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		<title>NHS Showcase Items</title>
		<link>http://www.nic.nhs.uk</link>
		<description>The latest Showcase Items.</description>
		<copyright>Copyright 2012 NHS.</copyright>
		<item>
			<id>1</id>
			<title>VNUS Closure</title>
			<summary>This clinically proven, minimally invasive procedure treats varicose veins and their underlying cause, venous reflux, quickly and with little or no pain. </summary>
			<description><![CDATA[Conventional treatment for varicose veins involves surgery to strip them out; a procedure that can be painful for the patient and is relatively time-consuming and expensive for the NHS. Full patient recovery after varicose vein surgery can take several weeks and it is estimated that, following vein stripping, 36% of patients require an overnight stay in hospital.
By contrast, the VNUS Closure procedure is minimally-invasive and carried out under local anaesthetic, usually in a simple treatment room rather than an operating theatre. The Closure procedure involves inserting a fine catheter into the affected refluxing vein. The catheter is connected to a VNUS RFG Plus radio frequency generator which generates radiofrequency energy. Using this energy, the catheter heats the vein wall in 7cm segments to a precisely controlled temperature, at which point the vein starts to shrink and close. As the vein closes, the blood collected in it is diverted to a healthy vein. Over time, the treated vein is simply absorbed by the body and in 6-12 months it is virtually invisible on ultrasound. Because the vein is shut down, there is no need for the closed vein to be surgically removed.
Closure patients can walk away from the vein procedure and return to everyday activities, at home and at work, within a day.
Benefits for the NHS and patients each year


    Generates potential savings for the NHS of &#163; 17 million
    More than 7,000 patients will be saved further treatment due to failed alternative methods
    For same costs, a further 25,000 patients could be treated earlier and avoid pain or discomfort


]]></description>
			<link>http://www.showcase.nic.nhs.uk/ShowcaseDetails.aspx?id=1</link>
			<pubDate>Fri, 20 Mar 2009 00:00:00 GMT</pubDate>
			<Benefits>
				<additional>
					<content><![CDATA[
A recent US study, commissioned by VNUS Technologies,&#160;compared the VNUS Closure procedure with another non-invasive treatment option - Endovenous Laser Ablation ( EVL or EVLT).&#160;This &#8216;head to head&#8217; randomised controlled trial, found that VNUS Closure patients experienced significantly less pain, less bruising and fewer complications than those treated with endovenous laser.
 &#160; 
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					<thumbnail-path>http://www.showcase.nic.nhs.uk/Nic.Common/file.ashx?path=Images%5cShowcaseItems%5c1%5cclip_image002.jpg</thumbnail-path>
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				<key>
					<content><![CDATA[The key benefits for patients are a hospital stay of just a couple of hours, treatment under local rather than general anaesthetic and a much faster recovery time; patients can usually walk out of the treatment room unaided and are usually able to return home and resume work within a day with little or no pain.
The major benefits for the NHS lie in the fact that this procedure is much less resource-intensive than surgery. Conventional varicose vein stripping is a common operation, taking-up a great deal of operating theatre time. Because the VNUS Closure procedure can be carried-out in a treatment room, it has the potential to free-up theatre-time, enabling the NHS to treat other serious conditions more quickly and so reduce waiting-times. 
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				<specifications>
					<content><![CDATA[The VNUS Closure system consists of a radiofrequency (RF) generator and disposable single-patient use catheters. The radiofrequency generator delivers RF energy to the catheter, enabling controlled vein lumen contraction. Temperature and power are continuously monitored for optimal performance.&#160; A simple and intuitive user interface, combined with a large, colour screen and optimised internal software, helps make the procedure easy to administer.
The catheter runs over a .025 guide-wire and is controlled by the Surgeon with a built- in energy delivery control switch. The catheter&#8217;s unique Segmental Ablation Technology delivers controlled radiofrequency energy to the vein wall. Unlike other endovenous ablative methods, that depend on a manual pull-back method, this catheter delivers in seven centimeter segments whilst the catheter is stationary. Segmental Ablation Technology thus eliminates problems of uncontrolled and inadequate energy delivery with too slow or too fast pull-back.

