70 ways to save the NHS: part three

As the NHS approaches its 70th year, it faces a continuous battle to stretch budgets to meet growing demand.

To combat the problem, medical staff, scientists and health officials are pioneering new ideas which could keep the health service running for generations to come.

From bringing in robotic technology to providing a dose of good old-fashioned common sense, here – in the final part of our three-part series – we highlight 20 innovative ideas which are injecting life into the NHS and helping to preserve it for the future. The full list is available online at telegraph.co.uk/nhs70.

51. A cuddly, calming robot seal for dementia patients

A robot called Paro – designed to look like a fluffy seal pup – has been shown to help dementia patients cope with anxiety and memory loss. Artificial intelligence means the £5,000 robot learns to respond to any name the patients give it, as well as sensing sounds, light and touch. It responds to patient interaction by opening its big eyes, squeaking and wiggling. Tests by the University of Brighton found the robots helped reduced stress in dementia patients and could be kept clean enough to meet hospital infection control requirements, meaning it could be used on acute dementia wards in future.

52. Specialist eye care in a shopping centre

Britain’s ageing population is facing an “epidemic” of age-related macular degeneration (AMD), an eye disease which causes blindness, with 200 new cases diagnosed every day. Vision can be stabilised or improved in patients who receive treatment in the early stages. Manchester Royal Eye Hospital has launched a scheme to improve early diagnosis rates by setting up specialist clinics in a shopping centre and a civic hall, making it easier and quicker for patients to see a specialist and get the treatment they need. 

53. Avoid pollution on the commute

Pollution causes an estimated 40,000 early deaths each year and levels in the UK are among the worst in Western Europe. Commuters can check – and avoid – pollution hotspots thanks to technology which monitors air pollution levels. One idea, the “Daily Pollute”, is an app which will use Google’s tracking technology combined with live data to alert users as to whether they are in a high-risk area. Leicester-based air quality monitoring company EarthSense has also developed an interactive online map which lets people check nitrogen dioxide levels in their local area. 

54. Video links to 999 calls

Video footage is being used to help 999 call handlers decide whether to send paramedics at two ambulance services in England. People calling emergency services are asked to use their mobile phone cameras to stream live footage via a link texted to them. Ambulance chiefs say it will help staff decide whether the case is an emergency or a minor issue which can wait. It is hoped it will help overstretched ambulance services to reduce delays reaching emergency patients. Evidence from paramedics suggests up to two thirds of the calls they attend are not emergencies.

55. Therapy dogs to cheer up ill children

Petting dogs can help sick children cope with the ordeal of undergoing hospital treatment, research shows. Southampton General Hospital has trialled letting the therapy dogs from the charity Pets as Therapy onto a ward for children with cancer and serious illnesses, to an enthusiastic welcome from patients. Last month, nurses called for the NHS to lift a general ban which prevents animals coming into hospitals other than in exceptional circumstances, to enable more therapy pets on wards. 

56. The “virtual ward”

Vulnerable patients are being cared for via a “virtual ward” in some parts of the country, including Devon and Dorset, to keep them out of hospital and well at home. Doctors, nurses, other healthcare professionals and social care staff meet each week to discuss how to manage the most complex patients in the area, including their medical needs as well as any care, lifestyle or family problems they may have. In West Dorset, the “virtual ward” deals with patients aged over-75 and often leads to home visits to nip any potential problems in the bud.  

57. Pain relief without medication

Millions of Britons suffer from chronic joint pain, including 10million people who have arthritis. Physiotherapy professor Mike Hurley has developed a six-week rehabilitation programme to help reduce this pain without relying on painkillers. The ESCAPE-pain programme involves 12 sessions over six weeks where patients are taught how to manage pain and to exercise safely. It is being delivered in person at 80 sites in the UK, as well as via an app, and has been shown to save the NHS £5.20 for every £1 spent by improving the wellbeing and quality of life of patients. 

58. Cutting A&E waiting times thanks to a flexible junior doctors’ rota

One hospital trust turned its struggling A&E around by offering junior doctors more flexibility on when they worked. Brighton & Sussex University Hospitals was spending £1 million per year on locum junior doctors before it brought in a new rota system which let staff choose which shifts they worked and new “clinical fellow” roles which allowed time away for study. The flexibility made staff happier and more likely to stay in the job, meaning all vacancies are now filled and locums are no longer needed. As a result, waiting times have been significantly cut and patient complaints reduced.

59. Stick-on sensors to monitor hospital patients

Nurses monitor the condition of hospital patients by regularly checking their vital signs, such as blood pressure and oxygen levels, but these can change rapidly. Technology firm Philips has developed a stick-on sensor which continuously monitors patients and sends alerts to medical staff if they start to deteriorate. The wearable biosensor device has been trialled in hospitals in the United States and in Europe but is yet to be taken up by UK hospitals.

60. Diet instead of tests for IBS

More than one in ten people in the UK have irritable bowel syndrome (IBS) and the condition costs the NHS around £12 million per year. In Somerset, doctors have piloted a scheme which avoids patients with suspected IBS having expensive – and often unnecessary – tests. Instead they are sent to a dietician who helps them follow a strict diet for six to eight weeks, removing certain types of carbohydrates and then slowly reintroducing them to identify foods which trigger symptoms. Trials found up to three quarters of patients got their symptoms under control using the diet, which has been adopted by 15 trusts in the UK.

