Forte Medical joins ABHI UK Healthcare Pavilion

The Association of British HealthTech Industries (ABHI) recently launched the UK Healthcare Pavilion, a single platform to unite MedTech companies with the UK healthcare sectors, both NHS and private. Forte Medical is very happy to have joined such an august and respected portfolio of companies, providers and innovators.  Our entry features films about our technology featuring advocates, policy makers, healthcare professionals and the AHSN Network. Click here to view.

Antibiotics and urinary tract infections

Antibiotics, better tests, UTI: Guardian publishes Forte response

A rise in persistent UTIs could be linked to antibiotic crackdown appeared in The Guardian on Saturday 5th October. As usual, no-one mentioned accurate basic specimen collection, which can lead to unwarranted specimen quality variation, failed analysis and less-than-targeted prescribing. Giovanna Forte had something to say. Click here to read her published letter.

Comment: The Basic Diagnostic Failure That Affects 1 in 3 Women

Its time to reignite our NHS! Now our beloved health system has been blessed with new funding, we can furnish every hospital and GP practice with the latest digital technology and AI. We can burnish the reputations of our healthcare leaders because they have modernized patient care. 

It seems it is so much easier to spend new money, than it is to fix a failing system. Yet while this exciting digital revolution takes place, the Department of Health and NHS continue to fail 15m patients every year, whilst flushing £1.2bn of public funds down the loo. This is more than a shame; it’s a scandal.

There is one basic diagnostic process which is not as sexy as glittering new tech. It doesn’t excite our healthcare commentators. It will not invest our clinical leadership with shiny accolades that add kudos to reputation. It will not be covered by the media because it’s a waste product that no one really likes to talk about. Yet this waste product carries as much, if not more diagnostic clues to our health as its counterpart, blood. We need to talk about urine.

“If you don’t make the effort to collect the urine specimen properly, all the clever stuff you do later is pretty pointless. It’s a case of rubbish in, rubbish out,” says a Senior Microbiologist at Barts’ Heath NHS Trust. “The need for change is likely to be politically driven, rather than scientifically.”  The science is evident, the political will is not.

The lack of any protocol for urine collection is causing persistent, widespread and expensive diagnostic failure that starts in the GP surgery. For unreliable frontline diagnoses lead to critical conditions, hospital admissions, and expensive, complex treatment, not to mention the millions of patients who continue to suffer. This is not the fault of our hardworking and overstretched GPs and frontline nursing staff.  It is our healthcare leaders who persistently overlook the need to make urine analysis and treatment right-first-time.

Take urinary tract infection (UTI), a condition largely suffered by women. The last relevant data to come out of the NHS Unplanned Admissions Committee cites untreated UTI as the cause of 184,000 unplanned hospital admissions that cost the NHS £434m to treat (2013/14). This is hardly surprising when we know that 20-30% of initial antibiotic prescribing for UTI fails (Chronic Urinary Tract Infection Campaign CUTIC).

The majority of these annual 15m diagnostic failures will relate to women, who with UTI, suffer the most pain, most time off work and loss of income, whilst being prescribed the highest rate of broad-spectrum antibiotics, putting us firmly in the front line of antibiotic immunity. The need for a robust protocol around urine analysis has become critical. Data from CUTIC tells us that:

  • 1.4m women suffer from chronic bladder pain and urinary dysfunction
  • 1 in 3 women will have a UTI by the age of 24
  • 50% of dipstick tests don’t detect infection
  • 70% of infections risk recurrence within a year
  • 47% of Gram-negative blood infections have a urinary source and can lead to potentially fatal sepsis

NHS Improvement advises that 50% of the global rise in Antimicrobial Resistance (AMR) has a urinary cause; yet our health service still routinely relies on unreliable dipstick tests to indicate infection, leading to broad spectrum antibiotics remaining the first prescribing port of call; for the pregnant woman this is highly undesirable as it can extend life-long risk of antibiotic immunity to the unborn child.

Overuse of antibiotics is directly linked to the lack of a protocol for urine collection, transportation and analysis. National contamination rates are as high as 70% in some areas of the country, a postcode lottery situation that fails patients, microbiologists and the clinicians whose job it is to make people better. Non-invasive and cheap to collect, urine can help diagnose myriad conditions that cost the NHS billions of pounds. They include:

  • Kidney stones, infection and disease
  • Bladder cancer
  • Diabetes mellitus
  • Hypertension
  • Liver disease
  • Pre-eclampsia and other potentially serious pregnancy related conditions

Matt Hancock, Secretary of State for Health and Professor Tim Briggs, founding father of the Department of Health’s NHS Getting It Right First Time programme (GIRFT) both cite the need to eliminate variation in national diagnosis and treatment. We must challenge them to make the changes necessary to this most basic diagnostic process, to save lives, save money and create a solid foundation upon which the evolution of diagnostic medicine can flourish.

