary. Many muscle stimulation devices can be painful  when set at voltages required to achieve a therapeutic level of muscle recruitment.
 
The Neurocare™ device has a unique electronic configuration which features AC output and allows very high voltage for full muscle recruitment at very low amperage for pain free comfortable therapy. Whether treatment occurs in clinic or in the home the objective is to recruit the patient as an enthusiastic active participant in their own programme of therapy.
 
The Neurocare™ device functions by introducing an electrical signal into the motor nerve of the muscle causing a muscle contraction which replicates exercise whilst activating the peripheral arterial and vascular systems which are essential to moving freshly oxygenated blood through the wound site.
 
Each treatment lasts between 30 to 45 minutes and may be administered once or twice daily as necessary at a cost of approximately £2 per treatment.
 
As an option remote web-based management incorporating a “virtual clinic” allows home self-treatment without the presence of healthcare professionals facilitating much more intensive therapy than periodic clinic/outpatient visits allow. This has potential for substantial cost reductions and significant acceleration of healing wounds or musculoskeletal rehabilitation with consequent improvement in HRQoL and timescales reduction.
 
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: 
Long term conditions: a whole system, person-centred approach / Wealth creation / Clinical trials and evidence / Innovation and adoption
Benefit to NHS:
As an adjunct therapy, NMES devices have been shown in clinical studies to reduce healing timescales compared with existing treatment pathways.  This is true of wound healing and musculoskeletal rehabilitation in general.
 
The Neurocare™  device is  simple,safe, non-invasive and comfortable. It is suitable for use in hospitals, clinics and the home and can be self-administered which permits both logistically and financially very much more intensive therapy than could be achieved with multiple visits to a clinic for outpatient treatment.
 
With the addition of the web-based management system the patient and Healthcare Professional can maintain constant contact for monitoring and management of the patient’s progress thus minimising the frequency of outpatient visits.
 
As an example diabetic ulcers are known to be slow healing. Six months plus  would be typical and many endure well in excess of one year. An adjunct therapy which can reduce  healing timescales by 25%+ and in many cases avoid patient episodes such as  revascularisation and amputation clearly reduces costs and radically improves the outcome for patients.
 
Many of the documents attached evidence the potential improvements accessible with this therapy which is very versatile and will bring more effective resource utilisation, cost reduction and improved patient outcomes across its very broad range of applications.
 
Web-enabled home self treatment accords well with NHS strategic priorities which stress the objective of bringing treatment closer to the patient and highlight the increasing importance of improving the patient experience.
 
Once established as a cost effective way of achieving wound healing the concept of using web-enabled treatment would be extended on a broad front. With NMES an extensive range of medical conditions can be treated remotely. The use of the Internet and the “Virtual Clinic” staffed by multi disciplinary experts allows scarce expert resources to be active over very large patient populations whilst simultaneously permits the patient to remain under the general care of their GP Practice.
Initial Review Rating
3.80 (3 ratings)
Benefit to WM population:
A healthy population is likely to be more productive than an unhealthy one and increasing productivity creates increasing wealth per capita. Healthcare delivered in the most productive way means that for each resource unit consumed more units of healthcare can be delivered.
 
Incremental productivity gains are largely driven by innovation but if maximum value is to be gained  proven innovation must be rapidly adopted and diffused.
 
Today’s aging population is increasingly frail and high quality care is increasingly expensive . Expectations will not be met if innovation driven productivity improvement stalls.
 
In a definitive NHS Document entitled ”Innovation Health and Wealth” published in Dec 2011, Innovation is defined as “An idea service or product new to the NHS or applied in a way that is new to the NHS, which significantly improves the quality of health and care wherever it is applied”. To this end the document recommends inter alia that the NHS should strive  to embrace innovation and become an early adopter, should make full  and early use of digital technologies and increasingly shift focus  toward early diagnosis and prevention,
 
The innovation proposed in this document accords well with these aspirations in that we are proposing the widespread adoption and diffusion of a clinically proven but as yet sparsely adopted medical technology supported by a state of art web-based management system.
 
Healing diabetic ulcers with home self-treatment has been chosen to illustrate the potential of web enabled management of NMES therapy  in this document but the same principles may be applied wherever this form of therapy has proven efficacy.
 
Effective prevention is difficult to prove clinically but several trials have shown that pressure ulcers can be prevented using NMES and the restoration of muscle strength and balance may extend self sufficient independence and thus delay nursing home and/or inpatient costs.
 
The way is open for CCGs to finance adoption trials at relatively low cost and risk pending widespread diffusion.
 
Current and planned activity: 
We are working with
1). Prof. Michael Edmonds at the Diabetic Foot Clinic - Kings College London.
2). Mr. David Russell at the Limb Salvage Clinic - Leeds NHS Trust
3). Prof. Ian Chetter - Vascular Surgeon at Hull NHS Trust

preparing an application for RfPB.

