By Mike Cowley
When paediatric surgeon Iain Hennessey gets home at the end of a long day working at Alder Hey Children’s Hospital in Liverpool, his four-year-old daughter Lucille – the youngest of his three girls – has been known to ask: “Have you built that machine to help sick children yet?”
She asks this because her father is clinical director of innovation at Alder Hey, and once told Lucille that he had been working on just such a machine.
And the reality is that he probably had. Not just one machine, but lots of them – which, combined in the form of technology, will help children to come through the trauma of their time in what is possibly the most advanced hospital of its type in the world.
For the new Alder Hey – which opened last October and has been fondly referred to as the Teletubbies House because its patients helped to create the quirky design as they didn’t want it to look like a hospital – is a centre of innovation excellence.
Set in the midst of Springfield Park following a land swap with Liverpool City Council, the visionary hospital is a leader in research and innovation related to children’s health in the UK – which, in turn, is influencing the way children are treated round the world.
Every patient’s window in the building overlooks the park, a design feature demanded by the sick kids themselves. It was a drawing by Eleanor Brogan, aged 15 at the time, that impressed architects and inspired the final design.
The new hospital is not just one building, but several health-related structures including a dedicated research, innovation and education centre – the Institute in the Park – and an innovation hub where technological advances are put through their paces before some of them make it into the hospital itself.
While the main hospital building is where all the new technology will be used – and there are already robots scurrying around picking up rubbish and delivering linen to wards – it is in the 1,000-square-metre basement where many of the advances start life.
Funded with help from the North West Coast Academic Health Science Network (which from this month goes by the name of the Innovation Agency), this is where clinicians, large companies, small and medium-sized enterprises (SMEs) and even patients come together to try to produce solutions to the day-today issues that are found in the hospital upstairs.
For example, they are currently working on an app which will provide new patients with an avatar to guide them round the building even before they arrive – and possibly even give them a virtual pet to accompany them on their journey.
“Children don’t like to be surprised by things,” Iain Hennessey says, “so coming into a hospital is a big thing for them and we want to make it as relaxing as possible. One way to do this is to help familiarise them with the hospital before they even arrive.”
Another exciting technology being developed at Alder Hey is a transdermal lactate sensor, which allows information that previously required an invasive blood test to be detected through a simple patch on the skin, wirelessly and in real time. This information is critical when monitoring children who have had complex heart operations, and allows rapid decisions to be made.
It is in the innovation hub that co-operative imaginings such as these can take flight – even the possibility of “3D-printed tastier tablets” has been contemplated – and nothing is off the agenda when it comes to improving the treatment of sick children.
Alder Hey is also looking at the best ways of rewarding children for positive health behaviour – something which Mr Hennessey has done previously by buying Pokémon cards in bulk and handing them out – but nowadays this is far more likely to take the form of “digital bribery”.
Distraction therapy is another method actively under discussion. “We are looking at this to use for children who are having burns dressed, which is very painful and often has to be done in a bath,” Mr Hennessey says. “It is amazing how powerful distraction is, and kids are much more distractible than adults.
“I’ve often used my smartphone to occupy them while I examine them, and we are hoping to take that to the next level – whether it is a game or a video. We are looking at using tablet devices, as we believe they can have the same calming effects as drugs but without the side effects.
“A master clinician can take blood from a child without them even noticing, so we are trying to think of ways of getting that distraction expertise into a digital form. We simply have to move with the times and the NHS has sometimes not been very good at that.”
When wearing his clinical director of innovation hat, Iain Hennessey sees himself as running “a concierge service” to make it easy for companies to interact with the hospital. “It is a question of: you have the technologies, we have the problems,” he says. “The end result is that they get into the NHS market and we get solutions for some of our problems.”
To make this happen, the hospital’s innovation team regularly hosts events which involve clinicians and technology companies. A recent “hackathon” sponsored by the Innovation Agency attracted an audience of more than 200, with the clinicians pitching their problems and local technology companies offering possible solutions.
