CADEMIA NHS COLLABORATION NHS ACADEMIA NHS COLLABORATION NHS INDUSTRY NHS COLLABORATION NHS ACAD NHS COLLABORATION NHS ACADEMIA NHS COLLABORATION NHS INDUSTRY NHS COLLABORATION NHS ACADEMIA NH OLLABORATION NHS ACADEMIA NHS COLLABORATION NHS INDUSTRY NHS COLLABORATION NHS ACADEMIA NHS COLL RATION NHS ACADEMIA NHS COLLABORATION NHS INDUSTRY NHS COLLABORATION NHS ACADEMIA NHS COLLABORAT HS ACADEMIA NHS COLLABORATION NHS INDUSTRY NHS COLLABORATION NHS ACADEMIA NHS COLLABORATION NHS CADEMIA NHS COLLABORATION NHS INDUSTRY NHS COLLABORATION NHS ACADEMIA NHS COLLABORATION NHS ACAD NHS COLLABORATION NHS INDUSTRY NHS COLLABORATION NHS ACADEMIA NHS COLLABORATION NHS ACADEMIA NH OLLABORATION NHS INDUSTRY NHS COLLABORATION NHS ACADEMIA NHS COLLABORATION NHS ACADEMIA NHS COLL RATION NHS INDUSTRY NHS COLLABORATION NHS ACADEMIA NHS COLLABORATION NHS ACADEMIA NHS COLLABORAT HS INDUSTRY NHS COLLABORATION NHS ACADEMIA NHS COLLABORATION NHS ACADEMIA NHS COLLABORATION NHS DUSTRY NHS COLLABORATION NHS ACADEMIA NHS COLLABORATION NHS ACADEMIA NHS COLLABORATION NHS INDU HS COLLABORATION NHS ACADEMIA NHS COLLABORATION NHS ACADEMIA NHS COLLABORATION NHS INDUSTRY NHS THE SHOWCASE MAGAZINE FOR WELSH LIFE SCIENCE 2018 OLLABORATION NHS ACADEMIA NHS COLLABORATION NHS ACADEMIA NHS COLLABORATION NHS INDUSTRY NHS COLL RATION NHS ACADEMIA NHS COLLABORATION NHS ACADEMIA NHS COLLABORATION NHS INDUSTRY NHS COLLABORAT HS ACADEMIA NHS COLLABORATION NHS ACADEMIA NHS COLLABORATION NHS INDUSTRY NHS COLLABORATION NHS CADEMIA NHS COLLABORATION NHS ACADEMIA NHS COLLABORATION NHS INDUSTRY NHS COLLABORATION NHS ACAD NHS COLLABORATION NHS ACADEMIA NHS COLLABORATION NHS INDUSTRY NHS COLLABORATION NHS ACADEMIA NH OLLABORATION NHS ACADEMIA NHS COLLABORATION NHS INDUSTRY NHS COLLABORATION NHS ACADEMIA NHS COLL RATION NHS ACADEMIA NHS COLLABORATION NHS INDUSTRY NHS COLLABORATION NHS ACADEMIA NHS COLLABORAT HS ACADEMIA NHS COLLABORATION NHS INDUSTRY NHS COLLABORATION NHS ACADEMIA NHS COLLABORATION NHS CADEMIA NHS COLLABORATION NHS INDUSTRY NHS COLLABORATION NHS ACADEMIA NHS COLLABORATION NHS ACAD NHS COLLABORATION NHS INDUSTRY NHS COLLABORATION NHS ACADEMIA NHS COLLABORATION NHS ACADEMIA NH OLLABORATION NHS INDUSTRY NHS COLLABORATION NHS ACADEMIA NHS COLLABORATION NHS ACADEMIA NHS COLL RATION NHS INDUSTRY NHS COLLABORATION NHS ACADEMIA NHS COLLABORATION NHS ACADEMIA NHS COLLABORAT HS INDUSTRY NHS COLLABORATION NHS ACADEMIA NHS COLLABORATION NHS ACADEMIA NHS COLLABORATION NHS DUSTRY NHS COLLABORATION NHS ACADEMIA NHS COLLABORATION NHS ACADEMIA NHS COLLABORATION NHS INDU HS COLLABORATION NHS ACADEMIA NHS COLLABORATION NHS ACADEMIA NHS COLLABORATION NHS INDUSTRY NHS OLLABORATION NHS ACADEMIA NHS COLLABORATION NHS ACADEMIA NHS COLLABORATION NHS INDUSTRY NHS COLL RATION NHS ACADEMIA NHS COLLABORATION NHS ACADEMIA NHS COLLABORATION NHS INDUSTRY NHS COLLABORAT HS ACADEMIA NHS COLLABORATION NHS ACADEMIA NHS COLLABORATION NHS INDUSTRY NHS COLLABORATION NHS CADEMIA NHS COLLABORATION NHS ACADEMIA NHS COLLABORATION NHS INDUSTRY NHS COLLABORATION NHS ACAD NHS COLLABORATION NHS ACADEMIA NHS COLLABORATION NHS INDUSTRY NHS COLLABORATION NHS ACADEMIA NH OLLABORATION NHS ACADEMIA NHS COLLABORATION NHS INDUSTRY NHS COLLABORATION NHS ACADEMIA NHS COLL RATION NHS ACADEMIA NHS COLLABORATION NHS INDUSTRY NHS COLLABORATION NHS ACADEMIA NHS COLLABORAT HS ACADEMIA NHS COLLABORATION NHS INDUSTRY NHS COLLABORATION NHS ACADEMIA NHS COLLABORATION NHS CADEMIA NHS COLLABORATION NHS INDUSTRY NHS COLLABORATION NHS ACADEMIA NHS COLLABORATION NHS ACAD NHS COLLABORATION NHS INDUSTRY NHS COLLABORATION NHS ACADEMIA NHS COLLABORATION NHS ACADEMIA NH OLLABORATION NHS INDUSTRY NHS COLLABORATION NHS ACADEMIA NHS COLLABORATION NHS ACADEMIA NHS COLL RATION NHS INDUSTRY NHS COLLABORATION NHS ACADEMIA NHS COLLABORATION NHS ACADEMIA NHS COLLABORAT HS INDUSTRY NHS COLLABORATION NHS ACADEMIA NHS COLLABORATION NHS ACADEMIA NHS COLLABORATION NHS DUSTRY NHS COLLABORATION NHS ACADEMIA NHS COLLABORATION NHS ACADEMIA NHS COLLABORATION NHS INDU HS COLLABORATION NHS ACADEMIA NHS COLLABORATION NHS ACADEMIA NHS COLLABORATION NHS INDUSTRY NHS OLLABORATION NHS ACADEMIA NHS COLLABORATION NHS ACADEMIA NHS COLLABORATION NHS INDUSTRY NHS COLL RATION NHS ACADEMIA NHS COLLABORATION NHS ACADEMIA NHS COLLABORATION NHS INDUSTRY NHS COLLABORAT HS ACADEMIA NHS COLLABORATION NHS ACADEMIA NHS COLLABORATION NHS INDUSTRY NHS COLLABORATION NHS CADEMIA NHS COLLABORATION NHS ACADEMIA NHS COLLABORATION NHS INDUSTRY NHS COLLABORATION NHS ACAD NHS COLLABORATION NHS ACADEMIA NHS COLLABORATION NHS INDUSTRY NHS COLLABORATION NHS ACADEMIA NH NHS Wales The Efficiency Advances andCOLL OLLABORATION NHS ACADEMIA NHS COLLABORATION NHS INDUSTRY NHS COLLABORATION NHS ACADEMIA NHS innovation and through achievements RATION NHS ACADEMIA NHS COLLABORATION NHS INDUSTRY NHS COLLABORATION NHS ACADEMIA NHS COLLABORAT successful Technology in the Welsh HS ACADEMIA NHS COLLABORATION NHS INDUSTRY NHS COLLABORATION NHS ACADEMIA NHS
Creative innovation in life science and NHS Wales collaborations
programme
life science industry
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S H O W C A S I N G
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A D VA N C E S
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Contents
SHOWCASING ADVANCES IN WELSH LIFESCIENCE
Innovation and collaboration in NHS Wales
The Efficiency through Technology Programme
Innovation in the Welsh life science industry
6 Improving detection of atrial fibrillation for
22 Efficiency through Technology
38 How a symbiotic relationship can deliver
7 Health monitoring in space provides
24 A cute solution to acute anxiety
41 Fighting persistent bacterial infections in
stroke prevention
in dementia
inspiration for the NHS
8 Collaborations fuel diabetes research and trials
wellbeing
9 Transforming lives with virtual pulmonary rehabilitation
10 Innovative machine recycles hospital waste 11 Digital system improves medication ordering process in care homes
25 Haematology database for
42 Quadruple success in design awards 42 Overseas investment secured to support
26 AgorIP: bringing innovation to
43 Toasting export success of mid-Wales
life
43 Clinical trial contract services come to Rhymney Valley
44 Connected pressure care systems bring array
29 Digital Health Ecosystem
Wales – tasked with increasing digital takeup
advanced medical therapies to Wales
12 Unique collaboration leads to use of
30 Working together to reduce
mathematical modelling in healthcare
infection
testing of gastrointestinal infections
programmes via Skype
15 VR and AI technologies changing the experience of cancer treatment
16 Electronic results and documents available clinicians
17 Capturing patient feedback electronically 18 New research focus on the role of communications in healthcare improvement
34 National e-learning platform
20 Evaluating use of a novel point of care test
36 Community mobilisation project
for urinary tract infections
LifeStories is produced and published by Teamworks for MediWales. www.teamworksdesign.com
25 YEARS AT THE HEART OF WELSH LIFE SCIENCE
1st Floor, The Bonded Warehouse, Cardiff CF10 4HF Tel: +44 (0)29 2047 3456 Web: www.mediwales.com
47 Pharmaceutical giant chooses UK’s first Diabetes Centre of Excellence
48 Crossing borders to get patient voices heard 48 Diagnostic company spots business 49 Technology facility demonstrates focus on quality
accurate heart attack diagnosis
19 Improving cancer awareness in
brain researchers
incubation opportunity
developed for NHS Wales
35 New defibrillators for more
45 Wrexham health tech pioneers win top prize 46 Leading neurotech company supports future quality
collaborations transform services in Wales and deliver five-fold return on investment
17 TALK to improve communication between
Clarity
46 Technology facility demonstrates focus on
32 Health technology
nationally in the Welsh clinical portal
44 Data integrity guidelines result in a need for community
31 Using molecular methods for
14 Delivering condition management
of benefits
45 Antibodies: the workhorse of the life sciences
harm from postpartum haemorrhage
13 Game of Stools trains staff to prevent
business growth
company
28 Health Technology Wales
12 Multi-million pound award brings
disadvantaged communities
slow-to-heal wounds
Wales
8 Gardening on prescription to boost
commercial success
49 Award and investment for social prescription technology company
50 Developing novel antimicrobial air sampling technology
50 Funding boost for jellyfish collagen
Editor, Sophie Davies sophie.davies@mediwales.com
Gwyn Tudor, CEO: gwyn.tudor@mediwales.com Debbie Laubach, Operations Manager: debbie.laubach@mediwales.com
Isabelle Ford, Events and Engagement Manager: isabelle.ford@mediwales.com Sophie Davies, Publications: sophie.davies@mediwales.com
Thank you to our Corporate Sponsors and University Partners
SUPPORTED BY WELSH GOVERNMENT
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Introduction
Welcome to the third edition of MediWales Lifestories – the publication dedicated to sharing success stories from the Welsh life science sector and NHS Wales.
What is MediWales?
This edition of MediWales Lifestories has been published to coincide with MediWales Connects 2018 on 20th June. The only event of its kind for the health and care community, MediWales Connects is the all Wales NHS collaboration conference. Now in its third year, this conference aims to highlight and showcase the excellent work being carried out by the health and care communities in Wales; improve collaborative working between the health boards, industry and research communities; raise the profile of NHS Wales and clinical innovation across the UK; and support closer working relationships between industry, NHS and research groups.
We encourage collaboration through our publications and a popular programme of events that focus on strategic issues for the life science sector, including regulatory updates, market access, finance and funding, clinical unmet needs, international trade and a range of special interest groups.
MediWales Lifestories is divided into three sections: Firstly, Innovation and collaboration in NHS Wales explores successful projects undertaken by NHS Health Boards and Trusts across Wales. Many of these projects involved collaboration between NHS Wales and companies, academic institutions, research organisations, charities and more. Stories include using a handheld electronic device for better detection of atrial
fibrillation, introducing a first-of-its-kind recycling machine for hospital waste, applying a device designed for astronauts to elderly patients, and deploying VR and AI technologies to change how patients experience cancer treatment. The second/middle section of the publication highlights projects funded by the Efficiency through Technology Programme, which is run by the Technology, Innovation and Strategy Team within the Welsh Government’s Health and Social Services Group. This ongoing programme has provided funding and support for a wide range of projects to accelerate NHS adoption of new products and services. Featured in this section are AgorIP, the Bevan Commission’s Health Technology Exemplars scheme and the recently launched Health Technology Wales, in addition to stories about groundbreaking projects undertaken within NHS Wales.
We support over 180 members from the medical technology, diagnostic and pharmaceutical industries, NHS health boards, university departments and professional services and suppliers.
Annual highlights in our calendar include the MediWales Connects conference and the MediWales Innovation Awards.
Finally, Innovation in the Welsh life science industry includes success
stories from Welsh companies across medical technology, biotechnology, diagnostics, digital health, medical device design and more.
MediWales Connects sector representation
300 AT T E N D E E S
4
58%
33%
9%
CLINICAL
INDUSTRY
POLICY / GOVERNMENT
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Innovation and collaboration in NHS Wales 5
S H O W
Innovation and collaboration in NHS Wales
Bwrdd Iechyd Prifysgol Abertawe Bro Morgannwg University Health Board
Bwrdd Iechyd Prifysgol Caerdydd a’r Fro Cardiff and Vale University Health Board
Improving detection of atrial fibrillation for stroke prevention Bwrdd Iechyd Prifysgol Aneurin Bevan University Health Board
Bwrdd Iechyd Prifysgol Cwm Taf University Health Board
Bwrdd Iechyd Prifysgol
Bwrdd Iechyd Prifysgol Hywel Dda University Health Board
Betsi is Cadwaladr Atrial fibrillation (AF) a common heart University Health Board rhythm disorder which can cause blood clots to form in the heart, increasing the risk of stroke. This risk can be reduced with anticoagulantBwrdd medication, but Iechyd Addysgu Powys around 25 per cent of AF-related strokes Powys Teaching occur before AF has been detected and Health Board diagnosed.
Abertawe Bro Morgannwg University Ymddiriedolaeth Health Board (ABMUHB) undertook a GIG Felindre Velindre NHS Tust single centre, 1000-patient randomised controlled trial of AF screening for stroke prevention. The trial was based in ABMUHB/Swansea University’s Joint Clinical Research Facility and received a collaborative Health Technology and Telehealth grant, co-funded by the Welsh Government and AliveCor Inc. The study, led by Professor Julian Halcox and Kathie Wareham, Director of the Joint Clinical Research Facility, investigated whether regular ECG monitoring by patients using a handheld electronic device, AliveCor Kardia Mobile, would result in better detection of AF than routine care. ECGs were uploaded over a secure internet server and reported remotely, with patients notified and reviewed as clinically indicated. Patients over the age of 65, with one or more additional stroke risk factors, were recruited for the trial.
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Just under two per cent of the patients screened for the trial were found to have AF at their Iechyd Cyhoeddus screening visit, unbeknownst to Cymru them or theirPublic GP.Health Over the course of the study,Wales it was found that the likelihood of AF diagnosis increased approximately fourfold Ymddiriedolaeth GIG Gwasanaethau Cymru with twice-weekly ECGAmbiwlans recordings Welsh Ambulance Services compared toNHS routine care. A Trust patient experience survey also showed that patients undergoing regular screening were generally happy with the process and felt less anxious about their heart rhythm than routine care patients.
