Other innovations
If your innovation doesn’t fit any of the active categories then this is the place to submit your innovation for feedback and the opportunity for wider adoption across the region.

Ideas (Wealth creation)

Innovation 'Elevator Pitch':
Flo-Tone CR is a tool helping patients acquire good Maintenance & Technique in using Pressurised Inhalers, teaching how to Inhale SLOWLY and STEADILY. Inhaler Technique Skills are important and a major theme in BTS, GINA and NICE guidance.
Overview of Innovation:
Flo-Tone MDI (also known as Flo-Tone CR) uses a ‘Positive’ Coaching Whistle to help patients learn to inhale SLOWLY and STEADILY. Whistle Signal is a prompt for the canister to be pressed releasing the medication & the duration of the Whistle helps the professional to coach the patient towards correct use.
Pressurised inhaler mouthpieces come in a variety of shapes, accordingly Flo-Tone was originally produced in ‘Circular’ & ‘Regular’ Models. A new improved Flo-Tone CR now fits all mouthpiece shapes by fitting inside the pMDI mouthpiece. The new design ensures all pMDIs produce a whistle at the same flow rate, helping standardise technique.
Studies have been conducted with the new Flo-Tone to ensure that it delivers the full dose. The first study detailing the development of the improvement & its performance was presented at BTS 2015 & subsequently at DDL26.
Available on prescription, the improved Flo-Tone CR can be used with a pMDI simulator (Trainhaler) for training & with the Patient pMDI. It incorporates a cap so that it can be left in situ on the Inhaler. It also includes a rim on the mouthpiece to help patients get their teeth out of the way of the aerosol spray.
We have tested Flo-Tone CR with a variety of inhaled medications (Flutiform, Clenil, Ventolin, QVAR and Sirdupla) – in each case the respirable dose (ie that part that reaches the lungs) delivered for the medication plus Flo-Tone closely matched that of the device alone & in each case unwanted throat deposition was reduced.
•Flo-Tone CR controls the resistance of the pMDI, thereby standardising the flow rate at which  
  Flo-Tone CR whistles
•Provide inhalation & coordination guidance
•Sounds (20-25 L/min)
•Drug delivery improvement = Therapeutic Improvement
•Less throat deposition – potentially less unwanted Throat Side-Effects
•Better control - less breakthrough – less SABA needed
•Better control – less hospitalisation 


• Spacer & Mask with anti-Microbial & anti-static properties
Collapsible – helps with storage & travel
• Visible valve movement - see that the drug is being Inhaled
• Suitable for adults & children
• Performance validated with pMDI’s
• Accepts all pMDI’s available
• Available with small & medium mask


• Ideal for emergency services use, schools & within General Practice & Hospitals for reversibility testing
• Single patient use
• Economical & environmentally friendly
• Performance validated with pMDI’s
• Available in bulk pack 
 
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 / Education, training and future workforce / Wealth creation / Clinical trials and evidence / Innovation and adoption / Patient and medicines safety / Person centred care
Benefit to NHS:
There have been many papers published, detailing the misuse of pMDI among patients;
Clement Clarke International have used their expertise to concentrate on this area of products. This
has led to the introduction of the ‘Inhaler Technique Training’ range. Each device is targeted at the
training of inhalation technique, guiding patients to inhale at the correct flow rate for pMDI use.
 
Inhaler technique errors occur in the hands of patients and healthcare professionals. It has been
demonstrated that the majority of healthcare professionals cannot demonstrate correct inhaler use
to their patients. It is not therefore surprising that patients are mostly unable to demonstrate good
inhaler technique. The consequences are significant; patients take higher doses to compensate for
lack of efficacy from medication lost through poor technique, this results in poorer control,
hospitalisation and increased healthcare costs.

The Clement Clarke ‘Inhaler Technique Training’ range delivers more reliable, more effective and patient friendly usage of medication and treatment (therapy) delivery.
Benefits summary
  • Patient friendly medication management and use
  • More effective and accurate delivery of medication to lungs
  • Reduced number of hospital admissions
  • Reduced number of un-planned clinical interventions
  • Reduced associated therapeutic costs
  • Improved patients’ health and quality of life
  • Available on the National Drug Tariff
  • Low cost devices
  • Available for immediate use
Initial Review Rating
4.00 (2 ratings)
Benefit to WM population:
The West Midlands region provides a great opportunity for rapid realisation of the benefits of improved inhaler training from a clinical, economic and patients’ quality of life perspectives.

All the required products and training materials are currently available for instant deployment and would offer significant benefits to those GP practices or secondary care providers willing to challenge existing ineffective training and delivery mechanisms and who would act as either the Regional or National adoption lead.
 
A comprehensive breakdown of the tools and devices required for a GP practice has been provided in an attached document (Essential Requirements for GP Practice Inhaler Training Kits).
Current and planned activity: 
Current NHS activity
Key areas of Contact are Lung Function & Respiratory Medicine which include Respiratory Physiologists & Respiratory Nurses both in Adults & Paediatrics.
 
Flo-Tone has been adopted by Wolverhampton CCG.

Planned/required activity
As a Manufacturer, Clement Clarke undertakes an extensive R&D program and also undertakes On-Site Clinical Trials with GP Practice & Secondary Care.
However, research and trials support partners would be welcomed to further develop the evidence base demonstrating the benefits of improved staff training with associated patient benefits.
In addition, Health Economic studies would also be welcomed to quantify the medication and admission cost savings that would be achieved. This would supplement the Isle of Wight study and include a wider geographical and ethnic / demographic patient cohort.
What is the intellectual property status of your innovation?:
All intellectual Property for devices and training is held by Clement Clarke International
Return on Investment (£ Value): 
medium
Return on Investment (Timescale): 
6-12 mon
Ease of scalability: 
3
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Anthony Silvio Philips 31/08/2016 - 12:46 Publish Login or Register to post comments
4
1
Votes
-99999
Innovation 'Elevator Pitch':
Disruptive technology prevents Left Ventricular remodelling post MI & promotes tissue regeneration. Product result of £10M EU investment & 5 years R&D. Biocompatible & Biodegradable product demonstrated pre-clinically in wide range of animal model.
Overview of Innovation:
Cardiac patch is a scaffold structure compatible with in-vitro cell seeding & cell culture used as a vector for cellular therapy in addition to structural support. Numerous applications include curettage & cardiac transmural use in addition to soft tissue engineering such as hernias & vein repair. Scaffold composition comprises poly(caprolactone), alginate & composites thereof with natural polymers such as chitosan & alginate fibroin decorated with a synthetic peptidic hydrogel. Porosity can be tailored with pore range of 10-250µm, permitting angiogenesis and cell seeding. Although the biomaterial can be used independently as a medical device for prosthetic applications, its main tissue engineering function is to enhance cell attachment, growth & differentiation. An extension of the device is its functionalisation with cell signalling agent capacity providing the scaffold with extracellular matrix like micro-environment. Polymeric self-assembled structure is composed of but not limited to peptidic or polyurethane amphiphiles & can be loaded with chemical & biological cues covalently or via entrapment.

To initiate regeneration, the biomaterial must encourage in-vivo revascularisation & promote integration with host tissue. Concurrently, it should biodegrade at the same rate that newly formed tissue replaces it, being removed from the body by natural metabolic pathways without toxic by-products.

The patch provides both a temporary mechanical support to the infarcted myocardium preventing further damage to the surrounding tissue and prevents aneurism formation in the infarcted area whilst regeneration take place

Myocardial infarct treatment
Device can be used for in-vitro & in-vivo applications. Both parts of the device can be loaded with cell signalling agents or drugs for research & clinical use. Fibre based secondary drug delivery structure allows multiple growth factor/drug release with different release profiles as a direct tool for gel functionalisation with patient blood components in-vivo.

The system’s mechanical properties match the tissue it replaces. 3D hydrophobic/hydrophilic scaffold provides mechanical support to a gel that acts as scaffold plasticizer & provides an hydrophilic interface with host environment. The gel can also collect cell signalling agents from its immediate environment. The electrospun fibre based drug delivery system can additionally be used as a complementary tool to the gel for loading with cell signalling agents, drugs etc
Stage of Development:
Evaluation stage - Representative model or prototype system developed and can be effectively evaluated
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 / Wealth creation / Clinical trials and evidence / Innovation and adoption / Person centred care
Benefit to NHS:
The leading global trend in interventional cardiology is to adopt less invasive technologies, reducing patient recovery time & improving quality of life.
 
PeptiGelDesign Cardiac Patch treats myocardial infarction (MI). Current treatments are based on medication &/or organ transplantation. Approx. 4,600 heart transplants are carried out pa in Europe & the USA (1,900 EU). Even with current medical management, over 1/3 of acute heart attacks are fatal. Rehabilitation levels following MI are variable with major damage unable to be fully healed. Current treatments to prevent tissue damage post MI include thrombolytic agents. These drugs have greatly reduced morbidity & mortality, but must be administered within a short interval following MI to be effective. Cardiac catheterization & Angioplasty have proven effective in restoring blood flow, but cannot reverse tissue damage. Transplantation is complicated surgery, severely limited by lack of donor organs.


