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The medic of the future - CDE themed call launch 16 July 2013

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Slides from launch event on 16 July 2013 for CDE themed call for research proposals. For full details of this call see: http://www.science.mod.uk/events/event_detail.aspx?eventid=260

Slides from launch event on 16 July 2013 for CDE themed call for research proposals. For full details of this call see: http://www.science.mod.uk/events/event_detail.aspx?eventid=260


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  • 1. © Crown copyright 2013 Dstl 23 July 2013
  • 2. The Medic of the Future Centre for Defence Enterprise
  • 3. Rapid technological change
  • 4. © Crown Copyright MOD 2011 The aim of CDE
  • 5. © Crown Copyright MOD 2011 Prove the value of novel, high-risk, high-potential-benefit research
  • 6. © Crown Copyright MOD 2011 To enable development of cost- effective military capability advantage
  • 7. 23 July 2013 Five key operating principles underpin the CDE model
  • 8. Engaging innovators
  • 9. 23 July 2013 Accessible opportunity
  • 10. Sustaining incentives
  • 11. Minimising participation costs
  • 12. Compliance
  • 13. Intellectual property
  • 14. Two routes to funding
  • 15. Online bid submission
  • 16. Themed calls
  • 17. CDE themed call programme Secure communications Call close 22 Aug 2013 Innovation in drug development processes Call close 29 Aug 2013 The medic of the future Call close 5 Sept 2013 Novel solutions for emulating ship signatures Call launch 23 Jul 2013 Strengthening biological security Call launch 17 Sept 2013 Register and further details at www.science.mod.uk under ‘Events and Calls’ All calls close at 17:00 hrs
  • 18. Defence Open Call
  • 19. Seeking the exceptional
  • 20. 4568 proposals received
  • 21. 17% proposals funded
  • 22. £41.5M contracts awarded
  • 23. Exemplar project
  • 24. Fuel efficiency
  • 25. ‘Micro generators’
  • 26. © Crown Copyright MOD 2011 Effective proposals
  • 27. Challenge, pace & exploitation
  • 28. The future of CDE
  • 29. The Medic of the Future
  • 30. Network and question
  • 31. Centre for Defence Enterprise 01235 438445 cde@dstl.gov.uk www.science.mod.uk/enterprise
  • 32. Surgeon General Defence Medical Services Air Marshal Paul Evans Surgeon General
  • 33. Surgeon General Defence Medical Services Mission Our Mission. Provide health policy & advice, healthcare and medical operational capability in order to maximise the fighting power of the Armed Forces
  • 34. Surgeon General AIM To PROMOTE, PROTECT & RESTORE the health of the Defence population in order to maximise fitness for role Aim of the Defence Medical Services HealthcareAdvice Operational Capability THE STRATEGY FOR THE DMS
  • 35. Surgeon General Role of Surgeon General End to end process owner of healthcare pathway for Service personnel Head of Service CEO of Defence Medical Services
  • 36. Surgeon General
  • 37. Surgeon General Scope Main Effort • Operations: Afghanistan & return to contingency Primary Care Rehabilitation & Mental Health Secondary Care Education & Training Research Current Issues/Discussion Points
  • 38. Surgeon General The Operational Patient Care Pathway
  • 39. Surgeon General The Operational Patient Care Pathway  Point of Wounding }  Buddy-Buddy Care } Pre-hosp  Role 1 Effect – Medic + Doc }  Evacuation – Damage Control Resuscitation } Care  Role 2/3 • Damage Control Resuscitation • Damage Control Surgery • Hold  Evacuation • Tactical • Strategic
  • 40. Surgeon General The Operational Patient Care Pathway Role 4 • Royal Centre for Defence Medicine – Birmingham – Clinical Care – Support to the Patient Group • Defence Medical Rehabilitation Centre Headley Court  Return to Duty / Medical Discharge
  • 41. Surgeon General Operating Theatre History Number of trips to theatre 27 Specialities involved 6 inc: Orthopaedics, Plastic Surgeons, Vascular, Urology, General Surgeons, Intensivists. Total amount of time spent in surgery 75 hours & 15 mins Theatre trip time length Shortest: 1hr 15 mins Longest: 6hrs Procedures included Femoral nail, closure of abdo, consistent debridement & washout of all wounds, reconstructive soft tissue flap, split skin grafting, colostomy, insertion of iliosacral screws, changing of dressings, inc application of TNP & other necessary procedures