Right now, the best digital diagnostic technology in the world that relies on urine, won’t work. If the basics are right, the rest can follow. If they are not, then Mr Hancock and Professor Briggs … keep on flushing.

urine infection medication

Comment On Incentivising Companies To Develop New Antibiotics

It is very interesting to read that pharma companies are to be incentivised to develop new antibiotics to combat antimicrobial resistance (AMR). A significant yet consistently overlooked contribution to the problem of AMR is unreliable urine collection and analysis, which leads to the staggeringly high rates of broad-spectrum antibiotic prescribing that is fuelling the AMR crisis.

NHS Improvement data confirms that 50% of the global rise in AMR has a urinary source and that Urinary Tract Infection (UTI) is being routinely treated with increasingly pointless broad spectrum antibiotics.

All NHS and Public Health England guidelines specify that midstream urine is required for accurate analysis. There is no guarantee that this occurs as there is no protocol for urine collection. We know from a 2016 FOI request to all NHS Trusts that urine specimen contamination rates reach as high as 70%, with an average of 23%. This means 15m people a year are not being accurately diagnosed and are generally prescribed a broad spectrum antibiotic that will not treat their condition.

Some years ago, in response to failed UTI treatment amongst his patients, a diligent NHS GP identified this problem and invented a low-cost, British made medical device that collects midstream urine specimens. It has taken almost 15 years for us to persuade the NHS that his device is worth using; clinical trial results confirm its efficacy and substantial cost savings due to reduced retesting and false-positive urine specimens. Our world-first device delivers win-win for diagnostics, clinicians, patients, AMR and NHS finances all for 87p. Can the pharma companies compete with this?

Before the Government “incentivises” the already well-off pharma industry to develop new medicines, it would do well to get the basics right and look to NHS generated innovation to help it succeed. As it happens, our British SME is looking for investment; perhaps the Government would instead like to incentivise our work in delivering a tangible, ready-made solution for this global problem?

Urine specimen testing

Urine Is Liquid Gold When It Comes To Testing

Today’s Hippocratic Post features an overview on the importance of urine and the evidence supporting why our technology plays such a vital role in enabling right-first-time diagnosis and treatment.

 

urine sample testing

“If you come down with a UTI, seek treatment and get your urine tested.”

This is the latest recommendation following publication of a Californian study about the rise of antibiotic-resistant bacteria.   But right-first-time diagnosis and treatment is only possible if the urine sample is collected correctly in the first place.

In the UK, nearly 1 in 3 women will have a UTI by the time they are 24 and around 1 in 30 boys by the age of 16.   Additionally – according to the Unplanned Admissions Committee  the NHS spent £434 million in 2013/14 on treating 184,000 patients in unplanned admissions associated with a UTI.

antibiotic resistant UTI

Antibiotic-Resistant UTI Bacteria More Common

A new study shows that Antibiotic-resistant UTI bacteria is becoming more common; Knowlex has created a short-film about the research and what you should know about this worrying dilemma.

49% of AMR increase has a urinary source.    Health policy makers must stop overlooking basic specimen collection and create a protocol for use.

Read the article and watch the film

Giovanna Forte on TV

Disruptive TV: Giant Live Health Innovators

Barry Shrier, Founder of annual health innovation event Giant Live, presents the third Disruptor Giant Health Innovators TV interview featuring Giovanna Forte, CEO of Forte Medical, Francis White from AliveCor, Dr Sophie Bostoc​k of Sleepio and Etienne Bourdon from Healthy Health. Watch the half-hour programme here with Disruptive Live

Urine infection medication

AMR: A Heavy Price To Pay

News from the USA: “the share of bacterial infections in the United States that were antibiotic resistant more than doubled over 13 years, rising from 5.2% in 2002 to 11% in 2014”

To read more, click here

Antibiotics

New research: AMR and children’s E.coli

Antibiotic resistance in children’s E. coli, a bacteria that is the most common cause of urinary tract infection, is high against many antibiotics commonly prescribed in primary care and could make them ineffective as first-line treatments, warns a study led by researchers at the University of Bristol and Imperial College London.

Ashley Bryce, Céire Costelloe, Mandy Wootton, Christopher C Butler, Alastair D Hay; Comparison of risk factors for, and prevalence of, antibiotic resistance in contaminating and pathogenic urinary Escherichia coli in children in primary care: prospective cohort study, Journal of Antimicrobial Chemotherapy, , dkx525, https://doi.org/10.1093/jac/dkx525