Advantages of cardiac patch over current treatment regimes:
 
• Complements established therapies restoring damaged cardiac muscle ensuring improved contractility function & eliminating CHD related early mortality. Following non-lethal MI current treatments effectively restore blood flow, but cannot reverse tissue damage leading to limited rehabilitation & QoL
 
• Restoration of cardiac function drastically reduces re-infarction rates & need for subsequent interventions.


• Demonstrably increases life expectancy post MI. In cases of CABG (bypass), 5-year mortality rate for target population (patients with abnormal Left Ventricular (LV) function typically caused by MI) is 16.5% vs a mortality rate for patients with normal LV function of 8.5% (50% improvement). We could expect the cardiac patch to reduce mortality of patients undergoing MI to the level of those with normal LV function due to recovery of infarcted heart. Similarly, 5-year mortality rate of 80% for post MI patients undergoing an interventional procedure decreases to 40% - the mortality rate for patients undergoing the same procedure but with normal LV function.


• By enabling recovery of the heart muscle patients improve their NYHA class, suffer less Angina Pectoris, reduced incidence  of re-infarction, need less medication & hospitalization & improve QoL. NB: 10 years post CABG intervention, overall survival rate is 69% vs overall event free rate of 41%, suggesting that a significant portion of patients are surviving but with a fairly low QoL
Initial Review Rating
4.60 (1 ratings)
Benefit to WM population:
In addition to the many benefits to the wider NHS outlined above, there are specific regional benefits accruing from the adoption of this medical device and treatment regime.
 
The high incidence of Chronic Heart Disease and the costly rehabilitation of patients post heart attack is a recognised priority within the West Midlands population.
 
The cardiac patch offers a minimally invasive and rapidly deployable intervention that will significantly improve the quality of life for patients surviving Myocardial Infarction.
 
In addition, the cost and time savings to the NHS and social care through improving patient outcomes, reduced number of transplants and greater quality of life and increased independence for patients post MI will be significant.
Current and planned activity: 
(See attached document for more information)
PeptiGelDesign is currently engaged with the Liverpool Heart and Chest Hospital.

Wish to partner with NHS and NHS Research Organisations on clinical trials for cardiac patch development.

As our primary target market is the UK, we wish to raise profile within the NHS and work with its stakeholders to bring our technology to the market and ultimately to the patient.
  • Explore if entitled to an  Investigational Device Exemption (IDE) ?
  • Identify sources of funding to support PeptiGelDesign pursuing the further validation.
  • Procurement/Adoption: -  Require routes to GP sales - marketing products to CCGs
  • Evaluation/Validation/Clinical Trial - Need to gain additional validation - seeking a trial centre.
  • Concept Development - This is planned development work but seeking NHS partnership/advice.
Project Assistance required - The Company is interested in locating clinical/academic collaborators for new product development.
What is the intellectual property status of your innovation?:
PeptiGelDesign Ltd is licencing the WO2014044321 and finance patent granting process. Today, the patent has been accepted in USA, EU and Japan and will enter EU countries national phase in December 2016.
Return on Investment (£ Value): 
Very high
Return on Investment (Timescale): 
2 years
Ease of scalability: 
Simple
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Guillaume Saint-Pierre 04/08/2016 - 10:33 Publish 1 comment
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0
Votes
-99999
Innovation 'Elevator Pitch':
Half a million adults and children in the UK experience severe asthma symptoms despite high dose medication. Air4 offers a non pharmacological treatment of allergic disease using Temperature Laminar Airflow to reduce exposure to allergens in the bed.
Overview of Innovation:
Air4 is a unique, innovative medical device which uses Temperture Laminar Airflow (TLA) technology to protect patients with severe allergic asthma and eczema, from exposure to allergens and other airborne particles (pollens, housedust mite and animal danders etc.) that are in and around the bed at night whilst they sleep. The device has no side effects and can therefore be used for adults and children.

Air4 is installed in the bedroom alongside the bed; air is drawn in the device from the room where it is filtered and cooled to 0.5-0.8 degrees centigrade lower than the ambient temperature. As cool air is heavier than room temperature, gravity ensures the air gradually descends without an excessive breeze or draught creating the patients breathing zone; due to the density of the air in the breathing zone airborne allergens are unable to penetrate and therefore the patient sleeps in an allergen free zone.

In reducing the airborne allergens the device has shown in clinical trials that is has reduced exacerbations and the number of hosptial admissions; it has reduced day and night time symptoms in patients and improved quality of life (health related) and has shown to reduce the number of days off work/school.

Air4 has a Medical Technology Innovation briefing from NICE stating the device is clinically and cost effective.There is also an Innovation Medical Technology Overview  from Helath Improve Scotland showing the device is clinically and cost effective compared to standard treatment.

Using the Air4 in adults or children who are still symptomatic despite maximum inhaler treatment; can avoid long term side effects from oral corticosteroids as well as the regular hospital visits from other treatmenst

