Right-first-time: raising the bar at NHS Wakefield.

“If you don’t get it right first time, money is wasted by inefficiencies.” Dr Philip Earnshaw, Wakefield GP, CCG Chair: R4 Today Programme, 8th February 2017.

Who else heard this? The entire Department of Health and all who sail in the good ship NHS, I hope. Dr Earnshaw was talking generally about primary care practice, yet he could easily have been talking about the staggering waste generated by casual NHS and private sector attitudes to a basic diagnostic process, one that is carried out 65m times a year, every year.

Last October I met Professor Tim Briggs, creator of the Department of Health’s Getting It Right First Time Programme (GIRFT). He was unaware that an average 18% (and up to 70%) of urine specimens used for essential diagnoses are unreliable.

The Professor accepted that this could lead to delayed diagnosis and treatment and to avoidable repeat GP visits, which in the current climate our doctors could do without. Unreliable urine samples may also, as cited in this morning’s Today Programme, fail to identify urinary tract infection and prevent an elderly patient from leaving hospital. This last nugget is called “bed-blocking” and is a contemporary hot potato.

Given the insight of those being interviewed on R4’s Today and the £5 million predicted annual saving achieved through collaboration and a right first time policy, it is perhaps no coincidence that the GIRFT Urology Lead is based in Yorkshire, or that the diligent NHS in Wakefield has already identified the problem of unreliable urine samples. Some weeks ago we agreed a date to present and evaluate our solution, Peezy Midstream.

To explain the extent of problem urine specimens, the graphic above shows mixed-growth (contamination) rates across four regions of the UK.

Based on current specimen collection practice, of these 3.9m samples 790,586 patients will not be accurately treated first time. They will most likely be recalled for a second or third appointment, triggering more costly lab tests, healthcare professional time and material resources, including hospital beds.

Furthermore, when no retest is carried out and no accurate result obtained, these patients may be prescribed a broad spectrum antibiotic, against which around 20% of UTI bacteria are already resistant … and we all know where that little problem is going.

A recent debate in the House of Commons points to untreated UTI leading to the highest recorded rates of Chronic UTI, which causes immense suffering and wrecks lives.

The NHS in Wakefield is championing a principle that in any other sector would be implicit; repeated processes lead to unnecessary expenditure. Whilst the NHS has myriad improvements and savings to make, collecting reliable urine specimens should be the least of its problems. Yet its track record around this common area of basic diagnostic medicine is pitiful, albeit inevitable given the procedure has no protocol or established gold standard.

A rare piece of MedTech, Peezy Midstream is designed to reduce the size of its own market, whilst delivering massive cost and time savings to NHS and private providers.

According to Forte Medical’s independent economic model for Peezy Midstream technology, the regions outlined above could collectively enjoy direct savings on retesting of £2.2m and efficiency savings of £79.3m across all aspects of related expenditure. National savings reach £1.2bn.

Dr Phillip Earnshaw has a point: get the basics right … and the rest will follow.

This article first appeared on LinkedIn.

Health Tech 2017: a case for greater connection, featuring Forte Medical

Leading international law firm Nabarro today issued a report on UK Med Tech. The document features interviews with industry opinion formers drawn from the Association of British Healthcare Industries, MedTech Women, Apposite Capital and Forte Medical.

“The health tech sector is a market full of potential opportunities for innovation and investment,” say Nabarro. “We surveyed 202 NHS physicians, procurement managers, health tech investors and SMEs for their thoughts and opinions on the state of the UK health tech market.”

Download the report here.

Philip Kennedy appointed Non-Executive Director at Forte Medical

Forte Medical, the designer and manufacturer of innovative medical devices to improve specimen collection, is pleased to announce the appointment of Philip Kennedy as a Non-Executive Director with immediate effect.

Philip Kennedy is Chair of the Association of British Healthcare Industries (ABHI) as well as a senior med-tech adviser after many years in the industry. He is also a recently appointed Trustee of Cognent Skills Ltd, a not for profit organisation promoting and developing skills for the science industry. As an adviser and investor, Philip works with innovative SMEs and larger companies to help unlock the power of healthcare technologies with the goal of transforming the lives of patients and clinicians across the globe.

