A new highly-sensitive cardiac scanner using magnetic field analysis will make earlier diagnosis of heart conditions possible.

The new portable magnetometer, developed from research in quantum physics, is being developed at the University of Leeds with support from the Engineering and Physical Sciences Research Council.

The device's unique sensitivity to magnetic fluctuations enables it to detect a number of conditions, including heart problems in foetuses, earlier than currently available scanners.

The portable magnetometer will also be cheaper, smaller, simpler to operate and able to gather more information than other technologies. For the first time, nurses as well as doctors will be able to carry out heart scans. The device can be used through clothes, and can be taken to a patient's home.

"What we've been able to do is combine existing technology from the areas of atomic physics and medical physics in a completely unique way," said Professor Ben Varcoe, who is leading the research team.

The new magnetometer can reveal tiny variations in the heart's distinctive magnetic 'signature' that indicate a cardiac condition. The team is working to miniaturise the device, which could be ready for use in routine diagnosis within three years.

"Early detection of heart conditions improves the prospects for successful treatment. This system will also quickly identify people who need immediate treatment," said Professor Varcoe. "But our device won't just benefit patients - it will also help ease the strain on healthcare resources and hospital waiting lists."

The device is expected to be particularly effective in detecting ischaemic heart disease. It could also shorten surgical procedures to correct cardiac arrhythmia: scanning the heart with the new device during the operation would offer a much quicker way of pinpointing the node to be cauterised, reducing the time needed by 80%.

Portable magnetometer

Health Minister Mike O'Brien MP has visited the 3M Health Care site at Loughborough to see the company's advanced medical products.

Mr O'Brien was given a tour of the Derby Road manufacturing site, where more than 1,000 medical devices and other healthcare products are marketed.

The site has recently seen the installation of a production line for the Cavilon durable barrier cream, which protects the skin of incontinent patients. Global manufacturing of this product has moved here from the USA.

The Minister was also given a demonstration of the new Littmann 3100 stethoscope, which amplifies sound up to 24 times more than a standard stethoscope while reducing background noise by 85%. This year, 3M plans to launch the 3200 model, which uses Bluetooth technology to transmit sounds wirelessly to the patient's electronic record or to another consultant.

Gary Stapleton, Director of 3M Health Care, said: "Clinical trials are currently under way in the UK which combine use of the 3200 stethoscope with advanced diagnostic software to better detect heart murmurs. Such timely intervention will help save lives and offer significant savings for the NHS. We were delighted to be able to share these latest technologies with the Minister."

Mike O'Brien commented: "Innovation in medical technology can play a vital role in helping the NHS meet changing care needs and increase efficiency. We are therefore keen to support businesses which produce in the UK to help them succeed not only in the domestic market but also internationally, and champion the UK as a global partner of choice to overseas companies."

3M is a diversified technology company. The UK and Ireland is home to one of its largest subsidiaries outside the USA.

Mike O'Brien (third from left) at 3M

The European Medicines Agency has pledged to improve access to medicines in its Road Map to 2015, a publication that coincides with the Agency’s 15th anniversary.

Stakeholders, including the pharmaceutical industry, and the public have been invited to comment on the Agency’s strategic vision, The European Medicines Agency Road Map to 2015: The Agency's contribution to Science, Medicines, Health.

Building on the achievements made by the previous Road Map initiative between 2005 and 2010, the focus of the new Road Map to 2015 is on continuous high-quality delivery of the Agency’s core business in an increasingly complex regulatory and scientific environment.

In addition, the document proposes three priority areas for future actions to strengthen the Agency’s role in protecting and promoting human and animal health in the EU:

• Addressing public health needs by: stimulating research and medicines development in areas of unmet medical need or for neglected and rare diseases; facilitating new and innovative approaches to the development of medicines; implementing effective preparedness plans to deal with public health threats.
• Facilitating access to medicines by: addressing the high attrition rate during the development process of medicines; improving the Agency’s model for the assessment of benefits and risks of medicines; improving the quality and scientific and regulatory consistency of the medicines review process.
• Optimising the safe use of medicines by: strengthening the evidence base on the benefits and risks of a medicine following its authorisation; applying novel pharmacovigilance methodologies and risk minimisation tools; taking patient experience into account for improved decision-making; becoming a reference point on information about medicines evaluated by the Agency.

The Agency will hold a number of workshops and face-to-face discussions as part of the public consultation process.

