Physio innovations: bright ideas

How do you turn a great idea into a viable business or real-life product?

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Maximising a light bulb moment

These three ideas were developed in response to a challenge faced or identified by the respective innovators, one in her own family and two in the workplace. Bringing them to fruition has taken perseverance and persistence, and all three physios have increased their own knowledge in the process. 

The first innovative product was developed by Jenni Calcraft, a physiotherapist from Liverpool, following her personal experience of having a child who required tube feeding.

‘My son was born with additional health needs and became tube fed at the age of two due to an uncoordinated swallow,’ she explains.

‘He had to be fed via a pump and we were provided with a rucksack for him to carry his feed and pump. But when it arrived it was so heavy and bulky that he fell over backwards.’

The tube-feeding bag actually disabled her son more than his additional health needs, says Mrs Calcraft.

‘As a physiotherapist, I know that play and the freedom to move are essential for child development. But my son was unable to run, climb, fit in a swing or go down a slide with the standard issue rucksack, as it was simply too bulky.

‘Any parent would find this hard to stomach, but I felt completely unwilling to accept that my child’s physical development was going to be hindered by a rucksack.’

As a result, she joined forces with Mim Oldershaw, a nursing friend with a passion for textiles, and together they set out to design a more suitable tube-feeding bag, which would allow her son to remain active.

A versatile alternative

‘We talked to other parents of children requiring tube feeding, and we learnt that my son’s experience was by no means unique, and sadly toddlers were being confined to buggies for long periods during feeds,’ says Mrs Calcraft.

‘People voiced other needs for a rucksack solution: active children were feeling restricted, teenagers were refusing to wear the standard issue bags at school, adults reported frustratingly poor functionality . 

‘And all age and physical ability groups commented on the lack of individuality felt when you need to wear a rucksack that wasn’t of your choosing.

'As a physio I know that play and the freedom to move are essential for child development. But my son was unable to run, climb,fit in a swing or go down a slide with the standard issue rucksack, as it was simply too bulky'

‘So, it was clear that many people would benefit from having a bag like the one we had created.

‘We wanted to create a product that could turn any bag into a tube feeding bag in order to give total functionality and individuality to all ages of the tube feeding community.’

However, Mrs Calcraft says that designing such a versatile product proved to be a challenge, as there are three major nutrition companies operating in the UK and they all use different pumps and a wide variety of feed containers.

‘As a result, the idea for the final product, the TubieeGo insert, took a lot of trial and error. The time we realised that we could elasticate the feed container onto a removable plastic insert was a bit of a ‘eureka’ moment.’

Their finished product can be used with any of the feed containers used in the UK. And as well as offering ready-made bags, the entrepreneurs have introduced a bespoke service, which allows people to submit their favourite bag and have it adapted into a tube feeding bag.

‘Our very first bespoke adaptation was a Stella McCartney bag,’ says Mrs Calcraft.

A steep learning curve

It took less than a year to develop the product, and Mrs Calcraft says the main challenge during this time was navigating ‘a steep learning curve’.

‘Our backgrounds are in clinical practice and yet we were now designing, developing, testing, manufacturing, marketing and eventually selling a product,’ she says.

‘Every step we took required a period of learning, but thankfully we met a lot of people along the way who were willing to give their time and expertise to guide us in the right direction.’

The duo took advantage of various advisory services for start-up businesses, which provided them with education, support and a framework to help them achieve their objectives.

These included Liverpool-based organisations such as Dream High, The Women’s Organisation and the School for Social Entepreneurs.

‘We also gained invaluable advice from friends and the contacts of friends on issues ranging from accountancy 
to web design.’

Since launching the product, Mrs Calcraft says it’s wonderful to see the positive impact the idea has had on people’s overall quality of life.

‘As a physio, I find it very rewarding when I hear people are being more active thanks to their TubieeGo bags.’

Diagnosing with the aid of artificial intelligence

Artificial intelligence (AI) was the driver for Iain Loughran, an extended scope physio who works within a musculoskeletal (MSK) service at North Tees and Hartlepool NHS Trust.

He had his bright idea, for an AI software-based platform that could provide expert guidance to clinicians about musculoskeletal conditions, just over a year ago.

