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My invention: pocket flow spacer inhalers for children

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We talk to Paul Watson, school nurse, who developed the POCKETFLOWSpacer for children

Paul Watson RN, BA(Hons), PGCE, MIfL, school nurse, Downham Market Health Centre, inventor of the POCKETFLOWSpacer for inhalers used by children with asthma

1.  What is your background in nursing and what is your current job?

Following completion of my engineering diploma I had various jobs ranging from special constable to retail manager to Production Engineer and some in between. I eventually came into the NHS as a healthcare assistant following a short period of unemployment and was soon seconded to start my registered nurse training. Once qualified I worked on a busy Medical Admissions Unit (MAU) learning to deal with a fast-paced exciting role, working as part of a busy, committed team. After a short time I saw the opportunity to move into the local Walk-in-Centre and stayed there until another fantastic opportunity presented itself to me. I was seconded once again, this time going back to university to get my specialist practitioner degree in School Nursing. Since then, I have continued to work as a nurse in several schools, and have recently completed my Postgraduate Certificate in Practice Education. I continue to work as a School Nurse, working with young people around safeguarding issues and delivering health promotion and education within schools.

2.  What inspired your invention?

My youngest daughter was diagnosed with asthma aged six months, and had been using inhalers since. When she was five, she became very ill, suffering from a nasty asthma attack.

Rushing her into hospital, I was greeted by staff who advised me that she needed more medication and kept telling him to double the dose. I’d have advised the same thing had I been in their shoes, But something in me told me that wasn’t the case. It looked like an extreme allergic reaction to me, so I made an executive decision to stop giving her the medicine that night and the symptoms stopped right then. It turned out that Katherine was not taking her medication properly, it was getting stuck in the back of her throat, which had caused the allergic reaction. It was at that point that I decided a new product was needed to prevent this from happening to other children.

3.  What problem is it trying to solve?

Pressurised metered dose inhalers (pMDI) are widely used for the long-term management of asthma.  However there are a number of problems associated with their use. The amount of drug delivered to the lower airway can be limited by the size of the particles produced, there may be problems with lack of co-ordination between actuation and dose inhalation or adverse effects including oral candidiasis and dysphonia could occur.
Large-volume spacer devices, introduced to overcome these problems, can create difficulties themselves as they are large and cumbersome, bulky to carry around and complicated for children to use. The incorrect usage of asthma inhalers can lead to a poor uptake of medication, increased prescriptions, increased hospital admissions and elevated costs to the NHS. The POCKETFLOWSpacer has been designed to encourage all asthma sufferers to use their inhaler through a spacer device, but especially children and young people. The POCKETFLOWSpacer has been designed to be portable and easy to use. Following extensive testing it has proved to be effective, leading to a better absorption of medication and cost savings to the NHS.

4.  What financial or other user benefits are there?

There are currently 5.4 million patients with asthma and 900,000 with chronic obstructive pulmonary disease in the UK. The NHS spends around £1 billion per year on the treatment of chronic and acute asthma (Asthma 2008) representing almost 1% of its annual budget devoted to this one condition alone. Emergency admissions as a result of asthma cost the NHS over £36 million in the financial year 2008 to 2009. It is estimated that up to 75% of emergency admissions for asthma could be prevented with proper medication and device usage.
Cost savings to the NHS could range between £1,854,600 and £6,435,000 annually if POCKETFLOWSpacer were to replace other spacer devices. In addition, using a portable spacer could also result in fewer emergency admissions to hospitals, saving the NHS up to £11.5 million per year.

5.  How did you go about developing it?

Once I had come up with the idea, I approached the local innovation hub, Health Enterprise East (HEE). It helped to take the concept through design, computer modelling and prototyping. This has now moved onto manufacturing and is with a company who are continuing with the research and development before bringing it to the market.

6.  What obstacles did you encounter and how did you overcome them?

My biggest obstacle was time. I have been lucky that HEE have taken on the management of the project, as without their direction and management there would be no POCKETFLOWSpacer. I have completed my research and all communication around this project in my own time and out of hours (often to the disgust of my family). HEE has assisted with advice on intellectual property, licensing and accessing a suitable commercial partner.

7.  Is it going into commercial production? If so, when?

I have been lucky to have been advised and helped to find commercial partner, Vivo Smart Medical Devices, by Health Enterprise East, the NHS innovation hub at Papworth. Vivo showcased POCKETFLOWSpacer at the recent international Medica exhibition in Dusseldorf and is hoping to take the new spacer into commercial production within 2012.

8.  What do you hope for the future of your product?

It would be my dream to see this product being used by children whenever they use their inhaler. I want to be able to walk into a school playground and see the POCKETFLOWSpacer being used and think to myself “I designed that”. I want to see that by using this product patients are benefiting, and in turn the NHS has less cost associated to the condition that they can in turn put into other conditions.

9. Have you come up with any other ideas or products?

The POCKETFLOWSpacer is the only product that I have managed to move towards commercial production at the moment, although I have designed several other nursing models and devices, most have not been developed or moved forward. In 2008 I was a finalist in the Management in Practice Awards, Innovation in Training for a new Reflective Learning Model that I designed. 2011 saw me once again being a fFinalist at the General Practice Awards, Innovators of the year, for an Enuresis (Bed wetting) program for practitioners conducting enuresis clinics.  I am proud to say that I have been awarded the Alumni Success in Business Award from Anglia Ruskin University in 2011 for my work with the POCKETFLOWSpacer and I am hoping to progress some of my other ideas in 2012.

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