The free magazine from the North West NHS Innovation Hub

TRUSTECH News Issu

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Smart Solutions for Healthcare identifies innovations to shape

the future of care

Welcome to Issue 19 of TRUSTECH News

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General News 2

TRUSTECH Innovation Management 6

Open for Business 8

TRUSTECH Initiatives 10

Knowledge Centre 12

Cover images (clockwise from top left): iGrading CVD Software; Sleep Apnoea in Primary Care; VibraTip; Padd Device; See page 8 for full details.

TRUSTECH at 10 This year, TRUSTECH celebrates 10 years of providing innovation management services to NHS organisations in the North West. TRUSTECH remains an NHS organisation with the NHS at the heart of all that it does and with the mission to improve healthcare through innovation. Since its start with just two Technology Managers providing advice to about 30 Trusts, TRUSTECH has expanded both its team of staff and the breadth of services provided and has seen many changes in the NHS. In addition to its role providing innovation and intellectual property management advice to NHS Trusts, TRUSTECH is now positioned as a gateway between industry and NHS, pushing innovation out to a wider community and enabling the pull of innovation into the NHS from the commercial sector.

Services bringing industry and the NHS together have been developed such as the Smart Solutions programmes, including Smart Solutions for HCAI (Healthcare Associated Infections) and the current Smart Solutions for Healthcare (long term conditions and cardiovascular disease), as well as the Biobooth Initiative. In addition TRUSTECH is providing commercial consultancy services to the business, academic and commercial sectors. These services bring in opportunities for the NHS to acquire new products and services and it provides expertise of value to industry.

TRUSTECH’s 10th year (2010/11) highlights:

• 150 innovations arising from NHS staff were evaluated;• 16 licence agreements were finalised; • 18 collaboration and commercial agreements were signed; • 8 new products were brought to market; • Leveraged in £600,000 of income in sales, royalties and investment/grant

funding for member NHS Trusts;• Managed the final 2 rounds of InnovateNoW, the North West Regional

Innovation Fund (RIF), awarding £2.2m in total over the 4 funding rounds;• Concluded the Smart Solutions for HCAI programme with evaluation reports

published for 9 new product trials; • Formed a new joint venture, the MedTECH Centre, which now hosts and

supports 9 commercial companies (see page 10); • Launched a new Smart Solutions for Healthcare programme in long term

conditions and cardiovascular disease themes (see page 8);• Launched a pilot project funded by the Greater Manchester CLRN,

‘Optimising Medtech Access to the NHS’ and a project funded by Cheshire and Mersey CLRN on ‘Improving Industry Engagement (see page 9).

NHS changes

Across the NHS, the last 18 months have seen major reforms and this has impacted on TRUSTECH as well as Acute Trusts and PCTs. Historically, TRUSTECH has been part funded by the Department of Health, via the National Innovation Centre, and the Department of Business, Innovation and Skills, to develop early stage innovations and business from the NHS (funding streams that are no longer available). This money was used to subsidise the fees from member Trusts to fund TRUSTECH‘s core activities in providing an innovation management service to Trusts. Latterly, TRUSTECH’s commercial services to healthcare industry, have generated additional income.

TRUSTECH changes

TRUSTECH, in consultation with NHS Trust CEOs, has reviewed its business model in order to ensure that the innovation management services offered are suitable to help NHS Trusts to deliver the QIPP agenda and their NIHR contractual outputs. As a result of these discussions and feedback following an independent review of service delivery, TRUSTECH now offers three levels of services to NHS organisations. TRUSTECH has also focused upon improving its internal systems to ensure that there is more frequent liaison with Trusts and regular reporting on performance and value delivered.

TRUSTECH has already signed new contracts with a number of North West Trusts and is working with their R&D Managers and other senior management teams to provide a top quality innovation service. If you would like to know more, contact Rebecca Ryan (0161 276 5764, rebecca.ryan@cmft.nhs.uk).

Welcome to Issue 19 of TRUSTECH News

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General News

Elderly Care Model for China

Yuan Zhen, TRUSTECH, MIMIT and Steering Panel Members

TRUSTECH, working with Manchester Integrating Medicine and Innovative Technology (MIMIT), are collaborating with The Edward Centre for Healthcare Research to build an advanced framework for elderly care management for China. The project seeks to utilise the UK’s experience and techniques in elder care in order to develop a comprehensive set of manuals that detail best care criteria and standard operating procedures; thus, developing a framework that can meet the characteristics of the Chinese market.

The project commenced in March 2011 and will end in December 2011. The first phase of the project aims to develop a comprehensive and practical framework that can become the “gold standard” for elderly care in China. The Edward Centre for Healthcare Research is one of the wholly-owned subsidiaries of Yuan Zhen UK Investment

Limited. The centre is a market oriented research institute that aims to improve the quality of healthcare practice by advancing the understanding of the health and social service needs of elderly people.

