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Helicon Health is a UCL spin-out company providing a stroke prevention clinical management service (Helicon Heart) developed through UCL health informatics research. In partnership with Whittington Health, a large north London hospital, Helicon Heart provides stroke prevention management to 5 NHS Clinical Commissioning Groups (CCG) across north London and Hertfordshire, covering 2 Hospital Trusts, 30 General Practice delivery sites and 3 Community Pharmacies. The system underpins clinical care for 3,000 at-risk patients, and Helicon Health has secured additional contracts to extend this to 4,500 patients in 2014. Every prevented stroke saves the NHS £16,000 per annum; the estimated saving to each CCG is approximately £500,000 per annum, to which the Helicon Heart service makes a significant contribution.
The work of Cardiff University's Wound Healing Research Unit revealed a need for, and led the development of, a disease-specific Health-related Quality of Life (QoL) instrument; the Cardiff Wound Impact Schedule (CWIS). CWIS is able to quantify in a psychometrically sound manner the impact of chronic non-healing wounds upon a patient's QoL. The tool, a first of its type, is accurate and sensitive to changes in the healing status of chronic wounds, particularly those of the lower limb. CWIS has been adopted internationally advantaging QoL assessments in both commercial and practice settings to yield economic and practice impacts as well as direct patient benefits.
The PCI is a carefully designed Head & Neck (H&N) cancer pre-clinic consultation checklist and comprises aspects of care and outcomes that patients might wish to raise with the multi-professional healthcare team. The PCI is an innovative and effective tool whose development has been optimised for touch screen devices. (Full details on use of the PCI is given at http://www.patient-concerns-inventory.co.uk/PCI/Home.html.) The PCI has improved patient experiences of clinic consultations, helped development of quality indicators and improved professional practice. The impact of the programme of work has led to its wider implementation nationally as exemplified by its adoption by the British Association of Head and Neck Oncologists (BAHNO), its inclusion in the National H&N Cancer dataset, its emerging use internationally, and its development in other chronic conditions.
Research into parent-child attachment carried out by Professor Pasco Fearon and colleagues at UCL has had a major impact on clinical services, policy and wider society through the development of: 1) novel assessment tools for measuring parent-child attachment, which are used in a variety of clinical services; 2) innovative prevention and intervention programmes deployed throughout the world; 3) dissemination of research evidence and best practice, through training and policy work in the UK and internationally.
Many hand surgical units worldwide have routinely used night-time splints in all patients after Dupuytren's contracture fasciectomy and dermo-fasciectomy, despite the lack of robust evidence to support its use.
Jerosch-Herold's programme of research identified that routine night-time splinting for all patients after fasciectomy or dermo-fasciectomy surgical treatments for Dupuytren's contracture is not beneficial. This finding is changing clinical practice, and informing guidelines and policies in the UK, New Zealand and the USA. As a result, health care organisations are ceasing to prescribe routine night-time splinting. This reduces inconvenience and discomfort for patients, relieves pressure on services and generates financial savings, all whilst maintaining equally good clinical outcomes.
The reach of the research findings impact is high, as Dupuytren's contracture is a common disorder of people of Northern European ancestry which results in surgical interventions for thousands of people annually (13,000 pa in the UK alone).
Professor Hutton's research considers the biasing effect of selection of data due to consent procedures or selective reporting, and its consequences for the validity of conclusions and reliability of results. This research has had impacts on patients directly; on health and legal professionals by informing and influencing national and international guidelines for the treatment of epilepsy used by healthcare professionals and practitioners; and has provided expert evidence to legal professionals for the conclusion of civil litigations and a General Medical Council professional misconduct trial. Hutton's research also informs ethical debate associated with the validity and robustness of study results. This work has determined guidelines for ethical conduct of research, and requirements for publications, which are significant for all biomedical researchers.
Maternity staff from hospitals in the UK and around the world have benefited from training to improve their communication and team-working skills in emergency situations. This has been achieved through input into a standard training manual now in wide use, and through the development of course content used in `train-the-trainer' sessions for consultant obstetricians, consultant anaesthetists and senior midwives who have in turn been able to train their colleagues. Research findings at UWE, Bristol, contributed to showing that clinically better results correlate with specific linguistic behaviours. The findings of the work made a direct contribution to this training content.
As a result of research undertaken by Professor Mervyn Singer and colleagues at UCL, the oesophageal Doppler haemodynamic monitoring device is now a standard of care in intensive care units and operating theatres. The research underpinned the development of the CardioQ Oesophageal Doppler Monitor that guides optimisation of the circulation in critically ill and perioperative patients. In multiple studies its use has led to significant reductions in postoperative complication rates and length of stay in patients undergoing high-risk surgery. Over 500,000 patients have now benefitted from this technology that, between 2008-13, generated over £33m in sales for its manufacturer, Deltex Medical. The device is recommended in NICE guidance and has been identified by the Department of Health as one of six high impact innovations to be implemented fully across the NHS.
The Variable Life-Adjusted Display (VLAD) is a graphical tool for monitoring clinical outcomes. It has been widely adopted by UK cardiac surgery centres, and has helped a shift in culture towards more open outcome assessment in adult cardiac surgery, which has been credited with reduced mortality rates. VLAD is also being used for a broad range of other clinical outcomes by regulatory bodies worldwide. For example, Queensland Health uses VLAD as a major part of its Patient Safety and Quality Improvement Service to monitor 34 outcomes across 64 public hospitals, and NHS Blood and Transplant uses VLAD to monitor early outcomes of all UK transplants.