 
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 / Innovation and adoption / Person centred care
Benefit to NHS:
  • Reduction in exacerbations leading to fewer hospital admissions and clinic visits
  • Reduction in use of rescue medication leading to a reduction in drug spend
  • Reduction in the number of days taken off school and work
  • Cost effective and in some circumstances cost saving treatment. Annual rental cost is offset by the economc savings in medical costs resulting in a net cost to the NHS 
  • Fulfils Care closer to home: encouraging people to live independently; provide greater choice and control over health; Reduce NHS costs and the demands for hospital resources
Initial Review Rating
4.20 (2 ratings)
Benefit to WM population:
Home based overnight treatment which negates the need for hospital stays.
Improvement in quality of life (HRQLS)
Improvement in sleep
Reduction in the need for rescue medication
Reduction in exacerbations and therefore hospital stays and clinic visits.
Current and planned activity: 
Current Activity: Ongoing UK trial (LASER) with results due in spring 2017 (West Midlands have 2 investigator sites)
                          Working with Innovation Nexus Greater Manchester to support clinicians use of Air4
 Current Device Use: Royal Wolverhampton, Hereford
Planned Device Use: Birmingham Childrens, Sandwell, Worcester
What is the intellectual property status of your innovation?:
IP is held by the company
Current Certification: Class 1 Medical Device; CE Marked
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
6-12 mon
Ease of scalability: 
Simple
Regional Scalability:
Air4 is already being used in several accounts across the West Midlands with several more interested in trying the device. From a company perspective the warehouse will be informed of potential numbers and they will increase production to ensure they can meet with the increase in demand
Measures:
Overall measure of success of our innovation will be to see it accepted as a standard of care treatement for allergic disease and no longer applied for by an IFR for clinical exceptionality.
Quality Measures: Airsonett has implemented a quality management system compliant with ISO 9001, 13485 and QSR
Safety: Air4 is a CE marked class 1 medical device. As it is a non pharmacological device there are no known side effects and the device is installed,set up and removed by trained technicians.
Cost: There has been an economic analysis published in the BMJ Open Respiratory Research which found that the Air4 was a cost effective addition to standard treatment in patients with severe uncontrolled atopic asthma. These high risk patients with severe atopic asthma who use Air4 could reduce the incidence of hospitalization which could be cost saving to the NHS. Brazier et al (2015)         Airsonett® would be added to existing treatment and the average cost of long term treatment is £5.72 per day. Estimated cost of add on therapy currently used in the NHS is Omalizumab at approximately £23 per day.
The cost utility analysis estimated an incremental cost effectiveness ratio (ICER) of £8998 per quality of life adjusted year (QALY) with Airsonett®® compared to NHS standard care based on an incremental cost of £553 and a QALY gain of 0.0615. http://www.nice.org.uk/advice/MIB8/chapter/Technology-overview
People Measures:Success of the device will be measured using the following key performance indicators at 3 months for children and 6 months for adults: Improvement in the Asthma Control Test (ACT); reduction in exacerbations (compared to previous 12 months); reduction in or stopping of oral corticosteroids; Improvement in the Asthma Quality of Life Scores, adult and children (AQLQ: PAQLQ) and also improvement in sleep, work/school, and comorbid allergic disease such as eczema and/or perinnial rhinitis.
Adoption target:
Currently in WM there are 2 sites in the Laser trial (adult) and 2 sites (Paediatrics) who have patients on the device; approximately 5 additional sites across the WM with an interest. Based on the current interested sites I would estimate in the first year approximately 30 patients.
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Sarah Renshaw 03/08/2016 - 15:59 Detailed Submission Login or Register to post comments
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Innovation 'Elevator Pitch':
LiverMultiScan is an FDA 510(k) cleared and CE marked MRI technology that provides a quantitative assessment of liver health, including fibroinflammatory disease, steatosis and iron, all in a non-contrast 5 minute scan.
Overview of Innovation:
Perspectum Diagnostics is a medical imaging company with an ISO 13485 compliant CoreLab. The company has developed novel imaging technology, LiverMultiScan, an MRI-based non-invasive tool that has attained CE-marking and FDA 510(k) clearance to aid the diagnosis of patients with chronic liver disease.
LiverMultiScan (and LiverMultiScan Discover for clinical trial use) can characterise liver tissue in three ways, providing accurate measurements of liver fat, hepatic iron content and fibro-inflammatory disease, using the proprietary Liver Inflammation and Fibrosis (LIF) score. The LIF score has been shown to stratify NAFLD and NASH patients (Pavlides, 2015), correlate with histological markers of inflammation and fibrosis (Banerjee, 2014), and most importantly, is the first imaging test to predict liver-related clinical outcomes (Pavlides, 2016). It is the only liver imaging technology included in the UK Biobank study, with 100,000 scans to be performed in the coming years (Kelly, 2015).
Available as a Quantitative Analysis Service (QAS), LiverMultiScan has been cleared as an imaging tool to aid the diagnosis of early liver disease. It offers a standardised and high-quality method for supporting Gastroenterology/Hepatology and Radiology departments in diagnosis and monitoring of the liver in clinical settings and studies, and has potential to streamline clinical management by compressing the diagnostic pathway. Perspectum is also supporting multiple international clinical trials with LiverMultiScan Discover.
  • Banerjee et al. (2014) Multiparametric magnetic resonance for the non-invasive diagnosis of liver disease. J Hepatol. 60:69-77.
  • Kelly et al. (2015) Predicted prevalence of NAFLD and NASH in a large population using non-invasive multiparametric MRI. AASLD 2015. Abstract ID: 931.
  • Pavlides et al. (2015) Multi-parametric magnetic resonance can accurately assess NAFLD histological disease severity; comparison with transient elastography. AASLD 2015. Abstract ID: 2190.
  • Pavlides et al. (2016) Multiparametric magnetic resonance imaging predicts clinical outcomes in patients with chronic liver disease. J Hepatol. 64:308-315.
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 / Advanced diagnostics, genomics and precision medicine / Wealth creation / Clinical trials and evidence / Digital health / Patient and medicines safety
Benefit to NHS:
The utility of LiverMultiScan for assessing fibroinflammatory disease, steatosis and predicting clinical outcomes means it is well-positioned to reduce (and potentially remove) the need to perform invasive liver biopsies. It also facilitates longitudinal monitoring, which is near impossible with current sampling technology.
According to a recent NIHR HTA report, the cost of a liver biopsy is £956, but this can increase significantly with complications (clinically significant bleeding in 1.1 – 1.6%). For healthcare providers, liver biopsies are unappealing because of the attendant risk, financial cost, lack of reliability (as sampling only 0.002% of the liver volume), and uncertainty in interpretation. Nevertheless, primarily because there has not been a viable alternative, it is estimated that 650,000 liver biopsies are performed annually worldwide. 
There are substantial costs associated with managing patients with NAFLD, in particular for those patients progressing to NASH who are at significant risk of cirrhosis, HCC and liver failure. Although pharmacologic options are limited, there are numerous clinical trials ongoing.
Available treatment options increase (e.g., diet, surgery), outcomes improve and healthcare costs decrease the earlier those with, or at risk of, more advanced disease are identified. When combined with the rising incidence of NAFLD and NASH, the availability of a non-invasive test for accurately assessing fibroinflammatory disease, steatosis and predicting clinical outcomes, is vital.
A recent health economic study (submitted for publication) from the University of Birmingham concluded that LiverMultiScan is cost effective either as an adjunct to or replacement of Fibroscan in the diagnostic pathway of NAFLD. In addition, the utility of LiverMultiScan in reducing the proportion of patients with suspected NAFLD undergoing hospital consultations and/or liver biopsies is currently being evaluated in a large Europe-wide multicentre clinical trial (including the UK).
LiverMultiScan could allow:
  • A faster throughput and diagnostic analysis than conventional sampling – reducing patient lists and identifying those that need and do not need clinical intervention.
  • Regular monitoring of patients without painful invasive and potentially dangerous biopsies.
  • A less traumatic assessment of liver disease in children.
  • Assessment of liver health in other diseases (e.g., viral hepatitis, alcoholic liver disease)
Initial Review Rating
5.00 (2 ratings)
Benefit to WM population:
Liver disease is the fifth ‘big killer’ in England and Wales, after heart, cancer, stroke and respiratory disease (http://www.britishlivertrust.org.uk/about-us/media-centre/facts-about-liver-disease), with twice as many people dying from liver disease now compared to 1991.
In a European study, the healthcare costs for patients with NAFLD were 26% higher than for those without the disease (Baumeister, 2008). In the US, the direct costs of cirrhosis and chronic liver disease were estimated to by $2.5 billion, whereas indirect costs were estimated to be $10.6 billion (Ruhl, 2008).
Identifying those with, or at risk of, more advanced liver disease earlier increases treatment options available, reduces healthcare costs and improves outcomes. Benefitting both the NHS and wider West Midlands community.
This diagnostic test could also be used to aid the diagnosis and monitoring of liver disease in children, with a European clinical trial underway.
 
  • Baumeister et al. (2008) Impact of fatty liver disease on health care utilization and costs in a general population: A 5-year observation. Gastroenterology. 134:85.
  • Ruhl et al. (2008) Costs of digestive disease. In The Burden of Digestive Disease in the United States. NIH Publication. pp 137-143.
Current and planned activity: 
LiverMultiScan currently in use at University Hospitals in Birmingham, Edinburgh, Oxford Southampton & Kings College London (KCL). Discussions with other NHS sites

Recent completion of large Innovate UK funded 2.5 year study at University Hospitals Birmingham & Edinburgh to develop & validate against liver biopsy

KCL is UK site for large EU multi-centre clinical trial to evaluate cost-effectiveness of LiverMultiScan in primary care pathway.

Patient study - 100 patients with history of liver disease receive LiverMultiScan, nearing completion with extremely +ve feedback

LiverMultiScan is only liver imaging technology in UK Biobank - 100,000 subjects to be imaged

Planned activity
West Midlands location of choice as:
  • Build on relationship with University of Birmingham following 2.5 yr study
  • West Midland’s considerable expertise in liver disease
  • Large patient cohort and trials infrastructure
  • Involve Children’s Hospital in study
  • Dr Banerjee, founder & CEO, visiting Hon. Consultant Hepatologist at UHB
What is the intellectual property status of your innovation?:
Perspectum holds or exclusively licenses 7 patent applications in the UK and other territories. To date, one has been granted in the UK (GB2497668).
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
0-6 mon
Ease of scalability: 
Simple
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Matt Kelly 03/08/2016 - 12:07 Publish Login or Register to post comments
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-99999
Innovation 'Elevator Pitch':
A comprehensive package of training and development on safegaurding adults, mental capacity, deprivation of liberty safeguards and Prevent delivered through training DVDs, e-learning packages, patient stories, face-to-face training and webinars. 
Overview of Innovation:
Safeguarding Adults, Mental Capacity and Deprivation of Liberty Safeguards are mandatory training for all staff working with vulnerable adults across the health and social care economy. As this inevitably requires large numbers of staff, organisations are constantly being challenged with meeting the training compliance needed. This training is also required every 3 years.

This flexible training package is designed to meet the training needs of various organisations who have statutory obligations in this area. The training package includes:

- Safeguarding adults level 1 raising awareness 
- Safeguarding adults level 2 alerter/referrer 
- Safeguarding adults level 3 section 42 enquiries/case conference 
- Mental Capacity Act introduction
- Mental Capacity Act in practice
- Deprivation of Liberty introduction
- Deprivation of Liberty in practice
- Prevent
- Specialist modules on
    * self-neglect
    * modern day slavery and human trafficking
    * Female genital mutilation (FGM)
    * Domestic violence

These training modules can be delivered via:

- E-learning package including anonymised real patient story videos developed by the Trust
- Face-to-face for more advanced training
- Webinars
- Bespoke training individually costed
- Educational material such as booklets, posters, leaflets

All educational and training material can be customised to include the receiving organisation's branding and logo.

More bespoke services include:
- Organisational Review of existing safeguarding processes ,policies and procedures
- Develop safeguarding plan based on gap analysis
- Policy Development
- Risk Assessment, Care planning, report writing , Court reports
- Individual management reviews for SAR’s Domestic Homicide reviews
- Audit Evaluation and Implementation Plan
- Organisational preparation for CQC Inspections
- Organisational quality, risk and governance assurance
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: 
Mental Health: recovery, crisis and prevention / Long term conditions: a whole system, person-centred approach / Wellness and prevention of illness / Education, training and future workforce / Wealth creation / Innovation and adoption / Patient and medicines safety / Person centred care
Benefit to NHS:
- Flexible learning packages to meet mandatory training requirements for NHS organisations who do not have the capacity to provide the training in-house
- Improving the knowledge and skills of the workforce which will improve the safeguarding of patients
- Reduce organisational risk
- Improve outcomes for patients and carers
- Reduces demands on clinical time by way of providing training through e-learning
- Access to the most up-to-date contents as our team are constantly updating the training material
Online Discussion Rating
4.00 (1 ratings)
Initial Review Rating
3.80 (2 ratings)
Benefit to WM population:
The safeguarding of vulnerable adults is now statutory under the Care Act 2014. As such, its implementation is required locally, regionally and nationally.

