The new UK life science strategy and NHS innovation review, launched by the Government this month, has been praised by the UK medical technologies sector for its promotion of innovative research and the rapid uptake of high-value technologies.

The NHS Chief Executive’s review Innovation, Health and Wealth: accelerating adoption and diffusion in the NHS outlines a number of measures the NHS will take to work in partnership with industry in order to implement effective new medical technologies throughout the NHS.

The document draws in attention, in particular, to the potential of telehealth systems to improve the management of long-term conditions, reducing hospital admissions and GP visits and so reducing the overall cost of care while improving patient outcomes, as demonstrated by the recent Whole Systems Demonstrator project.

Other areas of medical technology highlighted by the innovation document include the use of fluid monitoring in acute care and the use of assistive technologies, including wheelchairs, to improve the access of disabled people to working and other everyday environments.

Peter Ellingworth, Chief Executive of the Association of British Healthcare Industries (ABHI), the leading UK medtech trade association, said: “I welcome the Government’s focus on the life science industry. As highlighted by the Prime Minister our sector is part of ‘the virtuous circle of health, wealth and well-being’ – a real growth area for the Government as well as having the potential to make a difference to patients through the innovation we bring.

“Measures such as reform to the tariff system, enforcement of NICE guidance and the development of a procurement strategy, if done properly, could make a real difference to the medical technology sector.

“ABHI will work with the Government to make sure that the measures outlined in the Innovation Review are translated into firm actions. The measures could make a real difference to the SMEs in our sector and it is crucial that we are able to take advantage of them and continue to grow.”

Doris-Ann Williams MBE, Chief Executive of the British in Vitro Diagnostics Association (BIVDA) and a member of the Innovation Review’s External Advisory Group, commented that the Government’s announcements “represent a crucial opportunity for the life sciences sector” – and that the life science strategy and the innovation review in combination “will reinforce a genuine partnership between industry, the NHS and government.”

“To accelerate the use of innovative technologies to benefit patients and the NHS, tangible and realistic proposals were needed,” she added. “The NICE Implementation Collaborative, an innovation scorecard and a commitment to examine reimbursement mechanisms for diagnostics will all help the IVD industry to do what it needs to do to turn the vision into reality.”

Tony Davis, Chair of health technology business support organisation Medilink UK, noted that the new life science strategy “sets the stage for telehealth and telecare technologies to be made available to every person with a long-term condition or in need of care in the UK, helping them manage their health while maintaining their independence.”

“Medilink UK has been working with industry, other trade associations and the Department of Health to accelerate the roll-out of telehealth and telecare services in the NHS and social care, which will enhance the lives of three million people over the next five years,” he concluded.

Increasing competition and budgetary pressure on the provider side are the biggest challenges facing the medical technology industry in Europe. Joerg Kruetten and Carlos Meca discuss the findings of a new industry survey.

Nobody would dispute that the medtech industry is a bastion of strength compared to many other industry sectors in the current economic turmoil. With an ageing population and an increasing prevalence of chronic and prosperity-related diseases, the EU market for medical technology products is and will continue to be a key place for the industry, with growing demand for efficacious and efficient prevention, diagnosis and treatment methods. The industry’s overall business expectations for 2011 are positive.

Rising pressure

However, a second and deeper look at the EU markets shows that the environment has become significantly more challenging in recent years. Stricter reimbursement controls by payers, which increasingly often are bound up with health technology assessments and/or case-based funding across the EU, are putting significant budgetary pressure on caregiver institutions. In response to cost pressures, many caregivers are focusing on the procurement side as a comparatively easy area to cut operating costs. This has increased the influence of procurement departments and reduced the influence of clinical staff on product and therapy choice.

In recent years, the focus on cutting procurement costs has also led to a high and growing prevalence of different forms of pooled purchasing in the EU member states through private provider chains, group purchasing organisations, national or regional public tenders or international distributors.

As a result of these developments, the industry is facing increasing price pressure and business risks as well as decreasing customer commitment and room for competitive differentiation. The impact of these procurement trends, however, largely varies with the complexity and maturity of a product or product category. Whereas purchasing department influence and pooled purchasing are very common for simple medical supplies, they are less prevalent with new and complex surgical procedures or capital equipment, where the purchasing/adoption decision is still predominantly influenced by the clinical and technical staff at the institution level.

