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Innovation 'Elevator Pitch':
OrthOracleTM – Multidisciplinary on-line orthopaedic educational resource 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:
Market ready and adopted - Fully proven, commercially deployable, market ready and already adopted in some areas (in a different region or sector)
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Innovation 'Elevator Pitch':
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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Innovation 'Elevator Pitch':
An expert-lead education platform for medical and dental professionals, providing crowd-sourced digital verifiable CPD and revalidation capabilities to improve patient care and administration for healthcare professionals and hospital trusts.
Overview of Innovation:
Medical professionals face a burden on managing their continuing education. To date, the methods of gaining CPD are largely book-based, rudimentary, expensive, fragmented and inconvenient. According to our market research, over 80% of dentists and medics surveyed wished to have a cheaper and simpler way to gain their CPD. Further to this, hospital trusts face great difficulties with CPD administration including revalidation, which is currently a largely manual based task in NHS trusts.
 
With over 95% of doctors and nurses owning a smartphone, there is an overwhelming need for a disruptive force to digitalise and advance this vastly under developed sector of professional education within one technological umbrella.
 
To solve these problems, we have been working with a large team consisting of 40 expert content writers, 5 experienced developers and several leading figures in NHS innovations to facilitate implementation within the wider healthcare environment.
 
With this great team, we have created the world's first innovative, simple and high-quality CPD education mobile app for medical professionals that crowdsources the way that expert-level content can be consumed and centralises all paperwork for the individual and HR trust.
 
An individual can gain all their CPD needs, directly accessing the expert knowledge pool of fellow medical professionals via our app, whilst enjoying the cheapest and easiest solution to do so from our market research*. An individual can save up to £130 each year on their required CPD hours from the MedicaliQ service, and hospital trusts will save an average of £10,000 annually. By creating an open platform for experts to contribute content, this will create a paradigm shift in the way that knowledge is gained and shared.

Further to this, we have created a breakthrough and simplified administration system for healthcare trusts to intelligently manage workforce-related issues such as revalidation and mandatory training, which is currently being piloted with the Manchester Hospital Trusts. 
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: 
Education, training and future workforce / Digital health / Innovation and adoption
Benefit to NHS:
Directly supports NHS workforce development

By crowdsourcing expert knowledge via CPD we aim to reduce the current CPD spend in terms of both administration time and in providing externally accredited courses (HR spend per staff on providing externally-accredited courses are estimated at £800/staff per module. This can greatly be reduced with our centralized pool of experts.  
 
Opportunity to deliver mandatory staff training through the education platform, encouraging greater autonomy in learning styles – can carry out training and revision both online and offline. All articles have an audio assist option with a variety of accessibility options to appeal to the wider learning taskforce.
 
We are piloting a breakthrough service with the University of Central Lancashire whereby the CPD courses offered within the app will also be academically certified as a qualification (PGCert, PGDip or Masters level), the first service of its kind in the UK.
 
The MedicaliQ platform can tie in with existing third-party educational resources and CPD providers to partner and add value to their educational offerings, allowing individuals to test and certify their knowledge in a unique collaborative environment.
 
Regular board meetings with advisory panel with divisional leads to direct key educational strategies

Content produced by senior practising clinicians and healthcare professionals within the NHS and private sector, ensuring a bank of expert-level knowledge disseminated for other clinicians
 
Management of workforce issues via our Revalidation program will help support individuals and trusts to streamline their administration requirements with the provision of approved and certified educational materials.

This dynamic educational resource will be available 24/7 and offline, and thus facilitates training in a cost-effective and immediate manner ensuring up-to-date knowledge for a better-informed workforce to improve patient outcomes and care. 
Initial Review Rating
4.60 (1 ratings)
Benefit to WM population:
MedicaliQ will have a NHS-wide and global reach.

An improvement in skills and knowledge of clinicians to offer enhanced patient care to citizens of the West Midlands region.

Unique opportunity for the local industry to gain feedback in current medical practices from leading consultants and professors, via in-app feedback, for crowdsourced knowledge pooling.

More simple, affordable and efficient access to high quality education for clinicians in the region and across England.

Engagement with higher educational institutions in the West Midlands to supplement and deliver their medical educational courses via more innovative platform (via in-app integration – currently being trialed with UCLan).

A specialist advisory board will be set up in the Medical and Dental sectors with meetings held in the West Midlands 4 times per year.

Devolves development and delivery of medical-related educational programs and CPD from hospitals to individuals in conjunction with the current expert pool via regional organizations and professional bodies such as the Royal Colleges and regulatory authorities.

Potential to utilize the crowd-sourced nature of the platform to develop the services to devolve and facilitate individual clinicians to partake in primary care research across the West Midlands area.

