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Idea Description
Supplementary Information
Innovation 'Elevator Pitch':
QbTest reduces delay to ADHD diagnosis, improves patient and family experience and saves significant clinical time required to rule in or rule out the disorder.
Overview of Innovation:
QbTest is an FDA cleared objective testing system that simultaneously measures attention, impulsivity and motor activity, a core requirement of diagnostic criteria in both DSMV and ICD10. After a 15-minute test, the individual patient’s performance is then compared to an age and sex-matched control group (n = 1307). A comprehensive report is available on test completion. Reports are in a readily understandable format and outline whether a child is more active, impulsive and inattentive than a group of age and gender-matched controls (children without ADHD).

QbTest results in a more accurate and timely clinical diagnosis. This includes ruling out ADHD as well as confirming ADHD.

QbTest includes a Data Management System to help demonstrate clinical/service outcomes through automatically collected data and is underpinned by a Professional Training Programme for quality assurance.

In 2017, the EMAHSN supported the delivery of 1231 QbTests within different pathways in three Trusts across the East Midlands. Time from assessment to diagnosis was reduced by 153 days. Costs were reduced by 32% by releasing 20% of the clinical time (median figures). 85% of patients found the results helpful and 94% of clinicians reported greater understanding of patient’s symptoms.

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':
GASP online is a fully moderated, collaborative online learning community for school children. It supports the mental health prevention agenda through access to information, signposting services and encouraging engagement.



 
Overview of Innovation:
GASP online provides a safe online space allowing children, teachers and organisations to learn together. By setting challenges and introducing new topics, it connects children, schools and experts from all over the UK. It takes down the walls of the classroom to brings a whole new dimension to learning.
 
All the content is moderated by a team of educational experts, ensuring that the space is entirely safe for users. As a digital innovation, this offers the opportunity to support to schools to scale their ‘prevention agenda for mental ill health’ enabling earlier intervention(s) at relatively low cost.
 
The child-centred communities enable professionals to host preventative information, deliver solutions, gather opinion and hold conversations in a safe, moderated environment. This integrated, approach provides a one-stop community where any issue which may impact upon a child's mental health can be discussed and advised upon such as housing and finances.
 
The communities give children help and information and signpost to services. Importantly they also give children of all ages a voice and empowerment in an environment that informs, inspires and encourages aspiration to drive confidence and resilience in future generations.



It can significantly widen the reach of NHS services impacting on cost-effectiveness.  GASP online (5-11) allows multiple stakeholders involved in the health and education of a child to work together in a variety of ways. The community offers opportunities to educate and inform users and provide long term preventative solutions.

They also provide healthcare professionals a permanent place to offer support and advice to teachers and support staff who often don’t know where best to turn.

As a STEM (Science, Technology, Engineering and Mathematics) learning platform focussed on aspiration  GASP can also help to tackle the upcoming skills gap in the health sector.
 
Taking a long-term approach, the NHS can attract the talent they will require to address the future clinical skills gap by developing a careers platform, engaging with children from when they start school to when they leave.
 
Developing a NHS skills pathway can create real social change and empower an effective future workforce.
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 / Wellness and prevention of illness / Education, training and future workforce / Wealth creation / Digital health / Innovation and adoption / Person centred care
Benefit to NHS:
At least 10% of children and young people are thought to suffer from anxiety, depression, self-harm, eating disorders or other mental health conditions. The numbers of under-18s seeking and receiving NHS care have soared over the last decade.
 
The government’s plans to tackle the mental health crisis among young people are based on three key elements: a teacher at every school and college becoming its designated lead for mental health; help for schools from new mental health support teams; and the guarantees of help within four weeks. Source: The Guardian
 
In a joint report, the Commons health and social care and education select committees criticise the plans as unambitious and inadequate given the fast-rising need for care and too reliant on already overworked teachers. Source: The Guardian
 
GASP offers opportunities to help to transform a failing mental health system. The projects and topics shared throughout the site encourage children to develop critical and higher order thinking skills. The space allows teachers to share best practice and save time.
 
In supporting the recommendations of the Five Year Forward View for Mental Health (2015)
they enable a true joined up approach to support the future health of millions of children. It enables partnerships between schools, communities and employers. Overwhelmingly the flexibility of the portals underpins the reports’ findings - enabling promotion of resilience, prevention, early intervention, measure engagement and impact.
 
Free at entry point for state schools and home learners there is no barrier to entry.
 