Low-cost competitors

A second unfavorable trend for established industry players is the emergence of new low-cost competitors, threatening their market position with good-quality and predominantly me-too products at very attractive price points. These low-cost companies strongly embark on the trend of caregiver institutions focusing on cutting procurement costs. Compared to established players that are driven strongly by innovation and have high R&D as well as sales and marketing expenditures, the new competitors follow different business models. Three types of new low-cost competition can be observed in the EU marketplace:

• Asian ‘broad liners’ who are still focused on R&D but benefit from lower personnel costs, scale on the procurement side, favorable currency fluctuations and lean sales and service models.

• ‘Copycats’ who are copying established products by intelligently circumventing existing patents, and are comparatively small in size and lean on the administration and sales side.

• ‘One-stop-shop’ distributors who benefit from procurement and sales scale and offer their own private label products in addition to established brands.

Besides these new competitors, further low-price competition can be found among established players who offer basic and/or mature products at high discounts to protect the remaining part of their business or offer a low-price product/brand alternative to their premium product by keeping an old-generation product on the market.

Major firms face trouble

These market trends were largely confirmed by the MedTech Barometer 2011, an industry survey conducted by global strategy and marketing consultancy Simon-Kucher & Partners. More than half of the 70 respondents, who are senior decision makers in globally leading medical technology companies with European business responsibility, stated that tight budgets on the customer side and increasing price competition are the biggest commercial challenges they currently face in the European marketplace.

The respondents saw a clear mid-term trend in Europe of increasing competitor price aggression in the fight for higher market shares. On the customer side, there is a clear expectation that purchasing department influence and the pooling of purchasing power will strengthen in the coming years.

60% of the respondents expect a ‘tighter to much tighter’ reimbursement and funding environment in the future, driven by the uncertain fiscal climate and forecasted revisions of reimbursement prices and rates in the EU member states. Close to 60% expect overall market prices to be ‘worse or much worse’ in the near future.

In response to these unfavorable commercial trends, the surveyed managers give first priority to increasing sales force effectiveness in order to deal with consolidation of buying centers and non-clinical procurement stakeholders. The second stated priority is the launch of new and enhanced products and services to increase competitive differentiation. In terms of other business goals, winning competitor accounts and increasing market share were prioritised over raising prices or slowing down price erosion.

50–60% of the respondents mentioned that they already face strong pressure from low-cost competitors and that this pressure is expected to increase in most sectors. The diagnostics sector in particular has been heavily exposed to low-cost competition: all respondents representing this sector have already been affected. Whereas the equipment and supplies sectors expect pressure from low-cost competition to increase, the device side expects the pressure to remain significant but stable.

Increasing innovation, enhancing customer service and processes, and better customer segmentation and prioritisation are believed to be the most effective responses to low-cost competition. Very few respondents believe that trying to match the price points of these competitors by reducing their own prices or introducing low-cost offers/brands is a commercially viable option.

Ready for the fight

In summary, the political framework and the demographic developments will continue to make Europe an important, growing and innovation-friendly market environment for medical technology products in the foreseeable future, despite the ongoing economic turmoil. However, the market climate for established industry players has and will continue to deteriorate due to stricter reimbursement controls and increasing purchasing professionalism and power on the customer side coupled with consistently strong and increasing competitive dynamics.

Despite the commercial challenges that established players in Europe are facing, the business outlook for the coming year remains positive. The respondents across the different sectors expect their operations to grow by 5–10% in terms of revenue, with device and diagnostics companies expecting the highest growth rates. At the same time, the surveyed companies expect to increase their market shares moderately in the area of 3%. The companies’ average selling prices are expected to remain stable. In essence, new product launches are compensating for price erosion among established products.

With increasing budgetary pressure at the payer level and economic uncertainty in the EU member states, it is however very likely that the commercial climate in the medical technology sector will deteriorate further. Stricter reimbursement controls, health technology assessments and cost-cutting pressure on the provider side, combined with strong competitive dynamics, will further increase pressure on prices and margins; the adoption of new products and technologies is likely to slow down. The automatism of continuously compensating for negative developments among established products with new product launches may come to an end at some point.