VNUS Closure&#174; and VNUS RFG Plus&#8482; are registered trademarks of VNUS Medical Technologies, Inc.
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				</specifications>
				<statistics>
					<content><![CDATA[It is said that as many as one in three adults in the UK suffers from venous reflux and / or varicose veins at some point in their life, and varicose vein treatment is one of the most common hospital procedures. Almost 90,000 varicose vein operations were carried-out by the NHS in 2005-06 (Source: Hansard), whilst approximately 20,000 similar operations were conducted privately (Source: Univ. of Birmingham) producing a total of around 110,000 procedures per year. As long ago as 1999, a study conducted by the University of Edinburgh, put the total cost to the NHS at between &#163;400m and &#163;600m.
It is difficult to compare accurately the direct costs of conventional surgery and VNUS Closure, but as the procedure is carried out under local anaesthetic without an overnight stay, and performed with minimal staff in a simple treatment room, it is clear that, by freeing-up staff and hospital operating theatres and reducing both treatment and recovery times, this technique offers significant benefits for the NHS. Cost savings are estimated to be between &#163;40 and &#163;450 per patient, depending on whether or not the patient requires an overnight stay. 
There are wider economic benefits too, with patients being able to return to work almost immediately after their procedure with little or no pain.
]]></content>
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				</statistics>
			</Benefits>
			<trials>
				<medical-centre>
					<name>Bristol Royal Infirmary</name>
					<postcode>BS1 3NU</postcode>
					<url>http://www.uhbristol.nhs.uk/</url>
				</medical-centre>
				<medical-centre>
					<name>Burnley Health Care NHS Trust</name>
					<postcode>BB10 2PQ</postcode>
					<url>http://www.hospitalsineastlancs.nhs.uk/</url>
				</medical-centre>
				<medical-centre>
					<name>Charing Cross Hospital</name>
					<postcode>W6 8RF</postcode>
					<url>http://www.imperial.nhs.uk/charingcross/index.htm</url>
				</medical-centre>
				<medical-centre>
					<name>Darent Valley Hospital</name>
					<postcode>DA2 8DA</postcode>
					<url>http://www.dvh.nhs.uk/</url>
				</medical-centre>
				<medical-centre>
					<name>Newport Hospital</name>
					<postcode>NP44 8YN</postcode>
					<url>http://www.wales.nhs.uk/</url>
				</medical-centre>
				<medical-centre>
					<name>Nottingham University Hospital</name>
					<postcode>NG5 1PB</postcode>
					<url>http://www.qmc.nhs.uk/</url>
				</medical-centre>
				<medical-centre>
					<name>Royal Cornwall Hospital</name>
					<postcode>TR1 3LJ</postcode>
					<url>http://www.rcht.nhs.uk</url>
				</medical-centre>
				<medical-centre>
					<name>Southampton General Hospital</name>
					<postcode>SO16 6YD</postcode>
					<url>http://www.suht.nhs.uk</url>
				</medical-centre>
				<medical-centre>
					<name>St Mary’s Hospital</name>
					<postcode>PO30 5TG</postcode>
					<url>http://www.iow.nhs.uk/</url>
				</medical-centre>
				<medical-centre>
					<name>Wakefield Hospital</name>
					<postcode>WF1 3JS</postcode>
					<url>http://www.midyorks.nhs.uk/</url>
				</medical-centre>
			</trials>
		</item>
		<item>
			<id>2</id>
			<title>Non-invasive glucose meter</title>
			<summary>People with Diabetes will be able to simply look into this device to measure their glucose level. Similar in appearance to a mobile phone, the Glucose Meter will eliminate the need for the traditional ‘finger stick’ procedure that many users find painful and cumbersome.</summary>
			<description><![CDATA[People with Diabetes could soon avoid painful finger-prinking glucose tests and, at the same time, save NHS money.&nbsp; 
Healthcare company, Lein Applied Diagnostics, have developed a non-invasive way of measuring glucose levels by shining a low-power laser beam into the eye. The device promises to alleviate both the pain and the cost of the traditional way of obtaining a glucose-level test, i.e. drawing blood several times a day using a disposable testing finger-stick. 
The Glucose Meter can record other important information such as the thickness of the cornea and lens; so may prove useful for other medical applications. Lein Applied Diagnostics are currently undertaking clinical trials and are developing a hand-held device that will be around the size of a mobile phone.
"We are delighted to announce the successful closure of this first stage of Lein's current round. This funding will allow us to build on our successes to date and implement and validate our technology in its hand-held form." (Dr Dan Daly)
Benefits for the NHS and patients each year

    Potential savings of &#163;30 million pound annually
    Significant social and comfort benefits for patients

]]></description>
			<link>http://www.showcase.nic.nhs.uk/ShowcaseDetails.aspx?id=2</link>
			<pubDate>Mon, 02 Mar 2009 13:07:00 GMT</pubDate>
			<Benefits>
				<additional>
					<content><![CDATA[
 
Because the device also measures the tear film, ocular lens and anterior chamber (aqueous humour filled area between the cornea and the lens) in the eye it offers the promise of additional diagnostics. There is potential to measure the level of pharmaceutical drugs in the body and for the optometry market both glaucoma testing and laser refractive or cataract surgery can benefit.