The eventual winner was a sensor to improve the safety of intravenous drug administration, suggested by one of the nursing staff and then engineered in conjunction with a local university. It just so happens that Liverpool is a centre of sensor excellence, so this was a problem seen as easy to solve and the breakthrough is now at the patent stage.
Another proven source of solutions for Alder Hey is 3D printing, something which has enabled them to take CT (computed tomography) scans and print out models of diseased organs which can then be used as part of the pre-operative planning. “It’s really cool that we have been able to print out models of tumours which we can look at before the operation,” Mr Hennessey says, “and we’ve even been able to create a sterilisable model of a spine that we can take into theatre with us.”
Then there is the potential offered by virtual engineering being undertaken at nearby Sci-Tech Daresbury, where virtual models of cars are being created, allowing engineers to sit inside wearing virtual goggles. In the case of Alder Hey, there is also now a giant virtual heart which Iain Hennessey and cardiac surgeon Rafael Guerrero have been able to walk through using a virtual torch to highlight areas of interest.
“It’s often a case of taking technology that is out there already and applying it to healthcare,” Iain Hennessey says. “Let’s face it – nothing is more important than making sick children well. People want to help you because it’s a children’s hospital, and we need to harness that.
“If the NHS is going to continue to be viable, we are going to have to find value in what we do – it can’t be viewed as a cost. The experience and knowledge of NHS staff is invaluable – that’s what we need to harness and make some money for it. If we can put that back into healthcare, it turns from a cost into an investment – that’s what we are trying to do.
“And we are creating jobs at the same time, so it’s a win-win situation. People often think about the NHS as being made up of silos, whereas I think it is made up of trenches where people are often reluctant to stick their heads over the top.”
Iain Hennessey readily admits being driven by the desire to help children, and believes he has the best job in the world because of it. “I think of children’s illness as a monster,” he says. “It frightens me because I see what it can do, its lack of mercy, and ultimately I have kids of my own and no family is immune. So we have to improve, we have to develop the technology in partnership with other industries to fight this monster.”
He often reflects that the diseases from which children were dying 100 years ago would be easily curable today with simple pieces of technology. “It frustrates me that at some point in the future we will find an answer to all of these problems,” he says. “But I don’t want to wait another 100 years, I want it now.”
Alder Hey is one of ten health innovation centres around the region being supported by the Innovation Agency – formerly the North West Coast Academic Health Science Network – with others in Lancaster, Chester, Chorley and Liverpool at various stages of development.
The Innovation Agency provided two awards of infrastructure funding for the Institute in the Park research centre, helping to leverage £12 million of European funding. This has led to the creation of a “living hospital laboratory” known by staff as “the Batcave”, where new technology can be tried out in realistic clinical settings.
In addition, the Innovation Agency has organised events and brought in local businesses with products, services and advice relevant to the set of needs identified by the hospital. This matchmaking has led to several collaborations to co-create innovative devices and systems.
One event saw cardiac surgeon Rafael Guerrero present a challenge to technology developers, and this led to the creation of a joint venture to develop a small wireless sensor to read defined signs of disease or abnormalities in the blood without breaking the skin, thus avoiding the use of needles to take blood. This development has since received £1m in funding from the Small Business Research Initiative for Healthcare.
The Innovation Agency also funded and supported a £50,000 telemedicine project, implemented at three sites to help families to access expert advice and support from consultants at Alder Hey through remote video monitoring.
Drinking to patients’ safety
When Mathew Done was helping to sell meals to the NHS ten years ago, he asked a therapist what else she needed. The response was safe, palatable and easy to prepare drinks suitable for people with dysphagia, a condition that causes difficulty in swallowing for more than 500 million patients worldwide.
Dysphagia is a secondary problem brought on by 127 different medical conditions including stroke, Alzheimer’s, multiple sclerosis and Parkinson’s, and is often a side effect of head and neck cancers. For those affected, ordinary liquids and solid foods flow too fast for them to swallow, and this can cause choking and respiratory problems leading to hospital re-admittance. To prevent this when drinking, the consistency of drinks must be changed to slow things down.