A lot will depend on maintaining innovation, and the European market is sure to remain an innovation-friendly environment. Companies that launch true innovations with convincing clinical and/or health economic benefits will continue to have great market opportunities. Still, the vulnerability of companies that only launch regular gradual improvements of existing products and companies with a high exposure to very mature product categories will continue to increase. The long-term success of established players in the European marketplace will largely depend on having a strong innovation pipeline and controlling the price erosion of established products.

Strategies for success

Long-term business success in Europe will thus require strategic and tactical adaptations by established firms. European medtech companies are still in general very R&D-orientated. Successful innovation will be key to developing competitive differentiation and limiting the exposure to increasing price pressure. However, European companies – which are often extremely good at selling technical and clinical benefits to clinical users and technicians – need to become better at selling clinical and health economic benefits to commercially-driven purchasers.

This means focusing primarily on the following areas:

• Prioritising and steering R&D projects early on according to reimbursement and price potential.

• Producing better clinical and/or health economic evidence to support positive reimbursement and adoption decisions when launching new products.

• Resources, skills and engagement models for interacting effectively with national or regional payers, as well as procurement managers and financial administrators.

• Balancing market share and profitability goals, differentiated by business area and according to a product’s life cycle stage and the level of competition.

• Offering service support areas to payers and providers that measurably help to drive their organisational efficiency beyond simple price cuts.

• Offering new and intelligent contract models to providers that limit upfront investment burden or ensure budget compliance while securing customer commitment.

• Pursuing a structured and defendable pricing policy rather than making opportunistic and spontaneous pricing decisions.

A management summary of the MedTech Barometer 2011 is available on request. Please contact Claudia Schulz at Simon-Kucher & Partners: claudia.schulz@simon-kucher.com, tel. +49 228 98 43 372.

Joerg Kruetten is Executive Vice-President at Simon-Kucher & Partners, a global consulting firm focused on Smart Profit Growth, and is head of the company’s international medical technology competence center. Dr. Carlos Meca is a senior consultant at Simon-Kucher & Partners.

Industry association Eucomed has proposed a new unified regulatory framework for medical devices across Europe.

The association’s position paper outlines six steps that will ensure patients have rapid access to innovative medical technologies that are value-based and safe.

Consistency, transparency and an integrated approach are the key themes identified by Eucomed as being in the shared interest of industry, healthcare providers and patients.

Eucomed’s position paper ‘A new EU regulatory framework for medical devices’ calls for enhanced member state engagement together with unified and science-based co-ordination of the regulatory system.

While prioritising delivery of high-quality healthcare, patient safety and rapid access to value-based medical technologies, the proposals also aim to encourage R&D and reduce the administrative burden on SMEs.

The association calls for a legal framework to provide a unified regulatory approach to the evaluation and certification of medical devices, with consistent and comprehensive implementation across all EU member states.

Existing bodies such as the European Commission, Competent Authorities and Notified Bodies can be used efficiently to provide a ‘smarter’ legal framework for medical devices, Eucomed says.

The six steps outlined are:

1. Only the best Notified Bodies – better control and monitoring of NBs are needed, including mandatory requirements for designation.

2. A single approach to vigilance and market surveillance – with a centralised reporting and surveillance system based on an EU portal.

3. Stronger harmonised standards – with greater engagement of international experts and earlier involvement of member states.

4. Consistent implementation of guidelines – to make medical device guidance more efficient and consistent across the EU, the current procedure must be revised (e.g. by commitment of member states to uniform implementation) and the European Commission’s current Medical Devices Expert Group (MDEG), which develops guidance, must be upgraded to a formal Advisory Committee.

5. Improved transparency – for better access to information for patients, consumers, healthcare professionals and manufacturers as well as regulatory and legislative bodies, it is critically important to establish a single EU database with information relating to such areas as market surveillance, vigilance and what products are available.

6. An integrated approach – better co-ordination and management, which could be supported by the Commission’s DG SANCO and Joint Research Centre (JRC). The JRC could play a crucial role in such areas as auditing Notified Bodies, co-ordinating vigilance, providing foresight intelligence on health issues, and giving scientific and policy advice to legislators.