Approvals for products to treat neglected diseases have steadily increased in recent years, a recent US study has revealed.

The research shows that the number of products to treat neglected diseases receiving marketing approval from regulatory agencies has grown as R&D funding for those diseases has increased.

According to the study, completed by the Tufts Center for the Study of Drug Development, the annual rate of new product approvals worldwide for neglected diseases increased from an average of 1.8 in 1975–99 to 2.6 in 2000–09.

Neglected diseases include malaria, kinetoplastids, diarrhoeal diseases, helminths (e.g. roundworm), bacterial pneumonia and meningitis, and typhoid and paratyphoid fever.

“During this past decade, a significant increase in R&D funding for neglected diseases has led to marketing approval for 26 drugs and vaccines,” said Joshua Cohen, Senior Research Fellow at Tufts CSDD and author of the study.

“While increased approvals are necessary to improve access, policy-makers need to ensure that safe, effective and easy-to-administer products are adopted by healthcare systems and providers on a consistent basis, that they are affordable, and that they reach the people who need them.”

The Tufts CSDD analysis discovered that an original study, which reported that only 16 of 1393 new drugs marketed between 1975 and 1999 targeted tropical diseases and tuberculosis, was inaccurate and a more accurate count was 33. However, this earlier study prompted increased funding for neglected diseases, from less than $100 million annually a decade ago to more than $2.5 billion annually today.

The new analysis, reported in the November/December Tufts CSDD Impact Report, also found that:

• Drugs to treat HIV/AIDS and malaria accounted for 81% of approvals during 2000–09.
• Vaccines have displaced drugs as the main products being developed for neglected diseases, accounting for 76% of all products.
• Public-private partnerships accounted for 46% of all new product development to treat neglected diseases during 2000–09, up from 15% in the 1975–99 period.

The Tufts Center for the Study of Drug Development, based at Tufts University in Boston, provides strategic information to help drug developers, regulators and policy-makers improve the quality and efficiency of pharmaceutical development, review and utilisation.

A new spin-out company from Cardiff University aims to bring a range of innovative surgical instruments to market.

Asalus Medical Instruments is developing three innovative devices aimed to improve the safety and efficiency of laparoscopic or 'keyhole' surgery.

The surgical start-up is a new portfolio company from Sheffield-based Fusion IP, which owns the exclusive rights to commercialise research from Cardiff and Sheffield universities.

Neil Warren, founder and Chief Technical Officer of Asalus, said: "Fusion's support, both commercially and financially, has been invaluable and we look forward to bringing our novel product range to market in the near future."

The combined power of commercial investment and scientific expertise was highlighted by Dominic Griffiths, Portfolio Investment Manager of Fusion Cardiff and Director of Asalus: "This is a great example of how the injection of know-how and money from the commercial sector can facilitate the rapid conversion of Cardiff's world-class IP pipeline into businesses with real value.

"Asalus has a great opportunity to be a developer of some of the UK's leading laparoscopic devices, and we look forward to supporting the company as it commercialises its product range."

Digital mammography delivers 22% less radiation on average than film mammography, according to a study published in the American Journal of Roentgenology.

The study, part-financed by the National Cancer Institute in the USA, indicates that digital radiology is preferable on safety grounds - but not that film mammography should be avoided as such.

The study analysed the results of the 2005 Digital Mammographic Imaging Screening Trial, involving 49,528 women. It found that digital mammograms detected up to 28% more cancers than film mammograms in women aged below 50 who had not experienced menopause and women with dense breast tissue.

Carol Lee, Chair of the American College of Radiology Breast Imaging Commission, said the new study showed that digital mammography "can be achieved with overall a lower radiation dose". Lowering the dose is preferable, she said: "We certainly want to keep radiation doses as low as possible and still achieve the desired goal of a good image."

However, Lee emphasised that where digital mammography is not available, women should not avoid film mammograms if these are recommended.

A new report from the Office for Life Sciences (OLS) draws up a road map for the advancement of the life science industries in the UK through collaboration between the public, private and academic sectors.

Life Sciences 2010: Delivering the Blueprint has been welcomed by industry trade associations as taking forward and building on the measures proposed in the OLS Blueprint six months ago.

The OLS initiative has focused on improving the commercial environment of the life science industries, with participation from trade associations representing medtech, biotech and pharma.