Mathew Done’s solution was to create Slõ Drinks, with the latest development going by the name of Slõ Milkshakes+. Available in strawberry and chocolate flavours, these are the first instant highcalorie milkshakes for people with dysphagia. The secret was finding a thickener that works with milk to make sure it matches the syrup or custard consistency demanded by NHS clinicians.
After four years of hard work, Slõ Drinks are now listed on NHS supplies and are being used in the stroke and rehabilitation wards of four UK hospitals including Manchester Royal Infirmary.
Mr Done’s Hadfield-based company was supported with funding and guidance from Greater Manchester Academic Health Science Network (AHSN), under the Innovation Nexus initiative which encourages industry partnership and growth. Slõ Drinks responded to one of Greater Manchester AHSN’s Technology Innovation Challenge awards to support patient safety and received one of several grants valued at £40,000.
“Without this funding and support,” Mr Done says, “it would have taken at least another four years to get into the market. In doing this, it has helped to grow the company and contribute to patient safety and quality of life”.
Scouting for breakthroughs
It might seem a far cry from his previous job working for the brand Tommee Tippee to his present role as head of commercial development at the North East Ambulance Service NHS Foundation Trust, but there is a common denominator for Jonathan Knox: innovation.
Despite no longer working on no-spill cups for babies, Mr Knox remains actively involved in looking for breakthroughs to improve patient care – and where he previously found inspiration from the mothers of toddlers, now he looks for similar input from within the 2,000 frontline staff in the ambulance service in the North East of England.
As part of this work he has become an innovation scout for the Academic Health Science Network for North East and North Cumbria (AHSN NENC), which is actively working with the Trust to promote innovation as a way of safeguarding the future of this sector of the NHS.
Jonathan Knox and five of his colleagues have gone through the Innovation Scout Scheme, run by the region’s AHSN to put together a network of professionals who will encourage innovation development. To date, the AHSN NENC has funded 52 innovation scouts across 19 organisations in the region, covering acute and mental health trusts, clinical commissioning groups and primary care.
The North East Ambulance Service NHS Foundation Trust has wholeheartedly thrown its weight behind the project by finding £50,000 to fund an Innovation Hub – this goes online next month to receive and process the ideas coming out of the service.
“We believe it is the people at the sharp end – those who know the problems – who are most likely to come up with the solutions,” Mr Knox says.
Comeback with a good idea
A nurse who retired recently after 40 years of service in the NHS is intending to make a comeback working with Airedale General Hospital in West Yorkshire – this time as the inventor of an innovative product to help her former patients.
Pat Gardner, who was previously a specialist practitioner in lymphoedema, a chronic condition that often causes swelling in legs, is working on a product that will help to alleviate a problem commonly associated with the condition: sore heels.
As a patient becomes older or suffers from other age-related conditions such as arthritis, they can often get swollen, heavy legs leading to poor mobility and consequently causing them to sit for long periods during the day and sometimes in the night as well. With this in mind, Ms Gardner has come up with a way of lifting the patients’ feet off the floor while they are sitting, in a way that should be easy to do and allows patients to remain in their shoes or slippers, thus retaining their independence.
“We looked around for a product that might help while I was still working,” she recalls, “but there simply wasn’t anything suitable that encouraged patients to remain mobile. So after I left, I began working with Dr Carole Paley, the head of research and innovation at Airedale General Hospital, and with her support and some funding came up with a design idea that will work.”
Pat Gardner is also being helped to reach the prototype stage through funding and expert support from the Yorkshire and Humber Academic Health Science Network, which has taken her through the stages from concept to product development. Her design recently won a £5,000 NHS innovation award, half of which had also been donated by the AHSN team.
“We are hoping the product will end the vicious circle we are seeing,” she says. “Because of sore heels, patients are less ambulatory and this just makes their condition worse.”