According to the editorial of Journal of Adult Protection Vol 18, No 2, 2016: "Across West Midlands, local authorities are struggling with the effects of austerity measures, unprotected social care budgets, restructuring, under-valued care workers, redundancies and more generally on the rising demands associated with an ageing society". Following re-organisation, many of the local authorities are struggling with a younger and less-experienced workforce with less intellectual memory and too many agency staff. This will be even more so in West Midlands following the councils' devolution plan delivery. This calls for increased training and support for staff delivering front-line services where demands have risen and resourses have dwindled. 
Current and planned activity: 
Currently we provide training to BCHCFT workforce which comprises over 5,000 members of staff. In addition, we provide training to limited number of NHS Trusts and a wider workforce in hospice care, special schools and some private and commissioning groups. All of this has been achieved through recommendations rather than utilising any marketing strategies.
What is the intellectual property status of your innovation?:
Training material need to be protected.
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
1 year
Ease of scalability: 
Simple
Regional Scalability:
The service can be provided across the West Midlands Health Authority region.
Measures:
- Provides the organisation across the health and social care with the mandatory training for staff dealing with vulnerable adults
- Knowledge assessment at the end of the training to ascertain the competences acquired by the individuals
Adoption target:
Health and social care organisations and private sector
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anne mcgarry 12/07/2016 - 16:18 Sign Posted Login or Register to post comments
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Innovation 'Elevator Pitch':
Exercise is the best medicine! The FABS Training Programme for older adult exercise tackles the consequences of physical inactivity as people age, increasing flexibility and mobility to improve everyday life.
Overview of Innovation:
We all understand the importance of moving more and sitting less when it comes to living a healthy and fulfilling life.  As we age this becomes even more important as our lives tend to become more sedentary which then leads to ‘inflammageing’ and many long-term health conditions.
 
The FABS Training Programme, developed by Move it or Lose it! in partnership with the Centre for Healthy Ageing Research at the University of Birmingham combines Flexibility, Aerobic, Balance and Strength exercises in every class, providing the four vital components of older adult fitness as per CMO guidelines.  This is made up of exercises that are safe, enjoyable, effective and accessible to everyone whatever their ability, and can be done seated or standing.
 
FABS classes ensure age or ability are no longer barriers to an active lifestyle. The aim of the class content is to increase strength and muscle density to reduce sarcopenia, improve balance to reduce the risk of falls, increase aerobic capacity to enable individuals to be more active and increase flexibility and mobility.
 
Via a blended approach of online learning and practical training, we train exercise instructors to become specialists in fitness for the over 60s enabling them to work with the fastest growing demographic in the UK. We have practical days scheduled for Birmingham, London, Manchester and Newcastle, with Edinburgh and Bristol coming in due course. 

The programme launched in March 2016 and has more than 90 instructors undertaking it to date. The aim is to train 1000 instructors who can deliver FABS classes within their local communities to combat social isolation, physical inactivity and cognitive decline and provide opportunities for fun and friendship for our fastest growing demographic; older people.  By training 1000 instructors the programme also generates wealth by creating 1000 small businesses with a licensing model similar to Zumba. 

Move it or Lose it! Exercise DVDs have been tried and tested.  The video stars in all our DVDs are not actors, but real people who have health conditions and mobility problems.  They have improved their lives through the Move it or Lose it! Exercise routines and they want to inspire others to do the same.
 
Move it or Lose it! DVDs are endorsed by Professor Janet Lord, Director of the MRC-ARUK Centre for Musculoskeletal Ageing Research at University of Birmingham as an ideal resource to aid active ageing.
 
http://www.moveitorloseit.co.uk/product-category/dvds/
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 / Education, training and future workforce / Wealth creation / Clinical trials and evidence / Person centred care
Benefit to NHS:
The consequences of physical inactivity as we age are not just associated with movement problems and ill health, but also social issues. This often leads to feeling isolated resulting in depression which can lead people into a downward spiral and consequently their loss of independence.
 
Professor Janet Lord, Director of the Centre for Healthy Ageing Research at University of Birmingham and advisor for the recent BBC One Programme ‘How to Stay Young’ says, “Exercise is the best medicine. We can reduce our risk of heart disease, some cancers, diabetes, obesity, arthritis and osteoporosis by up to 50% by simply getting people to move more and sit less.”
 
The programme has been recognised by the NHS and is currently involved in a trial with COPD patients for Birmingham Cross City CCG.  Patients will be monitored in aspects of biopsychosocial health with the aim of rolling out the sessions across the NHS.  From this 12 week COPD trial we will have a clear understanding of the benefits. We anticipate that general health will improve, in terms of physical function and mental wellbeing. This in turn will keep patients away from GP surgeries and hospitals for longer periods, thus reducing, or even preventing treatment costs. Education of self-management techniques will also contribute to this. 
 
The results will also be used to form the basis of a scientific research study which aims to reduce the effects of illnesses and long-term health conditions linked to inactivity in older people – such as diabetes and heart disease.
Online Discussion Rating
5.67 (3 ratings)
Initial Review Rating
5.00 (2 ratings)
Benefit to WM population:
The class members benefit from improvements in their health, reducing their risk of heart disease, some cancers, diabetes, obesity, arthritis and osteoporosis.  Move it or Lose it! assists with the development of practical solutions to improve levels of physical activity in older people.
 
This increase in activity has an economic impact for the NHS by improving physical and mental health, the cost of treatment needed for conditions associated with declines in health such as sarcopenia, osteoporosis and arthritis will be reduced. 
 
The FABS Training Programme provides job opportunities in the West Midlands. FABS Instructors will benefit from using an established brand in Move it or Lose it! that will help them to build their own business of exercise provision to the over 60s. 
Current and planned activity: 
We are currently engaged in a 12-week trial with the NHS, providing exercise as an intervention for COPD patients. This is taking place within the Birmingham Cross City CCG. 
 
We require academic support surrounding data evaluation to assist us to demonstrate the effectiveness of the exercise programme in terms of NHS financial savings and improved patient outcomes.
 
We are looking to expand our team of inspirational instructors and trainers so they can get everyone experiencing the fantastic benefits of Move it or Lose it! and FABS across the UK! Instructors receive continual support through The Exercise Network (T.E.N) aiding their knowledge and delivery. By building this network of exercise instructors Move it or Lose it! are helping older people and those with disabilities across the UK to get active to help them age well.
 
If you are passionate about helping older people to live life to the full then find out more here - http://www.moveitorloseit.co.uk/fabs/
 
Return on Investment (£ Value): 
N/A
Return on Investment (Timescale): 
N/A
Ease of scalability: 
Simple
Co-Authors:
Regional Scalability:
The FABS Training Programme is highly scalable due to eLearning platform, allowing many people to undertake the programme simultaneously. We can then offer multiple practical assessments dates at a central Birmingham location (as well as other venues nationally) for 20 instructors at a time. This would allow for rapid expansion of the programme in the West Midlands area.  The model that has been developed is a sustainable business model which ensures that income is generated from licensing, training and ongoing support.
Measures:
The aim of The FABS Training Programme innovation is to train 1000 specialist exercise instructors to the over 60s. The success of the innovation will be measured against achieving this goal.
The quality of The FABS Training Programme is measured through its recognition by industry regulators such as Active IQ and UK Active. This is also ensured via the company’s – Move it or Lose it – Quality Assurance Policy.
Move it or Lose it also has a Safety Policy and Equality and Diversity Policy to ensure the people training with us, the tutors and customers are kept safe and are treated with respect. 
Adoption target:
We would like to implement FABS classes within CCGs and be able to offer GPs with the opportunity for physical activity and social prescription within their own practice. Move it or Lose it would place FABS instructors into GP surgery’s increase social and activity levels to treat conditions such as COPD, diabetes, arthritis, osteoporosis and more.
 
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Joe Robinson 08/07/2016 - 17:38 Sign Posted 6 comments
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0
Votes

Innovation 'Elevator Pitch':
The National Osteoporosis Society has pioneered a package of support for the commissioning and improvement of secondary fracture prevention services.  This can save the average CCG 1.7m over 5 years.
 
Overview of Innovation:
The Fracture Liaison Service (FLS) care model enables secondary fracture prevention through identification of low trauma or fragility fractures by means of dedicated case finding, with assessment and treatment of osteoporosis where appropriate.  This model has been replicated across the UK since April 2015 with the support and expertise of the National Osteoporosis Society.  A team of specialist development managers with clinical and commissioning experience is currently working with 167 sites (to date) to support new service development (50), or quality improvement of existing services (78).  Preliminary results from an analysis of the effectiveness of these services in preventing secondary fractures indicate a significant positive difference between sites with an FLS, and those without.

Operating in a tough economic climate with health budgets tightly constrained, investment in new services must demonstrate both a solid evidence-base and a strong business case.  There is strong evidence that investment in FLS results in improved quality of care and financial savings in health and social care.  The NOS has produced a suite of online resources to support FLS development and improvement.  A comprehensive FLS Implementation Toolkit supports providers and payers in the commissioning process and is provided free of charge. [1] Users can create a compelling, evidence based business case without the need for advanced skills in costing, modelling or other health economic techniques.  The SDT is also available at any stage throughout the implementation process to support clinical pathway or business case development.  Advice is available regarding outcome measures and performance indicators, as well as effective data collection for service evaluation.  This service is provided free of charge. 