Reduces the administrative burden on staff for CPD whilst opening access to high-quality continuing education to ensure up-to-date knowledge and optimised patient care.

Ability to convert your CPD earned in the app into a real-life qualification via our academic partners UCLan.

Affiliations with national conferences held at the NEC Birmingham to administrate their CPD.

MedicaliQ will immediately create new jobs in the local area to support production with an opportunity for the team to grow as the services develops.

Looking to develop a global training focus on e-education in the West Midlands.
Current and planned activity: 
The current concept of mobile-based education is proven with our world-leading student app, and signing up over 5,000 dentists onto our dental CPD app.
 
MedicaliQ has been accepted onto the Digital Health.London 2016 accelerator, a pioneering NHS accelerator program that works to bring new innovations into the healthcare ecosystem.
 
Our pilot with the Manchester Trust will help inform our plans to create a product that can scale to the standard administration protocols of a large NHS Healthcare provider.
 
In scaling the mobile product, we will create a third party system for existing CPD providers to provide content. General CPD material will first be provided for the average medical professional with a view to engage specialist interests, in partnership with our advisory board. We are then looking to integrate the product to offer CPD solutions to the wider allied healthcare professionals, such as paramedics and health care assistants.
 
NOTE: Please see attached business summary
What is the intellectual property status of your innovation?:
MedicaliQ Ltd owns all IP involved in the innovation. The brand names, ‘DentaliQ’ and ‘MedicaliQ’ have been trademarked as both image and text (see attached). 
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
1 year
Ease of scalability: 
Simple
Regional Scalability:
Once developed, MedicaliQ can be scaled and adopted across hospitals and primary care providers in the West Midlands area for both individual based CPD and revalidation needs. Our pilot with the Manchester Hospitals trust will demonstrate how we may integrate such a solution from the HR personnel perspective, creating a streamlined system that can be scaled to any other hospital setting including the West Midlands. Our solution benefits both the individual clinician and the administration backend of hospitals, ensuring a two-pronged strategy. Distributing the platform via local GP surgeries to provide a similar service, via EMIS, will further provide scalability options in the region. There is a large focus towards a digital transition to care as part of Digital Birmingham’s agenda, so it would be concordant to roll the product out to other providers in the region. Hospital universities in the region will also benefit from the whitelabelled CPD package for their postgraduate students.
Measures:
There are three main outcome areas that impact is being measured against: individual clinicians, hospital trusts and contributing authors.
 
Individual clinicians: improving access and convenience to expert-lead education to enhance continuing education and promote self-learning. This ultimately leads to having more up-to-date knowledge and providing better patient care.
 
Hospitals: enhancing, digitalizing and streamlining the workforce administration methods for continuing education and revalidation to save clinical time and prioritise patient care.
 
Contributing authors: to provide authors with an opportunity to curate and disseminate their expert knowledge within a crowd-sourced environment to provide an independent income stream.
 
To support the above impact areas, we will be applying the following measures to gauge success of the innovation across both quantitative and qualitative aspects:
  • Number of monthly downloads
  • Monthly revenue
  • Profit margins
  • Number of purchased articles and repeat
  • Number of customers (and thus the market share)
  • The number of articles in our bank
  • User rating
  • User reviews
  • Time spent on app
  • Number of successful revalidation applications
  • Number of post-graduate student signups via University courses
Other measures across the broader aspects include:
 
Quality
Customer: number of purchased articles, repeat customers, user feedback/rating, time spent on app
Technology: reliability, accessibility, downtime
 
Safety
Customer: accurate educational content (verified by expert panel)
Technology: meets information governance standards, appropriate 2-step authentication procedures, back-up content
 
Cost
Customer: customer acquisition costs, amount paid per customer, amount earned by author’s per article
Technology: operational costs
 
People
Authors: quantity, engagement and submission rates; experience/qualifications
Adoption target:
The conservative business model assumes a national registered member accounting for 10,000 Year 1, 50,000 Year 2 and 100-200,000 Year 2. Our original DentaliQ product had 10,000 users register in the first month of launch in 2016. Assuming a 10% uptake by registered users for a paid-for CPD service, MedicaliQ will be viable by Q2 of Year 2.
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Innovation 'Elevator Pitch':
Optimised Equivalent® to best performing & highest volume branded orthopaedic implants (>1,000,000 patients), coupled with significant savings. Equivalent manufacture, materials, tolerances & sizes, along with operational technique & instrumentation.
Overview of Innovation:
The UK is the first country in the world to benefit from applying the principle of generics to orthopaedic products. Generic medicines have been a core part of the NHS since the 1980s, offering the same clinical outcomes for patients as originator drugs and now contributing over £12 billion in savings every year that can be reinvested into the health service (1)