The report brings together existing and impending measures aimed at improving the route from UK innovation to NHS practice. These include:

• Industry-Higher Education Forum – bringing together relevant stakeholders to identify critical disciplines and skills gaps within life science research.

• Capability Clusters – strengthening collaborative work between the NHS, academia and industry to develop new therapies (focusing initially on respiratory and inflammatory joint disease).

• NHS Operating Framework – embedding clinical trials within core NHS activity.

• RegenMed – a £21.5m programme managed by the Technology Strategy Board to support key areas of commercial R&D and develop R&D partnerships.

• Patent Box – reducing corporation tax on innovative UK industry activity.

• Innovation Pass – assisting rapid NHS uptake of treatments that show potential to deliver patient benefits but struggle to show cost-effectiveness at launch.

• NHS Life Sciences Delivery Board – improving the uptake and adoption of innovative technologies and medicines.

Richard Barker, Director General of the Association of British Pharmaceutical Industry (ABPI) said: “Life Sciences 2010 is a major milestone in the OLS initiative and demonstrates the potential of this new model of industry and government collaboration to deliver truly tangible results. Work to implement and extend this strategy must be a high priority for both government and industry in the coming years, to maintain the UK’s leadership role and the flow of life-changing, innovative therapies for patients.”

Doris-Ann Williams, Director General of BIVDA, commented: “The work of the OLS has provided an excellent example of what can happen when Government and business work together.”

Two of Sanofi Pasteur’s vaccines have made it onto Time magazine’s list of the 10 most important medical breakthroughs of 2009.

The firm’s HIV vaccine came in second place. The magazine highlighted that trials of its effectiveness yielded “reasonable” results, with an infection prevention rate of 31%.

However, it added that the implications of this are important: “Given that no other inoculation has shown any effect against the AIDS virus, it was reason to celebrate – cautiously.”

In fourth place was Sanofi Pasteur’s H1N1 vaccine, for which demand outstripped supply when it was launched last year. The publication highlighted that, in some areas, “there was not enough vaccine even to cover members of priority groups”.

Another pharmaceutical product to make it onto the list was Amgen’s denosumab at number 8, an innovative treatment for Alzheimer’s disease currently under review by the FDA.

Other breakthroughs listed included the lifting of the funding ban on stem-cell research, prostate cancer screening, new autism research that highlighted variations in DNA and studies into brown fat in adults.

The number of women under 30 diagnosed with cervical cancer will fall nearly two thirds by 2025 due to the HPV vaccine, new research has revealed.

The study, published in the British Journal of Cancer today, predicted that the number of women in their twenties diagnosed with cervical cancer will drop by 63% in the next 15 years.

Girls aged 12 and 13 have been offered the HPV vaccine in the UK since 2008. It protects against two types of the virus – HPV 16 and HPV 18 – which cause around 70% of cervical cancers.

The researchers calculated the number of cancers that would be prevented by the vaccine, assuming 80% of girls took it up (latest Government figures suggest that 78% of girls had received all three doses of the vaccine).

The researchers also predicted that 51% fewer women will have CIN3 – severe cell changes that need treatment because they could lead to cervical cancer – and that there will be 27% fewer abnormal smear tests.

Cancer Research UK’s Professor Jack Cuzick, lead author from Queen Mary, University of London, said: “In women in their twenties alone, around 145 cases of cervical cancer will be prevented each year in the UK thanks to the HPV vaccine. And around 13,000 women each year will be spared from having an abnormal screening test result.

“This is the most realistic estimate of the impact the vaccination programme will have on the number of women who develop cervical cancer. It shows that the vaccine has great potential in preventing the disease in the near future, but also that it’ll take several decades before we see its full benefits.”

There are around 2,800 new cases of cervical cancer diagnosed in the UK each year, and around 225 of these are in women in their twenties. Around 940 women die from cervical cancer each year in the UK.

Dr Lesley Walker, Director of Cancer Information at Cancer Research UK, said: “This is really good news for girls who have had the vaccine and for those who will have it in the future. But it’s important to remember that the vaccine will not completely wipe out cervical cancer because it doesn’t protect against every type of high-risk HPV.

“Now and for the foreseeable future, it’s vital that women go for cervical screening when they’re invited. Screening can prevent cervical cancer by detecting unusual changes in the cervix before cancer develops, and it saves thousands of lives in the UK each year.”