 
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				</additional>
				<key>
					<content><![CDATA[Dispensing with the current method of intrusive blood sampling has human and financial benefits.
The cost savings to the NHS are immense if &#8216;finger stick&#8217; testing can be replaced. At present a single-use disposable &#8216;finger stick&#8217; is used to draw blood each time the sufferer performs their glucose test. The global finger-stick market is valued at approximately &#163;5.9bn billion per annum and is growing at 10% per annum.
The long term physical and emotional health of Diabetes sufferers can be improved. The already painful, intrusive, inconvenient and unhygienic process can eventually lead to callused fingertips. Also, some patients don&#8217;t test themselves as often as necessary which can increase their susceptibility to other health problems.
]]></content>
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					<thumbnail-path>http://www.showcase.nic.nhs.uk/Nic.Common/file.ashx?path=-1</thumbnail-path>
				</key>
				<specifications>
					<content><![CDATA[The current prototype is hand-held size, with plans to make it the size of a mobile phone. The meter shines a low power beam of light into the eye and uses a special optical arrangement (a confocal configuration) to localise the measurement at one point in the eye at a time. By scanning this measurement point through the eye, knowledge of the glucose level in the body is obtained.
Reflections from the anterior chamber of the eye are used to calculate the glucose level, with each scan taking about 1/8 of a second. The meter analyses the measured data in real time, rejecting data if the patient is misaligned. By this method only good data is obtained. There are also a number of features within the system that help the patient to position the device correctly in order to take a good reading.
]]></content>
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					<thumbnail-path>http://www.showcase.nic.nhs.uk/Nic.Common/file.ashx?path=Images%5cShowcaseItems%5c2%5cglucose_meter.jpg</thumbnail-path>
				</specifications>
				<statistics>
					<content><![CDATA[The number of people with Diabetes across the globe is estimated at around 246 million (Source: International Diabetes Federation). In the UK, 2.3 million people suffer from the disease (Source: Diabetes UK). Due to the increase in the aging population and the prevalence of obesity these figures are set to grow, almost doubling by 2025 (Source: Diabetes UK). This is a major concern as the NHS is already spending &#163;1m an hour, 10% of its yearly budget, treating Diabetes and its complications (Source: Diabetes UK).
To control their condition, people with Type 1 Diabetes normally test their blood glucose concentration four to five times a day. To do so, they take a blood sample by pricking their finger tip.
]]></content>
					<thumbnail-title>Source: http://www.who.int/diabetes/facts/en/</thumbnail-title>
					<thumbnail-path>http://www.showcase.nic.nhs.uk/Nic.Common/file.ashx?path=Images%5cShowcaseItems%5c2%5clein_stats2.jpg</thumbnail-path>
				</statistics>
			</Benefits>
			<trials>
				<medical-centre>
					<name>Royal Berkshire Hospital</name>
					<postcode>RG1 5AN</postcode>
					<url>http://www.royalberkshire.nhs.uk</url>
				</medical-centre>
			</trials>
		</item>
		<item>
			<id>7</id>
			<title>TwistDX Rapid Portable MRSA Test</title>
			<summary>The spread of MRSA in hospitals could be curtailed with a quick, on-the-spot test being developed by a company in Cambridge. Based on a revolutionary new technology, TwistDX has designed a rapid, portable test specific for the DNA of Methicillin-resistant Staphylococcus Aureus (MRSA).</summary>
			<description><![CDATA[TwistDX&#8217;s new MRSA test is a major improvement on conventional testing methods. Current arrangements require highly-trained personnel and a centralized testing facility, and take up to 48 hours to produce results. By contrast, the TwistDX testing equipment is portable, easy to use and produces on-the-spot results within 15 minutes. 
The new testing device uses a revolutionary technology called Recombinase Polymerase Amplification, or RPA, which employs enzymes to amplify small amounts of DNA to detectable levels. When a patient enters hospital, a nasal swab is taken. The swab is inserted into the TwistDX device, which is small enough to sit on a nurse&#8217;s station. The device is able to detect the presence of MRSA within 10-15 minutes. Any person found to be carrying the bacteria can then be isolated, in accordance with the hospital&#8217;s infection control procedures.
Because it enables infected patients to be identified and treated more quickly, whilst reducing the chances of transmission to other patients, this rapid, portable system of MRSA testing has the potential to deliver not only cheaper and more efficient testing but also significantly better patient outcomes at substantially lower cost.
]]></description>
			<link>http://www.showcase.nic.nhs.uk/ShowcaseDetails.aspx?id=7</link>
			<pubDate>Tue, 31 Mar 2009 23:00:00 GMT</pubDate>
			<Benefits>
				<additional>
					<content><![CDATA[TwistDX&#8217;s new MRSA testing system is the first in a potentially wide range of DNA diagnostics applications for the company&#8217;s RPA technology. Other possible applications include medical diagnostics, public health (eg water testing), veterinary testing, agriculture and &#8216;bio-defence&#8217;.
The RPA technology on which all these DNA Diagnostics applications are based is highly portable, produces results quickly and is highly sensitive. (It can detect single copies of DNA and tens of copies of RNA.) RPA can also operate easily to single molecule levels, permitting the detection of trace levels of targets even in extremely complex nucleic acid samples. It can be readily applied to any DNA or RNA target and can be used to detect several different targets simultaneously. It is easy to use (because it does not necessarily require a &#8216;clean&#8217; sample), has relatively low &#8216;upfront&#8217; adoption costs and requires no refrigeration. 
]]></content>
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					<content><![CDATA[

TwistDX&#8217;s rapid, portable MRSA testing system will enable hospitals to test newly-admitted patients for MRSA earlier, more easily, in greater numbers and at considerable lower cost. And because the new system will produce results within 15 minutes rather than two days, it will enable hospitals to isolate and treat patients carrying the MRSA virus much more quickly. This in turn will lead to lower transmission and infection rates, better patient outcomes and a reduction in the number of lives lost to MRSA. Together, these benefits should also deliver very significant reductions in testing and treatment costs. 


]]></content>
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				<specifications>
					<content><![CDATA[

TwistDX&#8217;s RPA process employs an enzyme, known as Recombinase, which pairs oligonucleotide primers with homologous sequences in duplex DNA. Through this method, DNA synthesis is directed to defined points in a sample DNA. If the target sequence is present, an amplification reaction is initiated; no other sample manipulation such as thermal or chemical melting is required. The reaction progresses rapidly at a constant temperature (37&#186;C) and results in specific amplification from just a few target copies to detectable levels, within 15 minutes. 


