Month: March 2021

Trial aims to prevent blindness in patients with neurological condition IIH

Written by Louise Stanley on 30/03/2021. Posted in Clinical trials, Inflammation and chronic disease.

A new clinical trial being led by two Birmingham Health Partners founder-members aims to identify the best surgical treatment option to prevent blindness in patients with a neurological condition.

Funded by almost £1.5 million from the National Institute for Health Research (NIHR), it is hoped the research will lead to changes in healthcare policy for the treatment of patients with Idiopathic intracranial hypertension (IIH).

Thus far, there is no known cause for the neurological condition, which increases intracranial pressure around the brain without the presence of tumour or disease. Common symptoms of IIH include debilitating headaches, visual loss, pulsatile tinnitus, and back and neck pain. If left untreated, the disorder can lead to blindness.

The condition is managed with weight loss and medication, however, in severe cases that present as an emergency with decreasing vision, surgery is needed to prevent blindness.

Currently two different types of surgeries – dural venous sinus stenting (stenting) and cerebrospinal fluid (CSF) shunting – are used to prevent blindness, however there have been no clinical trials to determine which is the best operation. The team will carry out a clinical trial involving up to 138 IIH patients with rapid vision deterioration to establish which of the surgical procedures is the best at saving vision; the safest with least complications; and the most cost effective.

The research, which has been developed in consultation with patient charity IIH UK, will be carried out by a team of BHP experts at the University of Birmingham, University Hospitals Birmingham (UHB), and at sites around the UK.

Alexandra Sinclair, Professor of Neurology at the University of Birmingham, Honorary Consultant Neurologist at UHB and Chief Investigator of the new research project, explained: “CFS shunting involves implanting a thin tube known as a shunt in the brain, which allows the excess cerebrospinal fluid flow to another part of the body, thus rapidly reducing brain pressure.

“However, within the first year of surgery many tubes become blocked or infected and stop working. This, and other complications, have a significant impact on patients’ lives and have important cost implications for the NHS.

“More recently, stenting has been used, which involves placing a small stent across a narrowing of certain blood vessels in the brain, which can improve blood flow and lower brain pressure.”

Philip White, Professor of Interventional and Diagnostic Neuroradiology at the University of Newcastle and Co-Investigator, added: “So far, studies have not provided high quality evidence to show that this procedure can prevent blindness when vision is rapidly declining. Additionally, we need to confirm procedural durability compared with the surgery, which may need to be repeated and establish its safety is at least comparable.”

Miss Susan Mollan, Director of Ophthalmic Research at UHB and Co-Investigator, added: “We hope that the results of our study will provide evidence that will influence NHS policy and will lead to improved care for IIH patients, ensuring they receive the best possible treatment to prevent them from losing their eyesight.”

Amanda Denton, IIH UK Trustee and Research Representative, said: “IIH UK is delighted that this important trial is being carried out. Identifying the best types of intervention is one of our members’ top ten research priorities. Many of our members have shunts and stents to prevent them losing their sight and research to find the most effective method with the least complications is vital to improve their quality of life.”

The trial, will see participants being allocated to CSF shunting or stenting, which will be decided at random by a computer. The main outcome of the trial to be evaluated will be preservation of vision. A number of key additional outcomes, including treatment-related complications, headache and patient reported quality of life, will also be assessed.

Dr Ben Wakerley, Consultant Neurologist at UHB and Co-Investigator, comments: “The impact of these interventions on headache and quality of life have been highlighted to be of key importance by patients.”

An economic evaluation will be performed, led by Professor Emma Frew, University of Birmingham Co-Investigator, to estimate the cost-effectiveness of shunting versus stenting. Participants will be asked to attend routine hospital check-up visits over a year. Their health would then be monitored through linked NHS database records for longer-term follow up at two years.

a group of rugby players on the pitch, in a scrum formation

Rugby study identifies new method to diagnose concussion using saliva

Written by Louise Stanley on 23/03/2021. Posted in Early diagnosis and detection.