The results of the study demonstrate that this new approach has the potential to increase detection of AF and therefore reduce the number of AF-related strokes. Following the successful study, two spinoff clinical initiatives have commenced. One is evaluating the use of AliveCor Kardia Mobile to increase the detection of intermittent AF in stroke patients where a cause cannot be readily identified, leading to implementation of effective antithrombotic treatment. Another is exploring the use of AliveCor Kardia Mobile for diagnosis and management of patients with suspected and confirmed arrhythmia by the acute community medical team in Cimla. This could reduce the need for hospital admission and for more costly and inconvenient 12-lead and ambulatory ECG monitoring in elderly patients. Professor Halcox has now been funded by Bristol Myers Squibb to lead a community pharmacybased AF screening project to be conducted with the AliveCor Kardia Mobile. He is also working with a UK network of pharmacy colleagues to develop community pharmacies as prudent locations for AF screening.
fysgol organnwg h Board
fysgol
h Board
fysgol
h Board
t
Bwrdd Iechyd Prifysgol Caerdydd a’r Fro Cardiff and Vale University Health Board
Bwrdd Iechyd Prifysgol Cwm Taf University Health Board
Health monitoring in space provides inspiration for the NHS Bwrdd Iechyd Prifysgol Hywel Dda University Health Board
Iechyd Cyhoeddus
Cymru Research being undertaken by a Public Healthusing a clinician in Merthyr Tydfil, Wales device pioneered by the European Space Agency, could potentially help to reduce falls in elderly patients and detect Ymddiriedolaeth GIG tendon injuries inGwasanaethau athletes inAmbiwlans Cwm TafCymru Ambulance Services University HealthWelsh Board. NHS Trust
Gafin Morgan, an advanced podiatrist at Prince Charles Hospital who specialises in foot and ankle injuries, is carrying out the world’s first piece of research into whether a hand-held device called a Myoton, which is currently used to measure muscle loss in astronauts, could benefit the wider population. He believes the device could provide valuable early indicators of muscle and tendon loss in elderly patients, which could reduce the risk of falling. It could also potentially be used to detect problems with tendons in athletes. Maintaining muscle strength in space is very difficult, as there is no gravity, so the muscle and tendon strength of all astronauts is monitored carefully. Measurements of calf muscles before and after a mission on the International Space Station show that even when crew members carry out resistance exercises daily, muscle volume still decreases significantly. The Myoton device was obtained by Gafin, who has worked in Cwm Taf for more than 20 years, through connecting with university researchers in Germany and Estonia who share an interest in lower limb injuries. He has since conducted research into the impact of early measurements on 50 local patients with Achilles tendon problems and hopes to build on the results by researching the impact on elderly patients in particular. Gafin said: “If the device can detect early onset muscle loss in astronauts, then why not in our elderly patients? If we can treat some of the problems early to make patients stronger and more stable,
it could have a significant impact on falls and the implications of fall injuries. I am very excited about the real benefits the research could bring to frontline care.” Day to day, Gafin’s role in Cwm Taf involves treating patients who have foot or ankle injuries and identifying patients who may be able to be treated without invasive surgery. His approach to the management of Achilles tendon ruptures with a specialist rehabilitation boot has resulted in better outcomes for patients, saving the health board more than £250,000 a year through avoiding unnecessary surgery and hospital stays.
“It’s all about prudent healthcare and doing everything we can do first before opting for surgery, which often brings its own problems such as risk of infection and potential nerve damage. By working together with GPs and their primary care teams and with hospital colleagues, we can now assess and treat more patients conservatively without surgery, which is far better for the patient in the long term.” Gafin Morgan Advanced podiatrist Prince Charles Hospital
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Innovation and collaboration in NHS Wales
Bwrdd Iechyd Prifysgol Abertawe Bro Morgannwg University Health Board
Bwrdd Iechyd Prifysgol Caerdydd a’r Fro Cardiff and Vale University Health Board
Collaborations fuel diabetes research and trials Bwrdd Iechyd Prifysgol Aneurin Bevan University Health Board
Over the past ten years, through collaboration between Abertawe Bro Bwrdd Iechyd Prifysgol Morgannwg University Health Board Betsi Cadwaladr Health Board (ABMUHB) andUniversity Swansea University, the Diabetes Group has become a leading centre for collaborative clinical trials with industry. Bwrdd Iechyd Addysgu Powys
The Group has built strong partnerships Powys Teaching Health Boardcompanies with major pharmaceutical such as Astra Zeneca, BoehringerIngelheim, BMS, Eli Lilly, Novo Nordisk, Pfizer, Sanofi-Aventis Ymddiriedolaeth and Felindre Takeda, as well asGIG with small and Velindre NHS Tust medium enterprises producing diabetes management devices such as Cellnovo (Wales), EKF (Wales), CeQur Bwrdd Iechyd Prifysgol Caerdydd a’r Fro (Switzerland), Genmedica (Spain),
gol gannwg oard
Cardiff and Vale University Health Board
gol
Bwrdd Iechyd Prifysgol Cwm Taf University Health Board
Menarini (Italy), Mendor (Finland), Diartis (USA) and Senseonics (USA).
glucose sensor, in which the first UK patient was recruited in Swansea.
Recognised as the Group is frequently approached by companies looking for expertise in the development of therapies and devices Iechyd Cyhoeddus for diabetes treatment and in the design Cymru and conduct of early phase (proof-ofPublic Health concept) clinicalWales trials. The Joint Clinical Research Facility in Swansea University’s ILS2 is gaining widespread recognition Ymddiriedolaeth GIG as a site for evaluation of novel diabetes Gwasanaethau Ambiwlans Cymru therapies and medical devices.Services The Group Welsh Ambulance NHS Trust is also an established centre for testing blood glucose monitors to international standards (ISO15197) and has recently completed a study of an implantable
Following research and trials, several diabetes therapies have been translated to routine clinical use within the UK and worldwide, and are now part of the standard treatment guidelines. The Group’s work has been published in high-ranking medical journals and has directly led to improved care and a wider array of diabetes therapy options for patients.
Bwrdd Iechyd Prifysgol Hywel Dda aUniversity centre of excellence, Health Board
As a result of this work, the Diabetes Group won the award for NHS Collaboration with Industry at the 2017 MediWales Innovation Awards.
Bwrdd Iechyd Prifysgol Cwm Taf University Health Board
oard
Gardening on prescription to boost wellbeing
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Bwrdd Iechyd Prifysgol Hywel Dda University Health Board
oard
A new social prescribing project at Iechyd Cyhoeddus Cwm Taf University Health Board is Cymru offering gardeningPublic on prescription Health Wales to patients in the Rhondda to help improve their wellbeing. Rachel Bennett, a GP at Forest View Ymddiriedolaeth GIG Ambiwlans Cymru Medical Centre inGwasanaethau Treorchy, came Welsh Ambulance Services up with the idea ofNHS Grow Trust Rhondda, a therapeutic gardening group for patients presenting with mild anxiety, low mood, low self-esteem or social isolation. Patients can now be referred by their GP to the eight-week gardening programme, which is based at Ysbyty George Thomas in Treorchy. The project is a joint venture between Rhondda primary care, Ysbyty George Thomas and the community group
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“I think the benefit you will get from any gardening project is the fact you are outside. You can share that experience with other people and enjoy the aspect of the garden through the changes in the seasons, what you can plan or plant. Within a few weeks you have something growing and that’s a rewarding experience.“ Dave Harris Treorchy Men’s Sheds
Men’s Sheds, who are delivering the sessions to cultivate courtyard gardens at the hospital. Men’s Sheds were first developed in Australia to help combat male isolation and have spread to the UK and Ireland, with 32 ‘sheds’ now in Wales. The programme at Cwm Taf is open to both men and women.
Grow Rhondda was officially launched by the Chair of Cwm Taf University Health Board, Marcus Longley, who commented: “The health board is committed to improving the health and wellbeing of the people we serve. This is exactly the sort of thing we need to support in practice. It is a tremendous initiative and I hope to see similar projects grow across the health board area.”
ysgol
Board
ysgol
Board
Bwrdd Iechyd Prifysgol Cwm Taf University Health Board
Bwrdd Iechyd Prifysgol Hywel Dda University Health Board
Transforming lives with virtual pulmonary rehabilitation Iechyd Cyhoeddus Cymru Public Health Wales
Ymddiriedolaeth GIG
There are more than 57,500 Ambiwlans people inCymru Gwasanaethau Ambulance Services Wales living withWelsh Chronic Obstructive NHS Trust Pulmonary Disease (COPD). The National Institute of Clinical Excellence (NICE) recommends pulmonary rehabilitation (PR), a multidisciplinary disease management programme, to all COPD patients who are still breathless despite optimal medication. The Welsh Government also has an expectation that all eligible respiratory patients are offered PR as part of their healthcare pathway. However, Hywel Dda PR struggles with rural service provision. It does not exist at all in Ceredigion, is provided ad hoc in Pembrokeshire, and the service in Carmarthenshire now has an 8-12 month waiting list, due to loss of key staff and increasing demand. This has resulted in only 31 per cent of eligible patients being referred to PR in Hywel Dda, which is the lowest level in Wales.
Through investment from the Respiratory Health Implementation Group (RHIG) and by working in partnership with Comcen and Polycom, the Hywel Dda PR team have developed an innovative model of delivery, using video-conferencing to link a hub site, based at Glangwili General Hospital, to a spoke site, based in Tregaron Hall. This model has the ability to address staffing and rurality issues, in addition to increasing the number of patients being offered PR.
At the hub site, there is a specialist band 7 Physiotherapist and Occupational Therapist, with a band 3 tech support, for ten patients per programme. The
spoke site is staffed with a band 4 tech and a band 6 respiratory nurse, for eight patients per programme. However, the team are developing band 4 roles for support in the spoke sites, thus further reducing staff costs. The aim of this model, which has been named VIPAR (VIrtual PulmonAry Rehabilitation), is to add up to another three spoke sites which will link simultaneously to the hub. These spoke sites will be located throughout Hywel Dda to provide patients in need of PR access to the service, without a 30-50 mile journey, twice a week for seven weeks. However, maintaining the high standards of patient safety and benefit throughout PR is paramount. Therefore, the team are assessing a broad range of outcomes after the addition of each spoke site.
Analysis of the one hub-one spoke model has shown no differences between patients at either site in PR attendance rates, adverse events, or patient health outcomes. Both groups of patients received significant beneficial outcomes from the PR programme. From these results, the team have concluded that the model is feasible, safe, and effective. In addition to the positive patient outcomes, VIPAR also has the ability to reduce programme costs. Focus groups conducted with spoke patients have shown the positive impact of the programme: “I breathe better and I’ve got more confidence. I can do things now that I haven’t done for four or five years. I used to have a horse and go riding. Last Sunday was the first I’ve been on a horse for four years and I did four and a half miles”.
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Bwrdd Iechyd Prifysgol Abertawe Bro Morgannwg University Health Board
Bwrdd Iechyd Prifysgol Caerdydd a’r Fro
Innovation and collaboration in NHS Wales Cardiff and Vale
Bwrdd Iechyd Prifysgol Aneurin Bevan University Health Board
University Health Board
Bwrdd Iechyd Prifysgol Cwm Taf University Health Board
Innovative machine recycles hospital waste Bwrdd Iechyd Prifysgol Betsi Cadwaladr University Health Board
Bwrdd Iechyd Prifysgol Hywel Dda University Health Board
Bwrdd Iechyd Addysgu Powys
Iechyd Cyhoeddus Cymru
Plastic is a problem. Many different Powys Teaching Health Board types of plastics are used within the NHS and some of them, due to the locations in which they’re used, are difficult to recycle.Ymddiriedolaeth But what can the NHS do about it? GIG Felindre Velindre NHS Tust
“ It’s not something that we can tackle on our own. There needs to be private/public sector partnership to solve this, combining private sector innovation and investment with public sector support and knowledge. In short, we have to learn to take a chance, be innovative, look for creative solutions, trust external parties and maybe be a little less risk adverse.” Chris Davies Waste & Environmental Manager Aneurin Bevan University Health Board
Aneurin Bevan University Health Board has been working with Cardiff-based company Thermal Compaction Group (TCG) on a ‘backdoor’ innovation project to find a solution for the difficult plastic waste that is generated in all hospitals in the UK and around the world. By implementing TCG’s Sterimelt machine, the cost of waste disposal or incineration is removed and replaced with revenue, which can only have a positive impact on the NHS and on patient care. The Sterimelt machine converts clinical sterilisation wrap, used in operating theatres, into solid blocks of polypropylene plastic. These blocks have good commercial value and TCG buys them back from the NHS. Through a joint venture company the blocks are granulated, compounded and extruded into pellets and 3D filament. The pellets can be made into any new plastic items and the 3D filament can be used to
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Public Health Wales
Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru Welsh Ambulance Services NHS Trust
3D print items such as exoskeletal plaster casts or more mundane items like cups or kidney bowls. This is the circular economy in practice, taking single-use disposable plastic waste found in the NHS and returning it to the UK supply chain for use in new products. Sterimelt’s process aligns itself with the UK Government’s ‘Pledge4Plastics’, which aims to make plastics recyclable, re-usable or compostable by 2025. Already supported by the UK’s major supermarkets and 40 top UK companies, the NHS could be the first public sector entity to be part of ‘Pledge4Plastics’. In recent months, single-use plastics in the NHS other than clinical sterilisation wrap have been identified as suitable for the Sterimelt process.
Aneurin Bevan University Health Board now processes approximately 3 tonnes of wrap per month in the Sterimelt, diverting it away from the financially and environmentally costly clinical waste stream whilst receiving revenue for the plastic blocks. By thermally densifying the waste at source by 85 per cent, the new process also significantly reduces transportation costs, which has a positive environmental impact. Given the carbon footprint of incinerators globally, the diversion from using this method of disposal has a carbon footprint reduction of nearly 75 times. Burton NHS Foundation Trust has now purchased the second Sterimelt and installed it in Queen’s Hospital, Burton on Trent.
The world’s first Sterimelt machine was installed at Aneurin Bevan University Health Board, initially receiving wrap from the Hospital Sterilisation and Disinfection Unit at Royal Gwent Hospital, Newport. This was the beginning of a public/private sector collaboration whereby TCG and the health board collaborated to refine the process, resolve issues of behavioural change and upscale the initiative. The project was selected as a Bevan Commission Technology Exemplar and was the winner of the Innovation category at the NHS Sustainability Awards 2017.
The Government’s chief medical adviser, Prof Dame Sally C Davies, called the NHS a “significant polluter” after her annual report revealed that the health service creates 590,000 tonnes of waste a year, which is more than the entire municipal waste from some European countries like Cyprus and Luxembourg. She commented: “Everybody has a role to play in cutting pollution, but the NHS has more than a million staff, accounts for one in 20 vehicles on the road and is a big user of single-use disposable plastics.” Sterimelt begins to address the issue of plastic for the UK’s biggest employer.
Bwrdd Iechyd Prifysgol Abertawe Bro Morgannwg University Health Board
Bwrdd Iechyd Prifysgol Aneurin Bevan University Health Board
Bwrdd Iechyd Prifysgol Caerdydd a’r Fro Cardiff and Vale University Health Board
Bwrdd Iechyd Prifysgol Cwm Taf University Health Board
Digital system improves medication ordering process in care homes Bwrdd Iechyd Prifysgol Betsi Cadwaladr University Health Board
Bwrdd Iechyd Addysgu Powys
Aneurin Bevan University Health Powys Teaching Health‘My Board Board has introduced Health Online’ in five Blaenau Gwent care homes, with one control home, to improve the efficiency of repeat Ymddiriedolaeth GIG Felindre prescription medications ordering and NHS Tust reduce medicationVelindre waste.
Bwrdd Iechyd Prifysgol Hywel Dda University Health Board
Iechyd Cyhoeddus Cymru
Limiting over-ordering means that care Public Health Wales home residents only have the medication that they currently require. This reduces the risk of residents receiving medication Ymddiriedolaeth GIG that they were not prescribed or do Gwasanaethau Ambiwlans Cymru not require and therefore reduces the Welsh Ambulance Services NHS Trust possibility of medication errors and
adverse events. The care homes using My Health Online have seen a substantial reduction in the requesting of repeat prescriptions at short notice in comparison to the control unit – from five requests per week to one per week.
My Health Online makes the process of ordering medication for care homes more efficient and therefore saves staff time. Staff have said that ordering prescriptions with My Health Online takes just one hour compared to ordering by paper, which typically takes three hours. Consequently, two hours that are usually used for ordering prescriptions are freed up, giving the care home staff more time to focus on care for residents rather than administrative duties.