We also recently participated with other NHS hospitals & their Test Beds applications. We are continuing work with the Leeds Academic Health Network.
 
We are currently also working with four further AHSNs; East Midlands, West Midlands, West of England, Yorkshire and Humber.
  • Evaluation / Validation / Clinical Trial - Need to gain additional validation of system within the UK – Thus seeking a trial centre.
    Leading to:
  • Procurement / Adoption - Require addition assistance and validation to support UK sales and marketing to UK treatment centres within Acute and Primary sectors
What is the intellectual property status of your innovation?:
The device IP belongs to Neurocare Europe Limited under license from Neurocare  Inc USA.  
Return on Investment (£ Value): 
Very high
Return on Investment (Timescale): 
1 year
Ease of scalability: 
Simple
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Innovation 'Elevator Pitch':
Revamil Melginate Dressing:
  • 5x5cm & 10x10cm
  • 100% pure & controlled enzyme rich honey
  • Anti-microbial protection stimulates wound healing
  • Batch consistency with a low Ph 3.5
  • Suitable for a broad range of wound indications
  • Suitable for all ages & diabetics
Overview of Innovation:
Revamil Melginate is a calcium alginate sheet impregnated with pure honey and produced under controlled conditions. The carefully controlled production process guarantees that Revamil Melginate with honey does not contain any traces of pesticides and that the same quality can be reproduced consistently. When Revamil Melginate is applied on exudating wounds a gel is formed by absorption of wound fluid which protects the wound against maceration.
  • High moisture absorption capacity for use on low to high exudating wounds.
  • Enzyme rich Revamil honey offers protection against wound infections.
  • Revamil Melginate’s fast acting gel formation helps maintain a moist wound environment.
  • Revamil Melginate borders are not impregnated with honey, to maintain a high absorption capacity, preventing maceration
  • The alginate gelling facilitates easy dressing change because it does not adhere to wound, therefore, no residues remain in the wound after removal.
  • Revamil Melginate can be used on the following wound types:infected wounds, surgery and radiation induced oncological wounds, exudating wounds, bed sores, ulcers and 1st and 2nd degree burns.
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: 
Long term conditions: a whole system, person-centred approach / Innovation and adoption / Person centred care
Benefit to NHS:
In the clinical testing carried out Revamil honey killed Bacillus subtilis, Escherichia coli and Pseudomonas aeruginosa within 2 hours, whereas manuka honey, the comparator dressing, widely used within the NHS and had such rapid activity, only against B. subtilis. After 24 hours of incubation, both honeys killed all tested bacteria, including methicillin-resistant Staphylococcus aureus.
 
This would greatly improve wound healing outcomes and allow the patient to move along the wound healing pathway quicker as Revamil honey kills bioburden more rapidly within the wound site. The outcome meaning less dressing changes, reduced nursing time and greater patient comfort and efficacy.

Revamil honey dressing are 100% pure honey dressing and costings verses other 100% pure honey dressings and non-honey dressing Revamil is priced very favourably and can offer both CCG and Trust monitory savings.
Initial Review Rating
5.00 (1 ratings)
Benefit to WM population:
Case studies have been performed by Georgina Rostron tissue viability nurse Wigan, Warrington & Leigh community, using Revamil Melginate in a leg ulcer clinic on the treatment of several lower leg wounds, using a varied patient group.
 
The case studies demonstrate the success of using Revamil Melginate dressings on a variety of difficult and costly wounds within a community setting. The impact of such success using Revamil Melginate can lead to patient’s wellbeing and health benefiting from quicker healing times, reduced malodour and long-term psychological effects that stagnant painful wounds have on patients. Revamil Melginate dressing use can therefore support local health boards in cost efficiency and allow, where appropriate, an earlier return to work for the patient.
 
As a company, we have also had Revamil Melginate tested for the absorbency vs two of our closest competitors at the SMTL facilities in Newport South Wales. Revamil Melginate dressing over ten separate tests was the only honey calcium dressing to show superiority, our two competitor dressing readings at every test indicated a minus absorbency result.
Current and planned activity: 
Currently underway:
  • Wigan, Warrington & Leigh – Trial tissue viability
  • Barnsley Community – Trial tissue viability
  • Plymouth community – Trial tissue viability
  • Kent community – Trial tissue viability
We are seeking West Midlands partners to assist with a clinical evaluation for our UK evidence base, taking a holistic view of the economic impact from a department (Trust) and patient perspecitve.

 
Return on Investment (£ Value): 
low
Return on Investment (Timescale): 
2 years
Ease of scalability: 
2
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