With >66,000 NHS hip replacement operations performed every year (2) switching to generic hip implants from the current market leaders, the NHS could save up to £120 million by 2020 - enough to fund over 1,400 junior nurses every year (2,3,4)

This is well-timed following Lord Carter’s Review, which found that large efficiency savings can be made by all NHS hospitals – notably in orthopaedics. Some of these savings can be made by reducing the current variation in patient outcomes (5)
 
Evidence from over 1,000,000 hip replacement operations in published registry data shows that some of the most widely used devices with the lowest possible revision rates can be provided at a significantly reduced cost due to patent expiration. Orthimo have produced Optimised Equivalent® implants to the branded versions, providing significant cost savings without compromising patient outcomes.

The manufacturing of the Optimised Equivalent® implants are by well established suppliers with many decades of experience in manufacturing orthopaedic implants for the large Orthopaedic companies, further strengthening the equivalence value proposition.  Both the surgical instruments and techniques are also equivalent.

As a further indicator of reassurance, the Department of Health recently purchased a significant quantity of Optimised Equivalent® implants through a forward buying fund, which can be obtained via NHS Supply Chain.
 
At a time of unprecedented cost pressures on Healthcare systems worldwide, Optimised Equivalent® implants make a valuable contribution towards maintaining high quality hip replacement services within the limited resources available.

This means patients receive the best clinical outcomes at significant cost savings for hospitals.

http://www.odep.org.uk/Product.aspx?pid=2301

http://www.beyondcompliance.org.uk/product.aspx?pid=2301

https://my.supplychain.nhs.uk/Catalogue/product/fjh10279

Stage of Development:
Market ready and adopted - Fully proven, commercially deployable, market ready and already adopted in some areas (in a different region or sector)
WMAHSN priorities and themes addressed: 
Long term conditions: a whole system, person-centred approach / Wellness and prevention of illness / Wealth creation / Clinical trials and evidence
Benefit to NHS:
Orthimo provide equivalents of the best performing and most commonly used branded orthopaedic implants, as proven by registry data of over 1,000,000 patients. Similarly to generic pharmaceuticals, which the NHS already takes advantage of, Orthimo products come with significant savings of 30-60%. This could save the NHS up to £120million by 2020.
 
These can be provided with minimal disruption to services and procedures due to the sizes, instrumentation and operative technique being equivalent to the most commonly used branded products. They are available through a simple and transparent pricing structure, which can be via the Total Orthopaedic Solutions, Chester or NHS Supply Chain frameworks.
 
As an indicator of reassurance, the Department of Health recently purchased a significant quantity of Optimised Equivalent ® implants through a forward buying fund, which can be obtained via NHS Supply Chain. With most Trusts using one or more of the branded reference components, a transition to make savings has never been easier.
Initial Review Rating
2.60 (1 ratings)
Benefit to WM population:
Orthimo provides generic versions of the best performing hip implants, this means patients in the West Midland area can receive the best clinical outcomes at significant savings to the hospital and trusts in the region. 
 
In the West Midland approximately 6,000 hip replacements are performed per annum. If, at a conservative estimation, these cost £700 each on average, generic hip implants could save the West Midland area over £1.5m per annum.
Current and planned activity: 
With Optimised Equivalents being available via all Orthopaedic frameworks, Orthimo are seeking Surgeons to conduct small volume evaluations or for Trusts to allocate a proportion of their hip work.

As with the generic pharmaceutical industry, there is a need to establish a policy change to ensure the responsible and active use of generic orthopaedic implants.
  • Procurement: -  Require sales and marketing to Trauma & Orthopaedics departments and procurement
  • Evaluation - Seek ‘Beyond Compliance’ service evaluation centres for uncemented range
  • Adoption:- Seek Hospitals/Surgeons to conduct small volumes of procedures
  • New Product Development:- Require experts to propose and support development of new products
What is the intellectual property status of your innovation?:
All IP resides with Orthimo.

Orthimo holds BSI CE Mark for all implants.
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
0-6 mon
Ease of scalability: 
Simple
Regional Scalability:
Optimised Equivalents use the most common and best performing branded reference products. These are used in most Trusts across the country, and so an introduction will have minimal disruption. We use the same sub-contracted manufacturers and logistics which the large companies use, and so supply can be scaled rapidly. 
Measures:
Our products are being used via the Beyond Compliance process. This data will be used to apply for successive ODEP ratings when the criteria are acheived. 
Adoption target:
We are looking for Trusts to use Optimised Equivalents for their low risk, common primary elective total hip replacement procedures. It has been estimated that this would be in excess of 60% of cases. 
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