Last year was a colourful one for most, littered with flu pandemics, shamed MPs and very little loose change. NHIS reviews the most significant events of the 2009 NHS diary.

Arguably, the NHS in 2009 was conditioned greatly by Lord Darzi’s report, High Quality Care for All, published in June of the previous year; with an acute focus on quality and efficiency still highly apparent. Further, many ideas originally conceived in the report were witness to significant progression. In a year characterised by dramatic shifts in the economy, as well as the political cabinet, this was certainly no easy feat.

The National Health Intelligence Service (NHIS) looks back over a somewhat eventful year, and provides your comprehensive guide to the top goings on in the NHS.

January

2009 kicked off with the publication of the Health Bill. This permitted direct payments for healthcare to patients for the first time, allowing greater choice and control over the health services to which they are entitled. This was accompanied by the introduction of a personalised care plan for patients with long-term conditions and follows Alan Johnson’s belief that those patients in question should become experts in their own care. The Department of Health also moved a step closer towards the introduction of Personal Health Budgets in England by inviting expressions of interest for a new pilot programme. This invitation was readily accepted, with 68 projects being awarded provisional pilot status by May 2009.

February

The first National Dementia Strategy was launched. Backed by £150 million over the first two years, this initiative aimed to increase awareness of dementia, ensure early diagnosis and intervention and radically improve the quality of care that the people with the condition receive. Such concern also extended to the role of those who care for patients with debilitating conditions such as dementia. Research announced in February demonstrated that individual budgets can greatly improve carers’ quality of life, when compared with carers using conventional social services.

March

A package of measures was announced designed to speed up access to new drugs and treatments for NHS patients. The four proposed changes aimed to ensure that more NHS patients receive the life-saving drugs and treatments that they need. This initiative moved on later, in July, when a blueprint on proposals for an ‘Innovation Pass’ was released.

March was also witness to the publication of the Chief Medical Officer’s Annual Report 2008, as well as a renewed vision of the relationship between Practice Based Commissioning and World Class Commissioning. Further, as part of the drive towards a more preventative NHS, it was announced that NHS Health Checks would begin from April for everyone aged between 40 and 74 in England. Hailed as an essential tool in tackling health inequalities across the country, it was also stated that these checks could help to prevent 1600 heart attacks and strokes each year.

April

As the extent of the economic downturn became ever more apparent, it was announced that a £220 million fund would be made available to encourage innovation within the NHS. This sat alongside the introduction of a range of measures, designed to raise the quality of services and standards. These included the Performance Framework, Patient Recorded Outcome Measures (PROMS) and a new, simpler complaints system. Further to this, two new integrated organisations started work; the National Quality Board and the Care Quality Commission, the latter of which would have a significant impact with the production of its ‘annual health check’ later in the year.

In Northern Ireland, following an announcement in February, the previous four Health and Social Service Boards were replaced by a single Health and Social Care Board as part of the reorganisation to streamline health provision. This move was later echoed by the NHS in Wales, which also adopted a new structure in October.

May

NICE launched the web-based NHS Evidence, just short of a year after its initial conception in Lord Darzi’s High Quality Care for All Report in June 2008.

The Department of Health joined forces with The NHS Information Centre to publish a list of more than 200 Indicators for Quality Improvement (IQI), designed to measure the quality of care delivered in the NHS, highlight areas for improvement and track the changes they implement. The IQI span the three dimensions of high quality care: patient safety, effectiveness of care and patient experience.

Also in May, the NHS Chief Executive’s Report was published, outlining the achievements of the NHS in 2008/09. These achievements included surpassing targets for efficiency savings and the reduction of MRSA infections, as well as providing extended opening hours at 71% of GP practices and employing an additional 1,195 midwives. All in all, a very positive report.

June

Amidst the declaration of a swine flu pandemic and the scandal of illegitimate MP expenses, Gordon Brown’s cabinet reshuffle in June named Andy Burnham as the new health secretary.

The Quarter 4 (January-March 2009) performance report was published, and closely echoed much that was revealed in the Chief Executive’s report of the previous month. As well as outlining the beating of numerous targets, it also reported positive patient experiences and effective planning in response to swine flu.

The NHS Confederation addressed the increasingly worrying financial situation and published Dealing with the downturn: the greatest ever leadership challenge for the NHS? This document embraced the fact that the NHS is facing its most severe contraction in finance – with an £8-10 billion real terms cut likely in the three years from 2011 – and announced that the NHS will not survive the impending spending squeeze unchanged.

