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South Derbyshire NHS team share their experience with Silhouette for Diabetes Foot care


Learn more about how Silhouette is supporting integrated diabetes foot care in South Derbyshire

Video by kind permission of East Midlands Academic Health Science Network  


A new video from East Midlands Academic Health Sciences Network (EMAHSN) gives an insider view on South Derbyshire's technology-enabled diabetes foot care service which is deploying Silhouette®, an innovative digital wound assessment solution

The new model of care is supporting efficient MDFT service access across Derby Teaching Hospitals NHS Foundation Trust and Derbyshire Community Health Services NHS Foundation Trust by enabling care in community clinics with oversight from acute MDFT clinical leads. The Silhouette solution is empowering staff with remote access to real time diabetes foot ulcer assessment data including digital images, 3D measurements, ulcer healing charts and electronic clinical notes, making referral of care a much simpler process for the clinician.

The video features the Lead Clinicians from the NHS Provider Trusts, the Clinical Commissioning Lead, Patients and collaboration partners EMAHSN as the innovation catalyst and industry partners Entec Health Limited and Aranz Medical Ltd.

Watch the video to get a close and personal account of the digital health innovation journey and the benefits gained from the adoption of the new Silhouette technology in the South Derbyshire diabetes foot care pathway.

 Testimonials from the featured EMAHSN video

 FG, DB,CW - testimonials (3)

MH, testimonial (2)

DC, testimonial (2)



Learn more

Download new case studyDiabetes Foot Care – Integrated diabetes foot pathway, South Derbyshire, February 2019

Visit Silhouette for Diabetes Foot Management Application 

Book a conversation or Silhouette demonstration meeting with Entec Health: Email us at 

Watch Entec Health 2018 Highlights

The team at Entec Health has enjoyed a fantastic year, working together with our customers and partners. As many of you will know, Entec Health supports wound care transformation with a proven portfolio of enabling technologies. The offering includes the Silhouette wound assessment solution and the Wound Care Buddy App. As a team we have achieved some incredible milestones, with a shared mission to enable health innovation and ultimately, to help improve patient experience and patient care outcomes. 

Thank you to all our clients and partners who have made this success possible during 2018. Hope you enjoy watching the 2018 highlights from an amazing year captured in our short review video. 


Watch Entec Health 2018 Highlights here

It has been very rewarding to collaborate with pioneering and committed leaders and teams in the NHS, AHSNs and the wider healthcare community. We have shown that, together, we can develop and deliver new practices and new models of care in diabetes foot care and wound care to support sustainable healthcare services and improved patient experience.

Visit Diabetes Foot Care, Chronic Wound Management, Wound Formulary Management on our website to learn more.

Are you a healthcare innovator with a similar vision for the future? We are here to learn together and collaborate. Please drop us a line at to discuss your future plans for diabetes foot care, tissue viability and community nursing service development.

We look forward to working with our clients and partners in 2019 for more success in digitally-enabled health innovation.

Wishing you a Prosperous, Happy and Healthy New Year for 2019.

Best wishes from all the team at Entec Health



Introducing the New Generation of Silhouette digital wound assessment solutions

Entec Health is excited to present the New Generation of Silhouette, featuring SilhouetteStar2, SilhouetteLite+ and SilhouetteLite. The new Silhouette suite enables wound care specialists to assess patient wound outcomes in a range of care settings using digital wound imaging with the option of 3D or 2D wound measurement.

The wound data collected by the Silhouette devices is synchronised with a centrally hosted database, SilhouetteCentral. SilhouetteCentral is a web-based application and can be accessed remotely when a secure network connection is available. The point of care wound assessment device options include the SilhouetteStar2 3D measurement wireless camera, SilhouetteLite+ Application and 2D measurement Sensor for iPad/iPhone and the SilhouetteLite App for iOS devices.