A study of top-flight UK rugby players – carried out by BHP founder-member the University of Birmingham in collaboration with the Rugby Football Union (RFU), Premiership Rugby, and Marker Diagnostics – has identified a method of accurately diagnosing concussion using saliva, paving the way for the first non-invasive clinical test for concussion for use in sport and other settings.

Following the team’s previous research, which identified that the concentration of specific molecules in saliva changes rapidly after a traumatic brain injury, the researchers embarked on a three-year study in elite rugby to establish if these ‘biomarkers’ could be used as a diagnostic test for sport-related concussion.

Using DNA sequencing technology in the laboratory at the University of Birmingham, the research team tested these biomarkers in saliva samples from 1,028 professional men’s rugby players competing in English rugby’s top two leagues – the Premiership and Championship.

The results of SCRUM (Study of Concussion in Rugby Union through MicroRNAs), published today (March 23) in the British Journal of Sports Medicine, has for the first time shown that specific salivary biomarkers can be used to indicate if a player has been concussed. Additionally, the research has found these biomarkers provide further insights into the body’s response to injury as it evolves from immediately after trauma, to several hours and even days later.

The scientific breakthrough provides a new laboratory-based non-invasive salivary biological concussion test, which could have wide-reaching use and potential to reduce the risk of missing concussions not only in sport – from grassroots to professional levels – but also in wider settings such as military and healthcare.

In community sport, these biomarkers may provide a diagnostic test that is comparable in accuracy to the level of assessment available in a professional sport setting. While, at an elite level of rugby, the concussion test may be used in addition to the existing World Rugby Head Injury Assessment (HIA) protocol.

Marker Diagnostics, a subsidiary of Swiss biotechnology company Marker AG, is in the process of commercialising the patented salivary concussion test as an over-the-counter test for elite male athletes. It has also obtained a CE Mark for test, which has been named MDx.100.

The team now aims to collect further samples from players in two elite men’s rugby competitions in order to provide additional data to expand the test and develop its use to guide the prognosis and safe return to play after concussion and to further establish how it will work alongside the HIA process.

The team will present their findings and planned next research steps at the World Rugby Laws and Welfare Symposium to be held later this month.

Meanwhile, Marker Diagnostics and the University of Birmingham are also currently carrying out several additional studies to further validate and expand the test for use in different groups that were not included in the SCRUM study, including women, young athletes and community sports players.

The research is part of the REpetitive COncussion in Sport (ReCoS) research programme being led by the University of Birmingham through the National Institute for Health Research’s Surgical Reconstruction and Microbiology Research Centre (NIHR SRMRC) based at fellow BHP founder-member University Hospitals Birmingham NHS Foundation Trust (UHB).

First author Dr Valentina Di Pietro, of the University of Birmingham and NIHR SRMRC, said: “Concussion can be difficult to diagnose, particularly in settings such as grass roots sports where evaluation by a specialist clinician is not possible. Consequently, some concussions may go undiagnosed.

“There are also concerns regarding the long-term brain health of those exposed to repeated concussions.

“A non-invasive and accurate diagnostic test using saliva is a real game changer and may provide an invaluable tool to help clinicians diagnose concussions more consistently and accurately.

“In professional sports, this diagnostic tool may be used in addition to current head injury assessment protocols and return to play evaluation to ensure the safety of individuals.”

Senior author Antonio Belli, Professor of Trauma Neurosurgery at the University of Birmingham, Consultant Neurosurgeon at UHB, and Director of NIHR SRMRC, added: “Conducting a study in a professional contact sports setting has meant we have been able to collect invaluable data enabling us to make significant advances in our biological knowledge and understanding of concussion and its diagnosis.

“Crucially, the differences in the salivary concentration of these biomarkers are measurable within minutes of injury, which means we can make rapid diagnoses.