The risk of residents receiving the wrong medication is also reduced through making the process more efficient. This means that fewer medication errors should occur, limiting the number of avoidable visits from the GP or hospital admissions. A clear audit trail via My Health Online ensures that if any errors do occur, the time taken to investigate and correct them is significantly reduced. As a result of this initial project, waste was found to have reduced by 65 per cent and Aneurin Bevan University Health Board are now planning to upscale the project across the health board.
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Innovation and collaboration in NHS Wales
Multi-million pound award brings advanced medical therapies to Wales A health consortium, jointly led by the Welsh Blood Service (on behalf of NHS Wales) and the NIHR Birmingham Biomedical Research Centre, has been awarded £7.3 million of UK Government funding to ensure more patients benefit from a new generation of breakthrough therapies. £1.5 million will go directly to NHS Wales and £550k to Trakcel, a Welsh company developing scheduling/tracking software for advanced therapies, based on technology developed at Swansea University. The funding will support the Welsh Bwrdd Iechyd Prifysgol Abertawe Broto Morgannwg Government’s commitment developing University Health Board
Bwrdd Iechyd Prifysgol Aneurin Bevan University Health Board
an Advanced Therapies Strategy which will enable these therapies to be brought to Welsh patients and Advanced Therapy Medicinal Product (ATMP) companies to reach the clinical market, whilst building expertise, capability and capacity across NHS Wales to benefit patient outcomes. Cath O’Brien, Director of the Welsh Blood Service and Co-Director of the Midlands & Wales Advanced Therapy Treatment Centre, said: “A significant opportunity exists to position Wales as a leader in clinical trial and routine delivery of cell and gene therapies to maximise Bwrdd Iechyd Prifysgol Welsh patient benefit and opportunities Caerdydd a’r Fro for the national economy. The Welsh Cardiff and Vale University Health Board
Government is committed to exploring these revolutionary developments in healthcare and we are excited to have worked alongside consortium partners to secure funding through what was a highly competitive tendering process.” As part of the contract award, the first advanced therapy treatment sites in Wales will be established in Abertawe Bro Morgannwg and Cardiff & Vale University Health Boards. The focus of the centres will be to develop the infrastructure, processes and skilled workforce required to enable patients to be cared for, from diagnosis through to post-treatment follow-up.
Bwrdd Iechyd Prifysgol Cwm Taf University Health Board
Unique collaboration leads to use of mathematical modelling in healthcare Bwrdd Iechyd Prifysgol Betsi Cadwaladr University Health Board
For the last five years, postgraduate masters studentsBwrdd fromIechyd Cardiff Addysgu Powys University’s Department of Powys Teaching Health Board Mathematics have been working with the Aneurin Bevan Continuous Improvement (ABCi) centre, based in Aneurin BevanYmddiriedolaeth University Health GIGreal-world Felindre Board, to complete Velindre NHS Tust dissertation projects, based on challenges currently facing healthcare.
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Bwrdd Iechyd Prifysgol Hywel Dda University Health Board
of additional pharmacy and therapies Iechyd Cyhoeddus staff in the emergency department. Cymru
In 2017, for the first time, they were also joined by four members of health board staff who had chosen to undertake an ABCi modelling fellowship.
Health It also included aPublic focus on modelling Wales optimal nursing ratios for pressure ulcer prevention, forecasting scheduled care demand, and the development of Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru a decision support tool to assist with Welsh Ambulance Services elective orthopaedic scheduling. A NHS Trust certificate for the best oral presentation, voted for by the showcase delegates, was awarded to MSc student Michael Abaho for his social networking analysis of disease-specific communication on Twitter.
To celebrate the completion of the dissertation projects, as well as the work completed by the first cohort of modelling fellows, a showcase event was held. Innovative project topics presented at the showcase included the potential impact
Dr Doris Behrens, lead for innovation at ABCi, said: “The unique collaboration between Aneurin Bevan University Health Board and the Department of Mathematics at Cardiff University has successfully embedded modelling
techniques within the work of ABCi. We are now able to try out any idea without the cost of implementing it in the real world. This means we can gain insights into why our systems behave the way they do and estimate the risks involved in changes before they are made.” The Silver Modelling Fellows Programme, run by ABCi for health board staff, is now in its second year. Participants have the opportunity to develop their skills in analysing data related to their area of work, build visual geographical models to present findings, and explore ‘what if?’ scenarios to inform and improve their services. For further information, visit the ABCi website: http://bit.ly/ABCi_ MScModelling
Bwrdd Iechyd Prifysgol Aneurin Bevan University Health Board
Bwrdd Iechyd Prifysgol Cwm Taf University Health Board
Bwrdd Iechyd Prifysgol Betsi Cadwaladr University Health Board
Bwrdd Iechyd Prifysgol Hywel Dda University Health Board
Game of Stools trains staff to prevent infection Bwrdd Iechyd Addysgu Powys
Iechyd Cyhoeddus Cymru
Powys Teaching Health Board
Public Health Wales
While working as Ymddiriedolaeth an Infection GIG Felindre Prevention nurse,Velindre GarethNHS Pierce Tust Jones became interested in the use of alternative teaching methods. As a result, he began to design an educational board game to teach healthcare professionals about Clostridium difficile infection in a nontraditional and engaging way.
Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru Welsh Ambulance Services NHS Trust
The game was successfully trialled across all three main Betsi Cadwaladr University Health Board (BCUHB) hospitals before being taken to game manufacturer Focus Games. It was commercially launched as ‘Game of Stools’ in August 2017. C. difficile is recognised as one of the most important healthcare associated infections and BCUHB is committed to achieving excellent infection prevention practices. This is achieved through continually improving staff knowledge and clinical practices. A board game was seen as a perfect way to boost staff knowledge by encouraging discussion in a less formal teaching setting. During the trial period, the game was played by 85 healthcare professionals. It quickly became clear that people not only enjoyed playing the game but also improved their knowledge of infection by playing it. This was proven through a pre-game and post-game quiz. 98 per cent of staff correctly answered more questions in the post-game quiz, with many increasing their knowledge by 50 per cent. The game does not require a specialist trainer/facilitator to run sessions, so anyone can do it. It can be used as a standalone activity or can be woven into workshops and blended learning programmes. It is possible to run several games at the same time in the same
room and everything needed for a group session is inside the box. To play the game, two players (or teams of players) compete by answering questions and explaining facts about C. difficile prevention and management, while trying to avoid landing in isolation. Players can win the game by earning lots of Brownie Points or by being the first to successfully treat a ‘patient’ for C. difficile. Topics covered in the game include risk factors, transmission, laboratory diagnosis, isolation precautions and environmental cleaning. Face-to-face educational games are an effective way of encouraging players to explore and discuss new ideas and ways of working. They are also very effective at giving people the confidence to implement what they have learnt during a game. Increased staff knowledge and confidence regarding C. difficile infection is key to ensuring that patients are cared for promptly, correctly and safely. This ultimately contributes to the
“Gareth has managed to insert an educational message into a well-established (and therefore easily understood and quickly implemented) game format, with a genuinely humorous twist which grabs users’ attention. The combination of fun, interest, competition and humour delivers the teaching holy grail of audience engagement.” Dr Stuart D’Arcy Ysbyty Gwynedd, Bangor
successful prevention and management of potentially life-threatening infection. ‘Game of Stools’ won The Academy of Fabulous Stuff’s ‘Piccalilley’ award for NHS innovation in 2017 and was shortlisted for two Patient Safety Awards in 2018.
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Bwrdd Iechyd Prifysgol Betsi Cadwaladr University Health Board
Bwrdd Iechyd Prifysgol Hywel Dda University Health Board
Bwrdd Iechyd Addysgu Powys
Iechyd Cyhoeddus Cymru
Powys Teaching Health Board
Public Health Wales
Innovation and collaboration in NHS Wales
Delivering condition management programmes via Skype Ymddiriedolaeth GIG Felindre Velindre NHS Tust
In Wales there are an estimated 800,000 people living with a longterm health condition. There has been an increase of almost 30 per cent in the last 10 years. Powys Teaching Health Board have developed condition management programmes and one-to-one interventions that can be delivered by Skype. They enable quick and easy access for people to learn how they can better manage their conditions. This minimises the impact of health conditions on the day-to-day lives of patients and also reduces travel time for both patients and health board staff. Following consultation with participants, it was found that common reasons for patients failing to attend appointments and groups were physical symptoms, anxiety, logistics of travel, and difficulty
The success of the pilot has led to plans being developed for more blended learning approaches which support the individual and their family including e-learning modules, apps and text messaging services.
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Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru Welsh Ambulance Services NHS Trust
in getting time off work. This information, combined with a need to ensure prudent delivery of services within the rural environment of Powys, led to the development of the condition management programme, Invest in Your Health Online, as an option for those unable to attend sessions in person. The Invest in Your Health programme is delivered in six weekly sessions of two hours using the Skype for Business platform. This aims to build on and develop skills that empower individuals to manage their long-term health conditions with support from healthcare professionals through technology. Each participant saved an average of 331 travel miles over the course of the online programme. Staff also made significant travel and time savings. There was a
notable improvement in participantreported anxiety and depression, as well as increased wellbeing and activation. Every online session had full attendance. All of the participants had reported social anxiety prior to starting the course, but by engaging in social contact from the security of their own home, their confidence improved and they all went on to set goals at the end of the programme that saw them engaging with the wider community. For those people in work, the difficulties of taking time off to attend appointments often results in them not accessing services until it is too late. This pilot allowed people to join the programme from a quiet space at work and then return to work immediately after the session finished. Feedback from participants was excellent.
Bwrdd Iechyd Addysgu Powys
Iechyd Cyhoeddus Cymru
Powys Teaching Health Board
Public Health Wales
Ymddiriedolaeth GIG Felindre Velindre NHS Tust
Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru Welsh Ambulance Services NHS Trust
VR and AI technologies changing the experience of cancer treatment Velindre Cancer Centre is experimenting with emerging technologies, Virtual Reality (VR) and Artificial Intelligence (AI), to revolutionise the way in which cancer patients engage with their treatment and change how they train their staff. This work is being supported by the Bevan Commission Academy, which provides healthcare leaders in Wales, known as Bevan Exemplars, with expert mentoring to pursue projects that transform NHS Wales’ health outcomes, patient experience or resource efficiency.
‘Feeling’ treatment first through VR
Chatbots tailor care to personality
Velindre Cancer Centre is exploring the use of VR technology to enable patients to ‘feel’ experiences before they actually have them. An example of this is in radiotherapy treatment, where patients have an opportunity to become immersed in the radiotherapy room virtually before they experience it physically. VR technology enables the patient to ‘feel’ the sensation of radiology before they commit to treatment, mitigating treatment anxiety.
Artificial Intelligence (AI) technology will be used by Velindre Cancer Centre to power a chatbot that can engage patients in their healthcare and treatment by scouring the web for information and responding to psychological cues such as tone of voice. It is hoped that the virtual assistant will be able to provide useful healthcare information at the early stages of diagnosis and treatment that is free of clinical bias. Rather than treatment conversations being led by clinicians, a chatbot will respond to the first-person narrative of the patient, providing high quality conversation prompted by timely questions.
This initiative is being rolled out to cancer patients using cheap and easily accessible technology such as Samsung tablets, and video booths broadcasting the immersive experiences are also being trialled within Velindre Cancer Centre itself. There is also a YouTube channel that will allow patients access to this and other types of media content in VR. VR is also being employed in a number of innovative ways across Velindre, including educating staff through VR-broadcast lectures, staging immersive teaching experiences and using augmented reality to simulate real-life treatment scenarios. Data on staff responses will be gathered to assess the effectiveness of using digital technology to deliver training.
The use of chatbots will enable Velindre Cancer Centre to triage patients more quickly and therefore alleviate patient anxiety caused by waiting. The virtual assistant will also include a tonal analyser, which can distinguish whether a patient is distressed or not and change the response during conversation accordingly to become more empathetic to user mood. This AI initiative is a collaboration between Pfizer, the Bevan Commission, Velindre Cancer Centre and IBM Watson, which powers the virtual assistant.
“It is exciting to be pioneering technology that will help our patients experience and shape their cancer treatment. We hope that through our application of VR and AI we can alleviate treatment anxiety and enable patients to feel in control of their healthcare, by becoming better informed and more engaged, and make better choices. Automation will also allow us to focus our resources where they can add most value in terms of cancer care and patient experience.” Phil Webb Associate Director of Planning, Performance and Innovation Velindre Siôn Charles, Deputy Director of the Bevan Commission, said: “The key objective of the Bevan Commission Academy is to enable health and care professionals to transform services by testing out their own innovative ideas on the frontline. This initiative combines pioneering technology and indepth knowledge of patient care to make a positive difference to cancer treatment. It is fantastic to see Wales taking the lead in capitalising on the opportunities afforded by emerging technologies to improve patient experience and health outcomes.”
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Innovation and collaboration in NHS Wales Gwasanaeth Gwybodeg Informatics Service
Electronic results and documents available nationally in the Welsh Clinical Portal For the first time, health professionals across Wales can view clinical documents and test results electronically in hospitals, no matter where the tests were taken, via the Welsh Clinical Portal. An upgrade to the Welsh Clinical Portal in North Wales has been the final link to ensure that clinicians can now see the results and documents from anywhere across the country. The Welsh Clinical Portal is a digital workspace used by doctors and health professionals to share and display patient information from a number of sources, including the Welsh GP Record.
“Within the team I work in, many of our patients have cancer, and cancer treatments in South Wales are provided in lot of different places. Now if a patient tells me they had a blood test in a clinic a few days ago, I can look that up on the computer and it helps me make decisions, it prevents me having to take blood again, so it’s really making a difference.” Dr Victoria Wheatley Palliative Care Consultant
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As well as test results, clinical documents are being made available across health board organisational boundaries. There are now 12 million documents to view including electronic GP referrals, emergency department attendances, clinic and results letters. The Welsh Clinical Portal is enabling information to follow the patient wherever care is provided. Palliative Care Consultant Dr Victoria Wheatley is part of a team covering a large part of South East Wales. Her patients will have tests taken, and documents generated, in one of several hospitals in the area, and one of many GP surgeries or clinics. Before the introduction of the national results service she had to search for test results in different systems, or have them taken again. This landmark achievement has been made possible through collaborative working across Wales using the national
digital platform and standards. In March 2018, nearly 23,000 distinct out-of-area results were viewed by clinicians, all of which would previously have been chased over the phone or searched by other routes, taking up valuable time. In many cases the clinician would repeat these patient tests. In a project evaluation report, 100 per cent of users agreed that the availability of results across Wales has saved them valuable time. Comments from health professionals included “We are treating patients rather than chasing results. It’s what my job is all about” and “An excellent service that supports clinical decision makers with all the information that may be available. Especially useful to support crossboundary and out of hours care”. Wales-wide test results in the Welsh Clinical Portal are currently available for blood sciences, histopathology and microbiology tests, with radiology and others due to become nationally available in forthcoming months.
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Bwrdd Iechyd Prifysgol Caerdydd a’r Fro Cardiff and Vale University Health Board
TALK to improve communication between clinicians Bwrdd Iechyd Prifysgol Cwm Taf University Health Board
Debriefing is the process of an Iechyd Prifysgol individual or teamBwrdd formally reflecting Hywel Dda on their performance after a Board University Health particular task, shift or critical event. TALK© is a new debriefing tool, designed to guide an inclusive, constructive and Iechyd structured Cyhoeddus Cymru conversation between clinical team Public Health members. Its aimWales is to promote reflection within teams as a way to improve and maintain patient safety, Ymddiriedolaeth GIG increase efficiency and contribute Gwasanaethau Ambiwlans Cymru to a supportive culture of dialogue Welsh Ambulance Services NHS Trust and learning, in turn enhancing staff wellbeing. It also encourages individuals to take responsibility for identifying improvement opportunities and implementing necessary changes.
Bwrdd Iechyd Prifysgol Caerdydd a’r Fro Cardiff and Vale University Health Board
The project originated in Wales in 2014 and its original authors (C Diaz-Navarro, A Hadfield and S Pierce) are full-time clinicians. TARGET: What shall we discuss to improve patient care? Share your perspective. ANALYSIS: Explore specific points of patient care. 1. What helped or hindered... communication /decision making / situational awareness? 2. How can we repeat successful performances or improve? LEARNING: What can the team learn from the experience? KEY ACTIONS: What can we do to improve and maintain patient safety? Who will take responsibility for those actions?