In building a one-stop hub for children, we are creating an environment that empowers young people to participate, innovate and contribute to society. By empowering learners to be self-sufficient we can drive important messages and support directly to learners wherever they live. This allows the NHS to drive targeted information to this audience accessible at any time, in and out of school.

Education, voice and self-awareness lie at the core of our communities - joined up thinking, prevention and proactivity are central to our aims
Initial Review Rating
3.40 (2 ratings)
Benefit to WM population:
Poor mental health costs the region £3,000 per person in the Midlands area. Mental health issues are impacted by poor housing, low socio-economic status. This is combined with Birmingham having the youngest population in Europe. (Eurostat 2018). The Wonder Why Society and Bridgr communities provide a pathway for the NHS to work directly with schools and children throughout compulsory schooling, developing a digital preventative care pathway.
 
GASP can be used to support and introduce online learning in any subject. It can be used to set homework, encourage debate, facilitate high level thinking and extend classroom learning. It enhances digital skills, teaches online safety and embeds technology in to the curriculum.
 
We have a partnership with a Prevent agency who provide specialist support via the platforms for children to ask questions about things they might feel are embarrassing, difficult or confusing. We also have resources for teachers to use in the classroom that cover mental health, resilience, spiritual, moral, social and cultural (SMSC) and British Values.
 
Online safety is our number one priority. In order to ensure a safe environment, we comply with all of the recommendations outlined by The UK Council for Child Internet Safety (UKCCIS) and support the Think U Know campaign.
 
Nothing is published on our site until it has been checked by one of our qualified education moderators.
 
Upon joining, children agree to follow our online safety rules. Just by using the site children are naturally learning digital skills, online safety and ‘netiquette’. Anything that is submitted that is against our online safety code or causes any concern will be reported back to the school DSL.
 
GASP online moderating staff have been DBS checked and undertaken safeguarding training. We have a Safeguarding Policy and an appointed Safeguarding Lead.
 
 
Current and planned activity: 
From a mental health perspective, GASP online gives children a safe place, a voice and easy access to information that’s useful to them.
GASP online wishes to introduce measured testing to assess wellbeing, resilience and mental health issues. This will help us to quantify and qualify how we support young users and validate evidence gathered in initial trials.

Aspiration assessment
The platform encourages aspiration. We also seek advice and guidance on how this can be measured.

 
Currently our support service is open Monday to Friday from 9am – 4pm. To provide continuous support to children we wish to create a 24/7 support service and would like to work with regional health stakeholders to explore a potential referral pathway(s) / digital therapies that can be used out of school hours and during school holidays.
 
Funding is required to develop the 24/7 support service and we would welcome partners who could submit joint applications to bids / funding competitions.
What is the intellectual property status of your innovation?:
Edrev Ltd . Trademark pending. Copyright automatic. There is a licence between the 2 companies
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
6-12 mon
Ease of scalability: 
3
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Innovation 'Elevator Pitch':
Uflow meter - a low cost, simple to use device enabling men to measure their urine flow rate. Changes to flow can indicate a range of Lower Urinary Tract Symptoms (LUTS) & detect Bladder Outflow Obstruction (BOO) or an Overactive Active Bladder (OAB)
Overview of Innovation:
As the global population ages, the incidence of Lower Urinary Tract Symptoms (LUTS) is set to rise, as up to 50% of males over 40 likely to experience significant issues.
 
Management or treatment of LUTS is difficult for GPs as it relies on men’s awareness and accurate description of their urine flow rate relative to their ‘norm’. These factors may result in inappropriate medication or a delay in referral, as a ‘watch & wait’ strategy is adopted to determine symptomatic progression.
 
Current objective ‘office’ or clinic based uroflowmetry devices and procedures, are time consuming to use, expensive and difficult to maintain, requiring patients to visit a specialist clinic.
 
UFlow is a low cost, effective and simple to use male urine stream measurement device that can be used by the patient to aid in both the assessment & monitoring of bladder output issues at home.  This allows men to accurately and reliably monitor their urine flow, clearly identifying whether their flow is normal or not. This enables clinically important measurements to be easily acquired early in the diagnostic pathway of LUTS. Peak flow rate of urine is a useful and recognised quantitative indicator of any urodynamic obstructions for a doctor or surgeon.
 
The peak flow rate can be used as an objective outcome measure as to the effect of pharmacological, surgical or other treatments.
 
