HTN 100

HTN 100: NHS 111, SHMI, King’s, Closed Loop Medicine and DocPlanner

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NHS 111 online hits one million triages mark

NHS 111 online has been used more than one million times to get people the medical help they need since its launch in December 2017.

Around 13% of all NHS 111 online journeys end with self-care advice, almost half (48%) of all triages direct users to contact primary care and about a quarter (24.7%) of journeys end with instructions to ring 999 or attend A&E. In total 6.8% are advised to seek dental treatment and 7.4% are given other treatment dispositions, including speaking to a pharmacist. The most common symptoms for which people use NHS 111 online are related to abdominal pain and dental problems.

The data from NHS Digital shows the service continues to grow as 73.8% of visitors ‘in hours’ (weekdays 8am to 6pm) and 70.4% of visitors ‘out of hours’ (evenings, weekends, bank holidays) are using NHS 111 online for the first time. Women (68.3%) are also more likely to use the service than men (31.6%), and the average age of a user is 30 years old.

Summary Hospital-level Mortality Indicator (SHMI) updated

The SHMI is the ratio between the actual number of patients who die following hospitalisation, and the number that would be expected to die on the basis of average England figures.

The SHMI can be used by hospital trusts to compare their mortality outcomes to the national baseline. However, it should not be used to directly compare mortality outcomes between trusts and it is inappropriate to rank trusts according to their SHMI.

Full details of all the updates are available in the methodological changes document which is available to download from here.

NHS funds tech to protect prostate cancer patients during radiation treatment

An innovation that can reduce the side-effects of radiotherapy for prostate cancer patients by over 70 per cent will be rolled out across the NHS.

A deal struck by the NHS with manufacturer Boston Scientific, hospitals in England will now be encouraged to use its hydrogel device for all patients who could benefit, making radiotherapy a safer and less painful treatment option for many men.

When prostate cancer is caught early enough, radiotherapy can be a highly effective treatment. High-energy X-rays are targeted at the prostate, killing cancer cells and preventing them from spreading. However, the radiation is not absorbed by the prostate, meaning that nearby healthy organs can be affected. The hydrogel acts as a spacer, reducing the amount of radiation that can pass through the prostate and damage the rectum during treatment, by temporarily positioning it away from the high dose radiation used in treatment. The gel, made mostly of water, is injected before treatment starts and then remains in place during radiation therapy, before being naturally absorbed by the body after about 6 months.

In studies, its use has been shown to relatively reduce life-changing side effects, such as rectal pain, bleeding and diarrhoea, by over 70%, meaning significant improvements in quality of life for those battling prostate cancer.

King’s neurosurgeon carries out innovative surgery

Mr Bassel Zebian, a consultant neurosurgeon at King’s College Hospital, has adapted an endoscopic ultrasonic aspirator – a device that uses ultrasonic vibration to fragment a brain tumour and remove it – in order to carry out minimally invasive neurosurgery for deep tumours that would otherwise be extremely difficult to access.

The technique Mr Zebian uses in selected patients is the equivalent of keyhole surgery in the brain. The procedure is performed through a neuroendoscope – a small metal tube with a camera at the tip and a channel to allow instruments to pass through. In some cases a hole about 9mm wide is made in the skull for the endoscope to be inserted. Mr Zebian was able to modify an endoscopic ultrasonic aspirator to fit through a specific endoscope. This allows him to navigate the ventricles of the brain and reach very deep lesions and remove them with minimal damage to the surrounding healthy brain. The alternative technique would have resulted in a much bigger corridor, a few centimetres in diameter, through the healthy brain to allow access to the deep tumour.

Mr Zebian said: “This technique minimises damage to the healthy brain whilst maximising visualisation of and access to deep tumours. The difficulty neuroendoscopic surgeons often face is the control of bleeding and the lack of adequate instrumentation. With our modification of existing instruments we have been able to push the limits of minimally invasive resections in the best interest of our patients and we are increasingly able to resect even large, deep, solid tumours with one of the biggest cases series in the world.”

Closed Loop Medicine raises £2.1 million

Closed Loop Medicine,  the Cambridge-based health tech startup that helps doctors and healthcare providers to deliver personalised treatment regimens has raised £2.1 million in venture capital funding.

Closed Loop Medicine, a therapeutics company combines proven drug treatments with digital therapeutics. Digital therapeutics deliver evidence-based therapeutic interventions to patients that are driven by high quality software programs to prevent, manage, or treat a medical disorder or disease.  The Closed Loop Medicine approach uses data and insights about how a patient is responding to treatment to tailor drug and non-drug therapy, which provides a much faster way of getting an individual to their optimum outcome.

DocPlanner raises €80m

DocPlanner has raised €80m is Series E funding, a Polish company in the online doctor booking space. It offers doctors and clinics a SaaS tool to improve patient flow and help “digitise” their practices, and allows patients to book appointments through its online marketplace with healthcare professionals. DocPlanner says that it currently processes 1.5 million bookings every month, serving around 30 million patients.

“This fresh funding comes at the best moment in the company’s history. The growth rate in our core business is accelerating and we’re seeing more opportunities in our space, both in terms of customer segment and product offering, as the health tech market matures,” said Mariusz Gralewski, founder and CEO of DocPlanner.



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