‘The initial idea came from various conversations I had with colleagues,’ Dr Loughran explains.

‘About the quality of referrals, the over-use of investigations, the difficulty of diagnosing MSK conditions – as most lack definitive tests – and the difficulty of navigating ever-changing MSK service designs in order to get patients in the right place at the right time.’

As a result, Dr Loughran began thinking about how an AI-based software system could be used as soon as patients present, to aid clinicians during the diagnostic process.

‘My aim is to improve the early diagnosis and management in primary care settings, with the focus being on physiotherapists, GPs and nurses who are typically the first point of contact,’ he says.

‘The software will provide them with the most likely diagnosis or differentials and highlight where further investigation or referral may be useful.

‘And it will directly link to up-to-date evidence on management, to help ensure patients start on the right treatment pathway as soon as possible.’

Improving outcomes and efficiency

Once fully developed, the system will be able to help clinicians identify the most likely diagnosis for people with MSK conditions, as well as highlighting when further procedures – such as blood tests, x-rays or MRI scans – are necessary and will actually improve the diagnostic process.

‘This should help with the shared decision-making process with patients, and hopefully improve patient outcomes and service efficiency. Unnecessary tests, and inappropriate or delayed referrals, have an impact on patient outcomes and on the capacity of already overstretched services.’

Dr Loughran formalised his ideas when he applied to be part of the Clinical Entrepreneur Programme, run by NHS England and Health Education England.

‘I did an accelerator programme at Teesside University over last summer and then started the Clinical Entrepreneur Programme in September last year.

‘This allowed me to move from initial concept to early prototype and I’m now seeking seed investment to take things forward.’

Time constraints

He says one of the main challenges, so far, has been finding enough time to develop the idea, while maintaining the responsibilities of his full-time job.

‘The balance between working on the prototype and pitching for funding is also difficult to strike as they both require massive time input,’ he says.

‘And as a non-technical founder, the software development will become a barrier. But most of the prototype development doesn’t actually require programming and can be done in a low tech way.’

In the short-term, Dr Loughran hopes to develop a ‘minimum viable product’ version of the software, so it can be tested clinically in primary care settings.

‘The longer-term goal would be to develop further features and scale-up use of the platform across the NHS.’

To sign up for updates about the project visit.

Educational animations

Sally Sheppard, team lead for women’s and men’s health physiotherapy at Poole Hospital NHS Trust, was keen to find a way to improve the availability of information for patients about pelvic health issues.

‘Patients were always telling me they wished they had known information about their problem long before they needed referral,’ she says.

To remedy this situation, Mrs Sheppard is developing a series of animations that set out to provide pelvic floor education to patients.

Although pelvic floor problems are common, she says some patients find it hard to have conversations about their issues, as they find it embarrassing.

To counter this, she wanted to come up with an idea that would help to put an end to such ‘taboo’ topics in healthcare, as well as finding a new way for patients to find help without feeling embarrassed.

‘I thought that animation would be a good solution. 

It is a means of communicating information quickly and visually, which often supplements the message.

‘A short animation can easily be watched again, whereas a detailed handout might not be read twice.‘And I knew they could also include an element of fun, while also sharing information that addresses the difficult nature of the symptoms.’

Gaining support

Although she possessed the necessary clinical knowledge and experience to underpin the project, Mrs Sheppard says she had no idea how to take her ideas forward and turn them into something concrete.

‘I didn’t know how to start my idea , as it would take time and required skills that I didn’t have,’ she says.

‘And I felt like a small part in a giant organisation, not knowing how to effect change on a large scale.’

As a result, she applied to the Clinical Entrepreneur Programme last year and successfully gained a place.

‘By virtue of the application process, which required references and an agreement with the workplace, they were able to formally offer me support, encouragement, interview preparation and really they began the growth in my skills even before I gained a place,’ she says.

‘The programme also offered me a fantastic mentor who unlocked the skills that I was missing and encouraged me to develop and grow my idea and my skillset.’

The animations are currently being developed and, once the initial versions are finished, will be assessed by patients.

‘I have plans to obtain user feedback, as this is essential. Then,  there will be iterations to make,’ says Mrs Sheppard.