]]></content>
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				</specifications>
				<statistics>
					<content><![CDATA[The number of death certificates mentioning Meticillin-resistant Staphylococcus aureus (MRSA) decreased to 1,593 in 2007. This follows a sustained increase from 51 to 1,652 deaths between 1993 and 2006. Since then, the position has stabilised at a slightly lower level but the spread of MRSA remains a matter of very serious concern to hospitals, their patients and the wider public. Collectively, UK hospitals now spend huge sums on testing and treatment; one official source recently put the total annual cost of MRSA to the NHS at &#163;1bn. (Source: Health Direct.) It would therefore be difficult to exaggerate the potential economic benefits of this revolutionary testing regime.
Conventional screening-programmes are time-consuming, resource-intensive and relatively slow to generate results. By contrast, TwistDX&#8217;s revolutionary testing equipment is portable and easy to use and produces fast, &#8216;on-the-spot&#8217; results without the need to send samples to test-labs. It therefore has the potential to significantly reduce the cost of the national testing effort. 
Faster testing also yields significant economic benefits because it will enable hospitals to isolate and treat more quickly patients carrying the MRSA bacteria. Patients who contract an MRSA infection spend longer in hospital and cost a lot more to treat. By screening new patients on admission and identifying MRSA &#8216;carriers&#8217; within 10-15 minutes, the TwistDX system has the capacity to reduce transmission rates and the cost of treating MRSA &#8216;carriers&#8217;.
]]></content>
					<thumbnail-title>'Number of death certificates mentioning Staphylococcus aureus by meticillin resistance, England and Wales', Source:National Statisitics, Direct Gov</thumbnail-title>
					<thumbnail-path>http://www.showcase.nic.nhs.uk/Nic.Common/file.ashx?path=Images%5cShowcaseItems%5c7%5cTwistDXgraph.jpg</thumbnail-path>
				</statistics>
			</Benefits>
			<trials>
				<medical-centre>
					<name>Royal Manchester Children's Hospital</name>
					<postcode>M27 4HA</postcode>
					<url>http://www.cmft.nhs.uk/</url>
				</medical-centre>
			</trials>
		</item>
		<item>
			<id>8</id>
			<title>Virtual Veins clinical skills trainer</title>
			<summary>UK Haptics has developed a virtual-reality training simulator that could revolutionise the way healthcare practitioners are trained in venepuncture. ‘Virtual Veins’ offers a highly-realistic training experience, a wide range of practice scenarios and a safe, controlled learning environment. </summary>
			<description><![CDATA[Haptics is the science of applying touch (or &#8216;tactile sensation&#8217;) and control to human interaction with computer applications. Now, healthcare technology company, UK Haptics, has developed Virtual Veins, a training simulator for healthcare professionals learning or practicing the skill of venepuncture, the procedure by which veins are pierced in order to take blood samples or insert cannulae. 
Virtual Veins aims to offer healthcare staff - at all levels and across a range of disciplines - a more realistic training experience, a safer and more controlled learning environment and better assessment. It also aims to make training more affordable, by doing away with the need for the &#8216;disposables&#8217; which are an essential but expensive feature of traditional training regimes. Simulations take place in real time and combine training with detailed testing to provide user-feedback and clinical metrics for assessment. 
Unlike conventional techniques, which use manikins, &#8216;Virtual Veins&#8217; uses a set of fully-manipulable 3D virtual reality arms and hands. Different models are available, including an adult male hand, a geriatric hand and an Afro-Caribbean hand, in which the veins can be harder to identify, making practice on such hands highly desirable. More models and patient scenarios are due to follow shortly. 
Benefits for the NHS and patients each year


    Generates potential savings for the NHS of &#163; 19 million, based on one third adoption


]]></description>
			<link>http://www.showcase.nic.nhs.uk/ShowcaseDetails.aspx?id=8</link>
			<pubDate>Tue, 07 Apr 2009 23:00:00 GMT</pubDate>
			<Benefits>
				<additional>
					<content><![CDATA[UK Haptics&#8217; Clinical Skills Trainer (CST) uses cutting-edge technology to deliver a safe and highly-realistic virtual environment for clinical students and practitioners.  &#8220;Virtual Veins&#8221; is the first CST application the company has developed but the techniques behind it, which rely on a combination of &#8216;force-feedback&#8217; and high-quality 3D images, are by no means confined to venepuncture. Further applications are in development.  

Meanwhile, Virtual Veins itself is designed as an extensible collection of modules aimed at a growing number of healthcare practitioners across a range of disciplines, including  medical and nursing staff, paramedics, the blood transfusion service and sports specialists &#8211; all of whom need to be able to gain confidence and achieve a prescribed  level of competence.  To this end, UK Haptics is in the process of mapping its full range of Clinical Skills Training programmes to Healthcare and NHSLA Standards, whilst  Virtual Veins already provides a unique system of metrics, for the purposes of performance-measurement and certification.

]]></content>
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				<key>
					<content><![CDATA[The Virtual Veins clinical skills trainer offers a range of related benefits to patients, to medical and nursing staff and to the NHS.

To the NHS, Virtual Veins represents a highly realistic, efficient and cost-effective means of providing initial training in venepuncture, as well as a flexible and affordable system for delivering refresher course and advanced training.  The digital nature of the system means that progress and performance can be easily-monitored whilst the fact that there is no need for expensive disposables not only means lower operating costs than traditional approaches but also overcomes their financial disincentives to regular / repeat practice.

This, in turn, means better and more frequent initial and repeat training for medical and nursing staff, so that they gain in competence and confidence and their patients experience fewer difficulties when having blood tests, cannulisation and similar venepuncture procedures.

]]></content>
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				<specifications>
					<content><![CDATA[Using an algorithm developed in Sweden, the Clinical Skills Trainer combines force- feedback (delivered by an Omni Haptics Device) and very high quality 3D images to create a highly-realistic virtual training environment.  When inserting a cannula, for instance, the clinician feels the needle enter the skin and then the vein, experiencing a &#8216;pop&#8217; when the cannula is in the vein. The system is so finely-tuned that a round-shouldered cannula produces a more pronounced &#8216;pop&#8217; than a tapered one.   Training sessions can be recorded, enabling the trainer to benchmark results against pre-defined standards. Typically, the report of a vascular access training session covers 

    
    the procedure followed prior to entry, 
    the initial entry angle, 
    the angle of entry into the vein, 
    the depth of penetration of the vein, 
    the rotational angle of the needle bevel, 
    the disposal of the needle.
    