Early in May the Yuan Zhen team was delighted to meet the steering group for its elderly care management project, whose job is to provide expert opinions and advice on the elder care system co-ordinated by TRUSTECH. The team comprises an impressive array of distinguished experts whose diverse knowledge and skills will ensure that the system advocated by TRUSTECH will have a truly unique and professional character. The steering group includes CEOs and managing directors of major UK healthcare providers, elderly care experts, high profile academics, geriatricians and healthcare consultants.

Quick summary of TRUSTECH services

For NHS Organisations

Value – This service provides engagement between TRUSTECH and the Trust and provides a core innovation advice service by phone or email to the Trust and staff, with access to training and funding opportunities. Site visits, case meetings etc can be provided on a priced basis if required.

Standard - This provides an innovation management service, including defined assistance with development of an innovation culture within the Trust and a number of site visits or innovation audits. This service also provides access to TRUSTECH’s £100,000 Pathfinder Fund to support innovations with commercial potential, and opportunities for bringing trials and innovations to the Trust. Regular updates will be provided on external funding opportunities and, where appropriate, TRUSTECH may work with Trust staff to develop, submit and if successful, project manage grant/investment applications.

Bespoke – This is a service tailored to the needs of individual Trusts, usually where the Trust has already put in place some infrastructure to support its innovation activities. This provides, in addition to the above services, a more engaged level of service, and a range of broader innovation management opportunities are available including support for developing the Trust’s commercial and innovation strategy and promoting both inward and outward flow of innovations.

For Commercial Organisations

Market Research – tailored market research for healthcare products and services; including competitor product analysis, route to market studies, market needs assessment, surveys, expert opinions, focus groups and developing business cases.

Product Trials – facilitating in situ clinical evaluation of products from cleaning solutions to diagnostics, from dressings to software, including identification of host Trust and principal investigator, strategy development, and project management.

Look out for changes to TRUSTECH’s website, literature and other resources over the coming months as TRUSTECH‘s branding is given a refresh as well as its services. TRUSTECH will also be holding a series of refresh and relaunch events throughout the region. The first of these is in Manchester on September 14th, a second will be held in Liverpool at a date to be confirmed. If you would like to know more about these events, contact Rebecca Ryan.

Update your detailsIf you would like to update your subscription to TRUSTECH News to receive a postal or electronic copy in the future, would like to add a colleague to the mailing list, or would prefer not to receive any further issues, please contact carl.peachey@cmft.nhs.uk.

General News

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The £25m Northwest Fund for Biomedical is open for business

The £25m Northwest Fund for Biomedical is part of the £185m evergreen fund provided by the European Investment Bank (EIB) and European Regional Development Fund (ERDF), providing equity investment from £50,000 to £1.5M to small and medium businesses in the biomedical sector in the North West of EnglandTRUSTECH is currently in discussion with fund managers, SPARK Impact, to look at investment opportunities for innovative new technologies originating from NHS Trusts in the region. SPARK Impact have recognised the potential of the NHS as a source of valuable innovations addressing real clinical needs. SPARK Impact have already completed their first two investment deals for Aventé Medical Products Ltd and

TopCat Research Ltd, with both receiving £50,000 Pathfinder Investments. Aventé Medical Products Ltd has ambitious plans to develop a range of high-quality, cost-effective, single-use medical devices, whilst TopCat Research Ltd is developing cost-effective immunoassay-based diagnostic tests for the pharmaceutical, environmental and food markets. Both companies are addressing clear market needs and will be closely supported by the SPARK Impact investment team, which includes newly appointed investment director Dr Marc d’Abbadie and investment manager Dr Andy Round, to fulfil their commercial potential.SPARK Impact have a strong pipeline of opportunities being considered for funding, and over the coming months TRUSTECH will be exploring opportunities to introduce NHS innovations to them.Dr Penny Attridge, Senior Investment Director at SPARK Impact and manager of the Fund, said: “We are looking for exciting innovative companies addressing clear market needs with relevant solutions. When applying to

the fund, remember to outline the market problem and give a concise explanation of the solution. Set out how much total funding is required to get the product to market, a realistic time frame and an exit strategy.”The £25m North West Biomedical Fund Facts:• Open to biomedical companies

based in, or prepared to relocate to, the North West.

• 40% of the fund is going to be invested on Merseyside.

• Over 50 businesses will receive investment from the fund.

• Initial tranches of funding for start-up companies (up to £50K) could be awarded six – eight weeks from the initial contact.

• Applications are now being accepted.