The TALK project has been awarded a Horizon 2020, Excellent Science, MSCARISE Grant by the European Commission, which funds three years of collaborative research exploring its potential international impact. The grant consortium is led by Cardiff & Vale University Health Board, coordinating a collaboration with University of Barcelona, Cardiff University, Hospital Clinic I Provincial de Barcelona and University Hospital of Stavanger. The results of the research are expected to produce findings that may transform future clinical team communication and education. Use of the tool has already grown beyond this group, as it is also being applied in Denmark, Iceland, Portugal and New Zealand. Aiming to make the project sustainable in the long term, a UK charity has been set up with international trustees – the TALK Foundation.
Gwasanaeth Gwybodeg Informatics Service
Capturing patient feedback electronically Bwrdd Iechyd Prifysgol Cwm Taf University Health Board
The All-Wales Patient Reported Outcomes Measures (PROMs), Patient Bwrdd Iechyd Prifysgol Reported Experience HywelMeasures Dda University Health Board (PREMs) and Effectiveness Programme (PPEP) is a national programme, established to progress the collection of patient reported outcome and Iechydacross Cyhoeddus experience measures NHS Cymru Wales. With funding from the Welsh Public Health Wales through Government Efficiency Technology Programme (ETTP), an electronic platform that captures Ymddiriedolaeth GIG outcome and experience measures using Gwasanaethau Ambiwlans Cymru PROMs and PREMs tools has been Welsh Ambulance Services NHS Trust developed, and initial data collection has commenced. The programme aims to invite all patients attending secondary care services across Wales to complete PROMs and PREMs surveys.
Patient reported outcome measures have been collected across most NHS Wales organisations using the NWIS built electronic platform. Over 17000 questionnaires have now been collected and 28 questionnaires are available over 30 patient pathways. The Programme’s analytical team, HOPE Wales, has begun to provide reports on the health status of patients. The PROMs platform is designed so that patients can complete their questionnaires at home on their own devices, or while attending a clinic. This approach minimises the impact of PROMs collection on clinic resources. By providing a virtual follow up for surgical procedures, the new system will also reduce the demand for outpatient clinic appointments.
Electronic PROMs collection is currently active in different stages of roll out in five health boards, with the remaining two hoping to begin collection by summer 2018.
As PROMs collection grows, clinicians will be better informed about their patients’ quality of life and will be able to see how their interventions have an impact. This will enable clinicians and health boards to measure the effectiveness of the services they provide and drive improvement in the care provided by NHS Wales.
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Innovation and collaboration in NHS Wales
New research focus on the role of communications in healthcare improvement The Swansea University Centre for Improvement and Innovation in Health and Social Care and the 1000 Lives Improvement service in NHS Wales have announced a new partnership to develop a research base for the use of communications as a central part of quality improvement. The research will explore how those involved in the practice of healthcare improvement can be supported to apply robust theories in selecting and evaluating the right communication tools and approaches for their change initiatives.
“We are delighted to be working with 1000 Lives Improvement to explore the role of communication and its critical contribution to the success and sustainability of improving healthcare services. Drawing from various disciplines, we hope to develop an evidencebase that supports and integrates the use of communication theories and practices into quality improvement.” Professor Sharon Williams Improvement Science Fellow lead for the Centre
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To support this new focus, Andrew Cooper from 1000 Lives Improvement has taken up an honorary position with the Centre as a senior research associate. Andrew led the communications for the 1000 Lives Campaign and much of its subsequent work and has been leading both a local and international focus on the role of communications in improvement. This has included the launch of The #QiComms
Charter to encourage organisations to ensure that communication is embedded in improvement work right from the start. Andrew commented: “Whilst the role and contribution of communications is well acknowledged and recognised in the public health domain and other sectors of healthcare, it remains under-examined and under-used in the quality improvement arena. This new opportunity will be important in creating a sound evidencebase and ensuring that the theoretical contribution of communications is more widely understood, valued – and applied.” For further information, visit www.1000livesplus.wales.nhs.uk/ QiComms
Improving cancer awareness in disadvantaged communities Cancer survival rates are lower in areas of socioeconomic deprivation. Through developing and evaluating a facilitated online ‘Health Check’, the ABACus project aims to make improvements in awareness of cancer symptoms and lifestyle risk factors that will contribute to improving cancer outcomes in deprived communities of Wales and Yorkshire. ABACus (Awareness and Beliefs About Cancer) involves PRIME Centre and Centre for Trials Research researchers from Cardiff University and members of the Welsh and Yorkshire clinical and academic communities, working closely with the charity Tenovus Cancer Care. The team has also built strong links with community partners including Health Boards and Communities First local health leads, as well as with industry partner Digital Morphosis.
“As someone who lives in one of the areas where the research is taking place and who had a late diagnosis of locally advanced bowel cancer four years ago, I am delighted that steps are being taken to increase awareness of the early signs of cancer and to encourage people to take action to have symptoms investigated immediately.”
In the first stage of the project, funded by Cancer Research UK, an adapted Health Check was developed and piloted in partnership with Tenovus Cancer Care. The findings have been shared with clinical networks in and beyond Wales, culminating in a major focus on early diagnosis in the refreshed Cancer Delivery
“My wife Wendy, born in Leeds, had her cancer detected only after an A&E visit. She died less than six months later. For many cancers there are clear early warnings and early treatment can save and extend lives.”
Plan and its implementation through the Wales Cancer Network’s Detecting Cancer Earlier Programme Board. Further funding has now been awarded from Yorkshire Cancer Research to conduct a randomised controlled trial to test the effectiveness of the Health Check in improving cancer awareness. Participants in the trial will come from deprived areas of South Wales and South/West Yorkshire. The Health Check is an interactive touchscreen questionnaire including questions about cancer symptoms, screening and lifestyle, with behaviour change advice delivered by a trained lay advisor. Personalised results are delivered
by the lay advisor using a traffic light system, with ‘red’ and ‘amber’ results indicating where action should be taken. For more information please contact Dr Kate Brain BrainKE@cardiff.ac.uk, the ABACus team abacus@cardiff.ac.uk or PRIME Centre info@primecentre.wales www.cardiff.ac.uk/centre-for-trialsresearch/research/studies-and-trials/ view/abacus
“Trialling the Health Check will allow us to evaluate whether the intervention improves cancer awareness and encourages earlier help seeking among adults living in disadvantaged communities, ultimately leading to earlier diagnosis and better outcomes.” Dr Kate Brain Cardiff University
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Innovation and collaboration in NHS Wales
Bwrdd Iechyd Prifysgol Abertawe Bro Morgannwg University Health Board
Bwrdd Iechyd Prifysgol Caerdydd a’r Fro Cardiff and Vale University Health Board
Evaluating use of a novel point of care test for urinary tract infections Urinary tract infection (UTI) is the most frequent bacterial infection affecting women. It is usually diagnosed on clinical grounds in general practice, and women with UTI symptoms are often prescribed an antibiotic without sending a urine sample for laboratory analysis. However, some women with UTI symptoms will not have a bacterial infection and others will have an infection with a bacterium that is resistant to one or more antibiotics. Inappropriate antibiotic use increases the risk of side effects, drives antibiotic resistance, prolongs symptoms, and wastes NHS resources. There is therefore an urgent need for new tests that help GPs identify which women have a bacterial UTI, and when a bacterial UTI is present, which antibiotic should be used. Researchers from Cardiff University led a study called POETIC to evaluate the use of a novel urine culture point of care test called FlexicultTM in general practices in four European countries – Wales, England, Spain and The Netherlands. Flexicult was originally developed by the Statens Serum Institut (SSI) and is already used in primary care practice in Denmark. The POETIC study, led by Professor Chris Butler, was part of a larger study funded by the EU Seventh Framework Programme (FP7).
Bwrdd Iechyd Prifysgol Aneurin Bevan University Health Board
Bwrdd Iechyd Prifysgol Cwm Taf University Health Board
Bwrdd Iechyd Prifysgol Betsi Cadwaladr University Health Board
Bwrdd Iechyd Prifysgol Hywel Dda University Health Board
It was supported by the Health and Care Iechyd Cyhoeddus Cymru Research Wales funded WSPCR (now Powys Teaching Public Health Health Board Centre Wales) and the Centre Wales for PRIME Trials Research (CTR). Partners included GIG the Public Health Wales SpecialistYmddiriedolaeth Ymddiriedolaeth Gwasanaethau Ambiwlans Cymru GIG Felindre Antimicrobial Chemotherapy UnitWelsh andAmbulance SSI. Services Velindre NHS Tust Bwrdd Iechyd Addysgu Powys
NHS Trust
After initially doing some work to validate the test characteristics of Flexicult, modifying it to include antibiotic sensitivity tests relevant to each of the countries included in the study, and conducting an observational study to describe current practice, the POETIC team then conducted a randomised controlled trial involving 649 patients. This trial evaluated the costs and effects of using Flexicult to guide diagnosis and treatment for symptoms of UTI in adult women. Participants were randomised either to standard care or to Flexicult guided treatment. Finally, the team assessed the barriers and facilitators to implementation by conducting interviews with clinicians and patients in all four countries. Clinicians indicated that using Flexicult changed their management more than two-thirds of the time. However, use of the test did not result in antibiotic use that was more in line with laboratory culture results, and there was no evidence of any differences in recovery, patient enablement, recurrence of UTI recurrences, antibiotic resistance, or admission to hospital. The
Flexicult is an overnight, culture-based test which enables the enumeration and identification of bacteria in urine, as well as identifying which commonly prescribed antibiotics the bacteria are sensitive or resistant to. The results are not available for 24 hours, but it can be used as part of a ‘delayed prescribing strategy’ where the patient is given antibiotics but told to not take them unless they are informed that the test is positive the next day, or is not given antibiotics but told that they will be prescribed the next day if needed. In addition, the test can be used to change antibiotic therapy the next day if the patient is found to have an infection with a bacterium that is resistant to the antibiotic prescribed.
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process evaluation found that there was a reluctance to not provide antibiotics while awaiting test results. Using a delayed prescribing approach could get around this problem. Despite being widely used in Denmark, results of POETIC suggest that Flexicult may not be suitable for implementation into routine clinical practice in the European countries included in the study when used mainly to modify initial antibiotic prescribing decisions. Further trials of the test will be required to see if it would be useful in enhancing the use of a ‘delayed prescribing’ strategy. The results of this study may help healthcare providers identify pathways in which the test could be further evaluated. An in-depth understanding of the healthcare settings, clinical pathways, real world effectiveness, and barriers/facilitators to use is essential in taking novel technologies to market. For more information, contact christopher. butler@phc.ox.ac.uk, PRIME Centre info@ primecentre.wales or CTR ctr@cardiff.ac.uk
Welsh Government Efficiency through Technology Programme 21
Efficiency through Technology Programme
Efficiency through Technology The ÂŁ6 million Efficiency through Technology Programme (ETTP) accelerates the adoption of new products and services into practice. Its purpose is to make health and care services in Wales more efficient and to deliver better outcomes and experiences for patients, aligned to the principles of Prudent Healthcare.
The programme encompasses four themes for new and improved ways of working in NHS Wales:
The ETTP takes account of the need for changed ways of working in NHS Wales, particularly in areas
Technology adoption This area consists of three strands: co-ordinated adoption, rapid evaluation and accelerated scale-up of technologies which demonstrate high impact at an all-Wales level.
where there is a need for better support structures and mechanisms that simplify and speed up the introduction of new technology.
Joint working and engagement, which are standard mechanisms for the Efficiency through Technology Programme, have been developed to simplify decision-making processes. This means that resources can be quickly directed to Welsh Government priorities or scaled up as required. Simple monitoring systems provide rapid feedback on delivery and impact, allowing resources to be reallocated to better performing projects.
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The programme provides support and guidance through a number of mechanisms, examples of which include: Health Technology Wales; which is tasked with the robust appraisal of non-medicine health technology and the promotion of their take-up in the health service. Innovative procurement/the Small Business Research Initiative (SBRI); which is a procurement mechanism for the public sector to develop solutions by helping small businesses/organisations test the feasibility of prototypes and determine their suitability for market, through contributory research funding and advice. Contact for further information: healthtechfund@gov.wales
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Digital platforms and systems This supports the delivery of priorities in the new Digital Health and Care Strategy. It accelerates the development and implementation of essential digital infrastructure and open connectivity, which will provide a platform for improved practice, products and services.
Practice innovation
Technology development
This enables changes in practice and innovative collaborations. New partnerships between NHS Wales, academia and industry, as well as new models and platforms, will allow NHS Wales to operate more freely.
This involves developing new products and services, particularly in response to unmet needs and as an outcome from applied research in Wales.
The four principles of Prudent Healthcare: l Achieve health and wellbeing with the public, patients and professionals as equal partners through coproduction. l Care for those with the greatest health need first, making the most effective use of all skills and resources. l Do only what is needed, no more, no less, and do no harm. l Reduce inappropriate variation using evidence based practices consistently and transparently.
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Efficiency through Technology Programme
Bwrdd Iechyd Prifysgol Aneurin Bevan University Health Board
Bwrdd Iechyd Prifysgol Cwm Taf University Health Board
Bwrdd Iechyd Prifysgol Betsi Cadwaladr University Health Board
Bwrdd Iechyd Prifysgol Hywel Dda University Health Board
A cute solution to acute anxiety in dementia For patients with dementia, travelling to hospital appointments can be a source of anxiety and stress. A wide range of situations, such as becoming lost, not knowing which bus or train to catch and not knowing where to get off, can result in a distressed response. Sometimes patients become so stressed that they become late and miss their appointment or even abandon their journey and return home.
Research has shown that dementia alone does not necessarily prevent people from driving, but people do tend to stop driving within three years of their first dementia symptoms. Travelling alone can be difficult for anyone who is vulnerable due to age, a learning disability or a mental health problem such as anxiety. It can be particularly difficult for people with dementia to plan journeys in order to attend hospital appointments.
To reduce the stress and anxiety of hospital visits for people with dementia, including the journey to get there, Betsi Cadwaladr University Health Board (BCUHB) bid for funding from the Small Business Research Initiative (SBRI), which enables public sector bodies to connect with technology businesses in order to provide innovative solutions to specific public sector challenges and needs. The SBRI challenge title was ‘A Cute Solution for Acute Anxiety in Dementia’. In 2016, BCUHB was awarded SBRI funding, match-funded by the Department for Transport. The health board called on
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Bwrdd Iechyd Addysgu Powys
Iechyd Cyhoeddus Cymru
Powys Teaching Health Board
Public Health Wales
Ymddiriedolaeth GIG Felindre Velindre NHS Tust
businesses to come forward with creative ideas to address the challenge. Chris Roberts from Rhuddlan, who dedicates his time to being a champion for other people with dementia like himself, said: “Imagine being lifted out of your comfort zone or put into a foreign environment, and trying to cope – that’s what it’s like living with dementia. Any change to plans makes you very anxious and nervous, which makes your dementia worse and has an effect on the person you’re with. Technology is absolutely amazing now, and I’m sure someone can come up with something to help us make it easier to get to hospital appointments, or manage anxiety when in a waiting
Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru
Welsh Ambulance Services room. If we can get it right for dementia, NHS Trust it’ll help so many other people too – people with brain injuries or mental health difficulties for example.”
After an evaluation process, two suppliers – Zipabout and Damibu – were chosen to work on Phase 2 of the project and BCUHB’s Informatics Project Team are now working with both suppliers to develop their solution to the challenge. They are carrying out extensive patient engagement, in the form of co-creation, to deliver unique prototype mobile phone applications. Cutting-edge technology is being trialled to ensure the final solution is exactly what people living with dementia want.