Any needle procedure can be simulated, including relatively complex tasks such as placing needles for dialysis via a fistula. The system simulates both the pressure of the blood in the fistula and the characteristic &#8216;buzzing&#8217; sensation, making for a highly-realistic training experience.
]]></content>
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				</specifications>
				<statistics>
					<content><![CDATA[No-one knows exactly how much the NHS spends on venepuncture training.  Costs vary according to which of the medical professions is being trained, what equipment is being used and the number of training opportunities offered. What we can say with some certainty, however, is that because venepuncture is a common procedure, carried-out in a wide range of settings by large numbers of nursing and medical staff, the cost of the national training effort is considerable. We know, too, that due to the high price of the &#8216;disposables&#8217; used in conventional training, training-costs tend to spiral rapidly where prolonged or repeat training is required. 

Unlike conventional approaches, UK Haptics &#8216;Virtual Veins&#8217; simulation software package requires no disposables. It therefore offers a more affordable and financially sustainable training option that allows students and clinical practitioners to practice more often, more safely and with minimal supervision.  

Virtual Veins also offers detailed &#8216;metrics&#8217;, enabling supervisors to assess the trainee&#8217;s performance much more closely and objectively than they can by observing the trainee&#8217;s use of a manikin. 
]]></content>
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				</statistics>
			</Benefits>
			<trials>
				<medical-centre>
					<name>Doncaster NHS Trust</name>
					<postcode>DN2 5LT</postcode>
					<url>http://www.dbh.nhs.uk</url>
				</medical-centre>
				<medical-centre>
					<name>North East Ambulance Service NHS Trust</name>
					<postcode>NE15 8NY</postcode>
					<url>http://www.neambulance.nhs.uk/</url>
				</medical-centre>
				<medical-centre>
					<name>Sheffield Hallam University</name>
					<postcode>S1 1WB</postcode>
					<url>http://www.shu.ac.uk/</url>
				</medical-centre>
				<medical-centre>
					<name>South Devon Healthcare NHS Foundation Trust</name>
					<postcode>TQ2 7AA</postcode>
					<url>http://www.sdhct.nhs.uk</url>
				</medical-centre>
				<medical-centre>
					<name>The University for the West of Scotland</name>
					<postcode>PA1 2BE</postcode>
					<url>http://www.paisley.ac.uk/</url>
				</medical-centre>
			</trials>
		</item>
		<item>
			<id>9</id>
			<title>The Waste-Watcher Toolkit</title>
			<summary>Using Video Compact Disc technology, the Toolkit offers a flexible-learning tool for all hospital personnel, from ancillary staff to consultants.</summary>
			<description><![CDATA[Waste disposal is a huge, expensive and complicated issue for the NHS. Huge; because the NHS produces around 1% of the UK&#8217;s annual domestic waste, including an average of 250,000 tonnes of clinical waste per year. Expensive; because disposing of clinical waste alone costs the taxpayer an estimated &#163;90+ million per annum. And complicated because, when disposing of their waste &#8211; and especially clinical waste &#8211; NHS Trusts have to comply not only with stringent NHS regulations but also with the Government&#8217;s wider and increasingly tough environmental rules for waste-producers. 
These were some of the considerations that prompted the development of the Waste Watcher Toolkit at the Royal Berkshire Hospitals Foundation Trust. The Trust&#8217;s Facilities Team calculated that it cost &#163;370 to dispose of 1 tonne of clinical waste, but only &#163;70 for 1 tonne of non-clinical waste. At the time, the Trust was processing 480 tonnes of clinical waste a year but estimated that a large proportion of this (perhaps as much as 40%) was actually non-clinical waste that could be disposed-of more cheaply. 
Realizing that the key to more efficient waste-disposal lay in educating and empowering front-line staff, Steve Sellwood, Facilities Manager with the Trust, developed and piloted the Waste Watcher Toolkit; a Video Compact Disc (VCD) based training package for use with all front-line staff. The training package has proved to be so effective that it is estimated that the Royal Berks Trust could see initial savings of around &#163;70,000 per year &#8211; with additional savings possible in the longer term. And with other NHS Trusts now showing a great deal of interest in the pack, it is clear that the Toolkit has the potential to deliver very significant cost-reductions throughout the NHS.
Benefits for the NHS and patients each year

    Potential savings of &#163;10 million to the NHS

]]></description>
			<link>http://www.showcase.nic.nhs.uk/ShowcaseDetails.aspx?id=9</link>
			<pubDate>Sat, 30 May 2009 23:00:00 GMT</pubDate>
			<Benefits>
				<additional>
					<content><![CDATA[As well as the savings it can generate, the Waste Watcher Toolkit has a wide range of other potential benefits for hospitals, patients and society in general.  

As major producers of waste, hospitals have to comply with stringent environmental and health regulation on waste-disposal.  Failure to do so can lead to serious sanctions being applied. The Toolkit actively engages the co-operation of hospital staff in securing compliance.  

Better waste-management practice also brings obvious benefits for patients, since it reduces the risk of infection arising from waste being handled incorrectly.  