“The ability to rapidly diagnose concussion using biomarkers in addition to existing tools solves a major unmet need in the sporting world as well as in military and healthcare settings, particularly in injuries without significant visible symptoms.”

Author Dr Simon Kemp, RFU’s Medical Services Director, said: “This study is an important part of the portfolio of collaborative research initiatives the RFU undertakes into concussion.

“While still a way from having something that can be used in community rugby, it is extremely encouraging to now be able to start to develop a rapid and non-invasive test which could add real value particularly at a grassroots level of the game.

“We would like to thank all the players and clubs who participated in the study and to World Rugby for granting permission for us to extend the duration of the HIA from 10 to 13 minutes in order for the saliva samples to be captured. We wouldn’t have been able to do it without this support.

“We will now be working with World Rugby to secure further research options in two elite men’s competitions.”

Author Dr Matt Cross, Head of Science and Medical Operations at Premiership Rugby, said: “We would like to thank our clubs and all of the players for volunteering to be part of this very important research project.

“The findings from the study are clearly promising and highlight the potential for salivary biomarkers to further support clinical decision making and the accurate identification and diagnosis of concussion in a range of different sporting and non-sporting settings.

“Premiership Rugby and the Premiership clubs support a number of player welfare focused research projects, and we are looking forward to continuing to collaborate and support further research in the next phase of this specific project from 2021-22 onwards.”

Dr Éanna Falvey, World Rugby Chief Medical Officer, added: “Elite Rugby’s Head Injury Assessment process has proven an invaluable tool in the identification of concussion with an accuracy of over 90 per cent, but we are continually evaluating the latest developments in science and technology to identify potential enhancements.

“This study, its rigour and outcomes demonstrates the value in a targeted, scientific approach and reflects rugby’s progressive commitment to player welfare.”

Tinus Maree, CEO of Marker AG, said: “This ground-breaking validation of the biomarker panel shows that we can use the simple swab collection of saliva to accurately and specifically diagnose concussion.

“It is a biological measure of mild traumatic brain injury and will contribute to a new global standard of care for the injury and a meaningful reduction of the cost and health burden associated with concussion.

“We are grateful to our collaborators, especially to Dr Simon Kemp and the RFU, for their efforts and visionary support of this important work.”

The study, fully supported by The Rugby Players’ Association, saw the team obtaining saliva samples from male professional players in the top two tiers of England’s elite rugby union competition during the 2017-18 and 2018-19 rugby seasons.

Saliva samples were collected pre-season from 1,028 players. They were also collected from 156 of these players during standardised World Rugby head injury assessments (HIAs) at three time points – in-game, post-game, and 36-48 hours post-game. The HIA protocol, used by rugby medical staff, includes a neurological examination, a series of cognitive tests and evaluation of gait and balance to determine if a player has been concussed.

‘Control’ samples were also collected from 102 uninjured players and 66 players who were removed from the game due to musculoskeletal injuries.

Using samples collected during the 2017-18 season, the team identified a panel of a combination of 14 salivary biomarkers – known as small non-coding RNAs or sncRNAs – that was highly accurate (96%) at identifying concussed players from all other groups.

This included players with suspicion of mild traumatic brain injury who had a concussion ruled out after a structured HIA; uninjured controls from the same game; and players who had suffered musculoskeletal injuries.

The panel was prospectively tested during the 2018-19 season, and the research showed it could successfully predict whether players would be positive or negative for concussion via the HIA protocol in 94% of cases.

The study was funded by the Midland Neurosciences Teaching and Research Fund, NIHR SRMC, Medical Research Council, Rugby Football Union and Marker AG.

New gene therapy innovation centre to turn scientific discoveries into life-changing treatments

Written by Louise Stanley on 18/03/2021. Posted in Experimental medicine.

BHP founder-member the University of Birmingham is set to play a key role in a pioneering new gene therapy innovation centre which will advance scientific discoveries into promising treatment options for millions of patients with life-threatening diseases.