To date, 9 new FLS have been commissioned (8 new services and 1 augmented service).  These new services represent FLS provision to an additional cumulative population of nearly three million people, which could prevent more than 1000 hip fractures over 5 years.  This in turn represents gross savings across health, social care, and community services of £17.3m (service costs typically run at less than 40% of the gross benefit).
 
[1] The Implementation Toolkit https://www.nos.org.uk/health-professionals
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 / Innovation and adoption / Person centred care
Benefit to NHS:
The aim of the National Osteoporosis Society (NOS) is a future without fragility fractures.   Fragility fractures are common: 1 in 2 women and 1 in 5 men break a bone after the age of 50.[i]  People who have had one fracture are at greater risk of sustaining another (i.e. a secondary fracture).  There is strong evidence that investment in Fracture Liaison Services (FLS) results in improved quality of care and financial savings for the whole associated health economy.  
As highlighted earlier, to date, nine new FLS have been commissioned nationally (eight new services and one augmented service), with the support of NOS project management.  These new services represent FLS provision to an additional cumulative population of nearly three million people, which could prevent more than 1000 hip fractures over five years.  This in turn represents gross savings across health, social care, and community services of £17.3m (service costs typically run at less than 40% of the gross benefit).
 
[i] Van Staa TP, Dennison EM, Leufkens HG, Cooper C. Epidemiology of fractures in England and Wales, Bone 2001; 29 (6):517-522.
Initial Review Rating
5.00 (1 ratings)
Benefit to WM population:
As part of the FLS Implementation Toolkit[i], the NOS has developed a financial model (the FLS Benefits Calculator) which demonstrates potential future fracture reduction and cost savings for any given population.  Taking an exemplar from the West Midlands: If Coventry and Rugby CCG were to commission a FLS, the Benefits Calculator indicates that 345 fractures would be prevented over 5 years of operation of the service.  Of these, 145 are hip fractures, which at a conservative estimate, cost the health economy around £17,000 each.  
The calculation shows a total gross saving[ii] of £2,909,841 - £1,470,702 in acute care, £1,362,565 in social care and £76,574 in community and primary care.
 
[ii] We estimate the cost of the service to be approximately 37% of the gross benefit
Current and planned activity: 
The NOS is currently providing bespoke project management support to 168 sites across the UK, including 15 sites in the West Midlands area, looking to set up or improve an FLS:  
  1. Facilitation of engagement with stakeholders to generate commitment to FLS.
  2. Assistance to stakeholders from inception to launch of FLS, including development of the economic and business case; service specification; and resource and capacity planning.
  3. Assistance with recruitment and training of the fracture liaison nurse (FLN). [i]
  4. Input to enable the development of an FLS to meet the UK FLS Clinical Standards. [ii]
  5. Help to establish relevant protocols/care pathways for the service.
  6. Work with commissioners to ensure services are sustained.
  7. Assistance re. data collection and methods of analysis, reporting and evaluation.
 
[i] FLS Fracture Prevention Practitioner Training https://www.nos.org.uk/health-professionals/elearning
What is the intellectual property status of your innovation?:
The Implementation Toolkit is the property of the National Osteoporosis Society, but is available free of charge.
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
3 years +
Ease of scalability: 
Simple
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Will Carr 04/07/2016 - 12:52 Publish Login or Register to post comments
0
0
Votes
-99999
Innovation 'Elevator Pitch':
This device, developed by a clinician at UHB, allows a surgeon to "tunnel" in through brain tissue to perform surgery deep into the brain but without damaging or having to remove tissue to create a channel.
Overview of Innovation:
There is potentially significant IP around this idea so we do not wish to disclose much more detail about how the challenge has been solved. The idea is very early stage and we are seeking commercial partners who would have knowledge of this area of surgery but mostly have an established route to market.
Stage of Development:
Ideas stage - Early concept and ideas stage
WMAHSN priorities and themes addressed: 
Wealth creation / Innovation and adoption
Benefit to NHS:
Improved surgery success rates, improved patient outcomes.
Initial Review Rating
3.40 (1 ratings)
Benefit to WM population:
As a patient - improved outcomes. We would be keen for a local company to adopt this as a future product with the associated benefit to the local economy
Current and planned activity: 
We are looking for commercial partners who are interested in partnering to take this to market. we have an early prototype and undergoing IP review
What is the intellectual property status of your innovation?:
No filed protection as yet. All discussions would be made under NDA. No disclosure of the idea has yet taken place so protection is still an opportunity
Return on Investment (£ Value): 
Very high
Return on Investment (Timescale): 
2 years
Ease of scalability: 
4
Rejection Reason:
Signosted to MidTECH as needs further development and will be resubmitted once at a stage more approrpriate for Meridian
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Mike Smith 09/06/2016 - 10:33 Rejected Login or Register to post comments
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0
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Initial Review Rating
3.93 (3 ratings)
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Anonymous 12/05/2016 - 12:36 Deleted
Innovation 'Elevator Pitch':
GENEO Software is an enterprise wide application for creating, governing, and managing all aspects of Standardised Work, also known as Standard Operating Procedures, or Work Instructions.
Overview of Innovation:
The GENEO Software was created in recognition of the difficulty most organisations have with the creation, governance, control and application of standardised work in the form of work instructions, local working procedures, standard operating procedures - each organisation has its own name.

Our software provides; 
  • A simple to use interface where documents are built and edited, without the formatting worries and headaches that come with Word or Excel.  
  • A governance framework that is both transparent and seamless, allowing an agile approach to recording process change and implementation.  
  • Full history and version control of documentation with changes and commentary around changes fully maintained.
  • Fully customisable output that can be paper based or presented on-screen - computer or tablet.
  • Web based application that enables enterprise wide access, based on flexible permissions structure, so that best practice may be shared.
  • Linking of work requirements to competencies in an auto-generated skills matrix
  • Linking of regulatory requirements to work instructions to fully understand where change is needed when it happens.
  • Binding NatSIPs to LocSIPs in a meaningful way to demonstrate compliance to nationally recognised best practice.
The software has been designed to bring empowerment to the workforce encouraging engagement in the use and creation of standards and work instructions.  
Managing the full cycle of change and improvement can now be done in one place. Leadership can enable staff to create and authorise, assign to a process flow, control competency and capture the training history. Also, on a micro level within the standardised work, teams can capture the one best way: the safest, most, quality assured and productive method, whilst benefiting from a knowledge management system for driving out waste.

All of the above provides the groundwork and stability required for the ultimate goal of Continuous Improvement. 
 
 
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 / Education, training and future workforce / Wealth creation / Digital health / Innovation and adoption / Patient and medicines safety
Return on Investment (£ Value): 
N/A
Return on Investment (Timescale): 
N/A
Ease of scalability: 
N/A
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Bob Newton 21/04/2016 - 16:31 Archived Login or Register to post comments
0
0
Votes

Innovation 'Elevator Pitch':
Birmingham Surgeons created endoscope-i an award-winning system that enables the viewing, recording & sharing of HD endoscopic images & videos using an iPhone/iPod. Endoscope-i works with existing endoscopes or supplied as a secured turn-key solution
Overview of Innovation:
Smartphones & tablets are becoming a central technology within clinical care systems for their high definition cameras, brilliant screens, integrated sensors and unlimited software potential.
 
Originally developed as a simple and cost effective solution to mobile endoscopic HD imaging Endoscope-i can benefit both clinicians and patients across several specialities. To date otolaryngologists, urologists, gynaecologists, orthopaedic physicians, laparoscopic surgeons and anaesthetists are some of the many specialties which benefit from using endoscopes. The superior lighting and optics allow for visualisation of 'hard to reach' areas within the human body. Endoscope-i has been involved in a number of projects globally to facilitate cost effective HD imaging and documentation.
 
The multiple award winning Endoscope-i is simple to operate and comprises an adapter to connect a medical endoscope to align with the camera of an iOS device (iPhone or iPod). The ‘e-iPro’ app allows the user to calibrate and centre the acquired image and prevents rotation allowing images to be recorded in high definition (HD) video or still images which can be shown to the patients and stored in the patient’s medical record in seconds.
 
Endoscope-i will fit any endoscope with a 32mm eyepiece, which means the possibilities are endless. A shared endoscopic view was previously the reserve of the privileged few   - where they have large expensive stacking systems - Endoscope-i makes this technology available to everyone, at a fraction of the cost and in a more convenient portable format.” 
People are surprised to hear that before Endoscope-i, clinicians relied on hand drawn sketches to update patient records.
 
NB: Data and images are currently distributed via NHS.net. Discussions are ongoing with the Information Commissioners Office to design bespoke data management protocols.
 
Endoscope-i is available to fit a range of iOS devices and has a multitude of uses which include both clinical and non clinical applications such as:-
 
Otolaryngology
HD imaging of the ear nose & throat to allow rapid and easy storage and sharing of images and videos with both patients and clinicians
 
Anaesthetics
Portable HD viewing to facilitate endoscopic fibre optic intubations available at any time
 
Veterinary
Small and large animal endoscopy from the surgery to the field using the most advanced portable camera technology
 
Engineering
Carry only one portable device for communication and sharing of images obtained on site
 
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 / Education, training and future workforce / Wealth creation / Digital health / Innovation and adoption / Person centred care
Benefit to NHS:
A target has been set for the NHS to become paperless by 2020. Many health trusts have facilitated this by creating their own electronic health record (EHR). However, though a transcription of the patient consultation can be typed directly into the record there is no efficient means of capturing and storing images of patient findings safely into the patient record.
 