He began his career at Smiths Group PLC before moving on in 1999 to help establish a start-up healthcare technology business raising over $10m in the process. In 2001 he was part of a private investment group that acquired Eschmann Equipment and became its Managing Director in 2008. In 2010 he led the sale of the business to Sisk Group and subsequently its sale in 2013 to US multinational Steris Corporation where Philip became Vice President for Global Marketing Surgical.

Giovanna Forte, Chief Executive, Forte Medical, commented:

“This is a very exciting time for Forte Medical in terms of innovation and growth and we are delighted that Philip is joining the Board. He brings a wealth of sector specific experience and business insights that will undoubtedly help us enhance the Company’s profile and increase growth opportunities.

Philip Kennedy, commenting on his appointment said:

“Delivering innovation in the health sector is something often spoken about but for SMEs such as Forte Medical, it is a difficult arena to penetrate. I am looking forward to working with Giovanna and her team in realizing their ambitious and exciting plans for the Company as it builds its customer base in the UK and internationally.”


Managing Innovation in Healthcare

In his new book “Managing Innovation in Healthcare”, Professor James Barlow has written about Forte Medical’s journey to achieve adoption of its Peezy Midstream system into the NHS. He discusses his book and how innovation can best be implemented, with News-Medical.net.

Giant global innovation

Diagnostic innovation: making midstream mainstream


Forte Medical’s MedTech is low tech … and that’s the point at which interest wanes, for people want the intangible techie stuff, the next clever component of money-spinning technology … and urine simply does not tick that box.

Why am I so excited about pee? I’ll be honest, it’ because our medical device is set to change the lives of the millions who suffer from Chronic Urinary Tract Infection and other diseases that can be identified through a simple urine specimen. We know of novel urine tests for pancreatic, ovarian, cervical and other cancers that will rely on a decent urine specimen; we know of a company that has developed a method of using biomarkers found in urine to assess and track the progress of cancer tumours. Goodbye biopsies!

All of this reinforces our belief that Peezy Midstream is poised to bring life-changing accuracy to both novel and established urine tests. It will facilitate highly targeted prescribing for conditions that historically attract unacceptable levels of broad spectrum antibiotic prescribing. But urine isn’t sexy; even the most diligent healthcare professional is prone to laugh, eyes raised heavenwards and say its only pee!

At its most basic, only pee is the window to human health; in days of yore, clinicians inspected it with their eyes and nose, for only pee can tell you instantly that something is amiss. Current methods of urine collection do nothing to protect the urine specimen from amassing bacteria that can mask the interesting stuff with a heavy mixed growth.

No-one expects a detective to inspect a crime scene through a dirty window, yet in this day and age it is still what we ask microbiologists to do every day … and it does not work. Inaccuracy leads to retesting, repeat appointments and a likely broad spectrum antibiotic prescription for the hapless patient.

Creating Peezy Midstream has revealed to me that healthcare systems all over the world are overlooking integrity around basic medicine in favour of smart stuff that they perceive to be more compelling, more high tech – more current.

Here’s the real currency: 65m urine specimens are taken annually in the NHS, yet every day up to 45,000 will be unreliable. Those patients cannot be accurately diagnosed and treated. That’s current enough for me and poses the question: if urine is taken for the same diagnostic reasons as blood why does it not enjoy any kind of protocol?

GIANT has invited me to share with you our journey; how against the odds we have created an overdue and valuable new medical device that in an age of chronic infections, spreading cancer, new diseases and antimicrobial resistance, is fit for purpose.

Pitch at Palace

Pitch@Palace: what’s that all about, then?

“Why don’t you go for Pitch@Palace?” asked a new business contact. Why indeed! I had never heard of it and frankly, what could The Palace do for us? A growing company whose product development has led to a far, far bigger remit than it envisaged ten years ago.

For whilst Forte Medical has developed and brought to market the world’s first accurate midstream urine collection system, we have launched it into a British market seemingly unaware of the vast NHS Trust-by-Trust inequality of diagnoses and treatment of (very) common complaints identified with urine.