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Haematology database for Wales
The NHS Wales Haematological Malignancy Data solution: An NHS Wales, Welsh Government and Janssen Joint Working Initiative. Haematology services in Wales require an innovative and personalised database, which can critically analyse the outcome data for patients with myeloma and eventually all other haematological malignancies. This project will deliver a mechanism for measuring the impact of treatment, generating Real World Evidence and operationalising complex patient access schemes. In the longer term, the database could also be a future revenue generating stream for Wales. Welsh Government and NHS Wales are working collaboratively with industry, focusing on delivering better outcomes for people in Wales, by improving the efficiency and effectiveness of services in line with the principles of ‘Prudent Healthcare’. There has been rapid therapeutic advancement in the treatment of myeloma in recent years which has improved patient outcomes. However, novel agent therapy comes at high cost and long-term treatment of myeloma, which remains a chronic incurable malignancy, remains highly challenging. The aim should be to maximise patient longevity and quality of life through minimisation of the shortand long-term damage incurred by both the disease and the drugs used to treat it. This requires scrutiny of both patient disease burden and fitness at diagnosis, together with their response to treatment and its impact in terms of quality of life. This can only be achieved through systematic data capture throughout the patient journey, from diagnosis to death. This project was motivated by a policy intention to move from a traditionally transactional approach to NHS/industry engagement to one that is data, evidence and outcome focused. This can lead to ‘commissioning for outcomes’ where investment by pharmaceutical companies in the health
sector can take the form of the means to access novel therapies early in their development, together with support for resources which will make these agents more cost-effective and feasible to deliver. It was identified that haematology services in Wales require an innovative and personalised database which can critically analyse the outcome data for patients with myeloma and eventually all other haematological malignancies. As such, units should have access to a database whereby all patients can be registered at diagnosis with data regarding their demographic features, disease presentation/staging, diagnostic features, treatment plan, response to treatment and overall survival. Quality of life data may also be collected, both to justify the cost and burden of treatment and demonstrate the impact of treatment over non-treatment from a patient perspective. Historically, data capture for cancer patients in Wales has been through the Cancer Network Information System Cymru (CaNISC) system, which is designed for solid tumours and is ill equipped to capture the nuances of haematological diseases. It is also not suitable for the requirements of quality of life data capture or treatment response. This unscrutinised treatment with high cost, potentially toxic drugs inevitably led to wasted resource and ineffective treatment for some patients. Investment in data capture is urgently required to reverse this trend. The key benefit of implementing a Welsh Haematological Malignancy Database is being able to measure the impact of treatment on patient outcome and quality of life and to justify costs. For the first time, it will accurately record detailed information on incidence, treatment and survival rates from myeloma and subsequently all haematological cancers across Wales. This will enable NHS
Wales and Welsh Government to see the outcomes for any drugs that are approved and make more informed decisions about which treatments they should either be investing in, or no longer wish to fund. Also, patients can be provided with a more honest assessment of what to expect from treatment pathways based on Real World Evidence data.
The database will also potentially give Welsh Government the opportunity to gain access to medicines ahead of other UK countries, as pharmaceutical companies will be drawn by the incentive of efficient data capture. By having a robust system in place that will allow pharmaceutical companies to propose patient access schemes, NHS Wales and Welsh Government will have the data available to make an informed decision on what is best for patients in Wales and ensure they are getting access to the best medicines, at the best price, as early as possible.
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Efficiency through Technology Programme
AgorIP: bringing innovation to life AgorIP is a new approach to innovation, helping to bring ideas and Intellectual Property to life. Thanks to support from Swansea University, the EU and Welsh Government, the project is working to capture, protect, develop and commercialise new ideas and inventions. The project was launched in late 2016, following the successful pilot Swansea Healthcare Innovation Partnership Program (SHIPP), and is based at Swansea University’s School of Management. AgorIP’s team of experts – including technology transfer officers and managers, administrators, patent experts and pipeline managers – are working with academics, industry, the NHS, investors and entrepreneurs in order to improve the health and wealth of the people of Wales. Their aim is to turn innovation and Intellectual Property (IP) into new businesses which will help create new jobs, and also improve NHS care by taking cutting edge research and turning it into new medicines, devices, technology and services. Since its launch, AgorIP has developed a varied portfolio of projects across a
range of sectors. Example projects in life sciences are highlighted on the next page. Other projects in AgorIP’s portfolio include a digital academic tool, a corrosion inhibitor and a downhill mountain bike for disabled users.
l Have you got an idea, a business plan, a prototype or research that you think
could be a commercial success?
l Would your idea benefit the regions of North Wales, West Wales or the South
Wales Valleys?
l Do you need help with market research to check the commercial potential of
your idea?
l Would you like to access money which would help you take your idea to
market?
l Do you need access to designers or other experts to help you develop a
prototype or test your research or idea?
l Would the advice of a commercial expert enable you to pitch to potential
investors?
l Do you need advice on how to protect your idea or invention so you can make
money from it?
Visit: www.agorip.com
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“Swansea University is delighted to be leading this important project and we as a School of Management are delighted to host the project. AgorIP links academics and the NHS with investors and business experts to develop innovative ideas and ways of working. I’m confident the results will be of major benefit to the Welsh economy. As a university we pride ourselves on our links with industry and this is another example of how many sectors can work together for the greater good.” Professor Marc Clement Vice-President of Swansea University and Dean of the School of Management
Bwrdd Iechyd Prifysgol Abertawe Bro Morgannwg University Health Board
Bwrdd BwrddIechyd IechydPrifysgol Prifysgol Abertawe Bro Morgannwg Aneurin Bevan University UniversityHealth HealthBoard Board
Bwrdd Iechyd Prifysgol Bwrdd Iechyd Prifysgol Betsi Cadwaladr Aneurin Bevan University Health Board University Health Board
Bwrdd BwrddIechyd IechydPrifysgol Betsi Cadwaladr Addysgu Powys University Health Board Powys Teaching Health Board
PulmonIR Contact:
Bwrdd Iechyd Ymddiriedolaeth Addysgu Powys GIG Felindre Powys Teaching Velindre NHS Tust Health Board
Dr Mark Bowman CEO Email: mark.bowman@pulmonir.com
Chronic Obstructive Pulmonary Disease Ymddiriedolaeth Felindre (COPD) affects GIG over 330 million people Velindre NHS Tust worldwide at an estimated cost to healthcare providers of over $2 trillion a year. PulmonIR is a Swansea-based, earlystage medical device company focused on the detection and monitoring of lung diseases, including COPD. PulmonIR’s proprietary technology is based on the work of Professor Paul Lewis from Swansea University. Professor Lewis has developed a new technology that can quickly and easily diagnose and monitor the condition. It can also predict an exacerbation event several days before it occurs - allowing treatment and preventing hospital admission. This technology is now being taken forward commercially through the spin-out company PulmonIR Ltd. Having secured a significant venture capital investment from IP Group, Finance Wales and the Swansea University Innovation Fund (SUIF), this technology is currently undergoing clinical evaluation through a collaboration with Prof John Geen at Cwm Taf University Health Board. These clinical trials are now underway following a capital grant from Welsh Government Health Technology Funding. Following completion of these clinical trials, PulmonIR will seek the necessary regulatory approvals before launching its commercial products into the UK National Health Service and international healthcare markets.
Bwrdd Iechyd Prifysgol Caerdydd a’r Fro
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Cardiff and Vale University Health Board
Bwrdd Iechyd Prifysgol Caerdydd a’r Fro
Bwrdd Iechyd Prifysgol Bwrdd Iechyd Prifysgol Caerdydd a’r Fro Cwm Taf Cardiff and Vale Respiratory diagnostics University Health Board University Health Board
Bwrdd Iechyd Prifysgol Abertawe Bro Morgannwg University Health Board
PulmonIR Ltd was established in February 2016 as a spin-out Swansea University Bwrddfrom Iechyd Prifysgol Bwrdd Prifysgol to develop low-cost, handheld medical Hywel Iechyd Dda Cwm Taf devices that are capableHealth of diagnosing University Board and University Health Board monitoring lung disease. The company’s first commercial target is chronic obstructive pulmonary disease (COPD).
Bwrdd Iechyd Prifysgol Aneurin Bevan University Health Board
Bwrdd Iechyd Prifysgol Cwm Taf University Health Board
Bwrdd Iechyd Prifysgol Betsi Cadwaladr University Health Board
Bwrdd Iechyd Prifysgol Hywel Dda University Health Board
AgorIP aims to provide NHS Wales organisations with a framework for The company has recently completed preliminaryas well commercialisation, clinical studiesBwrdd in collaboration with Cwm Taf Prifysgol IechydIechyd Cyhoeddus support andfinancially capacity Universityas Health BoardDda and is backed Hywel Cymru by IP Group, theUniversity Development Bank of Wales and Health Board Public Health toUniversity commercialise specific the Swansea Innovation Fund. Wales innovations. In December 2016, the company wasOver named the past as Start-up of the Year at the MediWales Innovationyear, Awards. AgorIP’s NHS portfolio Ymddiriedolaeth GIG has evolved During 2018, the company will shiftfrom its focus largely Iechyd Cyhoeddus Gwasanaethau Ambiwlans Cymru towards furtherCymru product development and innovations Welsh Ambulance Services regulatorySwansea-based approval. Public Health NHS Trust to Wales include projects with NHS organisations from other parts www.pulmonir.com of Ymddiriedolaeth Wales. Over GIG 25 per cent of Gwasanaethau Ambiwlans Cymru the innovations currently in Welsh Ambulance Services NHS Trust pipeline come from or AgorIP’s involve the NHS.
Biomarker for Colorectal Cancer in Primary Care Led by ABMU Health Board consultant colorectal surgeon Professor Dean Harris and Professor Peter Dunstan from the Department of Physics, a team of scientists based at Swansea University have developed a simple blood test which could make it easier for GPs to diagnose bowel cancer – the very first time people visit the surgery with symptoms. Clinical trials in GP practices across the Swansea area have been funded through the Efficiency through Technology Programme (ETTP) and Cancer Research Wales support. Parallel funding from AgorIP has led to the formation of a spin-out company (CanSense Ltd.) towards commercial realisation of this novel technology.
Bougie Introducer
Bwrdd Iechyd Addysgu Powys
Cardiff and Vale University Health Board
Iechyd Cyhoeddus Cymru
Public Health A bougie is a plastic guide wire passed Wales through the trachea to guide airway tubes. Dr Michael Oliver and Dr Robert Sparrow, Ymddiriedolaeth GIG from Cardiff & Vale University Health Ymddiriedolaeth Gwasanaethau Ambiwlans C GIG Felindre Welsh Ambulance Services Board and Swansea University, have Velindre NHS Tust NHS Trust developed the Bougie Introducer which reduces tracheal trauma for patients. AgorIP is helping to prototype the device and seeking suitable manufacturers. Powys Teaching Health Board
Diet or Disorder App Professor Jacinta Tan, Professor Alka Ahuja and Mr Gerrard McCullagh, from Swansea University’s Medical School and Aneurin Bevan University Health Board, have developed an app to support the prevention of eating disorders. The app gives users a range of information such as education about eating disorders and decision-making tools to help identify an eating problem. It also helps users find available support in Wales and offers simple self-help strategies and links to other resources.
27
Efficiency through Technology Programme
Bwrdd Iechyd Addysgu Powys
Iechyd Cyhoeddus Cymru
Powys Teaching Health Board
Public Health Wales
Ymddiriedolaeth GIG Felindre Velindre NHS Tust
Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru Welsh Ambulance Services NHS Trust
Health Technology Wales The Cabinet Secretary for Health and Social Services has launched a new funded body to identify, appraise and support the adoption of new health technologies across NHS Wales. Health Technology Wales (HTW), hosted by Velindre NHS Trust and funded by Welsh Government under the Efficiency through Technology Programme, has been established to provide advice on clinically and cost effective health technologies in Wales. It has a remit that covers all health technologies that are not medicines, which could include medical devices, surgical procedures, telemonitoring, psychological therapies, rehabilitation or any other non-medicine health intervention. Vaughan Gething, Cabinet Secretary for Health & Social Services, officially launched HTW in November 2017.
“Health Technology Wales is an independent, arms-length organisation that will deliver authoritative evidence-informed advice to health boards in Wales about the value for money of nonmedicine health technologies. It is an exciting development that will support the identification of new non-medicine health technologies that are important to Wales.” Vaughan Gething Cabinet Secretary for Health & Social Services
HTW has been working with partners across Wales and internationally to establish processes that will help create a common understanding of value across NHS Wales, leading to the best use of resources and improved patient care. Linking into national agendas for
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Health Technology Wales key messages: l provides independent
evaluation of non-medicine technologies
l helps to deliver better health
and social care, and improves outcomes
l makes NHS Wales more
effective in meeting health and social care needs
l supports technology
innovation in Wales
innovation and prudent healthcare, HTW will critically assess the best available international evidence about the clinical and cost effectiveness of a health technology, assisting with informed decision making and ensuring prudent investment in health technology that will enhance the consistency of patient care in Wales. Core to HTW’s remit is appraisal of health technologies. Health technology appraisal is a multidisciplinary field that addresses the clinical, economic, organisational, social, legal and ethical impacts of health technologies within specific health care contexts. These appraisal methods can range in time from around 3 months to a year or so. HTW’s focus will be on the rapid review end of the spectrum for most topics, aiming to produce advice within 3-6 months to support timesensitive decision making. However, HTW may, on occasion, undertake full health technology assessment, if required. HTW staff will include information scientists, health services researchers, health economists and other analysts to undertake the evidence appraisal work.
HTW’s work will be undertaken and overseen by two key groups who together will produce advice by NHS Wales for NHS Wales. The Assessment Group will ensure methodological rigour within the appraisal processes, while the Appraisal Panel will be responsible for providing insights from NHS Wales, translating the evidence and tailoring HTW’s advice to reflect the Welsh context. The status of HTW advice is ‘adopt or justify’, with NHS Wales required to adopt the advice or justify why it has not been followed. HTW will evaluate the uptake and impact of its advice. Topics recently appraised by HTW include mechanical chest compression for out-of-hospital cardiac arrest and epithelium-off corneal crosslinking for adults with keratoconus. Part of HTW’s remit is to act as a gateway or front door for non-medicine technologies in Wales, with HTW signposting some enquiries to other partners who may be better placed to assist. Topics currently under appraisal by HTW include Sacral Nerve Stimulation (SNS) for faecal incontinence and Freestyle Libre flash glucose monitoring for diabetes. Anyone can complete a topic proposal form. It is purposefully brief, with 15 key questions that gather information on the technology, key comparators, the rationale for appraisal, the available evidence, peer review groups and Welsh contextual information. The topic proposer is offered a structured 15 minute presentation slot at an Assessment Group meeting, followed by a discussion with the group to enable members to learn more about the technology. The Assessment Group members then assess the topic for inclusion. To fill in a topic proposal form or get more information, please visit the HTW website - www.healthtechnology.wales
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Gwasanaeth Gwybodeg Informatics Service
Digital Health Ecosystem Wales – tasked with increasing digital takeup The Digital Health Ecosystem Wales (DHEW) network is a collaboration between the Life Sciences Hub Wales and NHS Wales Informatics Service (NWIS) and supported by the Welsh Government’s Efficiency through Technology Programme. DHEW has been launched to share digital health innovations and to access NHS Wales’ health and care sector platforms. The key aim is to create a national network, an Ecosystem, to deliver new ways of enhancing wellbeing and the quality of care through the development of digital applications and services. The Ecosystem intends to build an enabling environment which: l Accelerates the delivery and
adoption of the latest digital solutions to improve patient outcomes and reduce costs
l Creates a pathway for access to
health and care data
l Fosters innovation from all
stakeholders, encouraging cross sector cooperation and implementation of new products and services to drive business growth, job security and creation, ensuring prosperity for all
systems. The first API, with NHS Wales Master Patient Index data, was developed to verify the demographic details of patients across Wales and is available now at https://dhew.wales. nhs.uk/hapi-fhir-jpaserver-example/
NWIS’s role is to provide a technical platform to allow industry to access demonstration versions of NHS Wales and other systems. A series of APIs (Application Programming Interfaces) will be launched through 2018 and 2019 to enable software developers across the globe to be able to connect to the demonstration versions of NHS Wales’
The Life Sciences Hub Wales’ role in developing the Ecosystem is to build a network of companies, stakeholders, support providers, NHS and NWIS staff. There will be a series of events held in 2018 and 2019 to give the network chances to come together and discuss new projects, new funding opportunities, new information and technologies.
l Supports the development
The series of events for 2018: July 18th Cardiff City Stadium Future Funding Opportunities Sept 18th Life Sciences Hub Wales AI and Robotics Dec 5th Life Sciences Hub Wales Data and APIs For information on the Ecosystem and to sign up for the events, please go to https://www.lifescienceshubwales.com/ dhew/ or email: digital@lifescienceshubwales.com
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Efficiency through Technology Programme
Working together to reduce harm from postpartum haemorrhage Postpartum Haemorrhage Postpartum haemorrhage (PPH) is the loss of more than 500ml of blood during childbirth. Severe postpartum haemorrhage is a significant contributor to both maternal morbidity and mortality in the UK, and its incidence is increasing. Management of PPH is challenging and requires effective multidisciplinary team (MDT) working in combination with prompt recognition and appropriate use of drugs, surgical techniques and blood products.