For more information about the fund visit www.thenorthwestfund.co.uk or contact Louise Clancy on 0151 705 3416 or louise@sparkimpact.co.uk

‘Dragons’ Den’ style event grants over £100,000 funding

The Royal Liverpool and Broadgreen University Hospitals NHS Trust (RLBUHT) recently held their inaugural innovation event, known as ‘The I Factor’. Dr Richard Deed, Innovation Unit Manager for TRUSTECH, was a member of a panel of experts who met to discuss the merits of the applications.The competition, which was open to all staff at the Liverpool trust, aimed to identify innovative ideas to improve patient care. On offer was support and funding of up to £25,000 to develop and implement successful innovations. 17 applications were submitted and 5 of these were invited to pitch in front of a panel, mimicking the popular TV show. After significant cross-examination from the panel of judges, which comprised: Dr Peter Williams, Medical Director; Stella Clayton, Deputy Director of Organisational Development; Diane Wake, Executive Director of Nursing and Operations; and Denise Preece, Non-executive Director of the Trust Board – all from RLBUHT – all 5 innovations were awarded funding subject to performance milestones and qualifying caveats. They included: • the development of a 24 hour online

intravenous dosage calculator which ensures consistency in administering high risk medicines;

• a programme to help patients with inflammatory bowel disease to self-manage their condition;

• the redesign of the service and invention of a simple sizing tool, which allows GPs and healthcare professionals to identify the correct hand, wrist or thumb splints, which reduces the need for the patient to attend hospital for sizing.

Dr Deed said: “It was really great to see the Royal Liverpool actively searching for and supporting innovation within

the Trust, but what is most encouraging is that there are so many members of staff who are dedicated to finding novel ways to improve patient care on a day-to-day basis.”Steve Lake, member of the innovation working group at the Trust, who co-ordinated The I Factor said: “The Trust wanted to create an annual event to help staff free up some time to pursue their ideas for improvement and receive support. We are now eagerly awaiting the outcome from this year’s funded projects to help guide the programme for next year.”

2009 Innovation Awards Launch

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A new innovation in delivery of dialysis developed by Manchester Royal Infirmary, which allows patients to have dialysis in their own homes, has been awarded one of the first NHS Challenge Prizes of £100,000. The novel technique has been led by Dr Sandip Mitra, Consultant Nephrologist, who said about the award: “Manchester is proud to have a highly skilled team which enables and empowers patients to regain control of their lives leading to higher life expectancy, greater independence, fewer medications and a less restrictive lifestyle on dialysis. This award will inspire the team to continue its efforts to improve patient experiences on dialysis and support other units to establish home haemodialysis programmes.”

David Coil, a patient on the Manchester home dialysis programme commented that “for me, the best solution is carrying out my home dialysis overnight. This completely

frees up my working days giving my life back to me. I can also do longer sessions, which gives me a better quality of dialysis. The result is a very noticeable increase in energy levels and general well-being.”

Two other awards were also made:

• Cytosponge - a new pill that turns into a sponge, which is a simple way to test for oesophagal cancer and costs just £25 compared to the £400 cost of a traditional endoscopy. Developed by Cambridge Medical Research Council Cancer Unit and Addenbrookes University Hospitals.

• Scriptswitch - a computer program used by staff at NHS Bristol to share information on nutritional supplements prescribed to patients between hospitals and GP surgeries so they can identify patterns and prescribe more efficiently

leading to projected savings of £156,000 per year.

The NHS Challenge Prize fund aims to give all NHS staff the power and freedom to innovate to deliver better patient care. ”All staff have the power to improve service for patients - we want to give them the freedom to use it” says Health Minister, Lord Howe. The prizes have been developed to ensure that the NHS continues to be recognised as a world leader in the development of innovative techniques and technologies by rewarding those who help pioneer and modernise the health service through innovation.

For full details about the fund, please visit: www.challengeprizes.institute.nhs.uk.

Regional Innovation Fund update

Central Manchester University Hospitals NHS Foundation Trust awarded NHS Challenge Prize for Home Dialysis Programme

Round 4 of InnovateNoW, the North West Regional Innovation Fund (RIF), came to a conclusion at the start of 2011 with a total of 56 applications spread across the Innovation Sharing and Innovation Bursary categories (there was no funding for Enabling Change awards for round 4). Of these, 18 were awarded funding, details of which can be found by visiting www.innovatenow.org.uk/winners.htm.NHS North West has published case studies on the projects that received RIF (Sharing, Bursary and Enabling Change Awards) and Dragons’ Lair awards. The case studies can be accessed by the North West NHS Innovation Portal that is hosted by Advancing Quality Alliance (AQuA) at: www.advancingqualityalliance.nhs.uk/innovation/casestudies/. For the Healthcare Expo 2011 event, held in London back in March, a poster featuring a ‘tube map’ of innovation (pictured) was created to highlight which clinical pathways each project funded under the Regional Innovation Fund scheme was related to.

The map identifies all of the innovative projects that were awarded funding for the two financial years between 2009 and 2011 across all regions of England.

To view the poster with North West projects highlighted in yellow, please visit: www.TRUSTECH.org.uk/news/rifup-date.htm.

TRUSTECH Innovation Management

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The ‘Butterfly Pillow’ A new tool for diagnosing Atrial Fibrillation

The ‘Butterfly Pillow’, brainchild of Ann Parry, a neonatal nurse at Liverpool Women’s NHS Foundation Trust (LWH), has recently been licensed to Inspiration Healthcare who already market a range of products for newborn babies. Ann originally designed and made the pillow to provide positional support and help reduce ‘head flattening’ in premature babies in the neonatal unit. Ann had already met staff from Inspiration Healthcare as they were supplying products to the ward, but she contacted TRUSTECH to help explore an opportunity to work with them to market her product.