The speciality of ear, nose and throat (ENT) examines areas of the body that are usually difficult to visualise without endoscopes. However even though there it is possible to see inside the ear nose and throat many doctors must then create a sketch of their observations for documentation.
 
To overcome this major problem, a mobile imaging solution - Endoscope-i - has been developed by a team of specialists which include engineers, software developers and practicing clinicians. The ‘Endoscope-i system’ uses the power of smart phones to quickly and safely capture images from endoscopes and store them directly into the patients EHR with the touch of a button. What’s more, patients can now share their own examination findings with their doctor or relatives to understand their condition better.
 
The images produced are of such high definition that they can be taken by doctors in primary care and then sent on to specialists in secondary care for an expert opinion, without the patient ever having to go to hospital. This saves the cost of an outpatient referral for the commissioning group, is far more convenient for the patient, reduces unnecessary journeys, frees Consultants’ clinic time, speeds diagnosis and in the long term could save millions of pounds for the NHS.
 
Initial Review Rating
3.27 (3 ratings)
Benefit to WM population:
The proposed ‘Telescopic Mobile referral service’ will allow patients to get expert opinions of their ear conditions within hours and without ever having to visit the hospital, thus saving valuable consultant time and minimising travel and inconvenience for the patient.
 
Reduced cost and greater access to services will result through the use of Endoscope-i as there is no longer a need for multiple data capture and processing devices as each Consultant can use their own iOS device to record and transfer images. Additionally, Endoscope-i will work with existing endoscopes that have a 32mm diameter eyepiece and so directly enhances the equipment’s clinical benefit.
 
In the three months of the Telescopic Referrals (Telemedicine using Endoscope-i) in North Staffordshire and Stoke and Trent, 27 referrals have been dealt with remotely from 6 GP practices. 24 of these cases were managed without referral giving an 88% success rate to referral.
 
In the West Midlands region, a new patient referral currently costs the CCG £107 compared to the remote ‘Telescopic’ referral cost of £30, a dramatic saving for the CCG. This has already saved £1,758 in referral costs alone without measuring the indirect cost benefits for patients who did not require the Telescopic referral because of the improved diagnostic ability the GP had when using Endoscope-i.
 
Reducing the need for a physical consultation will also result in transport savings and time ‘away from work’ costs for both the patient and any employer.
Current and planned activity: 
Current WMHASN funded project with Dr Ruth Chambers (Clinical Telehealth Lead at NHS Stoke-on-Trent Clinical Commissioning Group), using 15 practices from the S-O-T and North Staffordshire CCGs piloting the Telescopic Mobile Referral Service. Currently 3 months into preliminary data collection showing 30 referrals handled with Telescopic referrals powered by Endoscope-I technology. Almost 90% of patients referred avoid being sent to hospital. Cost of teleconsultation is only £30 compared to £107 for a new patient hospital consultation.
 
Endoscope-i not only provides a rapid consultant opinion for the patient but helps to deal with the excessive burden on secondary care services by keeping chronic disease and some acute ear disease management within primary care.
What is the intellectual property status of your innovation?:
No patent on product. We have full copyright of the code written for the app. Endoscope-i is a registered trademark and adapter designs fall under design copyright.
Return on Investment (£ Value): 
Very high
Return on Investment (Timescale): 
1 year
Ease of scalability: 
Simple
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Ajith George 13/04/2016 - 07:57 Publish 5 comments
6
1
Votes
-99999
Innovation 'Elevator Pitch':
Combining patient demand, workforce availability & skills to deliver care, eCommunity supports right skill, right place, right time in the community, identifies daily & broader skill mix gaps, reducing time & improves quality of visit allocations
Overview of Innovation:
District and community nursing have unique pressures in terms of identifying and coping with high demand across a wide range of care needs. Service demand, rosters and skills have traditionally been held in separate systems, many of which are paper based. Bringing all this information together into a single visual solution enables service managers to make faster, smarter decisions ensuring quality care is delivered and the workforce isn’t burned out.
 
The additional released administration time for senior team members enables faster visit allocation and allows them to spend more time supporting their staff and patients.
 
eCommunity is a web based solution www.qes-online.com that enables visit allocators to rapidly plan days for frontline staff in under 30 mins, something that currently takes 2hrs +. This new allocation process is supported by supplying recommended best fit treatment by continuity, acuity, skills availability and location.
 
For the first time a team or whole service has a forward facing view of capacity and can create a roster to meet demand, be well informed of capacity gaps and proactively even out demand rather than react to circumstances.
 
Utilising a “care catalogue” dictating time and skill needed to deliver treatments, eCommunity ensures that the workload given to a member of staff is both appropriate for their skill mix and can be delivered within the allotted shift time, two advantages other services cannot evidence. “Actualising” the actual time it takes to deliver care and updating the care catalogue is a vital to ensure capacity and demand is based on real life evidence.
 
eCommunity is web based, making it accessible from home enabling staff to be well prepared for their first visit the following day, removing the need to “go to base” at the start of a shift saving hundreds of care hours a day.
 
Utilising smart capacity, demand & caseload allocations means fewer people can manage greater demand and larger teams. This further frees up often highly skilled team managers to focus on delivering care and supporting frontline staff.

eCommunity is the first dedicated operational tool designed by experienced, practicing community nursing teams to improve both the care delivery and working practices for staff.  This level of dynamic, real life operational support and intelligence has not previously been possible using existing clinical tools and systems.
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 / Education, training and future workforce / Wealth creation / Digital health / Patient and medicines safety / Person centred care
Benefit to NHS:
The quality of care delivered will be significantly improved via the “care catalogue” that ensures that the nurses assigned to deliver treatments have the appropriate skills. This not only improves care quality but also improves job satisfaction and role engagement as staff know the scope of care is within their capacity.
 
One of the largest efficiency savings will be the releasing of time available to care. This is possible by pre-planning, enabling care delivery to commence immediately at the start of a shift, not requiring a pre-meeting at which the visits are allocated. Hundreds of hours of additional care time will now be made available.
 
Business intelligence is key to optimising available capacity and demand, identifying skills gaps and aiding training & recruitment. Team differences in care delivery are identified through visit ‘actualisations’ and an accurate picture of what treatments are being delivered. This smart business intelligence can be used to drive discussions with commissioning organisations.
 
Significant reductions in travel mileage will also be realised by ensuring smart navigation and scheduling of visits that optimise travel. Given the huge mileage covered in delivering care, even a small saving in distance travelled delivers big financial and carbon footprint savings.

eCommunity can deliver these advantages for large teams or small teams delivering specialised services via a single license for unlimited use.
Initial Review Rating
3.40 (1 ratings)
Benefit to WM population:
eCommunity is flexible and adaptable able to work effectively with any kind of mobile workforce that includes a variety of skill mixes and challenges, where capacity and demand are under pressure.

Although primarily designed for use in community and district nursing, its value would be realised across any health or care service.
Current and planned activity: 
eCommunity now 12 months old and benefits in use are being collated
(See attached Appendix ‘Testimonials’ for NHS user testimonials)

eCommunity solutions have been trialled and liked by frontline staff and team leads. However, many care providers struggle to formulate suitable business plans to support investment, despite obvious savings, lacking adequate baseline data and IT support to evidence impact.
 
eCommunity development is ongoing to enable a ‘live view’ of workloads for all staff delivering care and flag when visits need re-allocation to ensure assigned visits & tasks can be delivered. This development is only possible by effecting cultural change to complete information immediately at the end of each visit, not waiting until return to base.
 
Work ongoing to integrate eCommunity within a clinical tool. Current tools are mis-perceived as the “be all and end all” of IT solutions by both frontline staff and senior management, despite their lack of support for operational needs
What is the intellectual property status of your innovation?:
IP is fully owned by QES
Return on Investment (£ Value): 
Very high
Return on Investment (Timescale): 
6-12 mon
Ease of scalability: 
Simple
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Nick Chinn 23/03/2016 - 09:49 Publish Login or Register to post comments
4.3
3
Votes
-99999
Innovation 'Elevator Pitch':
OrthOracle is a multidisciplinary on-line resource comprising a suite of Surgical Atlas’ delivering high definition image based Orthopaedic surgical techniques and educational content for Clinicians, Industry, Academia and Patients
Overview of Innovation:
The training of surgical specialities in the UK has both shortened and is less intense due to the combined effects of a restructured medical training and the European working time directive.
As these influences have been felt over the last decade the resources available to educate both surgeons and the medical workforce have not evolved to account for them. There is far greater requirement to demonstrate continuing education.
 
Allied with this are increased expectations from patients both in terms of their outcomes and level of information available to them to assist in making more informed choices about their healthcare. Increased professional regulation and a requirement to annually demonstrate appropriate levels of professional supporting activities are also areas where a high quality resource delivering validated CPD outcomes has huge potential.
 