John Brennan, Eucomed’s Director of Regulatory and Technical Affairs, commented: “By improving the regulatory framework for medical devices through the six solutions outlined in our position paper, we believe Europe will become stronger in many areas. We suggest many improvements that aid better management of the system by authorities and the Commission.

“In achieving this we think that the JRC is the natural partner for DG SANCO, member states and industry to shape and drive a smart EU medical technology legislative framework, as it is independent and experienced in the broad range of technologies that reflect the medical device industry.”

A cardiac pacing system designed for safe use during magnetic resonance imaging (MRI) scans has been implanted in UK patients for the first time.

The Accent MRI pacemaker and Tendril MRI lead from St Jude Medical were implanted at London’s Heart Hospital by Dr Edward Rowland.

The new pacemaker and lead (pictured), which received CE Mark approval in April 2011, enable the patient to undergo full-body, high-resolution MRI scans.

Approximately 46,000 UK patients receive pacemakers each year, and up to 75% of those are likely to benefit from MRI scans at some time in order to check for diseases that cannot be as effectively diagnosed with other imaging modalities.

The Accent MRI pacemaker system features an MRI Activator device that allows the pacemaker to be programmed to the appropriate MRI mode for use during the scan by a single button press, using parameters pre-set by the patient’s doctor.

Dr Rowland commented: “Undertaking MRI scans in patients with pacemakers has previously been impossible or fraught with technical difficulties. I feel I can now advise patients that a magnetic scan can be performed without compromising the safety of the pacemaker.”

"The Accent MRI conditional pacemaker has many advantages over what is currently available,” said Paul Turner, St. Jude Medical’s VP for the UK, Ireland and Canada. “It is a state-of-the-art pacemaker that offers full body scanning capability without restrictions, which is especially important to patients who may need an MRI scan in the chest and abdominal area.”

Based in Minnesota, USA, St. Jude Medical develops medical devices to treat cardiac and neurological disorders and chronic pain.

Michael Huggins, former North America President of bone implant specialist Synthes, has received a nine-month sentence for his role in an unauthorised clinical trial of bone cement that caused three human deaths.

Three other former Synthes executives, convicted of involvement in the same criminal activity, are awaiting sentence.

The US Justice Department had prosecuted the four executives in a drive to hold individuals to account for corporate crimes.

The executives had senior roles in Synthes’ Norian unit, which manufactured osteobiological implants. Norian was purchased by US company Kensey Nash earlier this year for $22 million.

Between 2002 and 2004, the Justice Department said, Norian carried out unauthorised clinical trials of Synthes’ Norian XR bone cement in surgeries to treat vertebral compression fractures (VCF), despite a warning against such use on the product label.

Initial studies had shown that the bone cement reacted chemically with human blood in vitro, producing clots – and that when used in a pig, the cement caused blood clots in the lungs.

Synthes continued to test the product on humans until it had caused three deaths, and even then the company misled the FDA, the Justice Department said.

In April 2011, Johnson & Johnson purchased Synthes for approximately $21.3 billion to merge it with its own troubled DePuy orthopaedic device business.

Intensive control of type 1 diabetes to maintain near-normal blood glucose levels halves the long-term risk of kidney disease, according to a US trial funded by the National Institutes of Health (NIH).

The landmark Diabetes Control and Complications Trial (DCCT) followed patients for more than 20 years following a 10-year trial period.

The results provide definitive evidence of the long-term benefits of intensive monitoring and medication adjustment soon after diagnosis to optimise the value of insulin therapy.

This finding adds significantly to the body of evidence supporting an intensive control strategy, despite the financial and logistical challenges it presents, and endorsing the use of new technologies for monitoring and insulin injection that help to address those challenges.

The DCCT was conducted from 1983 to 1993 in 1,441 people with type 1 diabetes, an average of six years after diagnosis. Half of them used conventional blood glucose control (based on daily testing) in the trial and half used a more intensive approach.

After an average of 22 years follow-up, 24 in the intensive group developed significantly reduced kidney function compared to 46 in the conventional group. Intensive control also reduced eye and nerve damage.

Griffin P. Rodgers, Director of the NIH’s National Institute of Diabetes and Digestive and Kidney Diseases, which oversaw the DCCT, commented that it showed “the value of long-term studies”.