Faced with its only pee from professionals and public alike who do not appreciate the need for a clear window for the laboratory to look through, we have found ourselves calling for a national protocol for this most common of diagnostic procedures. For Forte Medical have discovered that national UK mixed growth rates are as high as 70%, representing a lot of very dirty windows indeed. Until the nation gets its protocols right, diagnosis and treatment of urine-based infections is going to be a hit and miss affair, depending solely on your postcode.

I studied the Pitch@Palace website; I considered what its alumni claim it has done for them and I applied, albeit with firm conviction that despite the profusion of ‘P’s, the Palace would be unlikely to invite a company focused on our kind of pee, into its fold.

People, I was wrong. Within a week the invitation came; I was to present a three-minute pitch just a few weeks hence at Hillsborough Castle, the Queen’s Northern Ireland residence.  I would present to an audience of industry leaders, investors and others who could help forge excellent connections for me. It appeared that Pitch@Palace sponsors include global business leaders and others highly apposite to our line of work.

And so it came to pass that on 29th September after considerable preparation, a little training and a lot of advice, I found myself standing in a modest space between Hillsborough’s regal throne and aforementioned audience. I presented our compelling case and of 19 companies, Forte Medical was one of three selected to qualify for the next round of Pitch@Palace: Business Boot Camp at Harwell Science Park, Oxford.

I had not expected this success and more to the point, had not considered it because the Harwell event was trickily timed to take place the day before an early flight to Texas for the ABHI Healthcare Mission. This involved a week of back to back meetings with the leadership teams of influential healthcare providers across Texas; the Silicon Valley of health innovation. How was I to manage preparation for all of this in just two weeks, whilst maintaining the day-to-day responsibilities incumbent upon the CEO of an SME?

My reward for such triumph however, more than made up for the stress. The Pitch@Palace team, apparently furnished with a rather accurate crystal ball appointed me two mentors; one, a University Technology Transfer Director highly qualified to advise on our business, the other AstraZeneca, a company in tune with global urine-based medicine to which Forte Medical could be valuably introduced.

Preparations for both events complete, I arrived in Oxford to stay at the Science Park hotel and rose early for Boot Camp. Here I conferred with my Mentors and was first of 49 companies selected from around the UK to pitch to an audience of 100. Three minutes done, I was whisked to an anteroom where my one-minute pitch was filmed for online and further judging purposes. Whilst I was not shortlisted for the next round, I was invited to attend the Grand Finale at St James’s Palace on 2nd November. That’ll do nicely, I thought.

Later that day and in something of a daze, I made my way to Heathrow to stay at a less than wonderful Thistle Hotel and then up early for the 9am flight to Houston.

Back in London one week later, I was sent the guest list for St James’s; The Palace would arrange introductions to three guests most pertinent to my business, over and above which I was welcome to bend the ear of anyone else deemed of value to our future development.

I have met two of my selected three; one has thus far escaped me, but the ears of some very valuable others were duly bent … and I have emerged from the experience far more richly connected than before. For my list of contacts include amongst others, opinion leaders from Life Sciences Businesses, Professors of Medicine, Schools of Medicine, investors and a University Course Director who has invited me to deliver a business lecture.

In the course of Pitch@Palace I have been connected with people pertinent to the long-term growth of my business, whose notice I would otherwise have had little chance of attracting. I have also met and spoken with the Duke of York whose knowledge of the health industry and genuine interest in what we at Forte Medical are doing, was reassuring and welcome.

Since that Grand Finale the Pitch@Palace team has continued to influence, to introduce and to encourage. Suffice to say, the Duke of York’s extraordinary initiative has not only taken me by surprise, it appears to be taking Forte Medical to a whole new level.

Impressed? Indeed, I am and so should you be. Take advice from a freshly converted cynic; if your fledgling business needs a helping hand, look to Pitch@Palace for heraldic help. The dots they can join and the influence they bring to bear are of the very first and finest order.

To the Duke of York and his tireless team: thank you – and a very high five from Forte Medical.

ABHI Mission to Texas: we have lift-off

“You will get out of the ABHI what you put in,” said a friendly counterpart from the Urology world, to whom I had been sent for market advice. “Join … and see what happens.”