OBS Cymru OBS Cymru, the Obstetric Bleeding Strategy for Wales, was launched in November 2016 across the 12 Consultant Led Units in Wales. It is a collaborative Quality Improvement Programme (QIP) which is putting research into practice across Wales, attempting to establish a leading approach to PPH care. OBS Cymru aims to reduce variation in maternal morbidity and improve outcomes associated with postpartum haemorrhage (PPH) across Wales.
OBS Cymru Approach to Postapartum Haemorrhage Management The standardised Four Pillars Management set out by OBS Cymru strives for the early recognition and prompt, patient specific management of a PPH by: 1. Universal risk assessment for all women on admission to the delivery unit. 2. Early identification of haemorrhage by measured blood loss. 3. Multidisciplinary team working and appropriate escalation. 4. Patient specific blood product management using ROTEM, a point-of-care, video-elastometric test for clotting.
Specific Project Aims: l Reduce the number of women
requiring ICU level 3 care due to PPH
l Reduce the number of women
receiving hysterectomy due to PPH
l Achieve more than 50% reduction
in FFP transfusion
l Reduce the number of patients
having massive PPH (≥2500ml blood loss)
l Reduce the number of women
requiring ≥5 units of red blood cells
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Changing Culture OBS Cymru has been met with enthusiasm by the Obstetric MDT across the 12 Consultant Led Units in Wales. The culture with regards to PPH management is changing in Wales and this is very exciting for maternity services. In addition, measurement (rather than
estimation) of blood loss is becoming the norm with about 90% of PPH’s ≥ 1000ml having measured blood loss. There has also been additional interest in the work that OBS Cymru is doing from Obstetric teams in other areas of the UK as well as internationally.
To find out more about OBS Cymru: Email obs.cymru@wales.nhs.uk Visit www.1000livesplus.wales.nhs.uk/obs-cymru Follow @OBSCymru
Bwrdd Iechyd Prifysgol Betsi Cadwaladr University Health Board
Bwrdd Iechyd Prifysgol Hywel Dda University Health Board
Bwrdd Iechyd Addysgu Powys
Iechyd Cyhoeddus Cymru
Powys Teaching Health Board
Public Health Wales
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Using molecular methods for testing of gastrointestinal infections
Ymddiriedolaeth GIG Felindre Velindre NHS Tust
Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru Welsh Ambulance Services NHS Trust
Gastrointestinal infections are common and often transient illnesses. However, these infections can also cause serious and/or life-threatening disease and are a common cause of outbreaks, with norovirus outbreaks, for instance, frequently closing hospital wards in the winter months. For this reason, Public Health Microbiology has been working for some time on introducing advanced molecular methods to improve outcomes for patients and transform diagnostic laboratory workflow algorithms. Compared to conventional microbiology methods, molecular techniques provide an array of benefits in terms of quicker turnaround times, improved sensitivity and process efficiency. In clinical laboratories, molecular techniques are
routinely used to assist in making clinical decisions on the basis of how and when to treat patients. The use of these tests will inform timely and appropriate management of patients with suspected gastrointestinal infections. The short time frame from testing to result could also allow more efficient use of hospital beds and reduce both the number and impact of outbreaks within and outside healthcare facilities. Ceredigion is the first area in Wales to begin receiving a full molecular enteric service. Until recently, the Microbiology team at Bronglais Hospital was unable to provide testing for norovirus and C. difficile, with samples transported to Swansea for C. difficile testing with a turnaround of about two days. Norovirus testing was not available locally and
remote testing was limited and lacked timeliness. Daily testing for these infections is now available, with results sent out in under three hours after the sample cut-off time. Following a successful pilot of the technology, this will be rolled out over the next three years in Swansea, Cardiff and Rhyl.
The financial support from Welsh Government will enable Public Health Wales Microbiology to transform into a first-class National Infection Service.
31
Efficiency through Technology Programme
Bwrdd Iechyd Prifysgol Abertawe Bro Morgannwg University Health Board
Bwrdd Iechyd Prifysgol Aneurin Bevan University Health Board
Bwrdd Iechyd Prifysgol Caerdydd a’r Fro Cardiff and Vale University Health Board
Bwrdd Iechyd Prifysgol Cwm Taf University Health Board
Health technology collaborations transform services in Wales and deliver five-fold return on investment The Bevan Commission Health Technology Exemplars scheme has developed 39 collaborative projects to date which significantly improve health outcomes, patient experiences and resource efficiency. How do you embed technological innovation within NHS Wales at a time when its services and staff are under great pressure? The Bevan Commission Health Technology Exemplars scheme brings together health and care professionals working on the frontline of NHS Wales with industry partners, and provides the support and time needed to collaborate and test out new technologies.
The CANTAB Mobile App
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Bwrdd Iechyd Prifysgol Betsi Cadwaladr University Health Board
Bwrdd Iechyd Prifysgol Hywel Dda University Health Board
Bwrdd Iechyd Addysgu Powys
Iechyd Cyhoeddus Cymru
Powys Teaching Health Board
Public Health Wales
The scheme, which is run in partnership they can get their pioneering technologies between the Bevan Commission, NHS tested and evidenced by NHS Wales, Ymddiriedolaeth GIG Gwasanaethau Wales and technology collaborators Ymddiriedolaeth which can otherwise sometimes prove Ambiwlans Cymru GIG Felindre Welsh Ambulance Services Velindre NHS Tust (supported by the Welsh Government’s difficult to access as an organisation. NHS TrustFor Efficiency through Technology NHS Wales, the scheme provides a front Programme), has developed 39 door to engage with industry partners, successful projects to date which are and evaluate innovative techniques and trialling and evaluating innovative technologies in a contained trial before technologies within clinical pathways. scaling up. For every £1 invested by the Welsh Government, £5 is generated in economic Health Technology Exemplars benefits through in-kind support, waste reduction and staff redeployment. are delivering on the Bevan Commission’s prudent healthcare The incentive for frontline health and care principles, which emphasise the staff is that they are able to introduce importance of collaboration between innovative new technologies, safe in the NHS professionals, community knowledge that their time is backfilled members and industry partners to and supported. For industry partners, create a sustainable and efficient health and care system. Under this prudent and social healthcare model, costs and risks are mitigated through being shared between NHS Wales and technologists.
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Bwrdd Iechyd Prifysgol Aneurin Bevan University Health Board
Bwrdd Iechyd Prifysgol Cwm Taf University Health Board
Bwrdd Iechyd Prifysgol Betsi Cadwaladr University Health Board
Bwrdd Iechyd Prifysgol Hywel Dda University Health Board
Bwrdd Iechyd Prifysgol Abertawe Bro Morgannwg University Health Board
Iechyd Cyhoeddus Cymru
Bwrdd Iechyd Prifysgol Aneurin Bevan University Health Board
Bwrdd Iechyd Prifysgol Cwm Taf University Health Board
Bwrdd Iechyd Prifysgol Betsi Cadwaladr Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru University Health Board
Bwrdd Iechyd Prifysgol Hywel Dda University Health Board
Flagship Bevan Health Technology Exemplar projects include Bwrdd Iechyd a partnership Addysgu Powys between Aneurin Bevan University Powys Teaching Health Board Health Board and Thermal Compaction Group (TCG). This initiative introduced TCG’s recycling technology Sterimelt Ymddiriedolaeth to the health board to turn hospital GIG Felindre Velindre NHS Tust plastic waste (such as clinical wrap) into polypropene blocks that have commercial value and can be used to develop new products. As a result, recycling (which costs hospitals money) is transformed into a revenue stream. The innovative project has picked up several industry awards, including a South Wales Business award under Success through Innovation and a NHS Sustainability award for Innovation (through Aneurin Bevan University Health Board). Another successful Bevan Health Technology Exemplar is a collaboration between Betsi Cadwaladr University Health Board and Philips Healthcare, called Good NEWS 4 Home. Modern healthcare is challenged by both the increasing complexity of medical patients
Public Health Wales
Bwrdd Iechyd Prifysgol Caerdydd a’r Fro Cardiff and Vale University Health Board
Welsh Ambulance Services NHS Trust
Bwrdd Iechyd Addysgu Powys
Iechyd Cyhoeddus Cymru
Powys Teaching Health Board
Public Health Wales
Ymddiriedolaeth GIG Felindre Velindre NHS Tust
Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru
Philips Healthcare’s Intellivue Guardian Solution and the systems that document their condition, treatment and test results. Hidden within this data is information that can help doctors to decide which patient might be able to safely return to their own home. Philips Healthcare’s Intellivue Guardian Solution collects data on vital signs such as blood pressure, heart rate and speed of breathing and is able to run algorithms with this data as it is created. Betsi Cadwaldr medical professionals used this technology to collect vital signs from the patient’s bedside, benchmarking against Philips Healthcare’s UK-wide data which is summarised in the National Early Warning Score (NEWS). They have used this data to generate and test ‘decision support rules’ for safe discharge, identifying groups of patients who are very unlikely to become unstable and who could therefore be offered care in their own home, in rehabilitative hospitals or care homes. In 2017 the initiative was shortlisted for the HSJ Patient Safety award with an associated study which focused on a monitoring system for vital sign data. A final successful case study is the partnership between Abertawe Bro Morgannwg University Health Board and Cambridge Cognition Ltd. This Bevan Health Technology Exemplar sought to improve timely diagnosis of dementia by using a cognitive measurement tool, the CANTAB
Welsh Ambulance Services NHS Trust
Mobile. By using the CANTAB Mobile, mental health nurses and healthcare workers are able to triage patients more effectively by ‘screening in’ only those with a clinically significant memory impairment. The CANTAB Mobile, a touch screen iPad application, is an effective test of cognition and is 100% sensitive and 92% specific in detecting Alzheimer’s disease. It shows a sequence of abstract shapes to rapidly establish whether memory impairment is clinically significant or not, enabling healthcare professionals to make accurate and timely referrals to diagnose dementia. Its trial at Abertawe Bro Morgannwg University Health Board has been very successful in triaging for clinically significant memory impairment and the tool has since been recommended for all referrals to Memory Assessment Services throughout Wales. Healthcare professionals and technologists alike are invited to make their innovative ideas a reality and replicate the success of the previous Bevan Health Technology Exemplars, with the next open call open now. If you want to introduce an emerging technology to a clinical pathway, or develop a collaboration between NHS Wales and an industry partner, find out more and apply via the Bevan Commission website at www.bevancommission.org
33
Efficiency through Technology Programme
National e-learning platform developed for NHS Wales NHS Wales has a duty to provide safe, effective, high quality care through a workforce that is competent, skilled and compliant to provide that service. E-learning has a critical place in developing and sustaining a competent workforce and supporting strategic imperatives. Challenges identified in a baseline audit undertaken in 2014 revealed: Duplication of e-learning – E-learning was developed locally by individual organisations. Lack of collaboration resulted in duplication in the development of e-learning, as well as differences in quality, pedagogy, style and design. Unnecessary repeat training – Most e-learning modules lacked robust assessment, variations in content, target audiences and refresher periods. This restricted portability and resulted in unnecessary repeat training as staff moved between organisations in NHS Wales. Duplication of training solutions – Organisations across NHS Wales used different e-learning platforms and IT solutions, making it impossible to accurately report NHS workforce compliance. Cost – A significant amount of e-learning was being externally commissioned. Many suppliers produced e-learning on a licence basis, making it expensive to share e-learning across organisations or sectors. Accessibility – E-learning modules that were equally relevant to the wider public sector, Welsh university undergraduates, primary care etc, were not available or accessible to these sectors.
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To release efficiencies and maximise benefits, a national project was undertaken with the agreed strategic milestones: l Development of e-learning in line with policy and business requirements,
ONCE. This would require a strategy and processes that all NHS Wales organisations would align with.
l E-learning materials developed collaboratively, then shared across all NHS
Wales organisations, as well as the wider public sector.
l All e-learning would carry a competence assessment test to enable portability,
allowing competence to move with the individual throughout their career, eliminating unnecessary repeat training.
l E-learning would be quality assured using evidence based approaches. l Consistent and real-time compliance reporting to be available locally and
nationally to enable assurance visibility (as recommended in the NHS Wales Workforce Review 2016).
The overall vision of ‘Once for Wales’ and commitment to prudent healthcare principles enabled buy-in with the following benefits and improvements achieved over the last 18 months: l Removal of 10 legacy learning management systems to ONE single national platform. l Development of a co-productive model of collaboration that eliminated duplication of
e-learning modules and enabled the development of national e-learning materials ‘Once for Wales’.
l Development of processes to quality assure e-learning content, pedagogy and assessment
question banks.
l Development of national competences that eliminates unnecessary re-training. l Establishment of robust governance, management and support models of e-learning
development.
l Partnerships with Wales universities and primary care enabled access to core e-learning for
students and contractors. This approach is in line with the Future Generations (Wales) Act (2015).
l Establishment of a free operating model that completely eliminates licence costs. l Agile e-learning development. 300 e-learning courses have been developed/enhanced by
Wales for Wales.
l Accessibility in use of e-learning. There are now around 250,000+ e-learning users
registered.
l Utilisation. The average number of monthly learners has increased from 500 (2014) to over
20,000 (2016) 30,000 (2017).
This project has delivered a ‘One Wales’ national e-learning platform with courses available 24/7, 365 days a year at home or work. Access via mobile devices is being piloted to allow further flexibility.
Bwrdd Iechyd Addysgu Powys
Iechyd Cyhoeddus Cymru
Powys Teaching Health Board
Public Health Wales
Ymddiriedolaeth GIG Felindre Velindre NHS Tust
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Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru Welsh Ambulance Services NHS Trust
New defibrillators for more accurate heart attack diagnosis The Welsh Government’s Efficiency through Technology Programme supported a three year project which enabled Welsh Ambulance Service Trust (WAST) clinicians to send a diagnostic electrocardiogram (ECG) direct to patient-receiving cardiac centres in Wales and England. In 2014, WAST upgraded their standard defibrillator to the Corpuls3. One of the features of the Corpuls3 is the ability to send diagnostic ECGs to a secure web based platform via a 3G SIM card for viewing. This enables a paramedic – wishing to access a specialist centre to have a clinician to clinician discussion supported by the receiving unit – being able to view the ECG, accept or reject the patient or contact a senior clinician to review. Previously the decision to transfer patients directly to a PPCI was made by a paramedic diagnosing an acute myocardial infarction, following completion of a patient assessment which included reviewing a 12 lead ECG. Introducing telemetry has improved this process by ensuring that a patient’s ECG can be viewed ‘live’ by a specialist team who can then have a clinical discussion with WAST teams and provide support to the decision making process. This ensures that there is a robust process in place when making decisions around access to specialist centres, so the patient receives the right care and the time to reaching a tertiary centre is minimised.
The aim of the project is to increase the accuracy of diagnosis of patients suffering a heart attack to ensure that they receive the right intervention, at the right time, in the right place. Benefits are planned to include: l A reduction in a patient’s length
of stay in hospital
l A reduction in the number of
expensive interventions being performed on patients e.g. coronary artery bypass grafts
l A reduction in the number of
patients transferred to secondary care to enable them to have faster PCI treatment to increase their chance of survival
l An increase in the number of
patients referred to primary care or appropriate local care pathway where clinically appropriate for further assessment and treatment of Atrial Fibrillation
Baseline data collection and first quarter data collection within WAST has been gathered for the Cardiff and Vale area, and has already demonstrated a 50 per cent reduction in the number of secondary transfers required. The project is currently entering the third and final phase of its delivery, in which patients diagnosed with Atrial Fibrillation will be referred to primary care or an appropriate local care pathway where appropriate. This will explore the opportunities to identify patients with previously undiagnosed Atrial Fibrillation, which doesn’t require immediate admission to hospital, to be referred to primary care for follow up consultation. This will be supported with the diagnostic ECG taken at scene to be sent to the primary care physician. The project is due for completion in March 2019 when an evaluation of the project’s achievements over the three years will be undertaken.
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Efficiency through Technology Programme
Bwrdd Iechyd Prifysgol Abertawe Bro Morgannwg University Health Board
Bwrdd Iechyd Prifysgol Caerdydd a’r Fro Cardiff and Vale University Health Board
Community mobilisation project Bwrdd Iechyd Prifysgol Aneurin Bevan University Health Board
Bwrdd Iechyd Prifysgol Cwm Taf University Health Board
Bwrdd Iechyd Prifysgol Betsi Cadwaladr University Health Board
Bwrdd Iechyd Prifysgol Hywel Dda University Health Board
A community mobilisation project, supported by £2.5m Iechyd of funding from the EfficiencyBwrdd Addysgu Powys through Technology Programme, Powys Teaching Health Board has enabled Abertawe Bro Morgannwg University Health Board (AMBUHB) to connectYmddiriedolaeth Felindre with staff who previously hadGIG Velindre NHS Tust limited or no access to digital services. The project focused on the roll-out of 2,500 iPads to staff in the community and the provision of health board services to staff on their own devices. Underpinning the health board’s move to mobilising its workforce is investment in Wireless Infrastructure. At the end of March 2018, following £3.5m investment from Welsh Government, ABMUHB completed the wireless enablement of Singleton Hospital and a number of community sites. This means that all the health board’s main sites are now wirelessly enabled, allowing them to provide free WiFi for patients, visitors and staff, as well as providing a platform to offer mobile solutions to clinicians at the point of care. At the beginning of the Mobilisation Project, ABMUHB recognised that approximately 3,000 community-based staff did not have regular access to a dedicated computer, and 5,000 staff had no access at all. Therefore the aim of the project was to create the ability for ABMUHB to connect with all staff electronically through the provision of appropriate infrastructure and a combination of corporately and personally owned mobile devices. More than 3,000 devices are now using the service, of which 1,800 are personal. 2,500 corporately owned personally enabled (COPE) devices are being rolled out to community clinicians. The initial stages of the project allowed ABMUHB to establish the infrastructure,
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Iechyd Cyhoeddus Cymru Public Health Wales
district nurses to see whether it is getting better or worse, and determine whether an appointment with a specialist is required. Other features include a countdown timer to remind patients when they need to move in order to relieve pressure and get blood flowing again.
Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru Welsh Ambulance Services NHS Trust
iPad app for pressure ulcer prevention policies and technical ways of working to support mobile deployments across the health board. For example, neonatal units were provided with iPads so that mothers could see and speak to their babies while they were in the Special Care Baby Unit. Also, a trial was successfully completed using iPads to support sign language provision. When signing is required, ABMUHB contacts the Wales Council for Deaf People, which arranges for an interpreter to be present. However, there are times when, due to unforeseen circumstances such as illness or bad weather, or when patients need urgent or emergency care, an interpreter is unable to attend. In the trial, a deaf patient accessed sign language interpretation via a live FaceTime link, without an interpreter needing to be at the hospital in person. Another successful trial involved an iPad app created by PUPIS, ABMUHB’s multidisciplinary Pressure Ulcer Prevention and Intervention Service, with Welsh Government funding. The app is aimed at both monitoring pressure ulcers and preventing them from developing in the first place. It allows photographs of a pressure ulcer to be uploaded and details to be logged, which helps patients and
Using iPads in the community setting has led to substantial efficiency savings. For instance, the Neath Port Talbot Acute Clinical Team’s use of devices to manage caseload and new referrals has introduced a time saving of 60 minutes per day per Health Care Support Worker, 80 minutes per Staff Nurse, and 160 minutes per Contact Officer. The Neath Port Talbot Community Resource Team’s use of digital dictation has introduced an efficiency saving of 2 hours per day per member of staff. Across the community services, Digital Champions have been identified, who are responsible for engaging their team in embracing new ways of working and using the technology available to improve quality of care and patient outcomes.
The Mobilisation Project has also enabled adoption of high profile national programmes, including the implementation of Welsh Community Care Information System (WCCIS). The aim of WCCIS is to help health and social care staff work together to provide care closer to people’s homes. When fully implemented across Wales, it will overcome the obstacles posed when different organisations use different IT systems. Meanwhile, access to the Welsh Clinical Portal allows clinical services to view patient demographics, blood results and GP record summaries at the point of care in the community setting.
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Innovation in the Welsh life science industry 39
Innovation in the Welsh life science industry
How a symbiotic relationship can deliver commercial success Medical product designers, GX, have built a reputation for solving complex and challenging problems. In many cases, companies enlist the help of GX’s skilled design engineers to review existing products in order to improve a product’s performance or even resolve a specific issue. This multidisciplinary approach to product design has ensured global success for a leading international ultrasound scanning and training company – Medaphor. Following an initial request four years ago to review the design for their already successful training aid, ScanTrainer™ Compact, Medaphor’s own production team has continued to collaborate with the design team at GX. Developed to simulate transvaginal ultrasound scanning, the ScanTrainer quickly became a popular training device for sonographers. As orders grew, Medaphor wanted lower and more efficient production costs, so in 2014 enlisted the help of the design team at GX to value engineer their product. The design team at GX liaised closely with the production team at Medaphor to review production costs. These cost reducing revisions allowed Medaphor to export their innovative teaching aid to new markets globally and become recognised as a world leader in self-learning for sonographers and obstetricians, culminating in Medaphor winning the Export
Achievement Award at the 2016 Medilink UK Healthcare Business Awards. The association between Medaphor and GX is the perfect example of how a symbiotic partnership can yield success for medical products. GX has a multi-disciplinary way of working, drawing on experience from one sector to solve problems in another. What’s more, with in-house expertise in mechanical, industrial, electronic, software and system design and engineering, they adopt a collaborative approach to problem solving. Most recently, the design team at GX has once again worked alongside Medaphor to expand the scope of the ScanTrainer’s training capabilities. With GX’s help, the ScanTrainer Compact can now easily adapt to teach transvaginal scanning as well as transabdominal scanning. Core to the design revisions was ease of use as Gary Ross, GX’s design director, recalls: “Since this was already a well-used medical training device we wanted to be able to enhance the learning experience. Based on feedback we knew that the haptic technology incorporated in the main unit provided a perfect simulation, so we concentrated our efforts on seeking ways to be able to quickly convert the training device from one format to another.”
The design team at GX’s solution was able to re-engineer the base the unit sat upon. By adding an ergonomic armrest, including adjustable height and rotation, this allowed the operator freedom of movement. They also engineered two probes, one each for the different scanning purposes. Throughout the engineering process the team at GX were equally mindful of production costs; the rotational arm rest was designed with just two clamps, plus the unit could be assembled from the top face, enabling fast reconfiguration between training modes.
Since its inception in 2014, a study by Copenhagen University Hospital concluded that the ScanTrainer Compact had greatly accelerated ultrasound scanning skills. It is now exported worldwide and has led to Medaphor opening an office in Hong Kong to develop their customer base within the Asia-Pacific region.
www.gxgroup.com
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Fighting persistent bacterial infections in slow-to-heal wounds Neem Biotech’s pioneering work into what has recently become known as phenotypic antimicrobial resistance is gathering momentum. This concept broadens the idea of antimicrobial resistance as it is conventionally understood and encompasses the idea of host outcome in broader terms than only microbiological cure. The past two years have seen the company develop and hone its nonantibiotic small molecule technology for use against chronic lung infections in cystic fibrosis to also include a potential solution for persistent bacterial infections that are often found in slow-to-heal wounds.
Pseudomonas aeruginosa and Staphylococcus aureus frequently occur in wounds that are slow to heal. These bacteria can impede the rate of healing in wounds by forming biofilms that in turn limit the effectiveness of conventional antibiotics and the body’s own innate immune system to clear bacterial infections. These persistent bacterial infections translate to high medical costs, poor quality of life for patients and their significant others and increased opportunity for proliferation of antimicrobial resistance. When used together with conventional antibiotics or antiseptics, Neem’s compound NX-AS-911 disrupts the
biofilm formed by these bacteria and allows for greater effect of the prescribed medications and the body’s immune system.
Preparations are underway for a first-in-human clinical trial to be carried out in collaboration with the Welsh Wound Innovation Centre. A successful trial of NX-AS-911 would be an important step for the company and a critical milestone within the realm of wound management towards becoming a wellness society rather than an illness society.
www.neembiotech.com
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Innovation in the Welsh life science industry
Quadruple success in design awards Over the past year, Huntleigh has received four prestigious design awards for healthcare products created in collaboration with design consultancy PDR. In 2017, the company won an iF award for its range of Digital Hand Held Dopplers, which are used in both vascular assessment and obstetric applications. Designed to perform when you need it most, the new Dopplers offer reliability that clinicians can depend on, making their jobs easier, safer and more efficient. Judged by a panel of over sixty renowned experts in design, industry and architecture, iF design awards identify where state of the art design combines with the highest levels of quality and performance.
different to any of its predecessors, with the inclusion of more powerful features and a touch-screen for the first time. The competition received more than 5,500 entries from 54 countries and winners were chosen by an international jury seeking to reward products that stood out for having exceptional design qualities.
This win was soon followed by another one – a Red Dot award for Huntleigh’s fetal monitor Sonicaid Team 3. The design of the Sonicaid Team 3 is fundamentally
2018 then began with Huntleigh winning two Good Design awards – for the Sonicaid Team 3 and the DMX Digital Doppler. Founded in Chicago in 1950, Good Design remains the oldest and most recognised programme for design excellence worldwide.
www.huntleigh-diagnostics.com
Overseas investment secured to support business growth Welsh health technology company Bond Digital Health has secured £200,000 equity investment from an overseas investor, which is the first step of a planned £1 million funding round in 2018. The investment will be used to support the rapid growth of the business, including creating new jobs. Bond Digital Health develops digital healthcare solutions that operate in the ‘clinical whitespace’ void between patient visits for healthcare professionals. The company’s cloud-based solutions transform reactive intermittent treatments into real time, proactive, continuous care. The team’s technical expertise in app development and data management information systems, combined with an innovative approach to business development, won them £500,000 in commercial contracts in their first year of operation.
Based at the Life Sciences Hub in Cardiff Bay, the company is currently working with some of the leading Point-of-Care test and diagnostics developers in the UK. They are applying patient-centred software developments to cutting edge lateral flow tests, making them much more user friendly for both patients and healthcare professionals. Operating in this rapidly growing lateral flow market, the company aims to become the software partner of choice.
Alongside their B2B software services, Bond Digital Health has their own grant-funded development projects. The company has successfully won Innovate UK grants for internal R&D projects as well as jointly with partners developing lateral flow diagnostic tests.
www.bondhealth.co.uk
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Toasting export success of mid-Wales company CellPath Ltd, a Wales-based family owned company specialising in the manufacture and worldwide supply of Cellular Pathology equipment, consumables and services, has been celebrating a brace of recent export awards. December 2017 saw CellPath presented with the MediWales Export Achievement Award, given for ‘maximising opportunities to develop new markets and outstanding performance in other areas of international trade.’ Following this success, CellPath was shortlisted in the national Medilink UK awards alongside other regional winners. With over 300 attending the ceremony held in April 2018, it was CellPath who was once
again celebrating, picking up the prestigious Export Award. These awards are testament to the successful implementation of an aggressive export strategy, focused on developing key distributor and OEM relationships through providing advanced product training, marketing assistance, designated customer care support and increasing brand awareness. Over the last year, CellPath has also exhibited at over 15 international events in the USA, Canada, Western and Eastern Europe, as well as the Middle East which has helped the company increase year-on-year turnover by over 37 per cent.
Any potential negative impact on customer service levels from the increased demand has been negated through the opening of a state-of-the-art International Distribution Centre, which has allowed the company to operate more leanly and shorten delivery times for customers. On top of this, CellPath’s market-leading archive management solution, branded CellNass, has also grown overseas. CellNass has now been successfully franchising to Belgium, Holland and Denmark. Following extensive research, CellNass GmbH has also recently been set up as a joint venture in Germany and has already attracted several potential customers.
www.cellpath.com
Clinical trial contract services come to Rhymney Valley Having purchased a large former pharmaceutical packaging site in mid-2017, Sharp Clinical Services are bringing their specialist clinical trial services to Rhymney, South Wales. Sharp is now nearing completion on a significant redevelopment of the site as a multiple-phase pharmaceutical manufacturing, packaging and distribution facility. The company will relocate its existing pharmaceutical manufacturing production from Crickhowell, Powys to the new large-scale facility. At 110,000 square feet it offers triple the existing capacity to
Sharp’s global pharmaceutical, biotech and clinical research centre clients. Sharp Clinical Services support pharma clients in clinical trial management from their early pre-clinical studies right through to full commercialisation stage. The company offers support for Phase I to IV clinical trial and commercial projects and the new site at Rhymney will extend to manufacturing and analytical capabilities, as well as automated bottling, blistering, serialisation and IRT services for commercial and clinical trial management.
The increase in capacity means Sharp can offer full service support for larger global clinical studies and customers from this new European clinical centre of excellence. According to Frank Lis, President of Sharp Clinical Services: “The move to Rhymney will enable us to offer expanded capacity, scalability and automation, meaning we can simultaneously support multiple large-scale Phase III studies, as well as projects at an earlier trial stage. It will also allow us to grow the Sharp team to support current business and to expand our clinical services portfolio to new customers, at a larger scale”.
www.sharpservices.com
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Innovation in the Welsh life science industry
Connected pressure care systems bring array of benefits A conversation over a beer on a Friday night led to a joint venture, in which an IT entrepreneur joined with a healthcare equipment company to design and manufacture the world’s first Smart (IoT) Pressure Care Mattress System. Now, nearly two years later, CloudCair Ltd have dispatched their first order to Australia. They also have interest from a number of other export markets, as well as several NHS Trusts closer to home. By monitoring the performance of these systems remotely, unplanned downtime can be reduced to zero. This means no patients at high risk of pressure ulcers lying on ineffective mattresses, no clinician’s time wasted on reporting faulty systems, and no unnecessary moving and handling. The connectivity also allows the alarm to
be remote, thus reducing the risk of alarm fatigue. The systems are so advanced that they can often be repaired remotely, and the status, location and usage of the systems can all be tracked centrally. The reengineering of a dated design has also allowed the company to reduce the system from a 240 volt operation to 15v. It has significantly reduced the energy usage, allowed an extended battery backup feature and meant that CloudCair can confidently offer a five year warranty on their systems.
Phil Spiby, MD of CloudCair, said: “We set out to design a product that improved things for everyone, changing nursing practice, improving patient experience and reducing lifetime costs by increased efficiencies. The technology we have developed is very powerful.”
www.cloudcair.com
Data integrity guidelines result in a need for Clarity South Wales based business Clarity Compliance Solutions provide regulatory compliance consultancy to Pharmaceutical, Biotech, R&D, Medical Device companies and to their suppliers of equipment, software and computerised systems. In May 2017, Clarity joined MediWales and began to network, building relationships with fellow members and industry professionals. For many years, Clarity have been supporting clients with all aspects of Data Integrity and Computer Systems Validation, building up a wealth of client inspection experiences. Much of this due to the recent questions the MHRA/FDA have raised in this industry hot topic. Even more so since March 2018, when the MHRA published its GxP Data Integrity guidelines, formally including GCP, GDP, GLP, GMP and GVP. Clarity have built relations with Welsh organisations, supporting Data Integrity
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programs with site and program audits, weaving Data Integrity into the fabric of the client organisation and creating a positive quality culture. Offering up a ‘Data Integrity Toolkit and Data Governance Framework’ allowing clients to leverage and tailor a unique set of tools - policies, strategic plans, assessment checklist, risk management,
reporting, new project development life cycle and project handover criteria. Clarity are in dialogue with a number of organisations in Wales to support projects and further develop their strategy to deliver a ‘Compliance Partner – a One Stop Shop for Compliance Needs’ to the Welsh life sciences sector.