“The full benefit of treatment may not be seen for decades, especially for complications of diabetes, such as kidney disease, which can progress slowly but have devastating consequences,” he said.

Diabetes is a leading cause of kidney failure – in the US, it accounts for 38% of patients on dialysis or living with a kidney transplant.

The British Standards Institution (BSI) is strengthening its presence in the German medical devices market by rebranding EUROCAT, the German medical devices Notified Body and Test House owned by the BSI Group, as BSI Healthcare Germany.

The rebranding of EUROCAT is expected to attract new business by offering a global market access capability to companies in the German, Austrian and Swiss medical devices markets.

BSI’s increasing investment in Germany shows the country’s growing importance within the European medtech market.

The new organisation will retain German Notified Body status and continue to use the EUROCAT approval number CE 0535.

Since its acquisition by BSI in 2009, EUROCAT has gained the capacity to approve high-risk in vitro diagnostics, raising its profile in the medtech market.

EUROCAT founder Werner Kexel said: “Without doubt the German medical devices market will benefit from the values associated with the BSI brand. BSI holds a significant market position across the globe based on world expertise, capability and quality of service.

“This, coupled with the ongoing investment which has been evident since the acquisition, will allow Germany to offer a testing services business with a truly global footprint, which we hope will attract new business from larger industry players.”

“In a difficult economic climate medical device manufacturers are under increasing pressure to become more efficient and increase the speed of their products to market,” commented Gary Slack, Director of BSI Healthcare.

“In response BSI is striving to help manufacturers gain market confidence by enhancing its capability and presence in the German market and by improving links with government competent authorities in Germany.

“Bringing EUROCAT under the BSI brand is evidence of BSI’s continued commitment to recognising Germany as a critical market for medical device certification,” he concluded.

As the PCTs form clusters from which the Clinical Commissioning Groups will hatch, a new generation of NHS commissioners is being born. Thoreya Swage examines how medtech can help these new customers to redesign services.

Irrespective of the progress of the Health and Social Care Bill currently going through the House of Lords, the momentum of reform of the NHS in England continues to gather pace.

Following a four-month hiatus while the wise and the good of the NHS Future Forum pondered and produced recommendations for the adjustment of the Bill, the Department of Health published further guidance on the developing role of the PCT Clusters. Although the 151 Primary Care Trusts have been squeezed into 51 PCT clusters in preparation for their demise in April 2013, it appears that they have a vital part to play in the development of the emerging Clinical Commissioning Groups (CCGs).

The guidance or ‘shared operating model’ for PCT clusters has been produced by the mandarins at the DH to ensure that the commissioning landscape is as consistent and smooth as possible in time for the takeover by the CCGs. This is to ensure that the nascent NHS Commissioning Board inherits a robust enough system to take charge of further developments and improvements in healthcare in early 2013.

The shared operating model identifies six main functions or ways of working, where consistency of approach is considered to be important. They are listed as commissioning development, financial and operational issues, ensuring quality, emergency planning, development of providers as Foundation Trusts and communications.

CCG commissioning development

The most important function of the PCT clusters is the preparation of CCGs for authorisation as soon as possible following the successful passage of the Health Bill through Parliament. The process of authorisation to become fully-fledged commissioners is due to begin in the second half of 2012. Although this is a year away, CCGs can commence their preparations now using a self-diagnostic tool: an interactive computer-based assessment that helps them to determine their capabilities and identify their development needs. The areas covered include:

• A clear clinical focus for the CCG commissioning plans to include tackling health inequalities and improving primary care.

• Demonstration of meaningful involvement of patients and the wider community.

• A plan for development that is clear and credible and that, in particular, delivers the QIPP (quality, innovation, productivity and prevention) agenda.

• Capacity and capability of the CCG, i.e. robust constitutional and governance arrangements that enable the CCG to commission care effectively and ensure financial control.

• Collaborative arrangements for working with other CCGs, local authorities and the NHS Commissioning Board.

• Capacity and capability of the CCG leadership, which ensures effective working.

The tool helps the CCGs to identify priority development areas, which form the basis of the developmental plan paving the way to full authorisation.

To support all this work, CCGs will receive £2 per head from the PCT clusters, as well as extra management resources to help the groups hone their commissioning skills and capabilities.