Finally, society as a whole benefits from the fact that better waste-management in hospitals &#8211; which account for around 1% of all waste &#8211; means more recycling and a lot less waste going into landfill.]]></content>
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				</additional>
				<key>
					<content><![CDATA[The Waste Watcher Toolkit not only ensures that hospital staff are more knowledgeable and &#8216;waste-aware&#8217; but also empowers them to improve their &#8211; and each other&#8217;s &#8211; waste-management practice, thereby generating significant savings for the Trusts who use it. 
]]></content>
					<thumbnail-title />
				</key>
				<specifications>
					<content><![CDATA[The VCD-based Waste Watcher Toolkit is both a training-package and an engagement tool. It is designed for use in both formal teaching situations and informal / self-directed learning.  

The VCD begins with a four-minute film on the collection and disposal of waste, at the end of which participants are asked to complete a short questionnaire.  Next comes information on the law, duty of care, waste-disposal costs, waste-segregation and security of waste &#8211; all from a healthcare perspective and all in a manner that encourages questions and discussion.  Finally, the VCD focuses on the role of Waste Watcher Champions; people who are prepared to be a point of contact within their ward or department on all matters related to waste.

This apparently simple idea is, in fact, highly ambitious in that it seeks to change the behaviour of a large and diverse group of healthcare workers. It is by challenging and encouraging all hospital employees to be &#8216;waste aware&#8217; - and recruiting Waste Watcher Champions from every ward and department - that the Toolkit achieves its aims and generates significant savings.]]></content>
					<thumbnail-title />
				</specifications>
				<statistics>
					<content><![CDATA[Disposing of clinical waste costs the taxpayer an estimated &#163;90+ million per annum. Assuming that the Royal Berks Hospital is representative of hospitals throughout the UK, then around 40% of that clinical waste is actually likely to be non-clinical material that could be disposed-of at a fraction of the cost, slashing the cost of clinical waste-disposal by around one-third and saving the NHS up to &#163;30 million per annum. 
Figures based on the following assumptions:
i.&nbsp; 250,000 tonnes of clinical waste per annum (DoH, 2007)
ii. Cost of disposing of 250,000 tonnes of clinical waste at &#163;370 per tonne (RBHT, 2008) 
iii. Cost of disposing of the same amount of waste after 40% reduction in clinical waste content
(150,000 tonnes at &#163;370. 100,000 tonnes at &#163;70)
]]></content>
					<thumbnail-title />
					<thumbnail-path>http://www.showcase.nic.nhs.uk/Nic.Common/file.ashx?path=Images%5cShowcaseItems%5c9%5cwastewatchers.jpg</thumbnail-path>
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			</Benefits>
			<trials>
				<medical-centre>
					<name>Royal Berkshire Hospital</name>
					<postcode>RG1 5AN</postcode>
					<url>http://www.royalberkshire.nhs.uk</url>
				</medical-centre>
			</trials>
		</item>
		<item>
			<id>11</id>
			<title>Tracheal transplant</title>
			<summary>Until now, transplants of the airways have not been performed because they would require the use of huge doses of immunosuppressive drugs.  However, this pioneering procedure used tissue-engineering techniques to develop a biologically-treated organ with which surgeons were able to replace a damaged bronchus without the need for immunosuppressive medication.</summary>
			<description><![CDATA[This revolutionary procedure relied on advanced stem cell technology (using adult as opposed to embryonic stem cells) to produce a tissue-engineered airway suitable for clinical transplantation without the need for heavy immunosuppression. 
The technique involved removing the cells from a donor tracheal segment to leave a connective tissue scaffold which was then re-seeded with cells from the recipient (chondrocytes on the outer surface and epithelial cells on the inner surface). The graft was incubated in a specially designed bioreactor. Once the recipient&#8217;s cells were attached to the scaffold, it was able to be transplanted. At three-month follow-up, the patient &#8211; a thirty-year old woman with a collapsed lung, the result of long-term tuberculosis - was well, with a functioning airway. Since the airway had all donor cells removed, immunosuppressive treatment was not necessary and there was no evidence of rejection.
The procedure was performed in Barcelona by an international team from the Universities of Bristol, Barcelona, Milan and Padua, led by Professors Martin Birchall and Paolo Macchiarini of the Universities of Bristol and Barcelona respectively.&#160; The team believes the new procedure, which has been widely hailed as a major medical &#8216;breakthrough&#8217;, paves the way for many more such operations in the future.

Most recent windpipe transplant success in UK&#160; -&#160; http://news.bbc.co.uk/1/hi/health/8576493.stm
]]></description>
			<link>http://www.showcase.nic.nhs.uk/ShowcaseDetails.aspx?id=11</link>
			<pubDate>Mon, 08 Jun 2009 23:00:00 GMT</pubDate>
			<Benefits>
				<additional>
					<content><![CDATA[
In the slightly longer term, these revolutionary techniques could transform transplant surgery as we currently know it, making new procedures possible and reducing the risk of rejection - and thus the need for immunosuppressive medication &#8211; in existing procedures

]]></content>
					<thumbnail-title />
					<thumbnail-path>http://www.showcase.nic.nhs.uk/Nic.Common/file.ashx?path=Images%5cShowcaseItems%5c11%5cspec.gif</thumbnail-path>
				</additional>
				<key>
					<content><![CDATA[
The principal immediate benefit of this truly remarkable breakthrough is that it should pave the way for further thoracic transplants around the world, saving many lives and improving countless others.


