A Medical Device Daily

A report detailing new ideas and inventions generated by the 1.3 million people who work in the National Health Service (NHS) was unveiled by the service last week.

In the 12 months up to March 2004 NHS Innovations, which is made up of a network of regional innovation centers known as NHS Innovations Hubs, handled nearly 500 new ideas brought to them by NHS staff. Of these, 100 new ideas were then selected for further development, and the NHS Innovations Hubs helped broker licenses for 24 of them. Patients are now benefiting from the products in use in the NHS.

The new inventions include:

• Child Imaging Chair: To obtain good quality images during kidney scans, children must be as still as possible. This specially designed chair ensures children do not move around so that accurate images can be obtained. The Imaging Chair was the idea of a medical physicist at Newcastle-upon-Tyne Hospitals, NHS Trust.

• X-Ray needle placement manikin: This mannequin mimics the human body in the feel and position of internal organs and bones. It is used in training to administer complicated epidural pain relief which involves placing needles into the spine and skull. This idea came from a consultant anesthetist at Salford Royal Hospitals, NHS Trust.

• E-PAQ, an electronic pelvic floor symptoms assessment questionnaire: Some medical conditions can be difficult for patients to discuss freely with their doctor, which can lead to uninformed consultations, poor diagnosis and poor condition management. This electronic patient questionnaire is completed in a private area of the waiting room, and the doctor can see a printed analysis before the consultation. This idea came from a consultant surgeon at Sheffield Teaching Hospitals NHS Foundation Trust.

• Pupilometer: A portable eye measuring device that paramedics can use at accidents sites to measure the size and responsiveness of the pupils of head injury victims. It allows a quick and accurate assessment of the possible extent of their injuries. This idea was that of a senior medical technologist at Newcastle-upon-Tyne Hospitals NHS Trust.

Nine NHS Innovations Hubs have been established based on the nine English Regional Development Agencies. Each serve the NHS organizations in their area, helping the NHS Trusts and Primary Care Trusts to develop their understanding of innovation, identify those new ideas which need development, and advise on licensing the best products to the industry. The products can then be accessed by the NHS and other healthcare markets.

Dr. Tony Bates, NHS intellectual property advisor and founder of NHS Innovations said: “Until the Hubs were created, an employee with an exciting innovation had nowhere to go. Good ideas leaked out, often going abroad, and any benefits to the inventor, the NHS and UK industry were lost. The clinician, technician or researcher can come up with discoveries which often have the potential to develop into new products or innovations in service delivery. NHS staff can be at the forefront of invention.“

Health Minister Lord Warner said: “Our aim is to create an environment in the NHS in which innovation is at the heart of our business. Establishing NHS Innovations Hubs was a major first step in recognizing the creative potential that lies within the NHS and enabling staff to get their ideas accepted whilst protecting intellectual property rights.“

He added: “The NHS is a rich source of excellent ideas that, if tapped, can provide enormous benefits for the NHS, for the inventors, for the patients and for the UK economy.“

Genetic screening comes with stress, anxiety

People screened for genetic disorders must have appropriate follow-up and monitoring to avoid stress and anxiety, according to new research from Cardiff University (Cardiff, Wales), sponsored by the Economic and Social Research Council (ESRC). Those with a condition may also find it difficult to have their disease diagnosed and treated satisfactorily, and there can be surprisingly little or no access to genetic counseling, according to the study.

These are among the key issues identified in a unique three-year project led by Professor Paul Atkinson of Cardiff University, examining the consequences of genetic screening.

It calls for urgent attention to these issues from health policymakers and planners.

Focusing on the disorder Genetic Haemochromatosis, the research team followed up otherwise healthy blood donors whose blood was tested as part of a study by Cardiff haematologists, and who were identified as susceptible to the disorder. Haemochromatosis causes the body to absorb an excessive amount of iron from food, and this can lead to damage to the liver and other body tissues.

The research found that identifying individuals as being at risk does not automatically mean that other potentially vulnerable members of the family will be alerted. People picked out as being at risk, but who did not yet have any symptoms, were not unduly anxious about their health, provided they felt they were being monitored and looked after. As a result, they often did not feel the need to pass on information about the condition to blood relatives who might also be at risk.

The study reveals that the risk status of individuals can be fraught with uncertainty. Identifying the gene does not predict with any degree of certainty whether full-blown symptoms will ever develop or, if they do, their severity or timing of onset.

Atkinson said: “Since the genetic science is still in its infancy, population screening exposes people to tentative projections of risk without giving them anything definite to go on.“

Screening for individuals who are at risk results in simple forms of medical management of the condition, including periodic bleeding to reduce the overload of iron. But there may be a more complex and expensive consequence for health services if such people need continuing support and advice.

Atkinson said: “Population screening can create a considerable burden of counseling and follow-up for primary and secondary health care services.“ And he warned that as population screening becomes available for an increasing variety of medical conditions, this burden will have to be assessed and related costs determined very carefully.

“The costs will be considerable, and may not be the best use of resources, which may be better directed to good diagnosis of the clinical condition“, he said.

Researchers also interviewed people with full-blown clinical Haemochromatosis, and members of the Haemo-chromatosis Society, which provides support and information for those affected by the disorder.

They found that, in contrast to the screened individuals, people with the symptoms of the condition had often experienced considerable difficulty in receiving an accurate diagnosis and suitable treatment from their general practitioner.

According to Atkinson: “There is a clear need for better diagnosis for those who develop the clinical symptoms who, if untreated, can suffer serious damage to their health. Because Genetic Haemochromatosis is relatively uncommon, GPs are not necessarily well equipped to recognize the symptoms of the disease for what they are.“

The research project, “Genetic screening for susceptibility to disease: the case of haemochromatosis,“ was funded by ESRC, the UK's largest funding agency for research and postgraduate training relating to social and economic issues.

Atkinson is Distinguished Research Professor in the School of Social Sciences, Cardiff University, and is Associate Director of the ESRC-funded Centre for Social and Economic Aspects of Genomics.