The Gene Therapy Innovation and Manufacturing Centre (GTIMC) will be led by the University of Sheffield in collaboration with the University of Birmingham, Cell & Gene Therapy Catapult, Centre of Process Innovation, University of Liverpool, and BHP’s Midlands-Wales Advanced Therapies Treatment Centre.

It is one of three pioneering hubs announced today in a new £18 million network funded by LifeArc and the Medical Research Council (MRC), with support from the Biotechnology and Biological Sciences Research Council.

Gene therapy is a promising treatment option for more than 7,000 rare diseases that currently have no cure. It aims to treat these conditions, by engineering another gene to replace, silence or manipulate the faulty one.

The UK has a world-class genetics research base – however, to date, academics have found it difficult to get access to the clinical materials, facilities and expertise required to progress gene therapy research into clinical trials.

Professor Mimoun Azzouz, Director of the GTIMC and Chair of Translational Neuroscience at the University of Sheffield, said: “The Gene Therapy Innovation and Manufacturing Centre will tackle major challenges in gene therapy development for some of the most devastating diseases.

“Gene therapies are pioneering medical advances that have the potential to offer much needed, novel, effective treatments for many rare and incurable diseases that cannot be treated by conventional drug compounds.

“Sheffield has emerged as one of the leading players in the cell and gene therapy and this national network of partners, facilities and training programmes will allow us to keep pace with translational discoveries for new and potentially life changing treatments. This is a momentous milestone for revolutionary medical advances.”

Professor Dame Pam Shaw, Director of the NIHR Sheffield Biomedical Research Centre and co-applicant on the GTIMC application said: “This exciting development and partnership will speed up the pull through of new gene therapies into early phase clinical trials and offer hope to patients with neurological and other rare diseases that can be addressed in this way.

“The support given to this initiative will greatly accelerate the translational potential of genetic therapies in the UK and bring benefits in key areas of unmet medical need.”

Professor Philip Newsome, Director of Research and Knowledge Transfer at the University of Birmingham’s College of Medical and Dental Sciences, said: “We are delighted to be part of this pioneering new gene therapy innovation centre, providing our leading expertise to play a pivotal role in its potentially life-changing work.

“By smoothing the transition between small-scale supply for early clinical trials through to larger-scale manufacture for patient trials, and beyond, the centre will be able to advance scientific discoveries into promising treatment options for millions of patients with life-threatening diseases.”

The state-of-the-art centre will bring together academic institutions, NHS trusts, non-profit and industry partners across the north of England, Midlands and Wales enabling academic-led clinical trials of novel gene therapies.

The GTIMC will deliver essential translational and regulatory support alongside extensive training and skills programmes to enable upskilling and address shortage of skills in Good Manufacturing Practice manufacturing.

The facility will utilise highly efficient processes to manufacture clinical grade adeno-associated viruses and provide all the necessary quality assurance, regulatory certification and governance for human trials at Advanced Therapies Treatment Centres and NHS trusts within the GTIMC and the national network.

The three national hubs, located at the University of Sheffield, Kings College London, and NHS Blood and Transplant in Bristol will operate as a coordinated network, sharing technical skills and resources to enable innovative gene therapy research.

Dr Melanie Lee, CEO of LifeArc, said: “Recent innovations in gene therapies hold enormous potential for treating conditions such as rare diseases, but often promising ideas – particularly in academia – are not making it through to patients. Through our collaboration, we aim to meet the need for researchers to have access to the essential facilities and translational advice to progress promising research.”

The GTIMC will manufacture commonly used vectors including both lentivirus and adeno-associated virus that are needed for genetic therapy trials, while positioning the UK for significant bioprocessing innovation work with the potential to radically increase yields and reduce productivity barriers in future years. The hub network will also design and share commercially ready platforms, using common cell-lines, plasmids and reagents to reduce costs, facilitate simplified licensing agreements and streamline regulatory reviews.

