Plaster which sticks inside the mouth will revolutionise treatment of oral conditions

University of Sheffield| June 2018 | Plaster which sticks inside the mouth will revolutionise treatment of oral conditions

The University of Sheffield’s School of Clinical Dentistry has collaborated with scientists from Dermtreat A/S, Copenhagen have created a unique patch which is able to adhere to moist surfaces due to a special polymer. The patch not only provides a protective barrier to the affected area, but is able to administer steroids directly to oral ulcers or lesions .

Up to this point, ulcers and lesions inside the mouth have been treated using either creams, ointments  or mouthwashes, which are used in the whole mouth rather than targeting the specific area, making them less effective. However, the biodegradable Rivelin® patch, has a long adhesion time and a high flexibility which makes it suitable for the surface inside the mouth.

Now funding from venture capitalists  will enable the patches to be tested in phase two clinical trials, which will run at several sites – including at the Charles Clifford Dental Hospital in Sheffield. (Source: University of Sheffield).

The study’s findings have been published in the journal Biomaterials 

Abstract

Oral lichen planus (OLP) and recurrent aphthous stomatitis (RAS) are chronic inflammatory conditions often characterised by erosive and/or painful oral lesions that have a considerable impact on quality of life. Current treatment often necessitates the use of steroids in the form of mouthwashes, creams or ointments, but these are often ineffective due to inadequate drug contact times with the lesion. Here we evaluate the performance of novel mucoadhesive patches for targeted drug delivery. Electrospun polymeric mucoadhesive patches were produced and characterised for their physical properties and cytotoxicity before evaluation of residence time and acceptability in a human feasibility study. Clobetasol-17-propionate incorporated into the patches was released in a sustained manner in both tissue-engineered oral mucosa and ex vivo porcine mucosa. Clobetasol-17 propionate-loaded patches were further evaluated for residence time and drug release in an in vivo animal model and demonstrated prolonged adhesion and drug release at therapeutic-relevant doses and time points. These data show that electrospun patches are adherent to mucosal tissue without causing tissue damage, and can be successfully loaded with and release clinically active drugs. These patches hold great promise for the treatment of oral conditions such as OLP and RAS, and potentially many other oral lesions.

Full reference:   Colley,H.E., Santocildes- Romero, M.E., Baker, S.R., D’Apice, K.D, Hansen^cL, Madsen, S., Thornhill, M.H., Hatton, P.V. & Murdoch, C. | Pre-clinical evaluation of novel mucoadhesive bilayer patches for local delivery of clobetasol-17-propionate to the oral mucosa | Biomaterials | Vol. 178| P. 134-146 | https://doi.org/10.1016/j.biomaterials.2018.06.009

Opportunity for innovators to develop hi-tech solutions to major health and care challenges

NHS England | 2018| NHS England and UK Space Agency launch multi-million pound drive to improve patient care

As part of a joint initiative with NHS England, The UK Space Agency has announced a £4 million of funding that it is allocating to the NHS.  The funding is available to help address four  specific health and care challenges in the NHS.

These include:

• Managing long term conditions including joining up health and care services
• Earlier diagnosis of cancer
• Transforming GP services and other primary care
• Meeting mental health needs

The initiative exists to design for use in space will be adapted into medical applications to improve NHS treatment and care. The four successful innovators will be supported by the UK Space Agency, NHS England and the European Space Agency

Space technology has a history of being utilised in the NHS, notable examples include a pill camera that patients swallow, wearables to prevent falls among the elderly, apps that help to prevent skin cancer, breast screening vans that send images to assessment centres

Professor Tony Young, NHS England’s national clinical director for innovation, said: “Throughout its 70 year history the NHS has been at the forefront of healthcare innovation.

“Through this competition we are seeking the latest greatest, ideas and technical solutions to help address the modern challenges facing our health and care services.”

The UK’s space industry builds 40 per cent of the world’s small satellites and 25 per cent of the world’s telecommunications satellites. It supports 40,000 jobs and generates £14 billion in revenue across the country.

Full details on how to become involved are available  from NHS England here

Ground breaking neck collar will help to ease pain for patients with MND

An innovative five- year project involving University of Sheffield, Sheffield Hallam University, &the NIHR Devices for Dignity (D4D) MedTech Co-operative, which is hosted by Sheffield Teaching Hospitals, has culminated in developing a revolutionary neck collar for patients with motor neurone disease (MND). The collar has been developed to ease pain for people with MND, as well as making tasks such as eating and communication easier (via University of  Sheffield). 

Patients with MND helped to create the collar, which provides personalised support to the collection of small muscles in the neck which are particularly vulnerable to the wasting effects of the debilitating disease.  A frequent problem caused by MND is the loss of strength in the neck, causing patients heads to droop to the side or the front. Before the Head Up Collar, the majority of the head supports available to MND patients resemble the restrictive braces used after a trauma, with alternatives being soft fabric collars. The Head Up collar has already been trialled in 10 different sites by over 100 MND patients – four-fifths  of whom felt the collar helped them and they wanted to carry on using the collar after the trial.