TRUSTECH have worked closely with Ann and LWH to negotiate a licence for Inspiration Healthcare to manufacture and market the pillow. This new agreement will see the pillow on sale in the UK and mainland Europe towards the end of 2011. Negotiations on behalf of LWH have ensured that royalties will be paid to the Trust based on future sales. Neil Campbell from Inspiration Healthcare said: “this is an exciting time…collaborating with Liverpool Women’s Hospital was a logical step in exploiting their product.” This is the Trust’s first product commercially developed with assistance from TRUSTECH and they are keen to explore further opportunities.

For further details on the pillow and for sales enquiries, please contact Inspiration Healthcare at: info@inspiration-healthcare.co.uk or telephone 01455 840 555.

Cerebrovascular strokes are the third largest cause of death in the UK and have a greater disability impact than any other condition. One in five acute NHS beds are occupied by stroke patients with care for these people costing the NHS in excess of £2.8 billion per year.

Atrial Fibrillation (AF) is a heart condition that significantly increases the risk of stroke. AF can be easily diagnosed by undertaking an Electro Cardio Graph (ECG) test and once diagnosed, the risk of stroke can be substantially reduced via the use of anticoagulation therapies.

Currently, an ECG test is usually carried out in a specialist clinic in an acute hospital. There has to be an initial suspicion that an ECG test is required, the patient has to be referred by their GP, they have to travel to the hospital and then back to their GP to receive the results. This can be a significant undertaking for elderly patients. Very few GP practices undertake ECG testing due to the time, equipment and expertise required. Unfortunately, for these reasons, many elderly patients only have an ECG recording and a diagnosis of AF after a stroke has occurred and they have been referred to an acute hospital for treatment.

TRUSTECH is currently working with Manchester Royal Infirmary to develop an ECG device that would enable primary care clinicians to screen their elderly patients for AF, enabling the timely prescription of anticoagulants and a reduction in the number of AF related strokes.

A recent AF screening project used standard ECG apparatus in GP surgeries and found a very high AF detection rate in older patients. Unfortunately, after the project ended, the uptake and practice of the principles from the project by GPs was very poor, with little or no continuing activity, reflecting the unsuitability of conventional ECG technology for use by GPs. TRUSTECH believe the new device will overcome these issues.

The key elements of the device are a novel electrode interface that is simply held against the patient’s chest, and an algorithm that will enable the automatic diagnosis of AF from the ECG data. The performance of the

electrode interface was proven in 2010 in a TRUSTECH funded study. Subsequently the team have been awarded a £90k grant from NHS South East Coast Strategic Health Authority under the Small Business Research Initiative (SRBI) scheme to develop the diagnostic algorithm and test it on patients attending Manchester Royal Infirmary. The long-term aim is to develop a commercially available device for GPs and other primary care clinicians.

Whilst the patient benefits and NHS cost savings that could be realised from the development of this device are very clear; in order to persuade a company to fund the costs of bringing the product to market, it is also necessary to produce a compelling business case demonstrating the commercial potential of the device. As the technical development activities proceed, TRUSTECH will be commissioning additional activities such as market research with GPs and commissioning bodies, health economics studies and identifying potential routes to market.

TRUSTECH will also be exploring the wider market potential of the device. As the NHS evolves, organisations such as local pharmacies and care homes may undertake screening procedures and could use an AF screening device. Stroke is a major problem in all developed economies particularly in Asian countries such as China and Japan so it is essential to consider the regulatory issues associated with devices for these markets as the development progresses.

The current practice for taking an ECG test involves specialist skills, training and equipment.

TRUSTECH Innovation Management

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Astigmatism is a refractive disorder of the eye where the normally sphere-shaped cornea becomes abnormally curved to resemble a rugby ball shape, which can cause blurred and distorted vision, squinting and headaches.

It is a lifelong condition and the prevalence increases with age. Patients with higher amounts of astigmatism may require contact lenses to achieve good visual acuity.With increasing age most patients will develop cataract, a clouding of the normally clear lens of the eye. The standard treatment for cataract is an operation, in which the cataracteous lens is removed and replaced by a clear monofocal artificial lens implant.Cataract surgery is the most common surgical procedure in the world and one of the most successful healthcare interventions based on outcomes, costs and the resulting improvement to the patient’s quality of life. 314,000 procedures were carried out by the NHS in 2008/09 and 3 million undertaken in the US.Toric lenses, a new type of lens implant, were introduced with the aim of correcting

pre-existing astigmatism at the time of cataract surgery. They have been shown to be safe, effective and reliable. There are two optical components of a Toric lens: a spherical component that corrects short-sightedness or far-sightedness (similar to the monofocal lens), and a toric component that can compensate for corneal astigmatism. The axis of the toric component of the lens and the axis of the corneal astigmatism have to be aligned to provide best compensation. Corneal marks that are placed on the cornea preoperatively support the surgeon during this alignment process.TRUSTECH assisted Bruno Zuberbühler, the Director of Cataract Surgery at the Manchester Royal Eye Hospital, to develop and commercialise a new surgical marking instrument that simplifies and speeds up the placement of Toric lenses.Mr Zuberbühler approached TRUSTECH with his idea in January 2010 and within 12 months the product was