I did, and I have … and people, it has been good; I write now to tell you about my first outward mission, supported by the Department for International Trade and organised by the Association of British Healthcare Industries.

On a sunny Saturday afternoon in late October we landed in sunny Houston where once through Immigration, Paul Benton ushered us into a waiting coach. Twelve good men and women were to get to know not only each other, but our businesses too; someone said that these missions could be as valuable for the UK contacts you made as well as the potential export opportunities and they were correct.

Our group comprised both UK and Texas Life Science Specialists from the Department for International Trade, two UK Academic Health Science Network Directors, one Director for Research an Innovation at a major NHS Trust plus a team of CEOs and Directors across a variety of healthcare developments. Our group included technology for breast cancer treatment, an innovative system to removes laparoscopy surgery smoke, anti-embolism wizardry, a clever antimicrobial cover for iPad, urology, gynae and pelvic floor innovations, a brand new algorithm that predicts adverse patient events plus leading edge devices for laryngoscopy, surgery, podiatry and more.

Sunday saw an informal and much anticipated trip to the Johnson Space Centre where we saw the original Mission Control, familiar from our youth (well, most of us!); this post is not the place to expand on that enormously exciting escapade but suffice to say that astronauts, rockets and lunar landings helped forge a number of friendships that afternoon.

To our own Mission then and a gathering at the offices of Norton Rose Fulbright, the international law firm whose hospitality that week included not just wonderful Texan fare, but guidance and in-depth knowledge of the markets we all sought to penetrate. They touched upon Intellectual Property, Tax and other essential advice and seemed to be on hand throughout, guiding us through the short and longer term implications of doing business in Texas, ways in which we might best exploit opportunity and spot pitfalls too.

Each day was heralded by an early start, usually boarding our Mission Bus by 7.30am for breakfast meetings at Technology and Innovation Centres or with potential customers. At each port of call we were treated to high level presentations by leadership teams, given a tour of always remarkable facilities and importantly, enjoyed an unrivalled opportunity to present our own technologies and businesses to those that are responsible for making decisions and either influencing or making buying decisions. The chance of doing this in the UK is oblique enough, but here in Texas with the ABHI both ahead of and behind us we were welcomed with open arms, listened to and more often than not invited to follow up with direct access to the people responsible for making things happen.

In Houston we met the Baylor College of Medicine, the Texas Global Business Network, MD Anderson, the Texas Children’s Hospital, TMX and JLabs innovation centres; we met the Director for Supply Chain at Harris County Hospitals and if icing could have been added to this particular cake, we enjoyed a fascinating presentation by the Director of Engineering at NASA followed by truly splendid hospitality from the Consul-General at her own residence.

The three-hour bus journey to San Antonio involved much camaraderie; everyone was on a high from the exceptional market intelligence and contacts made in Houston. We arrived as dusk began to settle on this pretty place and after checking into our central and rather luxe hotel, rounded off a splendid Riverside dinner with a walk to see the Alamo.

The following morning provided a friendly overview of market intelligence and services by the San Antonio Economic Development Agency after which we were taken on to the Military Hospital at Fort Sam where a talk about their work and tour of facilities proved compelling. Lunch at the UT Health Science Centre preceded a leadership meeting at the Methodist Hospital and a hugely valuable Reception where our Department for International Trade introduced me to a distributor interested in Forte Medical’s Peezy Midstream and whom, it has since transpired, does considerable business with all the prospects who engaged with me and the product during this Mission. I could see things starting to gel from possibilities into very real opportunity.

Our final stop was Austin where we saw how the brand new Dell Medical School was being planned to turn received wisdom on its head; here, healthcare innovation combines with selected traditional wisdom, cutting edge design, technology and an unbridled passion to transform the way healthcare is delivered. The new school is being built through the City’s residents who agreed to fund this remarkable and ground-breaking work by way of an additional tax. How many Hospitals can boast this kind of confidence from those it serves?

The good people at Dell organised not only a speed-dating pitch where we all met leaders from almost every aspect of medicine, but took up the ABHI’s suggestion of a Parkinson-style event. That afternoon we were treated to insights from the Medical Directors of McLaren, Dell Computers, Dell Medical School … and NASA. Gripping, it was indeed.