  • 42. Surgeon General The Operational Patient Care Pathway - Issues Golden Hour Bastion Vs Tent Time to Evacuation
  • 43. Surgeon General The formation of Defence Primary Healthcare means that SG will now deliver end-to-end clinical care in the firm base and the permanent bases overseas •More efficient use of personnel & resources; •Quicker implementation of healthcare policy & Defence change; •Better governance and performance management; •Better links with the NHS to manage access to secondary care; •More attractive employer for clinicians and administrative staff. Defence Primary Healthcare - Implications Key Benefits
  • 44. Surgeon General Primary Care 1 Apr 13 – Defence Primary Healthcare Care SG now directly accountable for tri-Service primary care delivery with budget DMS legislated to provide primary care Occupational Primary Care Service • Return to duty philosophy
  • 45. Surgeon General Defence Medical Rehabilitation Programme  Tiered approach – Multidisciplinary occupational approach  Tier 1 – Primary Care Rehabilitative Facility (PCRF)  Tier 2 – Regional Rehabilitation Unit (RRU) • 16 in UK • Function: – Medical Injury Assessment Clinic (MIAC) – Group Treatment capability  Tier 3 – Defence Medical Rehabilitation Centre (DMRC) • Complex Trauma • Musculoskeletal • Neuro
  • 46. Surgeon General The Future – Defence National Rehabilitation Centre A decision on a Defence National Rehabilitation Centre to meet future UK rehabilitation needs is likely this year •With a Defence element at its core, it would replace Headley Court •A campaign to raise £300M is being led by the Duke of Westminster •The Duke has already acquired a site – Stanford Hall in the Midlands •An announcement is likely once £200M has been raised (possibly later in 2013) •If confirmed, the intention would be to open the Defence element in 2017
  • 47. Surgeon General Defence Mental Health Occupational Community based service Departments of Community Mental Health (DCMHs) • Multidisciplinary – Psychiatrists, Clinical Psychologists, Mental Health nurses & social workers • 13 in UK Minimal requirement for in-patient capability • NHS contracted service with South Staffs consortium • NB – Lower admission threshold Academic Centre for Defence Mental Health - Kings
  • 48. Surgeon General Secondary Care NHS Provision under our entitled access to secondary care • Vast majority for provided under NHS routine access driven by clinical need • Majority of elective care is outpatient or day case • Contract for rapid access to Imaging & Operative orthopaedic care
  • 49. Surgeon General Strategic Challenges – Secondary Care Commissioning We need to resolve uncertainty about funding to meet the secondary care needs of Service personnel under new NHS arrangements. •Funding for military patients will be held centrally by NHS England, not regionally. •Will funding requirement be calculated accurately? •Discussions held up by delays to establishing posts within NHS England. •There is uncertainty about who will fund occupational referrals. •Our position: Any funding shortage should be a NHS risk not a Defence one.
  • 50. Surgeon General Education & Training Doctors: • Medical Cadets • Specialist training • GPVT • Direct Entrants Nurses • Direct Entrants • In-house Nurse Training – Birmingham City University AHPs • Some In-house some recruited post training
  • 51. Surgeon General Education & Training Defence Medic • Current Training Programme – Common Core 20 weeks – Individual Services Army/RAF – 7 weeks RN – 19 weeks – Professional Status – Keogh Barracks Aldershot
  • 52. Surgeon General The Future – Creating a Regional Centre of Excellence DMS Whittington will be at the hub of a regionally-based centre of professional excellence for the 21st Century •£138m construction including HQ, training and accommodation •Future home for over 1,000 military and 400 civilian staff •Phase 2 Construction will be completed by Feb 2014 •Currently on-time/on-budget/to user- defined requirement •Feedback is good across the board
  • 53. Surgeon General Research Created Medical Director post in 2009 Mission: To support deployed DMS personnel through academia, research, clinical policy, personnel management, and equipment capability developments, which ensure the highest standards of governance, whilst continually promoting innovative, world leading, quality and safe patient care.