Watch the Silhouette New Generation Suite video to learn more 


Silhouette New Generation overview video

To learn more, head to our Silhouette New Generation webpage to watch our video demonstrations

The Silhouette solution offers the following benefits to NHS Trusts and other healthcare providers: 

  • Fast, easy, objective wound assessment at the point of care
  • Supports outcomes-led practice for integrated, multi-disciplinary care of patients
  • Enables organisations to empower and equip clinicians to achieve improvements in wound outcomes, safety, patient experience and cost effectiveness
Email us at to book a call to discuss your wound care service development plans and how we can help. 

Silhouette is a registered trademark of ARANZ Healthcare Limited

The True Cost of Wound Care

Paper published in the BMJ Open [1] evaluates the annual NHS cost of managing wounds and associated co-morbidities as £5.3billion– comparable to cost of obesity [2].

I find this a surprising even staggering statistic. This has not been on my radar before and I am wondering how may NHS CEOs, CCG Commissioners, Finance Directors, LA Commissioners, clinical leaders and service managers have a grasp of the true cost of wound care?


Infographic © Entec Health March 2016

If this was a paper on obesity, diabetes or mental health, I wonder if its eye-opening findings would have been so hidden from the mainstream view?  So why is wound care so often the overlooked, day-to-day service of the NHS? As a nurse-led service, the care of patients is predominantly managed within the community. Is the lack of visibility therefore as a result of wound care not being physically represented in its true volume as a full waiting room or secondary care waiting list?

Messages I took from this BMJ Open article:

  • Eye-watering cost to health care of managing wounds and associated co-morbidities at £5.30 billion per annum, which when adjusted for comorbidities still runs at £5.1 to £4.5 billion.
  • Management is predominantly nurse led and as such receives far less attention as a service
  • “Clinical and economic benefits could accrue from improved systems of care and an increased awareness of the impact that wounds impose on patients and the NHS”


Infographic © Entec Health March 2016

So does this article cover the full cost of wound care?

The paper by Guest at al [1] takes into account the cost of health professionals’ time and prescribed products, but does not include social care costs (additional support at home, home adaptations, equipment and admissions to long term care).

The paper cites “Also excluded were the costs incurred by patients taking time off work. However, patients’ mean age was >65years, so it is unlikely that many were in employment”.  I would add to this – their family are likely to be in employment, and equally likely to be taking time off work to attend clinic appointments with patients and provide unpaid care.  How many will have had to give up work entirely in order to provide full-time care? 


“Invisible” patients lost in the system? 

Posnett et al [3] concluded in 2008 that 400,000 new pressure ulcers were occurring in the UK each year, whereas Guest et al cite a prevalence of 153,000.  This is a vast difference that Guest postulates could be accounted for by management in care and nursing homes – care predominantly provided by private providers on behalf of local authorities, leaving both open to additional management costs and risk of litigation.


The price of poor management of pressure ulcers

Pressure ulcers as an example, are seen as avoidable, although frequently an outcome of medical care.  Prevention of pressure ulcers is a key focus and rightly so. However, there is ample opportunity to also improve outcomes for those individuals already suffering from these painful and life-impairing wounds.  A recent request to the NHS Litigation Authority under Freedom of Information [4] has identified the cost of claims for clinical negligence associated with pressure sores from April 2010 to April 2015 is just under £19 million, with the cost of claims in the 2014/15 tax year alone exceeding £7.1 million for 172 successful claims. 

Each of these claims represents an individual person whose life has been blighted, distraught families, friends and loss of life quality.  No matter what we say about today’s litigious society, the decision to take legal action, with the time and stress involved is not an easy one.  Imagine feeling aggrieved enough to sue on behalf of yourself or your loved one.  Surely if curative actions were taken promptly, effectively, and accountably, the psychological impact of the injury could be reduced and we would hope the healing time improved.

What about the cost to social care?