The Texas Hospital Association hosted us on Friday morning before we met for a final round-up with Norton Rose Fulbright at their glittering Austen offices. Here, we exchanged views on the week and gave candid feedback to our very own Mission Control, made up of Paul Benton, ABHI Director for International Business, Phil Kennedy, ABHI Chairman.

Make no mistake: as well as the fun we had as a group, the week involved long hours, much focus, hard graft … and myriad opportunities. The promise of success is now down to us to convert opportunity into business; with assiduous and determined follow-up, the next six to nine months will I believe, bear fruit.

ABHI Mission Texas, you were more than worth the time, effort and (value for) money; count us in for March and keep us posted on your plans for world domination. Forte Medical intends to come with you every step of the way.

Reducing contamination in urine samples

Professor Frank Chindgwundoh MBE talks to News-Medical.net about the issues around inaccurate urine screening and how repeat testing and repeat patient appointments can be combated. Read his interview here.

The Forte Medical Forum at the Royal Society of Medicine

We are proud to be part of Urology Awareness Month this September:
“Clinical Innovation in Specimen Collection and Diagnostics”

Royal Society of Medicine
Tuesday 13 September 2016 – 9.30 am to 12.30 pm
A Urology Awareness Month Event


Imagine if blood specimens were delivered to the laboratory with mixed growth rates ranging from 0.38% to over 70%. Unlike blood specimen collection, there is no protocol for the collection of urine and this disparity in specimen quality is a reality across today’s NHS.

Like blood, urine is used for diagnosis and treatment that saves lives. Yet in this basic area of medicine, where 65 million urine specimens are analyzed annually in the UK, high numbers of unreliable specimens are wasting money and jeopardising the health of the nation.

Forte Medical is the leading designer of specimen collection systems that make right-first-time analysis, diagnosis and treatment implicit to routine medicine and this Forum, with the support and participation of The Urology Foundation, Association of British Healthcare Industries (ABHI) and the South East Health Technologies Alliance (SEHTA), will address the needs and incite debate around the adoption of improved collection processes.

Chaired by Dr Dawn Harper with an introduction from Louise de Winter, Chief Executive of The Urology Foundation, the Forum includes presentations by:
Miss Linda Collins, BSc MSc RN, Whittington Health NHS Trust, on the outcome of a three year, randomized, single blind comparative study on urine sampling method.

Professor Frank Chinegwundoh MBE, Barts and The Royal London NHS Trust, on Quality Improvement Audit results around diligent specimen collection, associated hygiene and what improvements mean for clinician and patient.

Professor James Barlow, Professor of Technology and Innovation Management (Healthcare), Imperial College Business School, on how innovation can transform health outcomes, with implicit cost and efficiency savings.

There will also be a discussion panel with the above participants and other key opinion-formers in health and patient care, including Professor Alan Sinclair, Director of Foundation for Diabetes Research in Older People, and Senior Editor of Pathy’s Principles and Practice of Geriatrics and Gerontology, followed by audience Q&As.

Places are limited: to book, please contact:
Nicola Hyde +44 (0)7801 187757 forum@forte-medical.com

Note to Media Editors:
Forte Medical: Introducing an accurate, hygienic and dignified solution to an overlooked area of basic medicine has been the mission of Forte Medical for the past ten years. Co-founded by Giovanna Forte and her NHS GP brother, Dr Vincent Forte, it began with Dr Forte’s repeated problems in getting reliable midstream urine specimens from patients from which he could diagnose their symptoms and accurately treat. He designed a solution, the Peezy Midstream. Today, the Peezy is in use within over 40 NHS Trusts and the private healthcare system. Proud to make in Britain, Forte Medical has recently started exporting to the USA.

All media enquiries to Nicola Hyde

NHS: brick walls to innovation and £30m savings

65m urine specimens are taken every year on the NHS … without a defined protocol. Mixed growth rates (unreliable specimens) vary from 1.4% to over 73% nationwide, calling for an established protocol to give this essential diagnostic procedure parity with blood, taken for the same purpose. MedTechEngine writes about the long and winding road experienced by Forte Medical in selling its Peezy Midstream innovation to the NHS. Read all about it at MedTech Engine