Design Sketch for Chair 4 LifeA key goal when designing the Chair 4 Life was that it would allow patients to interact socially with able bodied people, shown by the adjustable heights of the chair in the image. Without engagement from the NHS, patients and clinicians, valuable feedback like this would not have been obtainable.
On April 11, 2013, I visited a new medical technology trade show and conference, Med-Tech Innovation Expo, in Coventry, UK. One of the attractions at the show was a new design for a wheelchair for children and young adults, the Chair 4 Life (CFL).
Visiting the stand of the company who designed the chair, UK-based product design consultancy Renfrew Group, I was pleased to find much more than a wheelchair. It was immediately obvious that Renfrew are a group who, when approaching the design of a revolutionary product like the C4L, see it as a minimum requirement to engage with everyone involved in the wheelchair, including patients (the users), clinicians, carers and manufacturers.
“Traditionally, design of wheelchairs and the provision service has meant limited adaptability and flexibility to individuals’ growing needs and often led to a very lengthy waiting time for new products,” explains Renfrew design development director, Mike Phillips. “But a child in a wheelchair is far more than just that. The patient has a wide range of needs, including social ones, and the needs of the patient’s carer is another consideration,” he added.
In developing the chair design, Renfrew documented problems from everyone involved in looking after a child or young adult in a wheel chair, including the child themselves.
“We listened to patients who said they didn’t like the fact that when they entered a room all people saw was the chair,” said Mike. “Our engagement with all people involved, including carers, gave us the information we needed to develop a chair which met the needs of the patient, the carers and the clinicians.”
Experienced in Working with the NHS
The C4L project was carried out in partnership with the UK’s state-funded National Health Service (NHS). The NHS has recently undergone some of its biggest structural changes in decades, stimulating innovation in healthcare technology. Decisions regarding expenditure have been given to local and smaller groups of clinicians, mainly general practicitioners (GPs), allowing more decisions to be made at a local level and giving these clinicians more choice in procuring supplies, including medical devices.
Medical Plastics News supports this move because it opens up working relationships between industry—who know how to design and make things—and clinically-based experts and patients, who know what their unmet needs are. Medical Plastics News works with a number of clinicians who are based in the NHS and one of their most common complaints is that access to procurement is difficult, never mind providing valuable feedback to medical technology suppliers.
Renfrew’s work with the NHS is far-reaching. Mike Phillips explains.
“The need for efficiencies, driven by austerity, is currently driving a £20 bn reduction in spend. People are talking about a demographic tsunami—by 2040, aging baby boomers will demand a 300% increase in expenditure in real terms on long term care and treatment of conditions most common in the elderly, like dementia, cancer, cardiac disease, stroke and diabetes. Innovation for constant improvement is seen as the only means of meeting these challenges. On top of this, there are the regular and seasonal challenges of healthcare—healthcare associated injections (HCAIs) and emerging infection threats, for example.”
“Organisations, including the NHS and the UK government’s Department of Health, looking for revolutionary change, or practical delivery of innovations, come to us for help in facilitating change. Jointly with the organisations’ leadership and front line staff, we create, prototype and test new thinking. We use group creative problem solving, leadership in lateral thinking, visualisation, linked with prototyping and manufacturing capability to challenge thinking and test ideas with the users. Solving problems with the end user at the heart of the process doesn’t only ensure the result is user centred, but helps acceptance, buy-in or ‘adoption’.”
Two noteworthy UK government initiatives in which Renfrew has involvement are Innovation Health and Wealth (IHW) and the new Academic Health Science Networks (AHSNs). Both have the potential to harness technology and innovation with the benefits of working with the NHS for the good of the UK life science industry. Medical Plastics News wants to point out that access to NHS clinicians, carers and patients is major benefit for the UK’s medical technology industry in giving manufacturers a steer in helping to meet unmet clinical leads.
Innovation Health and Wealth (IHW)
Innovation Health and Wealth, a report published by the UK government in December 2011, gives an integrated set of urgent and immediate measures and actions to turn the NHS into a healthcare organisation defined by a commitment to innovation, research, and the rapid adoption of new ideas, products, services and clinical practice.
The report also proposed the designation of a number of Academic Health Science Networks (AHSNs), formed to help the NHS and academia work collaboratively with industry. Local visions for AHSNs are being developed by the NHS and academia with advice from industry and these seek to use the process of creating an AHSN to establish a set of relationships, including public health and social care that can “transform the quality of care locally by bringing together work on innovation with other levers, including research, service improvement, education and training and wealth creation”.
Closing, Mike Phillips’s remarked: “What is clear is that UK life science industry and the NHS are balanced in a unique and perhaps precarious moment. There still exists an opportunity to form truly constructive collaboration. It would seem that to overcome some of the internal machinations, silo thinking, and procurement issues that present barriers to innovation, that perhaps this is a role over which an external or overarching body should preside.”
He added: “The long term care revolution is a plan being backed by the Technology Strategy Board (TSB)—a UK government body that is responsible for delivery of public funds to stimulate technological innovation—seeking really revolutionary thinking to give a half a chance of addressing the oncoming tsunami. Perhaps we need a 50-year plan. Something outside the Department of Health, where a clear view of the whole health benefits of innovation, to the nation might be afforded. A role for a cross party treasury perhaps?”
At the Med-Tech Innovation Expo event in Coventry, Renfrew showed me other design projects worked on with direct involvement from NHS clinicians and patients. Renfrew listened to feedback from blood donors when developing a blood donor chair with easily adjustable and supportive positioning to make donors more comfortable and secure while giving blood, and to allow staff to reposition the donor if they require attention for example for the rare occasions when they feel faint and when getting on and off the chair. (see image). A temporary side room, designed to give hospitals extra single side room capacity for infection control and during peak times, was developed in tandem with clinicians.