As well as being of benefit to patients, by providing information about the symptoms of pelvic floor weakness and how to self-help, Mrs Sheppard hopes the animations will be useful to medical professionals too.

‘My small goal is to enable self-help prior to engagement with NHS services and to support patients within NHS services,’ she says.

‘And the larger goal is to contribute positively to moving away from the model of “suffering in silence” that is associated with symptoms of pelvic floor weakness in males and females.’ 

All three innovations have demonstrated wider benefits for their inventors who hope their example will lead to other people having the courage to develop their own bright ideas.  

Jenni’s top tips

  • Start some conversations – Just because you don’t know how to turn your idea into reality, doesn’t mean that nobody does. Picking up the phone often felt daunting, but we found that when we asked questions people were always happy to help and keen to give advice.
  • Be willing to take baby steps – The thought of turning your idea into reality may be overwhelming, but there is always one small achievable step you can make towards your goal. It may be simply learning about an area of business, or making a phone call enquiry. But once you’ve completed that step you move on to the next one. Over time, those baby steps build into big progress.
  • Expect a lot of setbacks (but enjoy them) – We quickly learnt that developing something new is full of ups and downs. There were numerous times that we faced problems that felt too big to overcome. But through perseverance, we learnt that you can navigate around most issues, and problem solving can become a fun part of the process. Don’t get despondent. Instead, try to view setbacks as simply challenges which will ultimately make your final outcome even better. 
  • For more information visit: www.tubieego.com

Iain’s top tips

  • Find out if there are any local accelerators or business advice programmes in your area. Most are run through local universities or councils. They can often provide bespoke business start-up advice which is generally free for pre start-ups/ early start-ups, and there are often small funding streams available of up to £5,000. And some NHS trusts have commercial teams that could offer you support as well.
  • Validate your idea early. Talk to colleagues, talk to patients, talk to other people who have done similar things. Most entrepreneurs are very happy to give advice and support. They appreciate how hard it can be to start out and are willing to help where they can. Developing a network early is very supportive in the long run.
  • Apply to the Clinical Entrepreneur Programme. It provides excellent training and access to an expert network.
  • Consider the time commitment. 
  • If you’re working full time, be aware of how much time and effort is required to get a start-up idea off the ground and to market. Finding a co-founder or partner to work on the idea is worth considering, as things tend to move forward much faster that way. But make sure you’re aware of what happens down the road.

Sally’s top tips

  • Never stop reviewing your idea
  • Be prepared to change it for the better
  • Ask others what they think and learn from their feedback

Clinical Entrepreneur Programme

Sally Sheppard and Iain Loughran have both benefited from the guidance and support they have received from the Clinical Entrepreneur Programme.

The annual programme, run by NHS England and Health Education England, aims to provide opportunities for health professionals to develop their entrepreneurial skills. Successful applicants gain access to funding, industry placements, mentoring and coaching, business development and procurement knowledge.

‘The training sessions are the most extraordinary events, filled with lectures from high performing experts in their field who give their time and knowledge so generously, says Ms Sheppard.

The programme also involves ‘pit stop events’, where leading speakers advise participants on various business and entrepreneurial topics, as well as talks from founders who have previously been through the programme.

‘You are also allocated a mentor and receive a minimum of four hours coaching across the programme,’ Dr Loughran says.

‘And there are opportunities to network with clinical, academic and industry people who can help drive your idea forward.’

Ms Sheppard agrees: ‘It gives you the opportunity to build a diverse network with other like-minded clinical entrepreneurs, who are multidisciplinary and have a passion for driving change in the workplace to benefit the system we work within and patients who use the services.’  

Find out more

Interested in innovative physio practice? 

Visit the Innovations in Physiotherapy database

It’s a platform for showcasing and sharing CSP members’ success and creativity in practice.

Read evidence-based examples that demonstrate our expertise and ability to innovate, adapt and deliver for patients across all areas of physiotherapy. 

Share successes and learning points among members, teams and regions.

Submit your own innovation. We are looking for examples from all areas of practice, which demonstrate innovative and adaptive ways of working to meet the needs of physiotherapy practice, management, education or policy.

The types of projects on the database include:

  • Evaluations of new/unique services or approaches 
  • Clinical audits
  • Systematic reviews exploring innovative approaches

Author : Robert Millett 

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