Surgery is an inherently visual discipline and the optimal demonstration of its techniques requires the clear illustration of human anatomy as well as it’s adjustment. Existing educational resources do not reflect the interdisciplinary nature of orthopaedic practice nor provide the range or quality of material that is required today.
 
Each Atlas will document the management of a patient from initial assessment through to surgery and then to rehabilitation. Surgical procedures are detailed with high definition images and commentary provided by a Board of senior Consultant Surgeons. Implant technologies for each procedure link directly to industry information.
 
Data is managed to allow different website front ends to be displayed for differing  members of the wider healthcare team and patients. The rich data will support the future development of simulation tools.
 
Boards meet regularly to review new procedures, best practice, patient safety and guidance, medical technologies and research.
 
OrthOracle is not just a digitised text book; it is an interactive web based resource, written by practicing clinicians bringing together the best in clinical practice and orthopaedic technologies covering the entire treatment pathway and facilitates collaboration between clinical, academic and industry sectors leading to improved patient outcomes.

www.footsurgeryatlas.com

The OrthOracle concept has been tested via an early version of The Foot Surgery Atlas, launched in 2007 which, despite no advertising, regularly received over 55,000 hits per month 
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: 
Long term conditions: a whole system, person-centred approach / Wellness and prevention of illness / Education, training and future workforce / Wealth creation / Clinical trials and evidence / Digital health / Innovation and adoption / Patient and medicines safety / Person centred care
Benefit to NHS:
OrthOracle directly support NHS workforce development .
 
The content of OrthOracle is produced by a Board senior practicing surgeons and healthcare professionals, helping to promote and disseminate best practice in all aspects of the healthcare journey.
 
The management of workforce issues such as CPD and revalidation are assisted by the provision of approved and certified educational materials ((ongoing discussions with Royal College of Surgeons (Edinburgh) and other Healthcare regulators and bodies)).
 
A planned secure clinician and patient specific interface for real-time outcome monitoring will assist with safe and optimal patient management.
 
Patient focussed information on their operation, rehabilitation and consent will enable patients to be better informed and prepared for their treatment. This will involve the patient more actively in the process leading to more efficient use of resources and with the aim of improved outcomes.
 
The availability of such a dynamic educational resource 24/7 facilitates training provision, is cost effective and ensures knowledge of procedures is up to date thus ensuring a better informed workforce with improved patient outcomes at all levels of professional practice.
 
Collaboration with QEH Clinical Photography department in developing advanced image capture technologies and protocols.
 
Board meetings regularly bring together NHS clinical consultant with industry to facilitate dialogue on implant development with potential commercial and research spin off benefits for the NHS.
Online Discussion Rating
6.00 (3 ratings)
Initial Review Rating
5.00 (1 ratings)
Benefit to WM population:
OrthOracle has a global reach. Based in Birmingham with planned events within the Region, supports the Region’s international profile providing a showcase for academic, clinical and industrial skills creating opportunities for the development of new clinical skills, training and product development.
 
It is envisaged that the editors in chief of the 5 additional Surgical Atlas’ (hip, knee, shoulder, spine, hand & wrist) will be recruited from West Midlands Trusts. A number of the additional 25 contributing editors will also be from West Midlands Trusts.
 
  • 6 speciality Boards meeting 3 times per year to be held regularly in West Midlands
  • Unique opportunity for industry to gain regular feedback from Consultant Surgeons
  • Potential for creating global opportunities for West Midlands organisations in new product development, research and training.
  • The multidisciplinary scope of OrthOracle and its high profile internationally active Editorial Boards support the hosting of an annual Digital Orthopaedics Conference which we hope will be based here in the region.
  • In consultation to directly support the proposed Medical Technologies assessment hub
  • OrthOracle creates a global clinical research nexus and hosting opportunity for surgical training, virtual and augmented reality training products and facilities
  • It will also provide Human Factors, User Experience design and multidisciplinary healthcare integration building upon existing world class regional strengths
  • Opportunities for the development and delivery of medical related educational programmes and CPD modules via regional organisations, in association with professional bodies, Royal Colleges and regulating authorities.
  • OrthOracle will immediately create new jobs and support existing employment locally; growing rapidly as additional Surgical Atlas’ and content develops.
  • Look to Developing a global training focus on Orthopaedics here in the West Midlands, building from the position the region has held for many decades in orthopaedics expertise.
 
NOTE: This training platform has the ability to cover a wide range of surgical fields – following the success of Foot & Ankle we will be developing other orthopaedic areas as well as inviting other renowned surgeons to develop their own speciality areas from this foundation.
Current and planned activity: 
Editorial teams members provide Consultant medical services directly and indirectly to the NHS across numerous regions.
 
Clinical photography services of QEH will provide all OrthOracle photography services and project represents a FTE dedicated post. These services are currently being used for the Foot Surgery Atlas.

Planned activities
  • Engage with Health Education England re: workforce development.
  • Seek  Regional surgeons to join Editorial Boards
  • Continue discussions with RCS (Ed) & other AHP bodies, specialist groups and regulating authorities re: partnership, accreditation and CPD
  • Establish a project office
  • Develop a robust marketing strategy/plan
  • Develop sustainable business development strategy/plan
  • Seek Regional participants to assist in evaluating and developing the training delivery process
  • Undertake scoping study re: surgical simulation and augmented reality 
What is the intellectual property status of your innovation?:
OrthOracleTM is a registered Trademark
 
All images in each Surgical Atlas are digitally watermarked and site content monitored to protect from unlicensed data stripping.
 
A policy relating to patient photographs and IP issues applying to all Editorial Board members’ organisations is currently being finalised.
 
A specialist IP legal advisor is retained by Surgical Armoury Ltd to manage should an IP issues arise from the OrthOracle project.
Return on Investment (£ Value): 
N/A
Return on Investment (Timescale): 
2 years
Ease of scalability: 
Simple
Regional Scalability:
The individual Atlas’ within the OrthOracle and supporting information/services are delivered on-line and so availability is worldwide and at scale.
Additional Orthopaedic surgical specialities will be rolled out as soon as editorial boards are in place using the same procedure capture format. Current plans are for Hip, Knee and Shoulder sections to be undertaken this year as Editors in Chiefs have been identified and are all prominent West Midlands Orthopaedic Surgeons.
Where possible all contributors and service providers will be sourced from within the West Midlands and the project administration centre will be based in Birmingham. There is a pressing need for a Chinese language version and discussions have been held with the head of the West Midlands Chinese business community who is very keen to support the project and a regionally based specialist medical translation service has been identified. 
Measures:
Detailed tracking of website visit statistics will be undertaken and the number and nature of individual visits will be captured and reviewed. Page specific statistics will be interrogated to establish where the page/site design can be refined. Log in data will be collected and generates geographic, organisational, professional and demographic data of the user population. Additional information will be directed to specific groups as appropriate.
Several areas of the site, such as general surgical images and data will be available as a Freemium service, however a stratified subscription model is currently being developed for individual and organisational users who wish to access the wealth of supporting information and services such as the ability to create individual and annotated versions of specific procedures, clinical administration documentation such as patient consent forms, patient guides, access to  research/evidence database, CPD content.
The provision of quality accredited CPD material is a core deliverable of OrthOracle and advanced discussions with The Royal College of Surgeons (Edinburgh) are ongoing with their President, CEO and Head of Education. The College is keen to support this project from their Birmingham offices. Other accreditation and provider bodies have been identified and approached.
A user friendly CPD portal will be created to record individual user CPD in accordance with Professional/regulatory body requirements for audit and revalidation. Each surgical procedure includes specific CPD modules set by the procedure’s submitting surgeon. Individual user access times and interactions can be recorded to facilitate site usage and page viewing metrics.
This education and training platform will be further developed through the development of associated virtual and augmented reality simulators linked to the OrthOracle content (West Midlands partners for the development of these have been identified e.g. Profs Bob Stone and Alan Wing – Bham. Uni)
Adoption target:
Conservative business model assumes global (not WM) registered members numbering 10,000 year 1, 50,000 year 2 & 100-200,000 year 3 (Orig. Atlas had 50,000 users/mth by 2015 without promotion)
Assuming 20% take up by registered users of one or more of the pay-for services the Atlas will be viable midpoint year 2
RCS(Ed) promotion to members not inc
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Mark Herron 21/03/2016 - 17:48 Sign Posted Login or Register to post comments
4.3
4
Votes

Innovation 'Elevator Pitch':
GRS is a proven fully integrated scheduling package that manages staff rostering, attendance, annual leave and sickness by streamlining everyday processes to increase efficiency and save money.
Overview of Innovation:
GRS is a powerful rostering software product providing a fully integrated suite of tools designed to manage the complex task of staff rostering in demand-led service delivery organisations. It also provides access to important personnel related data such as skills and contact details and enables organisations to make the most effective and efficient use of staff resources, in addition to providing comprehensive real time reporting.