 

 

Full details of the Head Up Collar can be found at the University of Sheffield 

Paramedic’s ‘light bulb’ moment saves the NHS more than £2 million

NHS England | May 2018 | Paramedic’s brainwave eases A&E pressures by keeping “frequent callers’ away

A senior  paramedic who noticed that a small number of patients used a lot of NHS resources and staff time came up with the idea to address their problems with an innovative programme. Rhian Monteith arranged a scheme where the frequent callers were able to meet for coffee and a chat.  The scheme The High Intensity User programme was innovated by Rhian who collaborated with other teams to compile  a list of 23 patients, many suffering from mental health problems or loneliness, who had visited A&E more than 700  times during the previous three months, mostly by ambulance. Through personal mentoring and one-to-one coaching, as well as getting them involved with community activities, the patients were encouraged to phone her rather than dial 999.

Rhian helped A&E attendances, 999 calls and hospital admissions drop by about 90 per cent among the group.  The scheme was then scaled up to cover about 300 patients in Blackpool over the following three years, saving the NHS more than £2million. It has now been rolled out to around a fifth of the country with 36 local heath teams adopting the scheme. (Public Health England)

The full news story is at NHS England 

How digital innovators are transforming the NHS

Public | April 2018 | The promise of Healthtech: How digital innovators are transforming the NHS 

Innovations such as cloud computing,  VR, 3D printing, genomics and artificial intelligence all provide opportunities for the NHS to sustainably relieve the
demographic and financial pressures it faces. Public, an organisation that helps startups to support the public sector, cautions that “without major reform, the NHS may see a £30 billion funding gap open up over the next three years alone.”

There are three factors driving this change, they are  the growing, ageing populations who are net consumers of public services, especially health care.  The rise in long-term, chronic conditions evident across all age groups.  The compounding effect of higher demand for health services and higher expectations for those health services as, in many cases, more expensive treatments become standard.  The report includes a feature on ‘Healthtech 27’ which are the most promising startups in healthcare.
Nicola Blackwood, the author of this report and former Health Innovation Minister,
argues that the NHS is still ‘risk averse’.  As part of this research, Public surveyed a number of health startups- they also spoke to NHS professionals, interviewing key decision-makers across the health and care landscape-to explore some of the barriers to innovation.

These interviews revealed:

• Lack of clarity about evidence 
• Regulation of digital health products is fast evolving
  
• Slow procurement
  
• Partial interoperability 
  
• Unclear data security standards 
• Limited change management and digital skills

 

Image source: public.io

Alongside this, Healthtech also predicts 9 areas of opportunity for the future

1. Procurement and productivity 
2. Recruitment and training 
3. Prevention
4. Winter pressures and supported self-care
5. AI in Pathology and Radiology
6. Patient safety
7. Mental health
8. Social care
9. Research 

‘Price match’ scheme created by Sheffield doctors helps to save £2 million

NHS England  | April 2018  | Pioneering price match scheme frees up millions for frontline care

A collaboration between doctors at hospitals in South Yorkshire which enabled them to purchase larger quantity of product has led to savings of  £2 million.  Among the savings  was a £400,000 in buying only one type of examination glove.

The clinician-led scheme in Sheffield  involved seven hospitals and required them to agree on the best product and commit to bulk buy jointly to save money. They used a scoring system on all products to ensure they met the high standards necessary for use by the NHS, with the products which met all of these criteria and provided the best value for money selected.  This led to an innovative ‘price match’ scheme that drove down the cost of simple items such as anti-embolism stockings and surgical gloves. 

Full story from NHS England 

 

Successfully Scaling Innovation in the NHS

In Against the Odds: Successfully scaling innovation in the NHS, the Innovation Unit and The Health Foundation identity 10  different UK innovations.  The authors look at various case studies to explore how these insights build on, and challenge, existing wisdom in the NHS.

Image source: http://www.innovationunit.org

The key findings of the report include:

• The ‘adopters’ of innovation need greater recognition and support. The current system primarily rewards innovators, but those taking up innovations often need time, space and resources to implement and adapt an innovation in their own setting.
• It needs to be easier for innovators to set up dedicated organisations or groups to drive innovation at scale. Scaling innovation can be a full-time job, and difficult to do alongside front-line service delivery. Dedicated organisations are often needed to consciously and strategically drive scaling efforts, including when innovators ‘spin out’ from the NHS.
• System leaders need to take more holistic and sophisticated approaches to scaling. Targets and tariffs are not a magic bullet for scaling; while they can help, they don’t create the intrinsic and sustained commitment required to replicate new ideas at scale. Different approaches are needed, including articulating national and local health care priorities in ways that create strategic opportunities for innovators, and using commissioning frameworks to enable, rather than hinder, the sustainable spread of innovations.

 

The full report can be found here