Recent compliance activities provided to clients in Wales include: l West Wales - DI training, DI and CSV strategic governance and consulting and implementation of EDMS l Cardiff - Agile SDLC methodology gap analysis, development and delivery of bespoke training and support for EDMS project l Cardiff - Review of CSV compliance, development of compliance roadmap l Cardiff - Provision of CSV consultant to support FDA inspection readiness and various CSV projects l Cardiff - Open-forum DI training course
www.clarity-compliance.com
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Antibodies: the workhorse of the life sciences community Ig Innovations Ltd produces antibodies for the diagnostics, research and therapeutic communities. From an academic background the company, through its numerous guises, has over 30 years expertise in the development, production and purification of polyclonal antibodies. As well as offering a service, the company as primary manufacturer has a catalogue of antibodies which it offers for direct sale or through its distributors. More recently, Ig has had a number of successful grant collaborations working on diverse projects such as antibiotic resistance, sepsis, biosensors, epigenetics and currently with exosomes and phage display antibodies. Ig is always looking for close collaborations where it can bring its antibody expertise and resources. Antibodies are the workhorse of the life sciences community. They can be produced to virtually any chemical or biological compounds: low molecular weight drugs/ pesticides, toxins, peptides, proteins, viruses, bacterial and fungi, etc.
Polyclonal antibody production and antibody use is experiencing new demands, through its integration with new technologies, e.g. phage display antibodies, affinity purification and an economical model for exploring the optimum peptide sequences before embarking on the more costly monoclonal or phage display options.
Working with a partner, Ig was able to demonstrate the production of an effective polyclonal antibody therapy for the Ebola virus much more quickly than alternative approaches. www.ig-innovations.co.uk
Wrexham health tech pioneers win top prize Welsh health data company Aparito was a joint winner of the AXA 2018 Health Tech & You Award for early diagnosis of dementia. The UK-wide Awards were held in May at the headquarters of the Royal College of General Practitioners in London. Dr Elin Haf Davies, Aparito’s founder and Chief Executive Officer, who hails from Bala but now lives in London, collected the award for the company’s proposal using a machine learning platform to monitor changes in sleep, activity, voice, activities of daily living and memory collectively. Aparito is proposing a platform that provides wearable devices and diseasespecific mobile apps to provide remote patient monitoring outside of the hospital
“It’s a real achievement for us and we are so proud of the innovative team who have been working so hard to develop the technology. Aparito is going from strength to strength with a number of projects in development and a study taking place in South Africa.” Dr Elin Haf Davies Founder and Chief Executive Officer Aparito environment. This continued monitoring provides real-time data for clinicians to capture subtle differences in ambulation
and sleeping patterns, which can’t be conveyed during short, snapshot clinic visits, in a way that actively supports and enhances diagnosis, treatment and drug development. The company is also developing a tool which can measure differences in speech patterns. This award success caps off a remarkable 18 months for the Wrexham Technology Business Park start-up which was established in 2014. In December 2017, Aparito won the award for ‘Best Start-up’ at the MediWales Innovation Awards.
www.aparito.com
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Innovation in the Welsh life science industry
Leading neurotech company supports future brain researchers Marking eight years of trading this summer, Cardiff based neuroscience technology specialists Rogue Resolutions have much to celebrate. During this time, Rogue Resolutions have become a leading, integrated brain stimulation and brain imaging solutions provider to neuroscientists the world over.
data to prove a research hypothesis to support further funding applications; a Young Investigator Award which recognises the accomplishments of slightly more established neuroscientists and a range of workshops covering a variety of brain stimulation and brain imaging techniques.
Working in collaboration with some of the world’s most renowned brain research centres including University College London’s Institute of Neurology, Cardiff University’s Brain Research and Imaging Centres (CUBRIC), The USA’s National Institutes for Health and the Max Planck Institute in Germany to name but a few.
The future of neuroscience lies in the next generation of researchers and BrainBox Initiative is an investment in that future. So far, the scheme has supported four Research Challenge winners by donating the equipment needed to conduct initial studies. The two 2017/18 winners are investigating the effects of transcranial electrical stimulation (tDCS) on Autism and also the use of functional near infrared spectroscopy (fNIRS) and EEG to explore the neural basis of stuttering.
Being deeply passionate about neuroscience and its future, founders Andrew Thomas and Dan Phillips recently set about creating a scheme to help support early career neuroscientists. Last year saw
the launch of the BrainBox Initiative: a programme of activities planned throughout the year designed specifically to provide researchers starting out with opportunities to present their research, help lift their profiles, develop their knowledge of neuroscience techniques and recognise their achievements. The BrainBox Initiative consists of a Research Challenge that provides winners with the tools they need to gather pilot
www.rogue-resolutions.com
Award for business development newcomer Judith Parker, Public Health England (PHE)’s Business Development and Marketing Manager, joined the Business Development team in July 2017 to support commercial opportunities across PHE’s scientific portfolio of products, services and innovations. Before joining PHE, Judith previously enjoyed a long and varied career in the NHS including 10 years’ experience establishing and delivering physical and mental health services. Judith champions marketing of PHE’s innovations, products and services, to defend and grow the agency’s circa £180 million external income, which defrays a third of its operating budget. These range from consultancy services to support the development of global public health services to training and exercise provision to ensure effective response to emergency situations. Although PHE’s statutory remit is England, it has a strong engagement with all home nations. With Wales, for example, PHE has
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been working with academic, private and public sector organisations. For instance, with Cardiff University, in the development of rapid diagnostics for sepsis; MicroPharm Limited (part of Flynn Pharma), in the development of therapies for Clostridium difficile and Ebola; and Public Health Wales, in topics ranging from clinical entrepreneurship to public health observatories. Since joining PHE, Judith has won the UK Pharmaceutical Licensing Group (PLG) business development best newcomer of the year award, having been recognised for her early achievements, which she attributes to the support she has been given by her colleagues within the business development team. On winning the award, Judith reflected: “Whilst I must be the oldest recipient of the ‘newcomer’ award from the PLG, winning the award reinforces the view that you are never too old to step up to new challenges and learn new skills.”
Judith was nominated by PHE’s senior business development manager Dr S.S. Vasan.
“Within a short time of making her transition to business development, Judith not only grasped the complexity of the job, but also brought in fresh perspectives from her transferable skills and NHS experience. This award vindicates our approach that we are not only able to provide an excellent environment for newcomers but also quickly mentor them into their role to deliver impact.”
Dr S.S. Vasan Senior Business Development Manager, PHE
www.gov.uk/phe
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Pharmaceutical giant chooses UK’s first Diabetes Centre of Excellence Swansea University Medical School’s Joint Clinical Research Facility (JCRF), in collaboration with the Diabetes Research Unit Cymru, has been chosen by the Sanofi Global Network as the UK’s first Diabetes Centre of Excellence.
The JCRF is a joint enterprise between Abertawe Bro Morgannwg University Health Board (ABMU) and Swansea University Medical School, and the Diabetes Research Unit Cymru is funded by Welsh Government via Health and Care Research Wales. Having worked closely on several clinical studies for Sanofi, Swansea University Medical School was chosen after the JCRF repeatedly demonstrated its ability to deliver a first class service.
Professor Steve Bain, ABMU Assistant Medical Director for Research and Development and Clinical Lead for the Diabetes Research Unit Cymru, said: “The
JCRF has an excellent track record for rapid recruitment and patient retention which is vital to the successful delivery of clinical trials. The vast experience of investigators in the Diabetes Research Unit Cymru, along with their accredited laboratory and public reference panel, enables a comprehensive service across diabetes research. We look forward to working on the exciting pipeline of drugs in development with this major pharmaceutical company.” Professor Keith Lloyd, Dean of the Medical School, added: “We know diabetes and related metabolic conditions are a leading cause of ill health and premature mortality regionally, nationally and globally, which brings with it huge financial pressures for our health services. This is Sanofi’s first ever UK Diabetes Centre of Excellence and is testament to the ongoing superb work by Professor Bain and his team here at the Medical School and at ABMU Health Board. The centre will work across all areas of diabetes research to help address the important social and healthcare needs in diabetes… As a top 5 UK Medical School, we are working to ensure the wealth of diabetes expertise we have within the school has impact both in terms of research to
develop new drugs and treatments but also to upskill our NHS workforce. We are delighted to have just launched our first distance learning MSc in Diabetes Practice which starts in September. This course will provide advanced knowledge, clinical skills and experience to support NHS staff in an environment of increasing complexity of diabetes care and to combat the decreasing numbers of diabetes specialist nurses (DSN) as highlighted by the Diabetes UK DSN Workforce Survey 2016 despite the increasing number of people diagnosed with diabetes in the UK.” Victoria DiBiaso, global head of Clinical Operations Strategy & Collaboration at Sanofi, commented: “The goal of this partnership is to apply the JCRF’s diabetes research expertise to help accelerate the conduct of Sanofi’s clinical trials. Fostering relationships with key research sites, combined with our global and UK clinical study unit’s operational experience in each phase of trial development, helps us advance medically meaningful studies for the benefit of patients.”
www.swansea.ac.uk
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Innovation in the Welsh life science industry
Crossing borders to get patient voices heard What is ataxia? A Greek word meaning ‘lack of order’. People with ataxia have problems with movement, balance, and speech. It’s a condition that gradually makes you lose control of your body and there is no cure.
The mission of Ataxia and Me is to “bring back the order to the lack of order”. Patients that happen to have a rare disease often need to ‘cross borders’ in order to get their voice heard. These borders could be physical, geographical and psychological.
Since joining the MediWales network, Ataxia and Me has attended and exhibited at many events and contributed to many meetings and conferences. Although independent, they are keen to collaborate with others in order to make patient engagement a normal practice.
Interacting and networking with the life science community through MediWales has given Ataxia and Me the knowledge to compile and launch its patient adventure poster at a large (Orphan Drugs) conference in Barcelona. A patient-led, patient-focused group based in Wales with a global following. Follow on social media Twitter @ataxiaandme Facebook @ataxia and me Instagram @ataxia_and_me
Diagnostic company spots business incubation opportunity Q5 Healthcare, which specialises in the diagnosis of infectious diseases, has become a tenant at the medtech and biotech incubator, Cardiff Medicentre. Having now taken up new space at the leading facility located in the grounds of the University Hospital of Wales, the team led by Medicinal Chemist Dr Raj Rao is developing a suite of diagnostic test kits for use by GPs and
clinics. These kits will help medical professionals all over the world pinpoint a patient’s infection at the point of care without having to conduct further investigation or send samples for laboratory testing. The company’s attention is currently fixed on primary care, particular the NHS, with the aim of providing a better, more efficient way of diagnosing and treating infections. Q5 Healthcare is preparing for commercialisation, with efforts being invested in honing its initial product. The company’s first device patent has recently reached international publication stage, and the product’s launch is planned for early 2019. The aim is
“Our main activity at the moment is in the fields of women’s intimate health and acute systemic infections, where the incorrect diagnosis of infectious diseases that frequently occurs often results in the wrong treatment being prescribed, and possibly poor treatment outcomes.”
Dr Michael Graz Managing Director Specialist in infectious diseases Q5 Healthcare
then to complete the development of at least four other diagnostic products that are currently in the pipeline. The company will be working with an innovative company based in Pontypridd to produce its first diagnostic device, and all manufacturing and marketing will take place in and from South Wales. In the longer term, the Q5 team is hoping to recruit locally to bring in several scientists as well as operations, and sales and marketing staff once commercialisation is underway.
www.q5healthcare.com
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Technology facility demonstrates focus on quality Central Biotechnology Services is a Cardiff University Technology Facility. It is based in the College of Biomedical and Life Sciences and is part of the Clinical Innovation Partnership between Cardiff & Vale University Health Board and Cardiff University. Its three focus areas are Genomics and Bioinformatics, Proteins and Diagnostics, and Cell Analysis/Imaging platforms.
9001:2008, had to transition to this new version before September 2018. Central Biotechnology Services transitioned a year and a half ahead of this deadline.
In March 2017 Cardiff University’s Central Biotechnology Services Technology Facility (CBS) successfully transitioned to ISO 9001:2015, the latest version of the ISO 9001 certification. All organisations certified to the previous ISO standard, ISO
This quality management system leads to improved efficiency, time savings and costs savings through the continual improvement of procedures and the streamlining of operations. Most crucially, these benefits result in improved customer satisfaction
To make this transition, an independent audit was carried out by the British Standards Institution (BSI) whereby Central Biotechnology Services demonstrated its commitment to quality by having an efficient and thorough quality management system in place.
as the quality and speed of the services to customers is increased, with a ‘right first time’ attitude adopted across the facility. Customer feedback confirms that this strong corporate governance and focus on quality is very important, enabling Central Biotechnology Services to broaden its appeal to a wide range of customers both within Cardiff University and externally.
www.centralbioserv.co.uk
Award and investment for social prescription technology company Signum Health is the brainchild of Victoria Norman, a primary care and public health specialist. Victoria worked in the health sector for 15 years before launching Signum Health in 2017. Signum Health uses artificial intelligence and cloud-based technology to deliver remote health care and support within local communities. Its Social Prescribing Platform enables GPs and other healthcare professionals to refer patients to non-clinical services across the public, private and third sector. This saves the NHS money and provides reassurance and convenience for patients.
The business was recently boosted by a six-figure equity investment lead by Development Bank of Wales, with further investment obtained from private investors, bringing its total fundraising to £600,000.
In May 2018, Signum Health also won the award for ‘Best Application of Tech’ at the ESTnet Wales Technology Awards. Speaking about winning the award, Victoria said: “The last 12 months have been incredibly exciting for us at Signum Health. Not only are we working towards changing the world of health and social care, but we’ve secured some big investments this year and even welcomed a new Chairman, Professor Stephen Smith FMedSci, who is former CEO of Imperial College NHS Trust. To win this award, and to be selected from such an
impressive shortlist, really is the icing on the cake.” To increase their range of services, Signum Health has acquired a sophisticated online diagnostic tool which was developed at the University Hospital Wales, Cardiff. It has already been used by medical practitioners around the UK to remotely diagnose a range of skin conditions and allergies. It can also diagnose 17 other medical conditions remotely and so has the potential to scale quickly.
www.signum-health.com
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Innovation in the Welsh life science industry
Developing novel microbiological air sampling technology Bridgend-based design and manufacturing company Pinpoint Scientific Limited have completed a proof of market study for novel microbiological air sampling technology. This work was partly funded by a grant from Innovate UK and has allowed Pinpoint to clearly understand the commercial opportunity and user requirements for a novel, isolator compatible microbial air monitor. Pinpoint Scientific is already leading the way in innovation with its premium continuous air monitor, ImpactAir, which is being used by top global pharmaceutical companies.
“Microbial air monitoring is a critical process within demanding environments such as aseptic and injectable medicines manufacturing. This requires highly efficient and accurate monitoring and control for optimal detection of viable particles. We are delighted that Innovate UK chose to support this study and believe it has been good value for both parties. The outcome has given Pinpoint the data to move forward with confidence into design and manufacturing of new products that can meet user and regulatory needs and be commercially successful.”
Gethin Jones Founder and Managing Director Pinpoint
Building on existing technology developed by Pinpoint and used in its ImpactAir system, work has now begun on the first phase of product design and development, with an initial launch planned for July 2018.
This will be followed by further product design and development to produce an alternative miniaturised version by mid-2019.
www.pinpointscientific.com
Funding boost for jellyfish collagen
M A RINE BIOTECHNOLOGIE S
Cardiff-based Jellagen has received £3.8m in funding to accelerate sales of its next-generation jellyfish-based medicine. The marine biotechnology firm is the first commercial manufacturer of jellyfish collagen, which is a a substance that can be used for wound care and regenerative medicine
“Jellyfish represent a source of ‘next generation’ collagen with diverse application potential, including for research in the medical, biotech and pharmaceutical markets. Because of the evolutionary lineage of jellyfish collagen, it presents the market with a valuable alternative to more conventional sources.” Professor Andrew Mearns Spragg
Founder and Chief Scientific Officer Jellagen
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Jellagen will use the investment to accelerate sales of its products into the cell culture market and regenerative medicine, whilst growing its specialist management team and strengthening its intellectual property portfolio.
The first range of products developed by the firm are cell culture reagents, which are used to grow stem cells. They also plan to produce medical devices engineered around jellyfish collagen.
www.jellagen.co.uk
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