Professor Fiona Watt, MRC’s Executive Chair, said: “The new network of Innovation Hubs for gene therapies will build on the UK’s great strengths in this area, providing targeted investment in vital infrastructure to accelerate academic research programmes down the path to patient benefit, supporting the delivery of a new wave of genetic medicines.”

£1.1m funding to improve uptake of at-home dialysis

Written by Louise Stanley on 18/03/2021. Posted in Inflammation and chronic disease.

A new study being carried out in collaboration with BHP founder-member the University of Birmingham could save the NHS up to £45m over three years by increasing the number of dialysis patients whose treatment takes place at home.

Funded by the National Institute for Health Research (NIHR), the study will focus on the reasons why home therapies are not used more equally and fairly by kidney centres across the country, as well as designing and testing possible solutions to improve the uptake of home therapies.

Called Inter-CEPt (“Intervening to eliminate the centre-effect variation in home dialysis use”), the research builds on previous collaborations and is a multi-disciplinary project integrating ethnographic and statistical expertise from Keele University, health policy researchers from the University of Birmingham and health economists from the University of Sheffield.

Around 30,000 kidney failure patients in the UK currently manage their condition with dialysis, either at home or by travelling to their local dialysis unit as an out-patient, where it is provided by healthcare staff.

Although national guidelines encourage the use of home dialysis, the uptake is limited and varies greatly by treatment centre. Some centres offer home treatments more than others, with provision varying between 2-28% of patients requiring kidney replacement therapy.

Having dialysis at home is associated with improved clinical outcomes, treatment satisfaction and patient autonomy. It has also been safer for patients during the Covid-19 pandemic.

Recent research by the Renal Registry has also found that certain groups in society were less likely to have home therapy, with patients from Black, Asian and Minority Ethnic (BAME) groups, and those from poorer or more disadvantaged backgrounds being particularly affected.

This research aims to change the uptake and availability of home dialysis treatments, by using a five-stage approach to assess the main factors affecting home dialysis availability, which will allow the researchers to develop a practical and feasible approach for dialysis centres to make these treatments more accessible.

The research team includes BHP’s Dr Iestyn Williams and Dr Kerry Allen, of the University of Birmingham’s College of Social Sciences, and Dr Sarah Damery, Institute of Applied Health Research, University of Birmingham.

Dr Williams, Reader in Health Policy and Management at the University of Birmingham, said: “It is really important that the most effective treatments are accessed by everyone, including marginalised and disadvantaged groups. This study will be crucial in helping us to understand how this can be achieved.”

Professor Simon Davies, of Keele University’s School of Medicine said: “We will use in-depth knowledge of what constitutes a strong and equitable home therapies programme to inform a wider survey of dialysis unit practices linked to patient outcomes.

“This will allow us to develop a bundle of interventions designed to support inclusion of those patients into home therapies who may not currently benefit from this treatment option.”

Professor Lisa Dikomitis, also of Keele University, added: “I am delighted to be part of this timely and important study, which is underpinned by a robust patient and public involvement and engagement strategy.

“Ethnographic and qualitative data will provide us with a better understanding of why certain groups in our society are less likely to have home therapy and how we can improve the uptake of such therapies.”

Dr James Fotheringham, of the University of Sheffield, who leading the health economics research for the study, said: “The internationally renowned expertise in health economics which the School of Health and Related Research brings to this project, ensures that the costs and benefits of these important treatments are fully understood so they can inform policy and clinical practice.”

Drug dosing technology to improve children’s cancer treatment

Written by Louise Stanley on 15/03/2021. Posted in Cancer outcomes.

A new project has been launched in collaboration with BHP founder-member the University of Birmingham aimed at aiding more precise drug dosing in children with cancer.

Children receiving chemotherapy treatment each process the drugs differently, leading to inconsistencies in drug concentrations in the blood (known as drug exposure).