]]></content>
					<thumbnail-title />
					<thumbnail-path>http://www.showcase.nic.nhs.uk/Nic.Common/file.ashx?path=-1</thumbnail-path>
				</key>
				<specifications>
					<content><![CDATA[
In airway transplantation, the integrity of the epithelial tissue and related vasculature is critical.  The Birchall group established that the airway has a rich immune structure; so allografts (epithelial tissue taken from one person for transplantation into another) will reject strongly.  Having discovered that replacement of the epithelium alone is sufficient to prevent the rejection of tracheal allografts in rats, the group developed a means of culturing and characterizing epithelial cells to facilitate airway grafting. 


The procedure involved re-seeding a connective-tissue scaffold with cells from the recipient; chondrocytes (cartilage cells) on the outer surface and epithelial cells on the inner.  That this was possible owed much to an earlier discovery (by Prof Anthony Hollander and colleagues, University of Bristol) of a way of producing chondrocytes. Stem cells are found in various parts of the body, including the bone marrow, which contains two types of stem cell; haematopoetic (they make blood cells) and mesenchymal, which can be turned into chondrocytes as well as bone and adipose cells. The Hollander group discovered a way of ensuring that mesenchymal stem cells turn into chondrocytes only.  

]]></content>
					<thumbnail-title />
				</specifications>
				<statistics>
					<content><![CDATA[
This is too recent an advance for anyone to say what its undoubted economic benefits might eventually amount to.  Much will depend on how quickly and how widely the techniques are adopted around the world. There are certainly many people whose lives could be transformed, even saved, by a thoracic transplant. But the advantages of this innovation are not confined to the field of thoracic procedures. Professor Birchall predicts that, in ten or twenty years time, all the main UK hospitals will have units dedicated to producing a range of tissue-engineered organs for transplant.  The fact that tissue-engineered organs have a greatly-reduced risk of rejection and are therefore suitable for transplantation without the use of immunosuppressive drugs means that, once it becomes more widely-adopted, this approach should be both more effective and less expensive than &#8216;conventional&#8217; transplant techniques across a range of transplant procedures. 
]]></content>
					<thumbnail-title />
				</statistics>
			</Benefits>
			<trials />
		</item>
		<item>
			<id>13</id>
			<title>StickSafe</title>
			<summary>StickSafe is a simple, environmentally friendly, low cost device that can significantly reduce needlestick injuries from hypodermic needles and vacutainers.  Its innovative design intuitively encourages healthcare workers to adopt safer workplace practices.</summary>
			<description><![CDATA[Needlestick injuries are wounds caused by the accidental puncture of the skin by a needle, and occur when needles are exposed during use and disposal.   Such injuries carry the risk of infection of diseases such as HIV and Hepatitis B and C, and require sometimes complex and lengthy treatment. 
In the UK, an estimated 100,000 needlestick injuries happen each year.  Apart from the physical injury, needlestick injuries subject NHS staff to stress and anxiety.  The NHS bears an estimated cost of &#163;300 million each year through lost workdays, litigation and the absence of highly trained personnel from the workforce.
StickSafe compels the user to re-sheath contaminated needles and ensures safe separation of the used needle from syringe before disposal &#8211; avoiding the biggest causes of needlestick injury.  StickSafe is fully compatible with standard hypodermic needles and vacutainers and enhances the safety and  functionality of the trays currently used to transport syringes and needles to and from the patient.  StickSafe is cheaper than alternative modified needles and requires very little training.
Reduces risk of needlestick injury by over 50%. - Potential NHS savings of over &#163;160 million
]]></description>
			<link>http://www.showcase.nic.nhs.uk/ShowcaseDetails.aspx?id=13</link>
			<pubDate>Sun, 03 Jan 2010 00:00:00 GMT</pubDate>
			<Benefits>
				<additional>
					<content><![CDATA[]]></content>
					<thumbnail-title />
				</additional>
				<key>
					<content><![CDATA[]]></content>
					<thumbnail-title />
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					<thumbnail-title />
				</specifications>
				<statistics>
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            In the
            UK, various sources estimate there are approximately 100,000 needlestick
            injuries per year, costing the NHS an estimated &#163;300 million. Significant
            under-reporting &#8211; estimated at 40-70%&nbsp; depending on the hospitals - means the
            total cost to the NHS is likely to be far higher, particularly as affected
            healthcare workers may only develop symptoms much later, thus triggering
            expensive contact tracing and treatment without officially recording the
            needlestick injury.&nbsp; There are additional issues of lost work time, stress for
            the person concerned and, in extreme cases, litigation.
            &nbsp;
            Government acknowledgement of the problem, together with the need for
            better management of needlestick and sharps incidents in the NHS, have been
            highlighted in a 2003 National Audit Office report and in a subsequent Public
            Accounts Committee hearing.
            
            &nbsp;
            StickSafe allows for more efficient waste disposal because it reduces
            the number of sharps bins for disposal (by an estimated 25% for 100% adoption)
            and, therefore, reduces the high cost of disposal of clinical waste. 
            &nbsp;
            &nbsp;
            Also,
            StickSafe eliminates the need for the more expensive sharp mini-sharps bins, as
            used needles can safely be transported across the ward.&nbsp; This generates
            significant cost savings, as the smaller bins are far more costly to buy and
            incinerate than their larger equivalents.&nbsp; 
            &nbsp;
            StickSafe is the cleanest system for hospitals as it is single use
            and disposable.&nbsp; The mini-bins are used with re-usable plastic trays that need
            to be cleaned before every use.&nbsp; This is extra work for nursing staff and also
            presents a significant risk to spreading HCAIs.&nbsp;&nbsp; 
            &nbsp;
            The
            device also avoids the use of the more expensive safety needles because it
            accommodates lower cost, standard injection needles. 
            &nbsp;
            StickSafe is a cost-beneficial solution to public and private health
            bodies: in the NHS, StickSafe promises a potential cost saving of over &#163;160
            million, associated with needlestick injuries, and that includes a net increase
            in procurement costs of &#163;14 million. 
            &nbsp;
            The table below identifies the various situations in which
            needlestick injuries occur; the right-hand column indicates the effect of using
            the StickSafe. Initial user testing indicates that StickSafe can eliminate up to
            53% of needlestick injuries. 
            &nbsp;
            