  • 54. Surgeon General JMC Medical Directorate Title ‘Medical Director’ aligns to NHS titles Job is outward looking to civilian NHS and academic practice Combines professional leadership with academic research Development of Clinical Policy and provision of clinical advice to Theatre/PJHQ in real time
  • 55. Surgeon General Defence Medical Academia 8 Defence Profs with senior lecturers and lecturers • Emergency Medicine • Surgery • Orthopaedics • Medicine • Anaesthetics & Critical Care • General Practice (GP) • Mental Health • Nursing Royal College recognition All are deployable and most have deployed in last 18 months
  • 56. Surgeon General DMS Academia & Research Research is focussed through SG’s Research Plan Multiple Internal, National and International Collaborative Partners (Dstl, Russell Group Universities, NIHR, TRBL Blast Centre, US, NATO Research and audit is part of medical revalidation Clearance of all clinical papers End users are often the researchers – unique to Defence
  • 57. Surgeon General Issues
  • 58. Surgeon General QUALITY AND ASSURANCE Care Quality Commission • Very positive review of both Primary and secondary care including operational environment Inspector General • Accountable to SG Defence Internal Audit Joint Force Command / SoS /HCDC
  • 59. Surgeon General Revalidation No different from civilian requirement NB – full clinical practice • Operations Role of Medical Manager
  • 60. Surgeon General Clinical Skills post Afghanistan Is a ‘dip’ in performance inevitable following draw-down in Afghanistan and if so, how deep will it be? •Unless maintained, skills will have to be relearned on the next campaign. •Will we retain our most able people if we return to a ‘peace-time’ routine? •Our Position. To maintain hard-won skills, we need to provide: •quality clinical placements, •exposure to simulation, •rewarding research opportunities •‘real-life’ opportunities
  • 61. Surgeon General  Changes in NHS  Efficiency pressures in NHS.  DH committed to development of new, mutually beneficial arrangements.  Includes DAs on Partnership Board  Placements for Secondary Healthcare Personnel  Level 1/Major Trauma Centres  Current MDHU Arrangements (placements & commissioning) no longer fit for purpose  Review has DH support.  DMG Scotland  Partnerships & Collaboration  Generate symbiotic relationships Changes in NHS England
  • 62. Surgeon General Conclusion
  • 63. Surgeon General VISION To be recognised by those we serve as a World Leader in military healthcare and health advice THE STRATEGY FOR THE DMS
  • 64. Surgeon General THE STRATEGY FOR THE DMS VALUES Excellence, by striving for continuous improvement and the highest quality in all that we do Commitment to patients, and evidence-based practice Integrity, by adhering to the highest professional and ethical standards, maintaining the trust and confidence of all with whom we engage Teamwork and leadership, which are key to success Respect, by treating those with whom we serve and work with dignity and respect
  • 65. MOD Medical Sciences Research Programme Overview Surgeon Commodore Alasdair Walker, Joint Medical Command Neal Smith, Dstl Programme Delivery Directorate 16 July 2013 © Crown copyright 2013 Dstl 23 July 2013
  • 66. Defence S&T Medical Sciences Programme 23 July 2013 © Dstl Casualty Care To investigate techniques and interventions that address complex injuries from current and emerging battlefield threats in conventional (non-CBRN) warfare. Force Effectiveness and Rehabilitation Focused on improving numbers of those fit to deploy, improving the quality of life of survivors from military conflict, minimising residual disability and providing aftercare support to wounded veterans. Medical Systems Research, develop and evaluate systems that will maintain and/or enhance the effectiveness of deployed forces in extreme and austere environments and produce medical treatments, interventions and rehabilitative support to injured personnel.
  • 67. Defence S&T Medical Sciences Programme 23 July 2013 © Dstl Casualty Care • Resuscitation • Haemorrhage Control • Battlefield Pain Management • Blast Injury Characterisation • Extremity Trauma
  • 68. Defence S&T Medical Sciences Programme 23 July 2013 © Dstl Force Effectiveness and Rehabilitation NIHR Programme (Joint MoD/Department of Health) • Acute response to injury • Microbiology • Regenerative/Reconstruction Medicine King’s Centre for Military Health Research • Long term investigation into possible health effects of operational deployment among UK Armed Forces personnel (initiated 2003) Health & Well-Being • Potential chronic health effects • Help seeking behaviours and stigma reduction • Nutrition • Noise Induced Hearing Loss & Vibration
  • 69. Defence S&T Medical Sciences Programme 23 July 2013 © Dstl Medical Systems Centre for Defence Enterprise 2012: The Extremes of Defence Medical Capability • Small Rugged Blood Fridge • Spiral peripheral nerve interface • Knitted prosthetic sleeves • Integrated patient monitor • One arm drive wheelchair Today… 2013: The Medic of the Future: Training and Support
  • 70. CDE Medical Call 2013 The Medic of the Future: Training and Support 16 July 2013 UNCLASSIFIED FOR PUBLIC RELEASE © Crown copyright 2013 Dstl 23 July 2013
  • 71. The Medic of the Future: Training and Support • Context • Technology Challenges: – 1: Exploring the potential of simulated training and high- fidelity models – 2: Identifying novel systems that will help those injured in battle • Exploitation UNCLASSIFIED FOR PUBLIC RELEASE © Crown copyright 2013 Dstl 23 July 2013
