Challenges regarding design and issues about adoption of innovative technologies

THE creation of innovative new medical products and equipment that could help revolutionise healthcare and save money is being hampered because of problems with intellectual property rights, legislation, and a lack of support from NHS staff, industry experts have warned.

At the recent 2011 Design Summit, speakers raised concern over the difficulty manufacturers continue to experience when trying to get their products adopted by the NHS.

Central to the debate was Bryn Jones, operations director of Bristol Maid, the company behind the redesign of the patient bedside cabinet as part of the Department of Health and Design Council's Design Bugs Out challenge. The initiative provided funding for private sector designers to produce new items of furniture that would enable improved infection control within hospitals and other healthcare settings. The challenge also gave the winning firms unprecedented access to NHS environments where they would be able to roadtest the equipment; a luxury most companies do not enjoy.

Products haven't really changed in the NHS much since 1953. People want traditional products and they want the same as they've always had. Trying to introduce something new is very difficult

Commenting on the challenges facing the industry, Jones said: "Products haven't really changed in the NHS much since 1953. People want traditional products and they want the same as they've always had. Trying to introduce something new is very difficult."

One of the main problems is the wealth of legislation within the healthcare marketplace, which can create a barrier many companies cannot overcome. Jones said: "There are lots of things that are laid down in legislation and that legislation is actually hampering development. It's fairly inflexible. As a company we try to use the British standards as a template for our product design, but that can also hamper how we can actually make changes for the better."

Also causing difficulties are the current laws around intellectual property rights, which leave businesses reluctant to spend huge amounts of money on research and development.

There are lots of things that are laid down in legislation and that legislation is actually hampering development

Jones said: "Intellectual property versus commercial realism is something that does crop up on a regular basis. Who owns the design rights? Who's going to get profit from it? Who's going to take it forward? This needs to be resolved."

This view was supported by Mark Prisk MP, who called on the Government to do more to reform and strengthen the legislation so as to encourage more innovation in the MedTech sector. In addition, Chris Saunders, chief executive of Navetas Energy Management, said more needed to be done to support spin-out companies, such as those linked to universities, which are renowned for innovation within the healthcare marketplace.

Based in Dorset, Bristol Maid has been operating since 1953, the year the NHS was launched, and the health service now constitutes 65% of its business.

But Jones said that, during this time, many companies have found it almost impossible to get a foot in the door of the NHS and it still lacks the vision that will see it take advantage of developments in the sector.

It's crazy that good practice, great product design and good environmental design in one area is not being adopted in other areas

"We can offer new products and new technology, [but] quite often the cost will go up," he said. "It is very difficult to introduce something to the NHS without actually adding some value. However, the problem then becomes selling the features and benefits of the new technology - what it is actually going to give back to the NHS and what are the improvements we're actually delivering.

"As a company supplying the NHS, it's been very difficult in the last few years to try and get people round the table to discuss problems, to develop ideas, and then to try to see them come through into the NHS."

This is where initiatives like Design Bugs Out can have a real impact, both on healthcare delivery and outcomes and access to the NHS for industry. Jones said: "Having a clear focus and a clear strategy with the infection prevention challenge meant we could talk to people one-to-one. They knew the problem, we knew the problem, and we had a common goal to resolve. We got all the experts around the table and the showcase hospitals was another big aspect that really helped introduce the new cabinets into the NHS.

As a company supplying the NHS, it's been very difficult in the last few years to try and get people round the table to discuss problems, to develop ideas, and then to try to see them come through into the NHS

"As a company, we've recognised that our products do have a big interface with the whole environment. A trolley isn't just a trolley. It actually has a big impact on the ergonomics, the feel of the place, and we believe it has actually helped change that environment for the patient, the user and also visitors coming into the hospitals. Design Bugs Out helped with all that."

And he advised companies to look at major drivers like infection control and privacy and dignity when considering the creation of new technologies. He added: "Pharmacy control is another key area. There's been a big push on improving controls on the security of drugs as well as productive wards and theatres. These are a new set of drivers for industry."

The standardisation of medical devices will also be an important area to consider.

"The NHS is a very large organisation and standardising products to make them commercially appealable for a manufacturer to produce in higher volumes is difficult and we do have issues trying to make something one-size-fits-all. There is work to be done on standardisation."

This will also help overcome the problem with NHS trusts in different areas using different equipment and approaches to healthcare. Jeremy Myerson, director of the Helen Hamlyn Centre at the Royal College of Art, explained: "We've got a project where we are redesigning the standard ambulance, except there is no standard ambulance. Every local area health authority is commissioning a different model. There is no national specification and it's crazy that good practice, great product design and good environmental design in one area is not being adopted in other areas. People are constantly repeating the same mistakes and I think that the current climate, where things like the National Patient Safety Agency - a national body trying to spread good practice - has actually been abolished by the Government, means everything is running in the wrong direction if we're going to have higher national design standards in our major public services."

There's a lot that we can do in the public sector to benefit from good design and, of course, it is critical to economic growth and innovation

But there is light at the end of the tunnel for the manufacturing industry. At the summit David Willetts MP revealed two new initiatives along the lines of Design Bugs Out, which are set to give MedTech companies and designers a helping hand with NHS purchasers.

The Department of Health-funded challenges will concentrate on design solutions to help patients with dementia and those to help older adults stay independent at home for longer. Willetts also announced that the Government's research budget would be ringfenced at £4.6billion and that the Government would produce an innovation and research strategy at the end of this year to address problems with the adoption of technology.

"Our estimate is that there are 230,000 designers in the UK and £15billion was spent on UK design in 2009," he told delegates. "There's a lot that we can do in the public sector to benefit from good design and, of course, it is critical to economic growth and innovation."

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Bristol Maid (more information, website)

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