CCGs experiencing difficulty in defining their boundaries will have guidance from PCT clusters on how to resolve this. PCT clusters also have the unenviable task of engaging the reluctant practices that so far have not participated in their local CCG discussions, with the aim of making them part of a viable CCG by October this year.

Separation of functions

Through the last quarter of this year, a detailed exercise is being carried out by the PCT clusters to identify and segregate the service areas that CCGs and NHS Commissioning Board will be responsible for.

Although the CCGs will be commissioning acute, mental health, community and ambulance care, other services that PCTs currently commission will need to be transferred to the umbrella of the NHS Commissioning Board:

• GP and other primary care contractor groups (primary care dental, pharmacy and optical services)

• secondary dental care

• prison, specialised and military health services.

Even though the contracts for GP services are held by another body, the CCGs are expected to have an input into primary care development and improvement.

Quality assurance

A vital component of the commissioning process is ensuring the quality of healthcare. Practices may have been involved to a greater or lesser degree in various quality assurance processes in the past; however, CCGs are required to take these responsibilities seriously on board.

There is a whole raft of procedures and measures including delivery of better health outcomes for patients, meeting the Care Quality Commission (CQC) requirements for safety and quality of services, standard contracts, the NHS Operating Framework, professional guidance and other relevant requirements that CCGs need to get to grips with.

This could potentially be a vulnerable time for the development of the CCGs if attention wanders and serious patient safety incidents are not acted on promptly. Clinical governance processes must therefore be extra-secure.

Budgets and responsibilities

Over the next year or so, there will be a period of dual functioning and handover as the CCGs mature and the PCT clusters delegate more and more responsibilities until April 2013. The handing over of the baton has started now, with PCT clusters having identified a ‘clear percentage of budgets’ to CCG pioneers or pathfinders in August and set plans for future delegation of budgets in October.

Sandwiched in between these two was the agreement in September on which mental health and community services will be subject to ‘Any Qualified Provider’ (AQP). This policy is set to be implemented from April 2012, when GPs can refer to providers of certain services eligible for AQP from a list of approved organisations, including private sector companies, drawn up by the DH.

A review of the commissioning support required by CCGs was undertaken in July, with clear arrangements to be agreed by the end of this year.

In March 2012, CCGs will be required to enable the development of the local health and wellbeing boards (the mechanism for joint health and social care planning and local commissioning) supported by their PCT clusters.

Meanwhile, individual PCTs will continue to carry out their statutory functions through the PCT clusters until their abolition in April 2013. The statutory functions include contract monitoring, ensuring that providers meet their QIPP obligations, and other statutory requirements such as safeguarding children and vulnerable adults.

The big challenge for CCGs begins when they are required to lead the next planning round for 2012/13. This will start towards the end of this year, and is a function previously undertaken by the PCTs. It involves doing a needs analysis, identifying local inequalities, understanding demand and resources for local services, negotiating and setting priorities with partners, and developing a local strategic vision. Handover of commissioning functions will continue, with CCGs being an active participant in the subsequent contract negotiations and agreements.

How medtech fits in

It is apparent that despite the pause for reflection on the proposed changes in the English health service earlier this year, the momentum of dissolving and restructuring healthcare organisations continues. The picture remains a little confusing, however, as CCGs are in varying stages of development and maturity and it is not clear that all are now truly viable although the October deadline has passed.

What is clear is that that the work of commissioning and delivering healthcare has to go on, and now is a good time to find out who the key movers are within the CCGs. At this point the developmental needs of CCGs are uppermost, and it is here that medtech companies can provide some input. Skills and knowledge in leadership development and highlighting evidence-based medical technologies that really make a difference are two key areas of potential input.

CCGs will be keen to redesign services in order to make patient pathways across primary and secondary care more consistent and to move more care into the community setting. It is here that telehealth and telecare will come into their own as a means to facilitate the transition.

Demonstrating the effectiveness of home monitoring of blood pressure, supporting community services such as HIV or stoma care, and promoting medical devices that offer continuous subcutaneous infusion of insulin are examples of technology implementation where a vital case can be made to these prospective healthcare commissioners. CCGs will also look favourably on management of their patients in the surgery with video links to consultants for advice, rather than sending them to outpatient services.