available for sale on a worldwide basis through Malosa Medical, a UK based manufacturer of disposable ophthalmic surgical instruments (www.malosa.com). As part of this process TRUSTECH used the services of the FabLab to manufacture prototype devices. The FabLab (www.fablabmanchester.org.uk) is a new facility in Manchester that enables companies, schools and private individuals to access advanced manufacturing facilities to develop new products and to learn about modern rapid prototyping techniques.TRUSTECH helped Bruno to file a UK patent application for the Toric Marker and to register the design as a European Community registered design.A video outlining the development of this device is available on the TRUSTECH website (video link) and can be seen in use on YouTube (http://www.youtube.com/watch?v=Ak8RPBXT9nk).

Toric marker

In June 2011, Dr Joanne Thomas, Senior Technology Manager at TRUSTECH, along with two inventors, Dr Bin Wang and Dr Mahmoud Chizari, collected the PraxisUnico ‘Collaborative Impact Award’ on behalf of the partnership that helped take GraftBolt®, an implantable orthopaedic device, from sketch to product.

The award recognises collaborative projects that leverage the intellectual assets of the research base of more than one partner. In the case of GraftBolt®, the product was developed from an initial sketch into a commercial product as a result of collaboration between University Hospital of South Manchester NHS Foundation Trust (UHSM), the University of Manchester and its commercialisation agent UMIP, Arthrex Inc and TRUSTECH.

The original concept came from Mr Martyn Snow, who was then an NHS surgeon at UHSM. He recognised the clinical need and sought advice, expertise and funding

from the University of Manchester and TRUSTECH. The funding was used to continue the initial development, feasibility work and testing and to file a patent. TRUSTECH then negotiated a licence with the leading US orthopaedic device company, Arthrex Inc, to develop the device into a commercially viable product.

The last edition of TRUSTECH News reported on how GraftBolt® had been officially launched and was now being used in anterior cruciate ligament (ACL) reconstructive surgery, just five years after the initial development. The device secures an ACL tendon graft to the tibia, and aims to improve the quality of the bonding of the graft to the bone and prevent graft failure post-op. The cost of repairing a failed ACL graft can cost about £3,000 on the NHS, and often 2 operations are required. GraftBolt® could therefore save NHS Trusts up to £6,000 for every ACL revision operation prevented. Joanne said: “The development of

GraftBolt® is an excellent example of how a clinician, academics, a company and an NHS Innovation Hub (TRUSTECH )can work together to develop a new product. The success was due to: good team communication; a robust patent; and a highly motivated commercial partner with excellent market knowledge. It is great to see the product now on sale, improving healthcare and generating royalties for the NHS Trust and the university.”For more details on GraftBolt®, please visit:www.arthrex.com.

GraftBolt® team win Collaborative Impact Award

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Open for Business

Finding innovations to shape the future of care in the NHS

Smart Solutions for Healthcare is a new programme, which was launched by TRUSTECH with the aim of finding companies with new technologies, services or other innovations that could help the NHS make significant improvements in Quality, Innovation, Productivity and Prevention. The programme covers two key priority areas - Cardiovascular Disease and Long Term Conditions.The call for applications ran between January and April 2011 and attracted global attention with website hits from over 60 countries across all continents. A total of 50 full applications were submitted from companies in the UK, Ireland, Germany, the USA, Canada, Israel and India – and these were assessed by a panel of leading clinical and healthcare experts from the North West. The assessment covered: product efficacy, potential clinical impact, level of innovation, cost, and healthcare need. The long list of applications was narrowed down to four winners, which will be evaluated at NHS sites throughout the North West region.

Using retinal imaging to assess cardiovascular risk iGrading CVD software from Medalytix (Liverpool)The government’s Health Check programme offers free screening for those over 40 to detect people at risk of cardiovascular disease, stroke, type 2 diabetes and kidney disease. The current methods of assessment for cardiovascular disease are time- consuming. A doctor’s appointment is required along with a blood test, and factors such as age, gender, blood pressure and weight must all be taken into account.iGrading CVD takes a new approach to assessment of the risk of cardiovascular disease: it is based on a simple retinal photograph which is then analysed using automated algorithms. It offers a non-invasive way to identify those at risk and provides almost instant results. Since the process is automated, it does not require specialist staff to analyse

the results and could even be carried out as part of a routine eye test.Medalytix suggests that the system could cut the costs of the Health Check programme by up to 35% and, as it is quick and does not involve the use of needles, could also increase patient uptake of screening.