  • 72. The Medic of the Future: Training and Support • Context – The human component is central to delivering military capability – Provision of sufficient, capable and appropriately trained personnel is critical to operational success – There is a need to sustain capability by protection, treatment and rehabilitation – Provision of high quality support, care and treatment at all points along the continuum of care is essential © Crown copyright 2013 Dstl 23 July 2013 UNCLASSIFIED FOR PUBLIC RELEASE
  • 73. The Medic of the Future: Training and Support Technology Challenge 1 • Exploring the development of high fidelity models with enhanced haptic feedback to replace existing live simulation methods especially in advanced clinical practice and surgery – Simulated Environments – Mannequins – Synthetic tissue – Trauma scenario simulation – Virtual coaching © Crown copyright 2013 Dstl 23 July 2013 UNCLASSIFIED FOR PUBLIC RELEASE
  • 74. The Medic of the Future: Training and Support Technology Challenge 1 • We want systems which: – Novel and innovative systems – Consider cost to MOD of introduction – Provide realistic scenarios, but avoid live models – Consider standards and measures of competency – Provide constructive feedback to trainees and trainers – Demonstration of proof-of-concept for further investigation. © Crown copyright 2013 Dstl 23 July 2013 UNCLASSIFIED FOR PUBLIC RELEASE
  • 75. The Medic of the Future: Training and Support Technology Challenge 1 • What we don’t want – Management or provision of training services. – Consultancy on training and education. – Existing ‘off the shelf’ products. © Crown copyright 2013 Dstl 23 July 2013 UNCLASSIFIED FOR PUBLIC RELEASE
  • 76. The Medic of the Future: Training and Support Technology Challenge 2 • Identifying novel systems that will help those injured in battle • Opportunities to maintain force effectiveness – Equipment enhancements – Easing burden for the battlefield medic – Enhanced protection for patients • Military Patient Transport – Reducing contamination and infection – Enhancing safety and protection © Crown copyright 2013 Dstl 23 July 2013 UNCLASSIFIED FOR PUBLIC RELEASE
  • 77. The Medic of the Future: Training and Support Technology Challenge 2 • What we want – Novel and innovative systems – Proposals that demonstrate the benefits of tailoring conventional medical systems to bespoke defence challenges – Demonstration of proof-of-concept for further investigation • What we don’t want – Systems which result in an unrealistic burden on other components of capability © Crown copyright 2013 Dstl 23 July 2013 UNCLASSIFIED FOR PUBLIC RELEASE
  • 78. The Medic of the Future: Training and Support Exploitation • Research integration – Medical Sciences Programme – Training & Education Programme • Procurement – Refine, trial or purchase • Policy – Refinement and implement – Development of doctrine © Crown copyright 2013 Dstl 23 July 2013 UNCLASSIFIED FOR PUBLIC RELEASE
  • 79. The Medic of the Future: Training and Support Summary • Technology Challenges – 1: Exploring the potential of simulated training and high-fidelity models – 2: Identifying novel systems that will help those injured in battle • What we want – Novel and innovative systems – Systems which consider full cost of introduction – Realistic models that assist training – Systems which ease the burden of the battlefield medic – Enhancements for patient and medic safety – Demonstration of proof-of-concept for further investigation © Crown copyright 2013 Dstl 23 July 2013 UNCLASSIFIED FOR PUBLIC RELEASE
  • 80. Centre for Defence Enterprise Submitting a Successful Proposal Centre for Defence Enterprise
  • 81. Maximising your chances
  • 82. Know what is available
  • 83. Know what is available
  • 84. Know what is available
  • 85. Read available information Start with – Quick Start Guide plus other CDE manuals – Account Manual, User Manual, Technology Application Manual Know what is available
  • 86. Know what is available
  • 87. Developing a CDE proposal
  • 88. Value from technology Innovative concept Future capability Proof of concept Incremental development
  • 89. The essentials
  • 90. Description
  • 91. mins Assessment
  • 92. Not an exam
  • 93. MOD Performance Assessment Framework Five criteria: Operational relevance Likelihood of exploitation Builds critical S&T capability Scientific quality/innovation Science, innovation and technology risk
  • 94. Commercial tab
  • 95. Government-furnished X
  • 96. Health and safety
  • 97. Ethics
  • 98. Unclassified
  • 99. Proposal health check
  • 100. Claim of future benefit
  • 101. Contribution to future benefit
  • 102. Logical programme of work
  • 103. Generation of evidence
  • 104. Demonstration of progress
  • 105. Based on a claim of future benefit Contribution to realisation of future benefit Logical programme of work Evidential outcomes Demonstration of progress towards goal Health check
  • 106. Early birds
  • 107. This call closes: 17:00 hrs on Thursday 5September 2013 Deadline
  • 108. www.science.mod.uk Events and Calls > Current calls for proposals > The Medic of the Future Webinar:23 July 2013 14:30-15:30 Register online Further information
  • 109. Centre for Defence Enterprise cde@dstl.gov.uk www.science.mod.uk/enterprise Call process queries
  • 110. The Medic of the Future
  • 111. © Crown copyright 2013 Dstl23 July 2013 1. Exploring the potential of simulated training and high-fidelity models 2. Identifying novel systems that will help those injured in battle Technology Challenges
  • 112. HD&MSDomain@dstl.gov.uk Call technical queries
  • 113. © Crown copyright 2013 Dstl 23 July 2013