The Uflow-meter comprises a transparent plastic funnel-shaped device graduated into four compartments of different sizes: ‘ CUP ’ , ‘ TOP ’ , ‘ MIDDLE ’  and ‘ BOTTOM ’ 




There is a hole at the end of the BOTTOM compartment through which urine can pass to the exterior so that the volume of voided urine can be measured.
 
To measure urinary flow, the patient holds the device vertically and urinates into it. Owing to the difference between the rates of urine flowing into and out of the device, a column of urine rises in the device. During micturation the urine column rises and rate of outflow eventually matches that of the inflow. The compartment reached by the peak fluid level indicates the range (category) of maximum urinary flow rate (Qmax).
 
Previous pilot studies demonstrated both the clinical value of the device the accuracy of the device showing that the category ‘ BOTTOM ’ satisfactorily indicates a steady flow of < 10 mL/s, ‘ MIDDLE ’ 10 – 15 mL/s, ‘ TOP ’ 15 – 19 mL/s, and ‘ CUP ’ > 19 mL/s

www.mdti.co.uk/uflow 
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 / Wellness and prevention of illness / Wealth creation / Clinical trials and evidence / Innovation and adoption / Person centred care
Benefit to NHS:
The ageing population and the heightened awareness of prostate cancer have increased the number of men with Lower Urinary Tract Symptoms (LUTS) requesting specialist assessment. Over 50% of men aged 40 and over will experience moderate to severe micturation problems. This increased demand creates problems for urology clinics, with limited staff, equipment and budgetary resources.
 
The diagnosis, treatment and management of LUTS also poses a significant problem for GPs as it relies on men performing a subjective assessment of their current urodynamics, against their ‘norm’ to determine if interventions or referrals are required.
 
Current objective uroflometry requires referral to a specialist urology clinic, incurring financial costs and delays for both the NHS and patient in reaching a clinical diagnosis and establishing a treatment regime.
 
Additionally, current uroflowmetry measurement systems are expensive to purchase, difficult to maintain, require clinic space and are time-consuming to use by specialist staff. For certain conditions, such as Benign Prostate Enlargement (BPE), it may not possible for patients to undergo traditional uroflometry in a timely manner due to limitation in clinic or staff availability.
 
Uflow provides a simple, reusable and low cost solution to objectively determining a patient’s peak urine flow, which can be used by the patient in their own home. This can therefore quickly ‘triage’ the patient, identifying if there are clinically significant LUTS such as BPE, Bladder Outflow Obstruction or Overactive Bladder. The Uflow meter can be particularly effective for patients who may be at higher risk of Acute Urinary Retention or require urgent surgical referral.
 
The use of the Uflow meter by the patient, at home, frees clinician and clinic time and is very cost effective. The additional peak flow data provided by the Uflow meter is a valuable urodynamic  adjunct to the widely used frequency volume chart completed prior to the initial GP or clinic visit, greatly aiding diagnosis and treatment planning.
 
Continued use of the Uflow meter can also accurately and cost effectively measure the effectiveness of treatment regimes.
 
Current ‘local’ costs of Urology clinic uroflowmetry is approximately £146 per assessment. By comparison the reusable Uflow meter is available, via NHS Supply Chain, for a bulk price of only £6.00, representing a significant cost and resource saving to the NHS, enabling more patients to be successfully ‘triaged’ and treated.
Initial Review Rating
4.60 (1 ratings)
Benefit to WM population:
In a 2009 Health Economics Study commissioned by the NHS and carried out by Adams Business Associates (attached), the number of patients passing through NHS treatment pathways was 1,415,700. This equated to a total NHS spend for male LUTS assessment of £291,280,275.
 
At an estimated 40% adoption rate for the UFlow device, the predicted savings to the NHS would be £45.3 million
 
Given that the population of the West Midlands represents approximately 20% of that of the UK as a whole, the scale of the savings to the regional NHS that would accrue from using U-Flow can be appreciated.

Uroflo meter is currently being used by several West Midlands NHS Trusts
Current and planned activity: 
Uflow is cuurently in use with a number of NHS Trusts and clinics throughout the UK.

The opportunity of engaging with additional users within the region would be welcomed.
What is the intellectual property status of your innovation?:
Uflow Meter is a Registered Design and is a protected Trademark
Return on Investment (£ Value): 
Very high
Return on Investment (Timescale): 
0-6 mon
Ease of scalability: 
Simple
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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: sales@sarissa-biomedical.com

Further information on Sarissa Biomedical Ltd and SMARTChip is available via the following links:

http://sarissa-diagnostics.com/

http://sarissa-diagnostics.com/?s=Smartchip
 
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