For more information see www.medalytix.com

Diagnosing peripheral arterial disease in primary care Padd from Dialog Devices (Loughborough)Peripheral arterial disease (PAD) is a progressive disease and is a high risk indicator for heart disease and stroke. Early diagnosis would enable patients to be treated more effectively through drugs and lifestyle changes and would save the health service money.Currently, in many cases, patients have to be referred to hospital for diagnosis and there is no easy way for GPs to monitor their condition. Padd offers a rapid and simple way to detect and monitor PAD in a primary care setting. The device uses infra-red light to assess blood volume in the foot. Sensors are applied and readings taken before and after raising the leg. The test takes just five minutes and can be carried out by a practice nurse or healthcare assistant. Unlike the ABPI (Ankle Brachial Pressure Index) tests in current use, Padd does not require pressure cuffs and is reliable for use on diabetic patients.

For more details see www.dialogdevices.co.uk

Testing for neuropathy in diabetics The VibraTip® by McCallan Medical (Nottingham)Peripheral neuropathy (nerve damage) in the foot is a well-known complication of diabetes and can result in foot ulcers, loss of tissue and ultimately amputation of limbs. Normally tests to detect neuropathy are carried out using a tuning fork and a monofilament to assess if patients can detect vibrations and touch stimuli.The VibraTip® was designed by Professor Andrew Levy at University Hospitals Bristol to overcome the limitations of tuning forks. It provides a consistent source of vibration at fixed amplitude so results are more reliable and recordable. The VibraTip® is the size of a key fob and costs around £6, so is small and inexpensive enough for nurses or patients to keep in their pocket.The VibraTip® vibrates when squeezed and, unlike a tuning fork, there are no visible or audible cues. It is simple to use and can be easily wiped clean.When patients suffer neuropathy, their ability to protect themselves from injury is impaired. While diagnosis in itself will not prevent ulcers, alerting patients to the problem encourages them to take better care. For more information see www.vibratip.com

Managing sleep apnoea in primary care Sleep studies by Trillian (Cambridge)Sleep apnoea can increase the risk of conditions such as heart attack, stroke and diabetes, but if diagnosed early can be easily treated through lifestyle changes.Currently patients must be referred to a hospital-based sleep centre for diagnosis at a cost of around £750. The Trillian service, already in use in Finland, allows a sleep study to be

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Over the last three years, TRUSTECH has engaged with over 300 companies, leading to over 20 commercial products being made available to the NHS (e.g. Patientrack, Nanopool®, Byotrol™). In addition, a number of innovations originating in the health service have been developed and licenced with TRUSTECH support (e.g. GraftBolt® ACL fixator, VitaloJAK™ Cough Monitor, SAGE & THYME®). TRUSTECH’s track record in engagement between Industry and NHS includes managing a number of regional and national programmes (e.g. Smart Solutions for HCAI, Smart Solutions for Health Care, the MedTECH Centre, the Biobooth project) to help the NHS and commercial sector connect to identify ways in which to drive healthcare forward. The strength of these commercial partnerships and knowledge of the commercial sector has recently led to TRUSTECH working very closely with two Comprehensive Local Research Networks (CLRN) in the North West on projects to increase Industry enagement with the National Institute for Health Research (NIHR) Research Networks. The Greater Manchester Comprehensive Local Research Network (GM CLRN) and TRUSTECH are working together over the course of 2011 to deliver more medical technology studies into the NIHR portfolio adoption process. So far the project has been helping ten studies to: match potential researchers,

design protocols, assist with costing the research and also act as the interface between industry and the NHS. The focus for the project was initially on the following GMCLRN clinical specialty area groups but is now broader and includes many more therapy areas:• Ear, Nose & Throat (ENT) – such as

hearing aids, hearing screening in the community, glaucoma intraocular pressure devices, reflux monitoring devices.

• Endocrine/Diabetes – such as gastric bands/balloons, insulin pumps, glucometers, growth hormone devices.

• Gastrointestinal (GI) – diagnostics, e.g. breath diagnostics.

• Musculoskeletal (MSK) – such as orthopaedic supports, arthritis supports, rehabilitation devices.

Cheshire and Merseyside CLRN (C&M CLRN) will be supported by TRUSTECH over the next six months in a project to inform further development of their action plan for growth of Industry engagement. TRUSTECH will be surveying the current levels of Industry clinical research activity in the NHS across Cheshire and Merseyside, and will provide in-depth analyses of a variety of factors which influence engagement.For more detail on these two projects, please contact Adrian Warner, Business Development Manager, adrian.warner@cmft.nhs.uk

TRUSTECH linking with ComprehensiveLocal Research Networks

carried out in the patient’s own home for just £250 through the use of an electronic monitoring device.Patients collect the device from their GP’s surgery and are shown how to use it. They attach it before bedtime, leave it on overnight and return it to the surgery the next day. The surgery staff then upload the recorded data to the Trillian server, where it is analysed by a consultant who sends back a report to the GP.The service would significantly reduce waiting times at hospital sleep centres. Trillian estimates this approach could save the health service £25 million a year if just half of all sleep tests were undertaken in this way.