Patients may not receive enough of the drug or in some cases may experience side effects following anthracycline treatment, predominantly in the form of dose-related cardiotoxicity.

A multidisciplinary team of experts working on the project, called ChromaDose, will develop a diagnostic drug monitoring tool to aid dose optimisation, enabling children receiving anthracycline chemotherapy – a type of the drug most commonly used to treat childhood lymphomas and leukaemias – to benefit from a personalised approach to treatment.

The technology behind ChromaDose, which is being led by UCL, will enable clinicians to calculate the patient’s drug exposure. Nurses administering the chemotherapy drug would collect a few drops of blood at different times following administration. These samples are then inserted into the ChromaDose bedside device using an innovative cassette design.

The machine automatically measures the amount of medicine within each blood drop and identifies the patient’s pharmacokinetic response (movement of drugs into and around the body), allowing ChromaDose to calculate the patient’s drug exposure.

Co-lead Professor Pamela Kearns, of the University of Birmingham, explained: “In 2021, there are nearly half a million survivors of childhood cancer in Europe and two thirds live with long term side effects from their treatment.

“One way to improve the side effect profile of a drug is to be more precise in the dosing. ChromaDose has the potential to allow us to individualise the dose of chemotherapy drugs to maximise effect on the tumour while minimising the side effects.

“I am looking forward to working with the team to move ChromaDose into clinical practice as a substantial step towards personalised medicine for children with cancer.”

Overall project lead Dr Stefan Guldin, of UCL Chemical Engineering, further explained: “We have come a long way from the first experiments in the lab to this unique opportunity to bring our technology into the clinic. The team we have been able to assemble in ChromaDose makes me confident that we can achieve our ambitious goals.”

Academics currently have the individual components which have shown promise when operated manually in a laboratory. They will now work to integrate these elements into an automated companion monitoring tool that will be able to provide reliable results within 30 minutes from insertion of the sample.

“The challenge of developing a fully-automated in-vitro diagnostic device for biochemical analysis on the ward cannot be underestimated,” explained Dr Alaric Taylor, Innovation & Design Lead at Vesynta Ltd, a UCL start-up. “Safety, performance, user experience and regulatory compliance are all competing factors.

“However, I believe that working within the ChromaDose consortium, with input and support from each and every stakeholder, makes the delivery of this technology possible.”

Co- lead Professor Gareth Veal, of the University of Newcastle, commented: “We have made great strides over a number of years in providing a national therapeutic drug monitoring service to support dosing decisions being made for childhood cancer patients across the UK.

“The development of a point-of-care diagnostic device funded through the i4i project could have a real impact on utilising drug monitoring approaches as routine cancer patient care in the future.”

The research team are working with a diverse group of stakeholders including children, parents, nurses, doctors, educators, designers, scientists and engineers. The Young Persons Advisory Groups at Great Ormond Street Hospital and North England were actively involved in the project planning stage, with over 60 participants, and remain important collaborators throughout the project. Additionally, parents and wider families of children who have experienced cancer will contribute through the Paediatric Oncology Reference Team.

Stakeholder satisfaction and user scenarios analysis will aid the translation of the ChromaDose innovation into the NHS healthcare system. This work is supported by partners at the National Institute for Health Research (NIHR) funded London In-Vitro Diagnostic Co-operative at Imperial College London. The expert team will map pathways for clinical integration alongside early stage health economic analysis, ensuring patient benefit is delivered rapidly and cost-effectively.

The ChromaDose project is funded by an NIHR i4i Product Development Award, which provides £980,000 for a nationwide multi-disciplinary team to conduct intensive research and development over 30 months. As project capstone, the team will seek regulatory approval from the notified body for widespread adoption.

Midlands’ maternity triage system goes nationwide

Written by Louise Stanley on 05/03/2021. Posted in Maternal health.

