NHS Innovation Awards 2010 Winners

More than 170 people from Industry and the regional NHS gathered at Weetwood Hall on Wednesday April 21st for Medipex’s 2010 NHS Innovation Awards evening.

The sponsors of this year’s Innovation Awards and Showcase 2010 were NHS Yorkshire and the Humber, Skills for Health, UDL, Yorkshire Forward, Medilink Yorkshire and Humber , South Yorkshire CLAHRC, South and West Yorkshire CLRN and CPD4 Health Innovation.

£10,000 in total prize money was awarded to the winners in the 4 categories; Medical Devices and Diagnostics, Software and ICT, and Publications, Publications and Training Materials and Innovation Adoption and Diffusion.

Software and ICT

Jonathan Ross from Sheffield Teaching Hospitals NHS Foundation Trust was the winner in the Software and ICT category with ‘Computerised, self-learning, autonomous control of Automated drug-infusions to support the Cardiovascular System in patients post Cardio Pulmonary Bypass’.

Circulatory failure, ‘shock’, displays wide variation in severity and rate of progression, and often is fatal. Management involves co-ordinating multiple drug infusions to maintain multiple cardiovascular variables within accepted bounds. Computer control of this therapy is notoriously difficult as every patient is unique, with infinitely variable presentations of myriad illnesses and widely varying responses to diseases and therapies. Patients’ responses in time and magnitude are notoriously non-linear; there is inter- and intra- patient parameter variability as well as outcome uncertainties, so the management of the multi-input, multi-output system is challenging. Conventional computer programming with all the necessary rules to achieve this successfully would take infinite time. No-one has managed to automate this treatment.

Automation is a ‘Holy Grail’ of ITU as many of the features of computerisation/ automation are highly prized in the clinical setting, including accurate control of target values through 24 hours of the day; no variability on expertise of the treating staff; their reliability and dependability. An automated system would allow less highly-trained staff to care safely for patients, thereby reducing staffing costs.

Following an extremely successful project funded by the Engineering and Physical Sciences Research Council between 2005 and 2008, myself and two Control Engineer colleagues from the Automated Systems and Control Engineering Department at the University of Sheffield achieved a ‘world-first’, demonstrating truly autonomous computer control in a clinical trial of three different Intensive Care patients’ cardiovascular systems. We published a series of breakthrough papers and abstracts demonstrating that a computer could control therapeutic drug infusions to precise target values demanded by a senior clinician without prior knowledge of the patient, or the possible responses to therapy. I developed the novel, hierarchical system of control rules from scratch. No pre-existing research work stratified the cardiovascular system, or the predicted responses in this novel manner.

Medical Devices and Diagnostics

The winner of the Medical Devices and Diagnostics Category, Alexander Oboh from Hull and East Yorkshire Hospitals NHS Trust entered the competition with a New Obstetrics forceps for assisted vaginal delivery.

Alex’s innovative idea is to produce a new obstetric forceps for assisted vaginal delivery (AVD) to reduce the risk of trauma to the baby and mother during childbirth. Globally 10-15% of births are AVD with either the forceps or vacuum devices. The forceps device has a higher success rate for AVD. The major drawbacks of the current forceps device are; the risk of trauma to the perineum of the mother and baby due to use of excessive traction force, the device being made of steel and its success being dependent on the operator’s skill and experience. Whilst the vacuum device been improved over time, there has been no innovative improvement to the forceps devices.
The new obstetric forceps have been designed with an in-built safety device to regulate the amount of traction force that can be applied to achieve a vaginal delivery. The operator is simultaneously able to see the amount of force being applied (from a traction force indicator built into the device) and get additional auditory and tactile feedback once the maximum traction force is exceeded. This removes individual variations in the maximum amount of force used and the risk of use excessive traction force. The new device will be single use and made of lightweight recyclable non-steel materials. This has environmental benefits and in low-resourced countries reduces the risk of cross infection and the cost of sterilisation.

Innovation Adoption and Diffusion Category

Debrah Bates from Northern Lincolnshire & Goole Hospitals NHS Foundation Trust was the winner with “Promoting breastfeeding through stopping the free supply of formula milk to newly delivered mothers in Northern Lincolnshire ” in the Innovation Adoption and Diffusion Category.

The aim of this innovation was to encourage and support mothers to acknowledge the benefits of breastfeeding for themselves and their infant and to encourage them to initiate breastfeeding at delivery.

In May 2009 the Maternity Services within Northern Lincolnshire & Goole Hospitals Foundation Trust stopped providing women, who had delivered well babies, formula milk with the intention improving breastfeeding rates through the promotion of breastfeeding. This is both a local Public Health Target, a Strategic Health authority CQuINS target and links closely to recommendations of the National Services Framework, Standard 11, Intervention 10.6 – ‘Where women choose to bottle feed, they are encouraged to take into hospital the bottles, teats and formulae feed they plan to use’.

The Trust stopped providing bottles, bottle brushes, teats, formula feed and sterilizing tablets to mothers who delivered well babies and who had made the informed decision to artificially feed their infant.

During the antenatal period midwives discuss feeding options and promote the benefits of breastfeeding. Women are informed at this time that if they choose to bottle feed their babies then they must supply their own formula milk whilst they are in the hospital. At delivery, all women are asked if they would like to put their baby to the breast. It has been noted that on occasion, some women have put baby to the breast rather than prepare the bottle feed that they have brought with them.

It has proven very rare that women do not bring formula feeds with them. Occasionally, partners have had to make a short trip to local supermarkets in the area to buy formula feeds, although the ward does stock a few bottles of artificial milk for emergency purposes only. These are rarely used.

The innovation also provides staff with an opportunity to ensure that those mothers who make the informed decision to artificially feed their baby know or learn how to sterilise equipment and prepare artificial feeds safely prior to being discharged home.

At the time of the innovation I was Head of Midwifery and developed the strategy and led on the implementation.

Publications and Training Materials

Heather Angilley from Mid Yorkshire Hospitals NHS Trust was the winner in the category Publication and Training Materials with her innovation “Working together to help children with developmental coordination disorder in Wakefield.”

The idea is to develop a pathway for early identification of children with this condition, involving both the health and education services.  Following on from this, to develop a treatment programme that is easy to use, requires minimal preparation and uses existing resources in schools.

Teaching and Education staff are trained to recognise movement disorders, with a particular emphasis on DCD which affects approx 6% of the population. Teaching staff identify children who require intervention and the pathway guides them through the various stages. Most children can be helped in school using the programme described below; only the more intractable conditions require formal referral to the NHS.

The intervention programme is set out in a loose-leaf folder. This has 10 sections covering areas such as ball skills, scissor skills and visual tracking. It has received positive feedback from schools, who find it easy to use and popular with the children. The therapy takes place in small groups within school. Educational Support Assistants screen each child using an assessment tool included in the programme. If a child is making measurable progress they continue with the programme. If they are not, they can then be referred for NHS therapy via the school health service. Early identification forms part of the SEN code of practice, and the programme provides the child with earlier access to targeted support while reducing the number of referrals to NHS therapy.

Medipex would like to acknowledge and thank the sponsors and supporters of our 2010 Innovation Competition: