Healthcare UK

UK Trade & Investment is the Government organisation established to support companies in the UK doing business internationally and overseas enterprises seeking to set up or expand in the UK.

Leading science and product innovation

The UK is a world leader in research, development, and innovation, and is home to some of the world’s most distinguished scientists and innovators. The UK is a country that excels in driving science and innovation right through to market success, with many global companies choosing the UK as their first choice to do business with and from.

The UK is a key influencer of European healthcare regulation, and products approved in the UK have access to the whole European market.

The UK’s healthcare industry is one of its strongest sectors, and has a great advantage with the National Health Service (NHS) recognised the world over as a benchmark of clinical excellence. The UK’s network of world-class universities work in conjunction with - and often spin-out their own - leading companies to ensure British technology remains at the cutting-edge of innovation.

The healthcare industries include innovators and manufacturers of revolutionary medical devices and healthcare consultants who are exporting British expertise in infrastructure and healthcare management across the globe. The UK has particular industry strengths in several sub-sectors, including advanced wound care, diagnostics and orthopaedics.

Healthcare in the UK operates in a globalised and increasingly consolidated market and, as quickly as consolidation occurs, new companies emerge, all requiring continuous investment in skills, knowledge and specialised infrastructure.

Approximately 38 million people in the UK, which is more than 50 per cent of the population, come into contact with a medical device every day. Patients on whom devices are used include those visiting hospitals, GPs, dentists, opticians and chiropodists as well as those who daily use glasses, contact lenses or dentures.

UK healthcare exports

The UK healthcare market was worth £111.42 billion in 2004*, and in 2006 healthcare goods and services to the value of £14 billion were exported.

Between 2000 and 2005, UK-based medical device manufacturers saw their profits increase by almost 74 per cent, with sales of £4.7bn in 2004, according to Office of National Statistics figures.

UK healthcare consultants, using the experience gained from working closely with the UK Government and NHS, are world-renowned. Their activities range from advising governments on how to structure their health services, to using models based on the UK’s Private Finance Initiative (PFI) to fund hospital construction. UK consultants have extensive experience in working with governments, healthcare providers and developers to identify healthcare needs and to design appropriate and cost-effective solutions.

Likewise, UK building and facilities management contractors, with experience of building PFI hospitals for the NHS, can increasingly add value to foreign projects by acting as project managers, including managing the design, build, equipping and running of hospitals.

Investing in the UK healthcare sector

The UK is a popular destination for large, multinational companies, notably from the USA. More than half (57 per cent) of all European Headquarters of global companies are based in the UK, with the number of companies choosing the UK rapidly increasing.

The UK's increasing presence in the global healthcare market has been attributed to three main factors:

• excellent working relationships between industry, Government, the NHS, the private sector and voluntary organisations,

• a highly developed healthcare infrastructure, including expertise in public private partnerships, and

• an outstanding and well-supported research base.

The NHS is a huge employer in the UK, with a workforce of more than 1.3 million, giving companies and investors access to a large resource of clinicians, patients, trials, research and range of specialities. The NHS also spends approximately £15 billion each year on goods and services.

The NHS develops internationally recognised qualifications and standards of competence for all professions associated with the provision of health services, with close co-operation between the NHS and leading academic institutions to deliver training, monitored by professional bodies. Many universities, medical schools, NHS training institutions and colleges of higher education support the training of professionals from overseas, including access to UK based education, appraisal missions to assist countries with identification of appropriate and cost-effective training and IT and distance learning-based training.

Additionally, the UK benefits from excellent transport links, to the rest of Europe and worldwide, a stable political and business environment, a well-developed legal and regulatory framework and European Union (EU) membership.

Leading on research

The UK is home to just 1 per cent of the world’s population, yet undertakes 5 per cent of the world’s science, produces 9-11 per cent of its academic papers and generates 12 per cent of its citations.

UK researchers publish around 25 per cent of the papers found in all English language scientific journals, with the UK being number one in terms of the international impact of its research output and is second only to the USA when it comes to receiving global life science R&D funding.

The UK is a world leader in healthcare education and training, being home to 29 medical schools, including many deemed to be world class and 18 royal colleges. It is home to four of the world’s top 20 universities, with the Universities of Cambridge and Oxford being ranked two and three respectively, followed by Imperial College London and the London School of Economics.

The cutting-edge research being undertaken by the UK’s universities attracts industry, with life science clusters formed around Cambridge, Oxford, London, Nottingham and Liverpool as well as in Scotland.

Alongside the 29 universities providing medical education, there are 108 higher education institutions providing undergraduate courses in nursing and applied health professions and each year 170 UK universities/higher education institutes produce approximately 300,000 graduates and almost 100,000 postgraduates at a Masters level, and 15,000 at a doctorate level.

In comparison with the pharmaceutical industry, the sector has relatively short product development cycles and draws on innovation from a wider range of sources.

Research and development across the healthcare sector is funded by the Government, through the Medical Research Council and NHS Research and Development, to the tune of £212 million in 2005/06. The not-for-profit sector also funds research, granting more than £228 million in 2004/05.

Improvements in the commercial clinical trial environment have been identified as significant for the competitiveness of the UK’s medical device sector and for R&D activities in particular.

Regulation of medical devices

All medical devices in the UK are subject to regulation by the Medicines and Healthcare Products Regulatory Agency (MHRA). The MHRA is one of the most respected regulatory agencies in the world. The Agency has the power to withdraw a product from the market and can prosecute manufacturers if it finds that laws have been broken.

The MHRA’s regulatory decisions are impartial and based on the extensive evidence of quality, safety, and efficacy required for each product. The MHRA is responsible for appointing the UK’s Notified Bodies, which verifies the safety of devices before granting permission to use a Conformity European (CE) marking. A medical device cannot generally be marketed in Europe without carrying a CE marking, which shows that a device meets the relevant regulatory requirements and, when used as intended, works properly and safely.

The MHRA also collaborates with other international regulators, such as the US Food and Drug Administration (FDA), and UK Government agencies involved in healthcare, including the National Patient Safety Agency (NPSA) and the National Institute for Health and Clinical Excellence (NICE).

The MHRA is also the body responsible for giving permission to manufacturers to conduct clinical trials in the UK. Although devices are always tested for mechanical and/or electrical safety before they are used, unlike medicines they are not automatically subject to a clinical trial.

The UK Clinical Research Collaboration (UKCRC) is working to establish the UK as a world leader in clinical research, harnessing the power of the NHS through a partnership of organisations.

It aims to improve the research infrastructure in the NHS, encourage more clinical staff to consider research careers, co-ordinate the funding of research and produce streamlined regulatory guidelines to ensure the safety and confidentiality of patients.

There are plans to increase funding for health research in the UK to £1.7 billion per year by 2010-11.

The Office for Strategic Co-ordination of Health Research, which oversees the Government-funded Medical Research Council (MRC) and NHS Research and Development programmes aims to introduce a single, integrated health research strategy, with funding to cover all aspects of health research including translational medicine, public health and e-health. Together, the MRC and NHS Research and Development are responsible for more than three-quarters of the non-pharmaceutical industry funded research carried out in the UK.

The NHS’s budget is set to increase by four perc ent per year until 2010-11, taking it from £90 billion in 2007-08 to £110 billion by 2010-11. A new Health Innovation Council, consisting of members of the NHS, academia and industry, will also receive £100 million to consider introducing new ideas in pharmaceuticals, other medical technologies, clinical practice, delivery models of service and management.

In-vitro diagnostics

The UK excels in the development of in-vitro diagnostic products, ranging from over-the-counter products to specialist diagnostics such as test kits, reagents and instrumentation.

The UK diagnostics market is worth £500 million, in a global market worth £19 billion. There are between 250-500 diagnostics companies in the UK with significant export capacity.

Companies tend to be small, with a turnover of less than £1 million, and clustered in areas with a strong scientific and related industry base, such as Oxford, Cambridge and Scotland.

Annual export sales in the diagnostics sector were in the region of £300 million in 2006, with key markets being found in Brazil and India.

UK universities lead the way with regards to cutting edge research in diagnostics, with University College London undertaking work into using holographic smart chips for biosensing and the development of a non-obtrusive, battery driven compact device for the trackside non-invasive measurement of muscle oxygenation in athletes.

The University of Warwick is developing biosensors for ATP and adenosine for use in in-vivo research, while scientists at City University London are working on the development of an optical sensor to aid the non-invasive monitoring of blood glucose.

A consortium of Northeast Universities has a major EU grant and is working with Helena Biosciences Europe to develop rapid, non-invasive testing for deep vein thrombosis (DVT).

The University of Nottingham’s Centre for Healthcare Acquired Infections has close links with the NHS and is investigating a range of new diagnostic techniques for the diagnosis of infections such as Clostridium difficile, E.coli and MRSA.

Also working in the arena of diagnostic holograms is Smart Holograms, which is looking at the use of sensors in the treatment and diagnosis of patients with diabetes. The reactive holograms remove the need for regular product calibration, with diagnostic analysis being continuous, accurate and real-time.

Stirling Medical Innovations, a subsidiary of Inverness Medical Innovations, is running a £67.5 million project in partnership with ITI Life Sciences focusing on developing novel biomarkers for use in new cardiovascular near-patient diagnostic and home-use tests, allowing clinicians to give rapid diagnoses and treatment.

Other UK companies and organisations in this area include:

County Antrim based Randox Laboratories is a diagnostic reagent and equipment manufacturer and the leading British manufacturer of clinical chemistry reagents. Its latest innovation is multianalyte biochip array technology for use in diagnostics laboratories worldwide.

Newmarket Laboratories specialises in the development and production of high-quality immunodiagnostics for infectious diseases, particularly syphilis and malaria, making it the number one supplier to national blood supply services throughout Europe.

3M Health Care in the UK has developed the BacLite system, which enables rapid testing for MRSA. The technology leads to faster processing and production of results, identifying carriers of the bacteria.

Biotec Laboratories manufactures medical laboratory diagnostics and bacteriology products and distributes them worldwide. The company is currently marketing products for both the detection of tuberculosis (TB) and rapid tests for its drug susceptibility. Market leading Lifescan Scotland Ltd (Johnson & Johnson) employs 1,400 staff in Inverness developing and manufacturing self monitoring blood glucose systems.

Abbott is a global, broad-based health care company devoted to the discovery, development, manufacture and marketing of pharmaceuticals and medical products, including nutritionals, devices and diagnostics. The company employs more than 60,000 people and markets its products in more than 130 countries. It employs close to 4,000 staff in a number of sites across the UK and Ireland, most recently expanding a major facility in the South-East of England. The biotechnology facility at its Murex Biotech location in Dartford, Kent, forms part of Abbott's €230 million expansion plan in Europe to meet the increasing global demand for diagnostic testing. The £39 million investment makes the company's Dartford facility a key international manufacturing site for diagnostics tests covering a wide range of diseases and medical conditions. Dartford plays a key role in Abbott's global operations, manufacturing a wide range of tests for infectious diseases including hepatitis and HIV. The new biotechnology facility adds capacity to manufacture antigen and antibodies used in testing for medical conditions such as cancer, cardiovascular, fertility/pregnancy, metabolic, transplant and thyroid diseases. The biotechnology expansion added 89,000 sq feet to the existing 130,000 sq feet facility, providing opportunities for scientists and technical staff in addition to increasing manufacturing capacity. Other diagnostics facilities in the UK include blood glucose test development and manufacturing for worldwide distribution, based in Oxfordshire.

Probe scientific Case study

Soon, however, clinicians will be able to improve the effectiveness of their care by using a powerful new tool that exploits ultra-advanced technology to maintain an automated, continuous and on-line watch on critically ill patients by monitoring key substances in their blood very precisely.

MicroEye™ is a sterile single-use blood sampling device that can be used intravenously for up to 48 hours. Sensors connected to the probe provide vital feedback to clinicians on ways the patient’s blood is reacting to biochemical or therapeutic drug treatments, providing crucial real-time information to maximise clinical care.

With MicroEye™ in the advanced stages of trials at present, its developers are working busily to draw attention to its enormous potential in medical markets worldwide – with vital help from UK Trade & Investment.

“We have already gained some very important specialist advice and analyses of our market sector from UK Trade & Investment experts and we are now in the very early stages of the Passport to Export programme,” reports Neil Smith, Chief Executive Officer of Probe Scientific, the young Bedfordbased company that has developed MicroEye™.

“Support from UK Trade & Investment will also enable us to attend the world’s biggest medical equipment trade show in Germany, giving us effectively a global platform from which to demonstrate our products to influential people from a wide range of national markets. This support is not a big sum of money, but it’s a contribution that can make the difference between not being able to afford to attend and grasping the opportunities this sort of event can offer.”

Overseas Market Introduction Service (OMIS) reports provided by UK Trade & Investment and British consular staff in overseas markets will also prove key to Probe Scientific’s progress, believes

Mr Smith. “These reports are enormously helpful for specific markets, while they also carry a lot of influence in the eyes of prospective investors in our company because they represent expert, independent market research. They also deliver key information much more quickly and comprehensively than anything we could provide on our own.”

“Support from UK trade & investment will also enable us to attend the world’s biggest medical equipment trade show, giving us effectively a global platform from which to demonstrate our products to influential people from a wide range of national markets.”

Neil Smith,

Chief Executive Officer,

Probe Scientific

Imaging

The UK is home to several of the world’s leading imaging organisations, with UK researchers having a particular strength in the innovation of new ways of imaging and the adaptation of existing technologies, such as digital imaging, ultrasound and molecular imaging.

Achievements in imaging innovation are leading to the earlier detection and treatment of disease, with the imaging market being worth around £206 million.

University College London is the home of the UCL centre for Medical Image Computing, where a team of physicists, computer scientists and mathematicians are hoping to develop new methods of using images. Researchers at the university are also working in conjunction with Philips Medical Systems on improved ways of utilising MRI to collect whole heart images.

Over the last 25 years, the University of Aberdeen has produced pioneering work on whole-body human imaging and is currently building a revolutionary new scanner based on Fast Field-Cycling MRI that could pave the way for new in-vivo diagnostics. Aberdeen is also one of the six universities involved in the recently announced Scottish Imaging Network: A Platform for Scientific Excellence (SINAPSE) which is focusing on the infrastructure for neuroimaging research in Scotland.

The University of Cambridge’s researchers are looking at how freehand 3D ultrasound can be made clinically practical, with particular implications for breast surgery or radiotherapy.

The University of Nottingham was home to much of the early pioneering work on MRI in the 1970s and the tradition continues today, with researchers at the university investigating new types of radiofrequency (RF) and gradient coils for incorporation in modern scanners, along with new clinical applications such as in foetal development and neuroscience.

Aston University is the home to research on non-invasive imaging techniques for the study of cortical function, while scientists at the University of Nottingham are focused on improving MRI techniques and echo-planar imaging.

Other UK companies and organisations in this area include:

KeyMed, a UK-based subsidiary of Olympus, specialises in technology relating to optics, in particular having a high share of the UK endoscopy market, as well as distribution of diagnostic ultrasound systems.

In Cambridge, Astron Clinica has developed its own method of skin imaging, SIAscopy, which uses light to analyse skin components to a depth of 2mm beneath the surface. The method is the only method that lets the clinician look under the surface of the skin, helping clinicians diagnose, treat and monitor skin conditions and diseases more accurately.

Optos Plc, a Scottish based global leader in retinal imaging devices, can produce high resolution images of approximately 82 per cent of the retina in a single capture in 0.25 seconds. The image provides information to facilitate early detection of disorders or diseases evidenced in the retina as well as certain systemic diseases.

Paraytec case study

A small UK company created just two years ago has won massive global recognition by clinching a top award for one of the most significant and important technology advances of the year in the highly competitive scientific instruments sector.

York-based Paraytec beat off challenges from more than 1,000 exhibiting companies at Pittcon 2007, the world’s premier exposition in the scientific instruments field, to win the Pittcon 2007 Editors’ Choice Silver Award – coming second only to the £485 million giant, Waters Corporation.

“This is global recognition at the highest level and we were literally speechless when we realised we had won the Pittcon Silver Award,”

Paraytec

Founder and Chief Scientific Officer

Professor David Goodall.

“For a small company from Yorkshire to have its first product voted number two in the world demonstrates the importance of this technology on the world stage.”

Paraytec’s innovative equipment was described by a panel of 150 editors from international scientific publications as a “novel and innovative product” that “transcends” boundaries in its contribution to life and analytical sciences.

The acclaim, which focuses on the company’s ActiPix D100 imaging detector, energises the latest phase of its progress since it was formed in January 2005 as a spin-out from York University. Since then UK Trade & Investment has worked closely with the business, introducing it to the Passport to Export Programme and Targeted Export Support Scheme (TESS) to help provide grants and well-prepared strategic advice and assistance.

UK Trade & Investment staff helped Paraytec prepare a targeted presentation to catch the eyes of judges at the Chicago exhibition to the merits of its imaging system, which allows scientists to “see” a complex analytical reaction in real time and to quantify its components.

UK Trade & Investment support is set now to help Paraytec continue to gain early-stage sales to end users and development partners in the UK, the rest of Europe and the United States.

Confidence is sky-high, reflected by Jim Lenke of protein sample preparation instrument specialist Protea Biosciences of West Virginia who has used ActiPix for several months and says he is “astounded” by its capabilities. “This is a detector with so much potential that it is bound to have an impact on key discoveries for years to come.”

Patient care and rehabilitation

Worcester’s Motion Analysis Research and Rehabilitation Centre specialises in examining the process of motion, with the technology being used for rehabilitation. The centre also has a fully equipped physiotherapy and podiatry facility

Oxford’s Nuffield Orthopaedic Centre is developing, manufacturing and testing new devices to treat back pain. The devices generate feedback from the skin overlying the lower back using vibrators, with the aim of reducing chronic pain.

The Newcastle-based Institute of Ageing has a large, trained panel of elderly people who are a key resource to identify and test a wide range of assistive technologies to aid independent living.

One of the UK’s largest producers of equipment used in pressure area care, patient positioning and transport is Huntleigh Healthcare. The company manufactures hospital beds and therapy couches, as well as compression devices to aid in the prevention and treatment of deep vein thrombosis.

Charnwood Healthcare is a UK-based specialist in the manufacture of medical devices to assist with the prevention of pressure sores or decubitus ulcers, including high technology mattresses and supports for operating theatres, recovery rooms, accident departments and other high dependency areas. The majority of hospital operating theatres in the UK are now equipped with Charnwood’s Liquid Displacement Cell Mattresses.

Other UK companies and organisations in this area include:

Hampshire-based Parafricta manufactures specialist dressings and bed sheets to prevent friction and shear forces on the skin and therefore help to prevent the potential development of pressure ulcers (bed sores) in bed-ridden patients or to help patients with compromised skin.

Park House Healthcare specialises in the manufacture of specialist pressure relieving and pressure reducing equipment which aim to take moving and handling into account, including beds, chairs, hoists and a bariatric range.

Salitas, a spin-out from the University of Bradford, manufactures the Bradford Sling, which is used in a range of applications, including aiding comfort and reducing recuperation times in those suffering from burns or complex trauma.

SensorCare Systems has developed a system which alerts healthcare staff, either in hospitals or rest homes, if a patient at risk of falling is attempting to move from their bed or chair. A change in pressure is identified as the person moves from their bed or chair in any direction. This information is detected by the control unit, which gives an audible and visual alarm.

Performance health products ltd case study

Performance Health Products Ltd (PHP) of the UK have won a contract to supply special needs mobility seating systems to the largest medical complex in the Middle East – The King Fahad Medical City.

PHP won the contract after attending NAIDEX, the biggest special needs healthcare exhibition in the UK.

“There is a huge demand for new products in the Saudi market and the special needs market is largely untapped," said Syed Zaman, Senior UK Trade & Investment Officer.

“You just need to make the effort to get a foothold in this booming market".

The UK Trade & Investment team worked closely with PHP, providing useful contacts and advice. Based in the British Embassy in Riyadh, the UK Trade & Investment trade team work at promoting trade and investment between the two countries.

The Saudi delegates, who regularly attend these exhibitions, were impressed with PHP and other UK products. The King Fahad Medical City has placed an order through Al Ewan, a local distributor. Zaman pointed out that a good local distributor is an important factor in getting such orders. Good distributors, such as the Al Ewan Medical Company in this case are on the constant lookout for opportunities. Repeat orders are expected for PHP. Other companies that participated in the exhibition are expecting firm orders to come through any day.

“While good business can be done with Saudis visiting the UK, it is essential for UK companies to visit Saudi Arabia if they aspire to be serious players in the market", said Zaman. “Face to face meetings are still the best way forward.

King Fahad Medical City is the centre for “Special Needs" and rehabilitation in the Kingdom and is in the process of setting up an advanced mobility seating system department. King Fahad Medical City and their suppliers will be the benchmark for other hospitals to follow.

Wound care and advanced wound care

The UK is a global player in the wound care market, with four of the world’s leading wound care companies being based, or having manufacturing facilities here.

Advanced wound care is based on the principle of moist wound healing, whereby wounds have been shown to heal faster without pain and with minimal scaring if a moist healing environment is maintained. Products include gels, films and foams and antimicrobial dressings to treat and prevent wound infection.

Benefits to patients include less discomfort, pain and need to reapply dressings, while the faster healing and reduced risk of complications such as infection and amputation has benefits for clinicians.

Advanced wound care is a £1.25 billion market globally, with the UK market estimated at £76 million, and the use of advanced wound care is forecast to grow by about 9 per cent each year until 2010. This is based on increasing acceptance of advanced wound care, new technologies, and an increasingly older population. The sector in the UK represents approximately 13 per cent of the global market and employs more than 6,000 people.

UK universities are leading the way with respect to research in wound care, with Cardiff University in particular making great strides in this sector through its world-leading Wound Healing Research Unit. This unit is one of the largest multi-disciplinary units in the world and has a key objective to ensure that new product development is in line with patient and clinical needs. The unit also works closely with manufacturers of high technology and basic wound care products and NHS Trusts.

The university also recently received a £1.2 million grant to develop so-called “intelligent dressings” for chronic wounds, which measure levels of bacterial infection to create a detectable digital instrument signal. This can then cut the use of antibiotics, as clinicians can see which wounds need treatment.

Researchers at the Institute of Medical Devices at the University of Strathclyde have developed a minimally-invasive sensor system to monitor the moisturestatus of the dressing and wound interface which will allow easy monitoring by the patient, nurse or attending clinician without removal of the dressing.

Leading players in the UK advanced wound care market include Smith & Nephew. Smith & Nephew has its global manufacturing site in the UK and manufactures 24 per cent of theworld’s advanced woundcare products. Johnson and Johnson's manufacturing site in Gargrave is the worldwide centre for the development of advanced wound care products. Its key products include highly absorbent hydrocellular dressings to keep wounds moist and maintain an optimum environment for improved healing, nanocrystalline silverbased antimicrobial dressings for treating infected wounds and instruments for surgical debridement to remove contaminated, dead and decaying tissue from wounds.

Other UK companies and organisations in this area include:

Advanced Medical Solutions takes advantage of the use of medical adhesives as a barrier for the protection of skin through the production of a topical, liquid barrier film that is painted onto the skin in a very thin layer to provide protection against skin damage caused by friction, shear and/or the presence of moisture.

The University of Bradford, in collaboration with the University of Leeds Medical School, is developing a novel polymer base dressing into which diagnostics (instant colorimetric analytical tests) or active antimicrobials can be incorporated for treatment of persistent leg ulcers.

Loughborough University is leading an £8 million, five year research project that also includes Cambridge University, University of Birmingham, University of Nottingham, University of Ulster and the UK Centre for Tissue Engineering (Liverpool/Manchester), that is dedicated to developing automated methods to produce cost-effective tissue engineered products for the regeneration of diseased and damaged tissues and organs.

Activa Healthcare has 40 per cent of the UK prescription hosiery market and is the largest supplier to the NHS, through its range of products to help with conditions such as varicose veins, leg ulcers and soft tissue injuries as well as sprains and strains. These products range from specialist stockings and tights to unique compression and non-compression bandages.

Tissue engineering is set to be a key factor in the UK’s continued dominance of the advanced wound care market. Intercytex, with facilities in Cambridge and Manchester, has products produced from living, human cells in advanced stages of clinical trials. These products will be used to treat venous leg ulcers, diabetic foot ulcers and skin grafts.

CellTran has introduced MySkin, a “living skin” treatment for burns and ulcers, which sees a patient’s own cells grown onto a gel disc and then reimplanted to encourage wound closure.

Zoobiotic has harnessed the power of a traditional wound healing method, live maggots, through the production of the LarvE BIOFoam dressing, as well as free maggots for areas with cavities or undermining.

Healthcare equipment

The UK is the leading location in Europe for the manufacture of equipment for use in the healthcare environment. The medical devices industry in the UK employed 47,000 in 2005.

It is estimated that more than 50 per cent of the UK’s population come into contact with a medical device on any one day.

The production of technologies for use in healthcare laboratories is a large export earner for the UK, with annual sales greater than £375 million.

One of the UK’s largest manufacturers of single-use, sterile medical devices is Pennine Healthcare, with its products being used in more than 70 countries worldwide.

Other UK companies and organisations in this area include:

Essex-based Clement Clarke International produces a range of equipment for use in respiratory healthcare settings, including peak flow meters, spirometers, nebulisers, spacers and smoking cessation products.

ParAid, of Birmingham, develop innovative products for use in emergency transportation, including a lightweight incubator for the movement of life-critical infants and equipment for use in aircraft.

Downs Surgical’s purpose-built facility in Sheffield uses traditional Sheffield steel manufacturing skills to make a huge range of surgical instruments. The company also produces orthopaedic implants, as well as percussors and tuning forks.

De Soutter Medical is a leading manufacturer of powered medical devices, primarily focused on orthopaedics with instruments being used in both large and small bone surgery, as well as for procedures in maxillofacial, oral, ENT, cardiothoracic, neurosurgery and plastics. Its products are distributed to more than 60 countries worldwide.

Manufacturing equipment for use in operating theatres, including a wide range of operating tables and theatre lights, is one of the specialities of West- Sussex based Eschmann. The company is also a leader in the field of instrument decontamination products, including autoclaves and washer disinfectors, along with the Eschmann instrument management system, which enables the traceable sterilisation of equipment along with hands-free instrument transfer, reducing the risk of sharps injuries.

Kimal has a long history of producing and distributing equipment for use in the renal field, including proportionating dialysis machines, dialysers, blood lines, fistula needles, haemodialysis catheters, peritoneal dialysis catheters and dialysis machines.

Vernon Carus, of Lancashire, is a leading company in the production of infection control products and surgical equipment, including traceable and X-ray detectable gauze swabs. The company also compiles surgical procedure trays for all surgical specialities at its own facilities, eliminating the need for hospitals to source equipment from a range of suppliers.

Johnson & Johnson Medical, Livingston, is a leader in wound management, including minimally invasive surgery, cardiovascular surgery and women’s health. Originally Ethicon, it has been manufacturing in Scotland for over 60 years.

Tenscare ltd case study

Worldwide demand for modern electrotherapy equipment is running at record levels, with millions of people taking advantage of the safe and easy-to-use ways in which it relieves chronic pain quickly and effectively.

And a UK company at the forefront of this sector has just gained a vital competitive advantage by breaking into one of the world’s potentially biggest markets - India.

TensCare Ltd, based in Epsom, Surrey, has grown successfully to become the largest distributor of transcutaneous electrical nerve stimulation, or TENS, products in Europe and an exporter to 40 countries including the United States. Yet India, where demand for TENS products is set to burgeon, remained an untapped market for TensCare until Peter Gautrey, the company’s Exports Manager, teamed with UK Trade & Investment.

“First I commissioned an OMIS report, which proved an excellent document with which I was very pleased,” reports Mr Gautrey. “It wasn’t just a passive set of facts and figures and indicators - it contained plenty of really useful background information and 10 or 12 actively primed contacts in India with whom we could discuss ways in which we could develop this very significant market.”

The next step saw TensCare joining the UK Trade & Investment LifeSciences Sector Team trade mission to India, during which staff from the UK posts in Mumbai and Delhi posts played crucial roles in providing the local help the company needed to achieve its objectives.

“I have been in the medical equipment export business for more than 30 years and this trade mission was the best-run that i have ever been on, with first-class support in the territory.”

Peter Gautrey,

Export Manager

TensCare Ltd

“have been in the medical equipment export business for more than 30 years and this trade mission was the best-run that I have ever been on, with first-class support in the territory,” adds Mr Gautrey.

“I held discussions with all the “hot leads” that UK Trade & Investment provided and was able to select and appoint one local dealer, Hansraj of Mumbai, on an exclusive contract. Hansraj had the right credentials and knew exactly what we were looking for in a local distributor, and although it is still early days in our relationship the signs are very positive.”

Already TensCare has gained an initial order for products across its range and the company is confident this will be the first of many from India.

Meanwhile TensCare is about to join the UK Trade & Investment Passport to Export programme under the experienced guidance of Les Plant, Sector Adviser for UK Trade & Investment’s south-east team, who, along with LifeSciences team Sector Manager Parminder Sunda, has provided key support to the company in its successful drive to energise its presence in the Indian market.

TensCare has seen its overseas customer base double in the past year and the company anticipates the Passport to Export programme will extend its export capabilities still further.

Dentistry

The UK’s dental industry has a highly trained, highly skilled workforce. The average size of an UK dental laboratory is small, with an average size of just one to five employees. UK dental laboratories are well regarded, particularly by the private sector, with the best performing labs working on implants.

All UK dental laboratories are well regulated. Every laboratory needs to be registered with the Medicines and Healthcare products Regulatory Agency registered with the MHRA, as well as being subject to their own independent auditing body, the Dental Appliance Manufacturers Audit Scheme, or DAMAS.

DAMAS is a quality management system designed specifically for the manufacturers of custom made medical devices, with laboratories being audited by a third party assessor once a year. Being a member of DAMAS improves efficiency, reduces waste, cuts remake levels and saves time.

UK research in dentistry has a particular focus on the development and use of innovative materials. Research at the University of Birmingham is concentrating on the development of new filling material with improved depth of cure through the monitoring and analysis of refractive index change through light activated fillings.

Scientists at the University of Leeds are investigating novel aesthetic dental restorative materials, with work into mica-based dental glass ceramics, which are particularly suitable for chair side processing.

The University of Bristol is looking at the development of automated rapid fabrication of net shape ceramics, work which could potentially revolutionise current manufacturing technologies in ceramics.

Other UK companies and organisations in this area include:

Odontis, a spin-out company from King’s College London, is in the early development of a new technology to enable patients to grow their own replacement teeth.

As one of the UK's largest independent full service labs, Attenborough's produce crown and bridgework, inlays, implant frameworks, orthodontic appliances, mouthguards, cobalt chrome and acrylic dentures, and swaged steel bases. The first UK lab with a digital laser scanning and in-house milling facility, it was also the first in the UK to receive ISO 9000 accreditation.

Scottish company Denfotex has developed equipment to allow chair side Photo Activated Disinfection, a revolutionary, minimally invasive, almost 100 per cent effective, method for eliminating bacteria in caries and root canals.

IDMoS, a spin-out from Dundee University, has developed a caries management support system and caries detection device, enabling dentists to detect caries earlier and with greater accuracy, without the risks associated with X-rays.

Orthopaedics

An aging population and changing lifestyle habits mean that the market for orthopaedic products is set to grow in the coming years. Orthopaedics is a sector in which the UK is particularly strong; the orthopaedics market has a leading position globally, valued at £8 billion. The UK market is worth more than £204 million, with an annual growth rate of 7 per cent.

The growing orthobiology segment of the orthopaedics market is valued at approximately £485 million and is estimated to grow at a compounded annual growth rate of 20 per cent, to reach £1 billion in 2010.

Alongside the strong manufacturing base, the UK has an enviable position with regards to orthopaedics research, particularly the work being undertaken into novel materials and tissue engineering.

Yorkshire has the largest cluster of orthopaedic companies in the UK with global manufacturing sites of Johnson and Johnson, DePuy, Symmetry Medical, Doncaster Medical Technology, B Braun, JRI and strong centres of academic and clinical excellence around the sector.

University College London is undertaking research into the development of tissueengineered implants to treat bone defects in revision total hip replacements and the development of doped phosphate glasses to prevent orthopaedic infections.

Smith & Nephew’s York research centre is leading the way on the production of new materials – from improved knee replacements to extending the life of hip replacements by reducing wear and tear. UK universities are also investigating how existing technologies can be improved, for example, scientists at the University of Southampton are using computational methods to predict the robustness of cementless total hip replacements, while the University of Leeds is undertaking research into wear prediction for artificial limb joints.

Other UK companies and organisations in this area include:

The Rutherford Appleton Laboratory is developing a new, non-invasive approach to the probing of bone tissue, using Raman spectroscopy, while scientists at Imperial College London are taking a new experimental approach to the study of synovial joint lubrication.

OrthoMimetics is the first spin-out venture from the Cambridge-MIT Institute (CMI) and specialises in the design, development, and manufacture of biological scaffolds that support tissue regeneration in the field of orthopaedics and regenerative medicine. Its ChondroMimetic device for use in repairing articular-cartilage damage, commonly seen in sporting injuries, is expected to be launched in late 2008/early 2009. The device is made of a material that closely resembles the structure of the surrounding cartilage and bone, making it easier for healing to occur.

Another orthopaedics spin out from the Universities of Aberdeen and Robert Gordon and NHS Grampian is currently developing products in the following areas: soft tissue monitoring; fracture fixation; IM nail alignment; tissue repair; and small joint prosthesis.

UK-based companies specialising in orthopaedics include Biomet UK, which manufactures high-quality implants at two sites in Wiltshire and South Wales and Biocomposites, a Keele-based company which develops and manufactures synthetic calcium composite devices for tissue regeneration.

Biovision supplies a range of innovative bone graft substitutes and other related medical devices for use in the repair and regeneration of bone in spinal and trauma surgery, total joint replacements and dental applications. Its products include particulate tissues, demineralised tissues, soft tissues and BioBone.

Jri ltd case study

Easy mobility of our bodies is a gift most us take for granted. But for many people, the simple business of moving around has become a painful, slow and unstable cause of anguish.

Fortunately, modern technology in the shape of efficient, long-lasting and lifeenhancing joint replacements that use advanced man-made materials can help a positive proportion of the people whose mobility suffers through disease or injury.

“The Overseas Market Introduction Service (OMIS) is a reliable and reasonably inexpensive way to undertake and develop this research” Fritz Dittmann, Export Manager, JRi.

One of the most successful companies specialising in creating replacement joints for hips and knees is Joint Replacement Instrumentation, known throughout its sector as JRi. With its office in London and manufacturing base in Sheffield, JRi has developed through more than 30 years and today commands an increasing share of the growing world market for these implanted devices.

In recent years the company’s export effort has gained increasing impetus through its involvement with UK Trade & Investment, reports Fritz Dittmann, Export Manager at JRi.

“We have found UK Trade & Investment market research, in particular, generates consistently good leads from which I can then establish useful contacts,”

Fritz Dittmann

Export Manager

JRi

“The OMIS is a reliable and reasonably inexpensive way to undertake and develop this research.

“Also the support we receive from UK Trade & Investment to attend trade missions enables us to maximise the value we get out of these activities. This year I will be attending a major trade show in Japan, which promises to provide a good starting-point from which I can develop more knowledge of my company and its capabilities in the Japanese market.

“Japanese people are quick to recognise and make use of the newest and best technology available, so we are already in a potentially strong position here. With the expertise and continuing support of UK Trade & Investment staff our scope in several export markets looks promising,” added Mr Dittmann.

JRi believes overseas markets will focus favourably on the benefits of its hip replacement system, which uses components coated with hydroxy apatite ceramic. This is found naturally in the body and allows implants to integrate with bone cells, enabling many patients to use the replacement hip for the rest of their lives.

Cardiology

Heart disease and cardiovascular disorders account for almost 50 per cent of all deaths in the western world, while rapidly becoming a major concern for developing countries, for example being described as reaching “epidemic proportions” in India.

Due to the prevalence of heart disease it is perhaps no surprise that the UK’s research community has a strong interest in the field.

Researchers at the University of Newcastle are developing an intelligent blood pressure measurement device to reduce measurement variability, as well as looking at how the assessment of heart disease can be made less invasive, through novel electrode placement and signal processing techniques.

Heart disease diagnostics are being investigated by researchers at Nottingham Trent University, developing a test involving the processing of whole blood to test for homocysteine, a biomarker which indicates susceptibility to heart disease.

The University of Nottingham is also investigating how the continuous observation of haemodynamics and cardiac function can be undertaken in conscious humans, while the University of Oxford is developing software to produce realistic heart simulations.

Other UK companies and organisations in this area include:

Cardionetics, a spinout company from Brunel University, provides innovative software solutions for diagnostic, monitoring, and screening. It has developed an intelligent heart monitor that provides real time automated analysis of ECGs, saving hospital referrals from GPs by 60 per cent, identifying serious arrhythmia conditions to enable immediate appropriate treatment, and saving lives and considerable cost to the NHS.

CardioDigital, a spinout company from Napier University, generates software to extend the functionality of defibrillators and pulse oximeters to give real-time patient status information.

Based at a custom built facility in Scotland, Vascutek is Europe’s market leader in the production of large diameter textile-based vascular grafts, as well as producing a range of heart valves. Vascutek’s products are well regarded by cardiovascular and vascular surgeons throughout the world.

Midlands-based Kimal produces a range of sterile procedure packs for use in cardiology, manufacturing more than 300,000 packs every year for export to 22 countries worldwide. The company also manufactures a variety of cardiac catheters, including angiographic needles, catheters and accessories and temporary pacing catheters for use in the fitting of pacemakers.

Radiotherapy

The global radiotherapy market has been valued at more than £26 billion, with an annual growth of 5 per cent. Multinationals currently dominate the market, through large investments in manufacturing, research and development.

ACORRN, the Academic Clinical Oncology and Radiobiology Research Network, is a new national Cancer Research Institute initiative, funded by Cancer Research UK, the Medical Research Council and the Department of Health. ACORRN has the aim of revitalising radiotherapy and radiobiology research in the UK by networking and supporting individuals and groups, developing infrastructure and an integrated strategy.

UK-based research into radiotherapy includes the University of Sheffield’s work into the development of intensity modulated radiotherapy, particularly aimed at use in the head and neck.

Research into the development and application of conformal radiotherapy techniques in bladder, breast, lymphoma, lung and testicular cancers is being undertaken by the Institute of Cancer Research.

Other UK companies and organisations in this area include:

Varian Medical Systems is the world’s leading manufacturer of integrated cancer care systems and a leading supplier of X-ray tubes and flat-panel sensors for imaging in medical, scientific and industrial applications. Its UK base in Crawley is home to the assembly and worldwide shipping of its Acuity radiotherapy treatment planning, simulation and verification system, as well as Exact couches for ultra-precise patient positioning. The company’s new On-Board Imager device for imageguided radiotherapy, and VariSource high dose rate afterloaders for brachytherapy treatment are also produced here.

e2v, based in Chelmsford, Essex, also produces thyratrons, magnetrons and modulator systems for use in radiotherapy.

E-HEALTH

E-health is having a huge impact on modern healthcare, with scenarios which were inconceivable just ten years ago now becoming a reality. Patients in remote regions of the world can be treated from a distance, even by a physician in another country or continent, through the use of telehealth, health professionals can upgrade their skills through e-learning without needing to leave their desks and national networks of electronic health records can make a patient’s entire medical history available at the touch of a button.

E-Health covers services that increase the value that physical practice sites can potentially provide patients as well as providing health information via the internet. The UK is working towards a fully integrated e-Health service and one that complements pan European initiatives too.

The aim is to establish a standard health information network infrastructure to facilitate the flow of health information throughout the EU, including the distribution of electronic health cards to all EU citizens and the launch of online health services including information on healthy living and illness prevention, electronic health records, tele-consultation and e-reimbursement.

There are approximately 120 companies in the UK healthcare IT sector, including several multinationals. UK-based multinationals include BT, which has developed a secure managed network for the NHS called NHSnet and Research in Motion (RIM), which has developed hand held devices to give transplant teams access to patient information.

City University London and Coventry University are working together on “NHS my-care”, research into a new system enabling patients to hold their own medical records, allowing the patient to update the records themselves, particularly in long-term chronic conditions and allowing easy access to records in the case of acute illness or accident. The research will involve liaison with the international telemedicine community, Connecting for Health and community groups such as Age Concern.

The Scottish Centre for Telehealth provides a centre of expertise to define and disseminate best practice and develop inter-operable standards, protocols and processes to support telehealth solutions as well as supporting a range of projects throughout Scotland focusing on unscheduled care, management of long term conditions, paediatrics, remote and rural support and education.

The UK is also to be home to a national digital X-ray archiving and communications system, the first in the world and a national programme for safer patient identification, developing and implementing automatic identification technologies.

The UK’s health technologies sector is one of the most successful in the world. The NHS in the UK is regarded as one of the most respected health care systems in the world and it is considered well advanced in comparison to many other territories. The NHS is also set to be home to a £5 billion information technologies (IT). programme, the largest civil IT project in the world. The National Programme for IT will see the storage of more than 48 million patient records and will put in place an infrastructure which supports telemedicine and telecare. The project is also likely to support research, enabling patient confidential information sharing between manufacturers, policy makers, clinicians and innovators.

Continua Health Alliance is a group of technology and healthcare companies who are working to establish an ecosystem of connected personal health and fitness products and services. There are 43 “promoter” members focused on personal telehealth, fitness and well-being, and chronic disease management.

Other UK companies and organisations in this area include:

Sensitron UK offers medical software solutions to the healthcare market through its careTrends Wireless Bridge system. The system aims to minimise transcription errors and lag time between the reading and capture and documentation of clinical data, through wirelessly enabled medical devices at the bedside.

Lincoln-based Telemedcare has developed technology to aid health management, including smart home technologies, Home Telehealth monitoring for people managing long term conditions, and clinical systems for residential care facilities and community settings. Its product portfolio includes a home telehealth system, a medication management system and the PreventaFall Device.

iPLATO case study

“Healthcare markets across Europe are all very, very different and without the expertise of UK Trade & Investment we would never have been able fully to determine how they operate and what their priorities are.”

Tobias Alpsten

iPLATO

They hinder the efficiency of health centres and hospital outpatient clinics, they cause annoyance to countless health professionals and they cost the National Health Service millions of pounds in lost time and productivity.

But now the proportion of those troublesome people who arrange an appointment at the doctor’s surgery and then, frustratingly, fail to turn up – the “Do not attends” in National Health Service parlance – is shrinking daily as the result of a smart new mobile phone capability pioneered by a young UK company.

Patient Care Messaging, created by iPLATO Limited of London, automatically reminds outpatients about scheduled appointments using text messaging technology, a simple but highly effective way of prompting busy (or forgetful) British people to attend – or at least to text or call the surgery to cancel their appointments in advance.

Now, with the help of UK Trade & Investment, this service is set to extend into other developed countries, many of which suffer similarly high no-show figures. Patient Care Messaging, created by iPLATO Limited of London.

“Since we started on this healthcare project in 2004 we have been positively involved with UK Trade & Investment in terms of market research, particularly into the potentially very important healthcare market in Germany,” reports Tobias Alpsten, the head of iPLATO.

“UK Trade & Investment produced an extremely good analysis of non-UK markets, which saved us a lot of time and money in understanding the very complex relationships between healthcare payer and provider in markets outside the UK and the ways in which they interreact. Healthcare markets across Europe are all very, very different and without the expertise of UK Trade & Investment we would never have been able to fully determine how they operate and what their priorities are.

“Beyond Europe, we look forward to continuing our progress with UK Trade & Investment when we put our main product on the United States market, a move that will definitely happen this year.” Mr Alpsten says his company’s goal in the UK and, increasingly, in overseas markets is to help clients successfully exploit new, practical mobile phone-based methods to help solve their real-world business problems.

The UK Trade & Investment Passport to Export programme, which we have joined, has the potential to help us achieve this goal rapidly and effectively.

Respiratory anaesthetics

Respiratory anaesthetics covers anaesthesia machines, ventilators and patient monitoring devices and the UK market is currently valued at £23 million.

The University of Oxford is undertaking research of direct relevance to respiratory anaesthetics including the development of new apparatus to measure lung function using forced inspired oxygen gas, controlled by a lap-top computer, making it suitable for use at the bedside or on anaesthetised patients in operating theatres.

Scientists at the University are also investigating the development of a membrane-covered multimicroelectrode array sensor to measure the concentration of oxygen and carbon dioxide in gas mixtures. Simple changes to the membrane material will also allow the measurement of the concentration of inhalational anaesthetic agents in gas delivered to patients.

Other UK companies and organisations in this area include:

Smiths Medical is a leader in the supply of high quality disposable airway management products, with a range specifically designed for anaesthesia, including anaesthesia airway, pressure monitoring respiratory systems products.

General Anesthetic Services (GAS) is the world's largest independent vaporiser service provider, designing, manufacturing and servicing anaesthetic vaporisers. GAS. is the sole service provider to the NHS. Its GAV. and RM3 vaporisers are manufactured in the UK.

OES Medical is a UK based manufacturer of Anaesthesia equipment and accessories, including absorbers, anaesthetic machines, vaporisers and ventilators, through its in-house machine shop.

Infrastructure ppp

The UK Government is particularly keen to utilise private finance to help fund public sector development where it is value for money to do so. In 2006 there were 200 Private Finance Initiative projects with a capital value of £26 billion in the pipeline until 2010, making it one of the world’s largest programmes of investment in public service infrastructure through PFI and PPP. The NHS is the single largest user of PFI in the UK, with a programme valued at an estimated £7-9 billion.

There are more than 500 consultancy practices in the UK offering services to the healthcare sector, with several specialising in healthcare, including advising governments on how to structure and organise health services.

British project management healthcare contractors are also in demand overseas, with its 40 contractors earning approximately £25 million a year from international projects.

Investment and improvement in the NHS is a continual process, one example of which is the introduction of NHS Local Improvement Finance Trust (LIFT), which is encouraging private sector investment in frontline primary and community care settings.

The UK is also an attractive place for foreign-direct investment in infrastructure, as demonstrated by the recent announcement that Alexandria Real Estate Equities, Inc are making their first investment within Europe as the development partner for the 1.4 million sq feet commercialisation research campus at Edinburgh BioQuarter.

Partnership UK (PUK) is a public and private sector partnership, with a majority stake held by the private sector. Its Health branch aims to assist public sector bodies such as the Department of Health in England, NHS Trusts and Primary Care Trusts introduce investment with the ultimate aim of modernising the National Health Service. PUK Health's activities include large hospital renovations and working on the NHS Lift programme. PUK Health has also completed a number of assignments overseas, typically working alongside national or provincial administrations.

Imperial College London’s Tanaka Business School is home to the Health and Care Infrastructure Research and Innovation Centre. The centre focuses on the built and technical infrastructure for health and social care, with the aim of aiding the modernisation of the UK’s health and social care system.

The centre has seven research themes: managing innovation in a context of technological change, procurement for innovation, innovative design and construction, care delivery practices, delivering improved performance through operations management, knowledge management in complex systems and design and evaluation of integrated systems.

Other UK companies and organisations in this area include:

International Hospitals Group offers healthcare consultancy both in the UK and worldwide, having completed more than 400 contracts in 35 countries, from the design of small, mobile clinics, to the development of large general hospitals.

Surrey-based PRP Architects has a team of architects, designers and project managers who specialise in working on acute, intermediate and primary healthcare projects. Projects cover the procurement and design of buildings including PFI community hospitals, new wards and projects to upgrade existing hospital facilities.

Serco offers healthcare solutions, from small scale, local developments of new clinical services to major joint venture projects with some of the longestablished leading service providers to the NHS. The Hampshire-based company also provides integrated facilities management services to several NHS hospitals, including porterage, security, cleaning, catering, switchboard, estates and waste management. It also provides clinicians and nursing staff to a variety of front-line settings, such as “out of hours” care and in prisons.

Also providing service healthcare accommodation under the UK’s Private Finance Initiative is Consort Healthcare. The company is a joint venture between construction company Balfour Beatty and the Royal Bank of Scotland. Balfour Beatty’s building services arm, Haden Young takes up facilities management, such as providing security, cleaning, catering and laundry.

Carillion Health is a specialist division within Carillion Plc which aims to integrate the group’s health planning, design and building expertise with support service management. Through the LIFT programme, Carillion is developing “onestop” treatment centres in Birmingham and Solihull and a community health facility in Bradford, as well as working on hospitals in the UK and in Canada.

Carillion’s joint venture with Lodestone Patient Care and Clinicenta, has been set up with the aim of providing additional facilities and services for the NHS. The aim is to deliver services such as health planning and design, project management, equipment specification, supply and maintenance and training through one point of contact.

Ryderhks architects St George’s park Case Study

RyderHKS Architects’ portfolio includes the delivery of major hospital projects in both the acute and mental health sectors in addition to diagnostic and treatment centres, primary care facilities and community hospitals. One such project is St Georges Park.

Northumberland Tyne and Wear NHS Trust is one of the largest of its type in England, with a turnover of over of £270 million per annum, employing 7,500 staff and serving a population in excess of 1.4 million within an area of 3,500 sq miles. St George’s Park is situated in the Northumbrian market town of Morpeth and serves a population of 318,000 within an area of 2,500 sq miles.

A mental health community, St George’s Park’s internal and external spaces integrate to form a caring environment where the need for privacy, dignity, confidentiality, access, independence and patient choice are balanced against security, safety, flexibility and efficiency in the delivery of the service and maintenance of the premises.

The scale of the development responds to the range and type of services provided, including the provision of all patient accommodation at ground floor level.

Sustainability and evolution of the landscape was a fundamental part of the concept design - not just in terms of energy targets and running costs, but as a positive, ecologically responsible approach to hospital design.

The healing palette has enhanced lighting, art, colour, texture, pattern and volume. Internally, pastel colours achieve a calm atmosphere. Colours from the cooler end of the spectrum soothe and reduce stress and externally brighter warmer colours provide contrast, particularly within the village.

Room adjacencies provide clear observation lines for staff safety and unobtrusive supervision, to reflect the Trust’s clinical models of care.

Environmental parameters have been identified for each space and activity to include thermal comfort, air quality and lighting while facilitating patient choice as far as practicable. Natural light and ventilation is available to all occupied spaces to instil and enhance a sense of well being and provide choice in the control of the immediate environment to all users in so far as is clinically appropriate.

There is a strong sense of place and identity both internally and externally through the communication routes and interlinked external gardens and courtyards. Simple geometric forms and the selection of materials and colour break down the perceived mass of buildings and reveal distinct and interesting compositions at every turn.

The scale and variety of the mental health village is arranged about the village green to promote interaction between people.

Privacy is provided throughout. This extends to ensuring that users can reside in the units without undue nuisance or intrusion from other residents, staff and visitors, or from plant and equipment noise. This is balanced with the need for supervision, particularly where there may be a risk of violence or self harm, or where the frailty of the patient may mean that they need prompt assistance.

All bedrooms have en-suite accommodation. Careful attention to layout and detail has ensured that an appropriate level of privacy is provided in bedrooms, sanitary facilities, treatment, interview and meeting areas.

To bring the outside in, transitional spaces have been incorporated throughout, from day areas to therapeutic private gardens. By maximising views and access St George’s Park provides a restorative environment promoting healing and reducing recovery times in environments where views and nature are integrated.

Useful contacts

• The Association of British Healthcare Industries (ABHI) www.abhi.org.uk

• British Expertise www.britishexpertise.org

• The British Healthcare Trades Association (BHTA) www.bhta.net

• British Dental Trade Association (BDTA) www.bdta.org.uk

• Dental Laboratories Association (DLA) www.dla.org.uk

• Department of Health www.dh.gov.uk

• European Medicines Agency (EMEA) www.emea.eu.int

• Gambica www.gambica.org.uk

• Medilink www.medilink.co.uk

UK Trade & Investment

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