Clinical services that utilise new or different medical technologies will require staff who are appropriately trained and have the skills and competencies to use the equipment. This training can be provided by the medtech industry.

As ever, good information forms the basis of good commissioning and the demonstration of successful patient outcomes. Data systems in the community setting have always lagged behind their counterparts in the acute setting. Given that CCGS will need to develop services in the community, new and better IT systems will be required.

Get ready!

The next few months will be busy while the NHS sorts itself out at a structural level. Once the picture begins to clear, the medtech industry will need to engage with the new clinically skilled commissioners who now have the financial responsibility for making decisions about healthcare.

Dr Thoreya Swage was formerly an NHS clinician and a senior manager in various NHS organisations covering acute and primary care. She has expertise in commissioning health services and is currently working for a number of NHS organisations, including DH agencies, to develop a more commercial approach to the commissioning of healthcare.

A new point-of-care ultrasound system could help to guide clinicians during acute care procedures such as regional anaesthesia, pain medication delivery and examination of critically ill patients.

The Sparq system (pictured) from Philips Healthcare, launched at this year’s MEDICA congress, is a mobile device designed to provide immediate, user-friendly ultrasound imaging in the operating room or at the patient bedside.

Key features of Sparq include:

• It is the first ultrasound system with a touchscreen for control, which assists infection control as well as providing a simple interface.

• It can be set to Simplicity Mode, a one-touch solution that presents only the functions needed most often.

• Its AutoSCAN feature adjusts the image while scanning, reducing the need for manual adjustment.

• Its Needle Visualisation feature provides rapid and accurate needle guidance.

Sparq offers a wide range of specific clinical applications for emergency medicine, critical care, regional anaesthesia and pain medication for specific regions of the body.

Further service capabilities can be added to the system, such as online clinical or technical support and proactive patient monitoring.

“The simplicity of its design and the intuitiveness of its user interface make Sparq a pleasure to use,” said Barry Nichols, Consultant in Anaesthesia and Pain Management at Musgrove Park Hospital, Taunton.

“Sparq’s ergonomically efficient controls and high-resolution screen really benefit our clinicians’ day-to-day workflows. A compact and highly mobile device, it is also perfect to use in the operating theatre environment.”

Conrad Smits, Philips Healthcare’s General Manager, Ultrasound, commented: “A great deal of effort went into Sparq’s features and design to meet the specific needs of our point-of-care customers. Our goal is for Sparq to simplify the use of ultrasound for clinicians.”

Based in the Netherlands, Philips Healthcare is a market-leading supplier of solutions for cardiac care, acute care and home healthcare.

Telehealth Solutions has launched a new managed telehealth service in the UK that has the potential to transform the treatment of serious long-term conditions.

The new service combines a customised home monitoring system and a specialist nurse triage service for patients with chronic obstructive pulmonary disease (COPD), diabetes or chronic heart failure.

As well as improving patient care through more regular monitoring and timely intervention, managed telehealth is expected to reduce hospital admissions and administrative workload for clinicians.

COPD affects 900,000 COPD people in the UK, with hospital admissions for these patients costing the NHS an estimated £35 million per year.

The ‘end-to-end’ managed telehealth service directly involves patients in their own treatment, while enabling clinicians to personalise the collection of data for each patient, detecting warning signs and making early interventions.

The Telehealth Solutions home monitoring system incorporates a range of vital sign collection devices: weight scales, peak flow meter, thermometer, pulse oximeter, blood pressure meter, ECG, blood glucose meter and INR tester.

John Dyson, Chief Executive of Telehealth Solutions, said: “The Telehealth Solutions ‘end-to-end’ service is a tailored, comprehensive patient care model, ensuring full collaboration and dialogue between patient and healthcare professional from the outset.

“It is a significant step forward for patients with these long-term conditions as they can now take more control over their treatment plan and actively participate in consultations.”

The DH will shortly publish the outcome of the NHS Whole Systems Demonstrator programme, which has trialled telehealth systems with 6,000 patients over three sites in England.

Based in Watford, Telehealth Solutions has achieved success with its GP practice-based Surgery Pod for monitoring patients with long-term conditions.