GRS was developed initially with the emergency services in mind and subsequently performs to the needs of a demand led service that can be unpredictable. GRS enables users to manage staff time more efficiently and can handle ANY type of rostering across ALL staff groups whether Operational, Administrative, Part-Time, Dual Contract, Flexi and Fixed work patterns and placing the emphasis on having the right people with the right skills in the right place at the right time.
The GRS solution has been developed over many years in demanding 24/7 operations and incorporates many key aspects specifically for the Scheduling and Management of an Organisation’s Personnel and includes a full and comprehensive integrated module for the management of Shift Pattern Working, Time worked, Overtime and Absences of any type.

Flexibility and customisation capabilities ensure that GRS is capable of managing the diversity of working practices, and can deal with the complexities of an Organisation’s local rules and interpretations in personnel contracts. Inbuilt Alert and Workflow facilities enable communication and action management across the organisation and incorporates out of the box Bradford Scoring Indexes and Working Time Directive Monitoring.

Proactive and configurable reporting facilities ensure managers have timely and accurate information for planning and forecasting of employee shifts, overtime and absences. With real time visibility of staff availability this ensures adequate levels of resource are maintained to meet the organisation’s needs over current and future planning horizons.
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 / Wellness and prevention of illness / Education, training and future workforce / Wealth creation / Digital health / Innovation and adoption / Patient and medicines safety / Person centred care
Benefit to NHS:
Benefits below are as a result of GRS being adopted and used by all NHS Ambulance trusts across the country along with Police Forces Nationwide including West Midlands Police.
  • A 5% reduction in annual operational costs was determined by one Ambulance Trust after the implementation of GRS
  • 50% reduction in sickness as a  result of the sickness package being used in conjunction with the rostering system
  • Significant and quantifiable multi million pound savings are achieved across Services with
    • Reduction in, and Management of, Overtime staffing costs
    • Automated and simplified Work flow and Authorisation processes for Annual Leave, TOIL and other absences such as training
    • Highlighting of Shift Patterns not delivering contractual needs
    • Employees failing to meet there contracted hours commitments
  • Visibility of Establishment, Skills, Demand and Absence distribution across the organisation
  • Auto generated Alerts from shift changes to Sickness KPI management increases communication, information sharing and action management across the organisation.
  • Promotes uniformity of working practices across the organisation

Peter Stelfox, a Resource Manager from North West Ambulance Service NHS Trust, has stated that the Global Rostering System (GRS) when introduced across their Emergency Service, now provides a far greater degree of management control than the legacy manual systems it replaced and enables the Trust to maximise effective use of the available staff resources. Any gaps in shift allocation can be quickly identified and addressed. Reports generated through GRS have fundamentally enhanced the timeliness and quality of management information providing visibility of resource levels and utilisation of overtime, improving annual leave and training release planning and contributing to more robust and focused absence management. The efficient input to an electronic system as opposed to the manual collation and analysis of information has also had an additional benefit in enhancing capacity of the service line’s administrative staff.
Initial Review Rating
4.60 (1 ratings)
Benefit to WM population:
Significant savings in operational costs can be attained by the use of GRS in streamlining workflow and administrative activities, and making more Efficient and Effective use of the most valuable resource of an organisation, its People.

Contracted Hours and Overtime can be more closely monitored, authorised and controlled, and reductions in Sickness Levels attained by improvements in reporting, recording, and health and well-being management.

Efficiency measures and savings made would allow re-investment of funds for improving or providing additional front-line services.

With the GRS system already adopted by both West Midlands Ambulance Trust and West Midlands Police it would enable a joined up, cross sector service throughout the Midlands region.

Software Enterprises is based within the West Midlands and wider adoption of GRS within the region would allow us to grow and facilitate further collaborations with other region based organisations.
Current and planned activity: 
GRS is adopted by all NHS Ambulance Trusts and we are keen to develop new relationships with more Trusts within the West Midlands region.

GRS is currently used by all NHS Ambulance Trusts and has proved to be a vital operational and cost saving tool.
 
Mobile App facilities are being released and continually being developed, along with Web Dashboards and Mapping Technologies.
 
Software Enterprises (UK) Ltd would like to see its software used by more NHS Trust Sectors and would welcome the opportunity to trial GRS in a variety of departments, be it Wards, Accident & Emergency or within Mental Health Trusts. We are currently developing a shift generation package that supplements our existing offer and would like to trial this within the NHS.
 
What is the intellectual property status of your innovation?:
Intellectual Property (IP) is retained for all Company designed software.
Return on Investment (£ Value): 
Very high
Return on Investment (Timescale): 
1 year
Ease of scalability: 
Simple
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Peter Hall 14/03/2016 - 13:48 Publish Login or Register to post comments
5
1
Votes
-99999
Innovation 'Elevator Pitch':
The MicroEye system delivers simple, reliable and highly cost-effective continuous glucose, lactate and many other blood analyte samples capable of measurement by stand-alone external diagnostic equipment for display on laptop or bed-head monitor.
Overview of Innovation:
MicroEye transforms point-of-care blood sampling from ‘point in time’ to automated continuous monitoring of a vast range of potential analytes, for improved outcomes in critical care. MicroEye is an easy to use device that is inserted using common peripheral venous catheters. It delivers dialysate to an external sensor system which means the blood can stay in the patient and real-time data is available to standalone monitors, bed head array systems or hospital information systems.

MicroEye is approved for use in the peripheral vascular system and in subcutaneous, intramuscular and adipose tissue. Most small water-soluble molecules can be monitored, and many including glucose and lactate can be monitored in real time, helping to improve clinical outcomes in a range of specialties including intensive care, cardiology, surgery, emergency medicine, paediatrics and neonatology.

Glucose Control
Continuous and automated real-time online monitoring of blood glucose using MicroEye® may provide accurate data for improved management of some patient groups. Although around 10 per cent of intensive care patients may be diabetic, the incidence of stress-induced hyperglycaemia has been reported to range from 30 to 100 per cent. Effective control of blood glucose levels reduces the incidence of hyperglycaemia and hypoglycaemia, both of which may compromise patient safety.
MicroEye delivers real-time blood glucose data which meets ISO 15197 accuracy criteria which results in improved patient outcomes, speedier recovery and shorter hospital stays.
Lactate Monitoring
MicroEye® can be used to assess metabolic stress by monitoring blood lactate levels. High blood lactate (hyperlactatemia) is frequently found in critically ill patients and often used as a marker of adverse outcome. A study* looking at all adult ICU admissions (n=13,932) in a healthcare institution over a three-year period found incidences of high blood lactate between 40 and 45 per cent. There was also a highly significant association between hyperlactatemia (blood lactate > 2 mmol/L) and mortality rates of 27 per cent. Other studies show that mortality rates of nearly 70 per cent are independently associated with blood lactate levels of at least 3.5 mmol/L.

MicroEye gives a reliable measure of cellular hypoxia and can help assess the effectiveness of therapeutic interventions. This data can then be used to improve patient outcomes and allow for a speedier recovery
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: 
Advanced diagnostics, genomics and precision medicine / Wealth creation / Clinical trials and evidence / Digital health / Innovation and adoption / Patient and medicines safety
Benefit to NHS:
  • Cost saving benefit through better glucose monitoring which has been proven to  improve patient well being resulting in shorter hospital stays
  • Automated continuous monitoring freeing up nurses and other staff to perform other essential tasks, which improves efficiency and ultimately provides a cost saving benefit to the NHS
  • Published work shows an improvement in patient outcome and cost savings from continuous Glycaemic control
  • Trend data can be displayed rather than point in time
  • Compares favourably in cost to current methods.
  • Many other analytes can be collected at the same time and measured offline  e.g. antibiotics
Initial Review Rating
4.60 (1 ratings)
Benefit to WM population:
Our  innovation will bring benefits to patients using the technology as soon as it we have finalised trials and able to bring to market. Thus during this development and the final marketing of this product it will help us secure the growth and develmpent of the company as well as it products, current and futurre

We also are looking forward to developing collaborations and stronger relationships with West Midlands NHS Clinical reseach teams to enhance one anothers research and the care we can deliver to patients.

Some of the lactate research has been conducted at the University of Coventry
Current and planned activity: 
  • Seeking NHS Evaluation Centres / collaborators - We plan to commence evaluations in NHS centres, if possible here in the West Midlands
     
  • Gaining Evaluation and Validation - The device is in final evaluation stage, although it is CE marked for use in EU hospitals
     
  • Developing Final Products & Sales - Following this we will moving through to mass production and growing our sales base from our offices in Coventry and developing exports to countries that have been showing interest.
     
  • Note: To early to say ROI - Value or Time Scale but we suspect thes will be very favourable and beneficial to the NHS and patients.
What is the intellectual property status of your innovation?:
Patented product and IP held by company. Licenced out IP to be used to integrate with other products abroad (Japan and Italy).

Curent Certification:CE marked product, ISO 13485, Directive 93/42/EEC
Return on Investment (£ Value): 
N/A
Return on Investment (Timescale): 
N/A
Ease of scalability: 
Simple
Regional Scalability:

We have already conducted feasability studies with our manufacturer to ensure volume production is possible

Measures:

Initially we are looking for user evaluations. We already know the device works succesfully. A full trial protocal is avilable in request

Adoption target:

initially we would lie to start eavuations in 1 -3 centres.

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Neil Smith 01/03/2016 - 15:03 Detailed Submission Login or Register to post comments
3.8
5
Votes
-99999

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