For more details see www.trillian-dx.com

Bryan Griffiths, Smart Solutions Programme Director, said: “the Smart Solutions team and TRUSTECH staff are really looking forward to working with these four companies and some North West Trusts to assess whether the selected products and services can help the NHS reduce costs and improve efficiency.” At the time of writing, the team are holding talks with a number of Trusts to identify the most suitable sites for the trials. Smart Solutions for Healthcare is supported by NHS North West, NESTA, Northwest Development Agency, England’s Northwest, Manchester City Council, Manchester: Knowledge Capital, and New Economy through the Innovation Investment Fund Partnership.For full details on the story and to keep up to date with the programme and evaluations, please visit: www.smartsolutionsforhc.co.uk.

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TRUSTECH Initiatives

Improving Swallowing FunctionPhagenesis are a start-up company, spun out from the University of Manchester, that are developing a device to treat acute dysphagia. Through a series of clinical studies Dr Shaheen Hamdy has been developing the first evidence-based treatment for acute dysphagia. The treatment is designed to improve swallowing function quickly, thereby reducing risks to patients, and the cost of care to healthcare providers. Since 2007 Dr Hamdy has been working with Phagenesis to translate the complex neurological mode of action

into a simple and robust device for routine use.The treatment involves the precise delivery of controlled electrical pulses to the nerve clusters linked to the muscle groups involved in swallowing.The stimulation pulses then travel back along nerve pathways to the swallowing control centres in both hemispheres of the brain. This focused stimulation selectively increases brain activity and results in rapid and long-lasting improvements in swallowing function and control.www.phagenesis.com

Meet the ExpertsThe MedTECH Centre regularly holds free 1:1 sessions for companies to meet with a team of experts to discuss whether their product or service has potential benefits in medtech or IT (applied to healthcare). The events allow companies to obtain knowledge in areas such as: access to the NHS market; building a business case; intellectual property; product trials within the NHS; and regulatory requirements.The next surgery is due to take place in September 2011. Places are limited, but if you think your product or service could improve healthcare services please register you interest by emailing: enquiries@medtechcentre.co.uk.

“How do I turn my idea into reality?” It’s a question that TRUSTECH often hears when dealing with aspiring medical technology innovators. The steps in developing a medical device or service innovation are daunting, but finding a suitable base and service that can provide the kind of business support that a small or medium sized enterprise (SME) needs when starting out, would offer a valuable step in the right direction. This was the thinking behind TRUSTECH partnering with Manchester Science Parks (msp) and Central Manchester University Hospitals NHS Foundation Trust (CMFT) to create the MedTECH Centre, a base for medical technology companies setting up in the North West. The MedTECH Centre offers a range of facilities including:• Office and dry-laboratory

accommodation in a dedicated unit near to the University of Manchester and CMFT;

• Hot-desk and rent-a-desk facilities;• Access to msp’s business support

programme.But it’s not just about office space, Centre Manager Paul Hanmer explains, “As important as an address is to a business, equally important is access to expertise. We provide this as part of the package for MedTECH Centre tenants.”

MedTECH Centre clients benefit from business development support including:• Access to NHS and university

facilities and expertise;• Access to manufacturing and design

facilities;• Co-location with Medilink North

West;• Access to free PR and business

development services;• Business networking including free

seminars and workshops;• Support with recruiting students;• Guidance on regulatory approval

processes and clinical trial set-up.“Early stage companies often come up against barriers which can easily be solved with access to the correct information and the right experts” says Paul,

“common difficulties are accessing funding, how to trial a product, understanding how to sell to the NHS or what regulations apply to a particular technology. We’re in a position to help companies overcome those barriers.”Phagenesis Ltd. is a company developing a treatment for dysphagia which has thrived as a MedTECH Centre tenant. A year ago the company leased an office in the centre with two employees. After raising £2million in venture capital funding, the company is now five employees strong with plans to grow to ten and take more space on Manchester Science Park. The MedTECH Centre currently has eight other tenant companies developing a range of technologies which could benefit NHS patients.For more information about The MedTECH Centre call Paul on 0161 820 8440, email enquiries@medtechcentre.co.uk or visit www.medtechcentre.co.uk.

The MedTECH Centre: A new home for medical innovations

Phagenesis: A MedTECH Centre resident

11

On June 9th 2011, TRUSTECH hosted an event at the Nowgen Centre in Manchester called ‘The Biobooth Initiative: Developing Partnerships for the Future’. The event, which marked the official launch of a new long-term project, attracted more than fifty industry and NHS delegates and was the first step towards a collaboration between the NHS and private sector.

The Biobooth Initiative is a collaborative programme, which is sponsored by North West eHealth, NHS North West, the NHS Life Sciences delivery board and TRUSTECH, with partnership from healthcare organisations such as MIMIT, Bionow, NHS Shared Business Services and Medilink North West. The aim of the

initiative is to develop an NHS interconnected outreach platform for clinical diagnosis and monitoring, capable of integrating Point of Care Testing (POCT) technology and telehealth technologies. The goal for the event was to make initial contact with interested companies who may have the solutions to realise these aims.

The Biobooth Initiative includes a series of work streams required for the design, development, implementation and rollout of an automated Biobooth. The outcome will produce a mobile, automated, and publically accessible ‘booth’ that produces excellent quality data that is uploaded in real time to

GP practices, improving patient management, productivity and self management.