A maternity triage system developed by clinicians and researchers in the West Midlands has launched training online for the first time, becoming readily available to maternity teams across the UK.

Midwives, obstetricians, and doctors across the NHS can now access the Birmingham Symptom-specific Obstetric Triage System (BSOTS) programme and training materials online for free via the Meridian Health Innovation Exchange – part of BHP member West Midlands Academic Health Network (WMAHSN).

There is no standardised triage system in maternity care. The Birmingham Symptom Specific Triage System (BSOTS) assesses women presenting themselves with unexpected pregnancy related problems or concerns, and then allocates a colour code, so hospital staff can see at a glance who needs to be prioritised.

Developed collaboratively between BHP founder members Birmingham Women’s and Children’s NHS Foundation Trust (BWC) and the University of Birmingham, supported by the WMAHSN and MidTECH Innovation, BSOTS was established to provide a standardised method of safely and efficiently assessing women when they attend with unexpected clinical concerns.

Until now, there has been no consistent process available. BSOTS involves a brief standardised assessment of the women on presentation, followed by clear guidance developed to help midwives and clinicians determine the clinical urgency in which women need to be seen. This ensures that variation in treatment and outcomes is minimal and that participating maternity triage departments are working cohesively.

An initial evaluation at BWC showed that BSOTS increased the number of women seen within 15 minutes of attendance to maternity triage from 38% (159/421) to 53% (209/391). The system also appeared to reduce the time between attendance to medical review for those who required it.

By digitising the resources and training materials, trusts from further afield can sign up and implement the award-winning programme more easily and quickly than ever.

BSOTS has been adopted by 34 maternity units in the UK with a further 20 in the process of implementation, and 17 awaiting training. Sunshine Hospital in Victoria, Australia are the first international maternity unit to implement BSOTS with interest from others. Participating Trusts have already noticed positive changes in work organisation and practices, along with a reduction in staff anxiety often associated with triage work.

Its success in safeguarding women has seen the BSOTS programme gain support by the Royal College of Midwives (RCM) and the Royal College of Obstetricians and Gynaecologists (RCOG) who support its implementation.

The programme has also been recognised at the Health Service Journal (HSJ) Patient Safety Awards 2020, as Maternity and Midwifery Services Initiative of the Year and was shortlisted for its Patient Safety Innovation of the Year award.

Helen Hunt, Patient Safety Assistant Programme Manager at WMAHSN, said: “We are so proud to be launching BSOTS on the Meridian Health Innovation Exchange. Streamlining the care of expecting mums is vital and taking the programme online will allow more NHS Trusts and maternity departments across the UK to take a step forward and help ensure that this happens nationwide. We’re so excited to see the roll out.”

Sara Kenyon, Professor of Evidence Based Maternity Care at the University of Birmingham, added: “Previously, BSOTS training has been done either face-to-face or over Zoom, meaning that training and materials haven’t been as accessible to maternity teams as we would have liked.

“However, the new electronic sign-up process makes it easier for maternity sites across the country to access the resources necessary to put BSOTS into practice and improve the way maternity triage work is managed.”

Dr Nina Johns, Consultant Obstetrician at The Royal Wolverhampton NHS Trust and co-creator of BSOTS added: “The BSOTS programme has proved to be invaluable to midwives, obstetricians, and doctors across the UK; not only does it improve quality of care and the safety of pregnant women and staff, it also allows for better communication and creates a less stressful triage environment for staff.

“We hope that by digitising the sign-up process, many more teams will be able to access and implement the service to improve safety & clinical safety in maternity triage.”

Maternity teams will be able to sign up for access to the BSOTS training materials for free via the Meridian Health Innovation Exchange. Existing BSOTS users will also be able to sign up to access to the digital triage resources which can be used independently or in conjunction with BadgerNet.

To find out more about BSOTS, or to sign up to the programme, visit the Meridian Health Innovation Exchange website.