In reaction to this realisation and to encourage an increase in the pace of change, the Department of Health announced that it is considering creating a ‘premier league’ of some 10-15 PCTs with enhanced freedoms and powers.

At the end of the month, Lord Darzi published a report examining the progress that has been made in the 12 months since High Quality Care for All was published. This latest report – High Quality Care for All: Our Journey So Far – found that there had been a real progress in all areas of quality, with patients already seeing the difference.

July

A matter of weeks after publishing his latest report, Lord Darzi resigned as health minister to devote more time to his clinical and research roles. He remains a government adviser.

Following the measures initiated in March, the Government, with NICE, introduced an ‘Innovation Pass’; a three-year initiative for selected medicines which will allow patients with the greatest need earlier access to the drugs. This has since become the subject of further discussion with the launch of a consultation in November.

The devolved countries focused on all things heart-related in July; with the publication of the Cardiac Disease National Service Framework for Wales and a Service Framework for Cardiovascular Health and Wellbeing in Northern Ireland. Scotland meanwhile, published the Better Heart Disease and Stroke Care Action Plan, which is committed to revising the CHD and Stroke Strategy of 2004.

August

As expected, August was a relatively quiet month. However, it was at this point – and in a rather low-key manner – that the Department of Health initiated a strategic approach to supporting Quality, Innovation, Productivity and Prevention on the NHS. This approach was rebranded in November as The Quality and Productivity Challenge and identified eight emerging priorities for the Department of Health to consider in the new financial context.

September

An introductory guide to the national programme of integrated care pilots was published. Originally announced in April, these pilots are designed to look beyond the traditional health and social care boundaries. The published guide summarised the work that each of the pilots will be doing as they implement and test their models of integrated care.

The Health Bill 2009 began its passage through Parliament and, following a consultation on Pharmacy in England, contains proposals that reflect a need to improve the provision of pharmaceutical services in the NHS. Further to this, an advisory group on the NHS Pharmaceutical Services Regulations was set up, drawn from leading interested parties, to consider and advise the Department of Health.

October

The health service in Wales was subject to an organisation restructure at the start of this month. Seven revised Local Health Boards were established and represented a greatly condensed version of the previous structure.

In England, the Care Quality Commission (established in April) published the performance ratings for all 392 trusts; including both PCOs and hospitals. This ‘annual health check’ alluded to some of the targets previously praised in the Chief Executive’s report in May, as well as announcing an increase in the number of people being screened for Chlamydia. Overall, the NHS was seen to be performing well on quality, as well as improving its financial management significantly. However, the CQC’s report also raised concerns about the 20 trusts identified as ‘weak’ on quality; launching a field day for the press.

Andy Burnham’s assertion that the best way to achieve reform was to improve existing services sparked debate over the role of competition in the NHS. With ‘good enough’ rather than ‘excellence’ placed in the frame, question marks were raised over the role of World Class Commissioning.

November

A joint report by the NHS Alliance and think-tank the Nuffield Trust suggested that Practice Based Commissioning had become unfit for purpose. It proposed that ‘local clinical partnerships’ (LCPs), multi-specialty groups of clinicians, should take responsibility for designing health with population-based budgets covering at least 100,000 people.

The NHS Scotland Chief Executive published his Annual Report for 2008/9. This outlined the progress made on the Scottish Government’s action plan for health – Better Health, Better Care – and assessed NHS Scotland’s performance against a range of ministerial objectives, targets and measures. Overall, the Chief Executive claims that the country’s NHS is continuing to improve, giving people faster access to a wider range of treatment.

December

The strategy, NHS 2010-2015: from good to great. Preventative, people-centred, productive, is published by the Department of Health to explain the need to accelerate the pace of the NHS reform to make the system more productive and to hasten improvements in quality of care. Measures here include a new payment system, linking hospital payments to patient satisfaction and greater patient choice.

Following this, the Department of Health also published the Operating Framework for 2010-11: for the NHS in England, which set out their priorities for the new year to enable them to start their planning processes. For the third consecutive year, these priorities have remained the same and provide important stability; particularly in a year that is set to be rocked with financial instability.

The National Health Intelligence Service provides solutions which help develop efficiencies or outcomes for healthcare organisations.