Daniel Zamora, Business Development Manager at TRUSTECH and Project Manager for the Biobooth Initiative, commented: “I am really pleased with the way the event went. Feedback from the delegates was very positive and it is great to see that there is some healthy commercial interest in the project. I’m now looking forward to building partnerships with some of these organisations to make improvements on the future of healthcare.”For more information on the Biobooth Initiative, please contact Daniel Zamora:daniel.zamora@cmft.nhs.uk.

TRUSTECH Launches the Biobooth Initiative

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Knowledge Centre

If you have any comments or suggestions for future issues of TRUSTECH News, please contact Carl Peachey, on: T: 0161 901 2524 E: carl.peachey@cmft.nhs.uk

© August 2011, TRUSTECH, Central Manchester University Hospitals NHS Foundation Trust. All rights reserved, not to be reproduced in whole or in part without the permission of the copyright holder.

No one in the NHS can have escaped the enormous restructuring of community services that has occurred over the last few months under ‘Transforming Community Services’.At the time of writing, in the North West, 20 of the 24 PCT community services have transferred to another organisation, either to an acute Trust (vertical integration) or to a Community Foundation Trust (via either a permanent or temporary transfer for 2 years). The transfer of the remaining 4 PCTs is imminent.When a PCT’s provider services are transferred over to a new provider, this is formalised with a Business Transfer Agreement (BTA).The BTA can run to over a hundred pages due to the complexity of the transfer of: staff, services, assets, licensed assets, equipment, information (e.g. health records) and contracts. It may also include the transfer (assignment) of any intellectual property (IP) from the PCT to the new provider organisation. The IP assigned could include: patents, copyright work, designs and trade marks.

To date, we have seen instances where a PCT has decided to transfer IP (registered designs and a registered trade mark) to the new provider organisation; and we have also seen examples where a PCT board has decided that the commissioning arm of the PCT will retain ownership of IP that it believes could have commercial potential (e.g. training course).If the IP transferred to the new provider organisation is associated with any agreements, such as a licence with a company (where the company makes and sells a product in return for paying fees and/or royalties); then unless the licence agreement has transferred to the new organisation as part of the transfer order issued by the Secretary of State, a licence novation agreement will need to be organised.A licence novation is a short agreement that transfers the benefits (e.g. royalties) and obligations (e.g. providing information) of the original licence agreement from the PCT to the new organisation. It is signed by the PCT, the new provider organisation and the company that holds the licence. It severs

the PCT from the licence and makes the new provider organisation the licensor.If you have recently transferred to a new provider organisation and have generated IP during your employment with your PCT, you may wish to check whether the IP has transferred with you under the BTA to your new employer. Your organisation’s legal services department should be able to tell you.And if you are working in a commissioning arm of a PCT and are aware of some IP that the PCT owns which has potential value, consider raising the issue of where this IP will go when the PCT dissolves.TRUSTECH is now working with the PCT cluster groups and new Community Healthcare Trusts to ensure that mechanisms are put in place to provide innovation services at grassroots levels across the region.For further information read the article entitled ‘NHS restructuring and its implication for NHS innovations’ in the April 2011 healthcare news brief produced by Hempsons: http://www.hempsons.co.uk/news/news-briefs/healthcare-news-brief/.

About TKTCThe demand for high standards of patient care within the NHS creates a constant pull for better ways of working, and a tough financial climate means research, technology and innovation are even more vital to improve efficiency.However, the dissemination of good ideas within the NHS is often slow, and sometimes even the best ideas fail to achieve widespread use. ‘Transferring Knowledge; Transforming Care’ brings together leading representatives from the health service, higher education, innovation, research, government and the private sector to discuss, share and develop ideas; identify barriers; and implement solutions. Together we can help create an effective system of innovation adoption across the region and accelerate the positive impact it has on patient care.

Why you should attend‘Transferring Knowledge; Transforming Care’ is the result of a unique collaboration between the three North West HIECs (Merseyside and Cheshire, Lancashire and Cumbria, Greater Manchester).As a result of this collaboration there will be a large number of formal and informal partners from across the public, private and third sector for you to meet when attending this event.Attending the conference will enable you to meet, network, and be part of a discussion with people and organisations who can drive forward improvements in patient care through the liberation of new ideas and innovation.This is your opportunity to hear from key opinion leaders and decision makers, and to ensure your ideas and views

influence the health, innovation and education agenda.What are HIECs?HIECs (Health Innovation and Education Clusters) are partnerships between NHS organisations, the higher education sector, industry and other public and private sector organisations.The HIECs’ mission is to enable high quality patient care and services by quickly bringing the benefits of best practice, research and innovation directly to front line staff.For full details on the event, including speakers, sessions, schedule and how to book a place, please visit: www.hiecsnorthwest.org.uk

IP issues associated with Transforming Community Services

Transferring Knowledge; Transforming Care 13-14th October 2011 at Kilhey Court Hotel, Wigan