            
                
                    
                        
                        &nbsp;
                        
                        
                        &nbsp;
                        
                        
                        Impact of Use of StickSafe
                        
                    
                    
                        
                        Manipulating needle in patient
                        
                        
                        27%
                        
                        
                        No change
                        
                    
                    
                        
                        IV
                        line-related causes
                        
                        
                        8%
                        
                        
                        No change
                        
                    
                    
                        
                        Handling/passing device during or after use
                        
                        
                        10%
                        
                        
                        Cut by half
                        
                    
                    
                        
                        Recapping
                        
                        
                        5%
                        
                        
                        Eliminate
                        
                    
                    
                        
                        Clean-up
                        
                        
                        11%
                        
                        
                        Eliminate
                        
                    
                    
                        
                        Collision with healthcare worker or sharp
                        
                        
                        8%
                        
                        
                        Eliminate
                        
                    
                    
                        
                        Disposal-related causes
                        
                        
                        12%
                        
                        
                        Eliminate
                        
                    
                    
                        
                        Improperly disposed sharp
                        
                        
                        10%
                        
                        
                        Eliminate
                        
                    
                    
                        
                        Handling/transferring specimens
                        
                        
                        5%
                        
                        
                        No change
                        
                    
                    
                        
                        Other
                        
                        
                        4%
                        
                        
                        Cut by half
                        
                    
                    
                        
                        &nbsp;
                        
                        
                        100%
                        
                        
                        &nbsp;
                        
                    
                    
                        
                        &nbsp;
                        
                        
                        &nbsp;
                        
                        
                        53%
                        
                    
                
            
            
            &nbsp;
            Source: US Centers of Disease Control and Prevention, initial
            StickSafe user trial data 
            &nbsp;
            &nbsp;
            At
            present StickSafe can retract and attach the most popular brand of standard
            needles and separates the needle from the syringe. In time, alternative
            StickSafe versions will be produced, that will be compatible with all brands of
            hypodermic needles, vacutainers and butterfly needles.
            &nbsp;
            Key
            technology features
            
            &nbsp;
            StickSafe incorporates a patented clutch mechanism
            that grips the protective sheath of a needle firmly and prevents rotation,
            allowing for safe one-handed uncapping or recapping. The device is configured
            for safe ambidextrous operation and the tapered edges provide better ergonomic
            comfort for fingers and thumbs; it features user-requested increased carrying
            volume and is made from 100% paper-pulp, an environmentally friendly recycled
            material. 
            &nbsp;
            Importantly, StickSafe is stackable, with a foot
            print comparable to conventional trays.
            
            Key benefits
            
            
            &#183;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Low cost solution;
            
            &#183;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Highly intuitive, easy-to-use
            
            &#183;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Requires very little training to become
            proficient
            
            &#183;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Compatible with familiar needle devices and
            techniques; 
            
            &#183;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Simple and reliable
            
            &#183;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Will save money on disposal costs &#8211; as a result of
            improved use of sharps bins, and through being able to safely use the more
            efficient and lower cost larger bins
            
            &#183;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Reduces risk and fear of NSI to staff and
            patients
            
            &#183;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Reduces risk of transmitting HCAI if replacing
            plastic trays that are not always cleaned before each use.&nbsp; New paper pulp trays
            are single use, and also eliminate the need or time to clean equipment
            &nbsp;
            
            
            &nbsp;
            &nbsp;
            
            
            
            &nbsp;
            &nbsp;
            
            
            
            &nbsp;
            &nbsp;
            
            
            
            &nbsp;
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            &nbsp;
            &nbsp;
            
            
            
            &nbsp;
            &nbsp;
            
            
            
            &nbsp;
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            &nbsp;
            &nbsp;
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            &nbsp;
            &nbsp;
            &nbsp;
            
            
            
            &nbsp;
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            &nbsp;
            
            
            &nbsp;
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            &nbsp;
            &nbsp;
            
        
    




[1]


A safer
place to work &#8211; improving 


the
management of health and safety risks to staff in NHS trusts. NAO Report April
2003, 






&nbsp;
&nbsp;
&nbsp;
&nbsp;


&nbsp;
]]></content>
					<thumbnail-title />
					<thumbnail-path>http://www.showcase.nic.nhs.uk/Nic.Common/file.ashx?path=Images%5cShowcaseItems%5c13%5cStickSafe_push+thumb.JPG</thumbnail-path>
				</statistics>
			</Benefits>
			<trials>
				<medical-centre>
					<name>Central Middlesex Hospital</name>
					<postcode>NW10 7NS</postcode>
					<url>http://www.nwlh.nhs.uk/</url>
				</medical-centre>
				<medical-centre>
					<name>St Mary’s Hospital</name>
					<postcode>W2 1NY</postcode>
					<url>http://www.imperial.nhs.uk/stmarys/contact/index.htm</url>
				</medical-centre>
			</trials>
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