61. Secure ‘WhatsApp-style’ messaging service for medical staff 

When multiple medical staff in different locations want to discuss a patient’s care, secure messaging services help them chat without risking data breaches or wasting time on pagers, landlines or fax machines. Forward – a WhatsApp-style system with extra security – is used by about 3,000 hospital staff in the UK and was the brainchild of a group of junior doctors. Secure messaging platform CareFlow, which was launched by two surgeons, helps hospitals communicate with GPs, community health staff and care workers and is used by 40,000 people at 20 sites.

62. 3D-printed insoles for comfort

Orthotics – plastic insoles given to patients with foot, balance or posture problems – are being 3D printed to improve performance and fit. The Podfo insole, developed by Newcastle University, Glasgow Caledonian University and Peacocks Medical Group, is designed to fit comfortably in the shoe and can be washed in the dishwasher. Previously, plastic insoles would deteriorate and require replacing every six months or would go unused as they were too uncomfortable or bulky to fit in normal shoes. The 3D-printed orthotics are being trialled at six hospitals in the UK.

63. The NHS Trust making and selling its own medications 

One hospital trust is generating its own income by making medication and sterile equipment, which it sells to other hospitals in the UK and abroad. Torbay Pharmaceuticals, part of Torbay and South Devon NHS Foundation Trust, started life in the Seventies as a pharmacy to meet local needs but has since expanded to make and sell around 200 different medical products, including eye droppers and painkillers. The scheme employs 150 local people and generates £16.5million in sales each year, with profits helping fund patient care.

64. Wearable tech to keep an eye on epilepsy patients 

Doctors can monitor epilepsy patients by giving them wearable devices which report if they have a fit. MyCareCentric Epilepsy is a scheme which encourages patients to monitor their own health via an app and a wearable device. It has been piloted at Poole Hospital, in Dorset, since Sept 2016 and patients have reported an 80 per cent reduction in the time taken for medical professionals to respond when they suffer a seizure, as well as 30 per cent fewer hospital admissions. The system could help the 500,000 people in the UK who have the condition.

65. Personalised letters to improve screening uptake

Patients who received a letter addressed to them from their GP were more likely to go for bowel cancer screening than those who received the standard automated letter, research by University College London (UCL) found. Researchers suggested making small changes to the letter template would have a one-off set-up cost of £78,000 but could save lives. Overall, personalised letters could lead to an extra 165 people at high or medium risk of colorectal cancer undergoing screening each year, with 61 more cancer cases detected. 

66. Training hairdressers to spot cancer

Hairdressers, beauticians and massage therapists have been called on to help fight skin cancer and improve detection rates. A free, certified training scheme called “Masced” teaches them to spot skin lesions which could be cancerous. Skcin, the charity behind the programme, said it could especially help young people who are more likely to visit a hairdresser than a doctor. Melanoma – the deadly form of skin cancer – is one of the most common cancers among 15 to 34-year-olds in the UK. 

67. Electronic patient tags which spot empty beds

Some NHS hospitals are using electronic patient tags instead of traditional plastic wristbands. They map patients’ location and can alert staff when a bed becomes free or a patient is being moved. Countess of Chester Hospital is piloting a system using 4,000 infra-red sensors across beds and on doorways, which has helped almost halve the time between a patient being discharged and a bed being ready for a new arrival. University College London Hospitals is also using recyclable electronic TeleTracking tags and disinfects them with ultra-violet light cabinets which destroy bacteria without harming the technology.

68. Special A&E for the over-80s 

In parts of Norfolk, one in 11 people is aged over 85 – compared to one in 42 people in the UK as a whole. In December, Norfolk and Norwich University Hospital opened an Older People’s Emergency Department specifically for the over-80s. The A&E treats around 50 elderly patients a day and is staffed by geriatric specialists who help avoid patients being admitted unnecessarily. In its first four months, the scheme led to the proportion of patients treated and discharged in a day improving by 200per cent. 

69. Video games to make physio fun

Physiotherapy is important for strengthening the muscles of frail or elderly people who are vulnerable to falling, but repetitive exercise can be dull for patients. To make physio more engaging for both older people and children, 23 health organisations have started using “exergames” where patients follow activities in a video game to exercise. Staff at Central Manchester University NHS Foundation Trust, said the Mira “exergame” software had helped cut the number of falls in some homes by two thirds.

70. Cooling babies to prevent brain damage

Cooling down newborn babies who were deprived of oxygen during birth can help reduce their risk of brain damage and of health problems in later life. Professor Marianne Thoresen, of the University of Bristol, was the first to show the benefits of the treatment which now saves 1,500 babies from death and disability each year. The number of children developing epilepsy dropped from seven per cent to two per cent since the cooling technique – known as therapeutic hypothermia – was introduced at St Michael’s Hospital, Bristol, in 2007. It has now been integrated into NICE guidelines and is saving the NHS £200 million per year. 

• For the complete list of ‘70 ways to save the NHS’, go to telegraph.co.uk/nhs70 – and email your own ideas to nhs70@telegraph.co.uk