Those admitted to long term care, already have a tendency towards conditions which reduce mobility and tissue viability.  Taylor et al 2010 [5] identified the following pre-existing conditions on admissions to long-term care in Oxfordshire:

Urinary incontinence                45%

Dementia                                 40%

Bowel incontinence                  34%

Depression                               25%

Visual impairment                    21%

Stroke                                      19%

Diabetes                                   17%

COPD                                       6%

Learning disability                     2%

Criteria for council funded admission for long-term care is stringent, these people already require a high level of support, add a poorly managed leg ulcer or pressure ulcer and mobility is further impacted, making the complexity and cost of management far higher.

How can we assess if money is being spent effectively on treatment?

Wound care forms part of community care provision, predominantly through district and community nursing.

The major concern over this state of affairs is that money is pouring into the service (whether sufficiently or not is another subject), without accurate outcome measurements to demonstrate if the spend, or any particular treatment is effective.

Without robust, documented evidence of outcomes achieved, there is a continued risk of lack of transparency on quality of care, cost-effectiveness and opportunities for continuous improvement.

There is an obvious duty of care to establish accountable care where each Trust/Service Provider can be confident that staff actions are  effective and delivering the best possible care to patients.  With clearer and mandatory reporting of wound outcomes we could avoid wasting time, effort and money on ineffective and often expensive treatment regimes. We can look to a future where the NHS stops relying on activity as a measurement of treatment and starts monitoring wound outcomes as a measure of effectiveness.

Practices have targeted high cost dressings in the past as a means of reducing costs, but have not addressed the need for accurate assessment, measurement and reporting  of wound progress and thereby the effectiveness of treatment.  Yes, savings have been made by centralising stock, and improved stock management, but what about answering the question “is this patient receiving the right treatment at the right time for the best possible outcome? ”


What can be done?

The key gap in wound care seems to be availability of robust wound informatics to monitor, document and report wound outcomes at a patient and patient-population level.

Accurate wound measurement, photographs and data sharing across the health economy allows for more objective management, holistic treatments, swifter interventions when regimens are ineffective and clearer visibility of the use of overstretched resources.   This would also mean that the cost of time invested can be evaluated, as each wound care action and outcome is recorded, and the whole system becomes fully accountable.

Digital solutions for wound assessment are now emerging to enable capture of wound outcomes data to support improved clinical management of patients. The NHS has an opportunity to upgrade it’s approach to delivering accountable, cost-effective care to patients who deserve optimal outcomes when suffering with chronic, complex or acute wounds.

 Download Silhouette Prospectus 

 Visit Silhouette website 

 Get in touch


[1] Health economic burden that wounds impose on the National Health Service in the UK: Guest JF, et al BMJ Open 2015:5:e009283. Doi:10.1136/bmjopen-2015-009283

[2] Royal College of Physicians 2013.  Action on obesity: Comprehensive care for all Report of a working party January 2013

[3] The burden of chronic wounds in the UK: Posnett et al Nurs Times 2008:104:44-5


[5] Oxfordshire County Council’s research into preventing care home admissions and subsequent service redesign: Taylor et al; Research, Policy and Planning (2010) 28(2), 91-102

© Entec Health March 2016

Entec Health shortlisted for MedilinkWM Award


Medilink West Midlands has announced Entec Health as a shortlisted candidate for Partnership with NHS, in its Medical and Healthcare Business Awards 2015. The Awards event will take place at Malmaison Birmingham on 14 January 2016 and is set to start the year with a great flourish for the ventures which will be celebrated for their expertise, commitment and success.

"I am delighted that Entec Health's collaboration with the NHS to support best practice in wound care for the benefit of patients has been recognised by the panel", said Achala Patel, Founder and Managing Director of Entec Health.  

Over the past 4 years, Entec Health has developed strong engagement with a wide range of NHS Trusts to explore a new evidence-based approach in wound management practice, enabled by digital technology. 

Currently there is unacceptable variability in the standard of chronic wound care practice and outcomes achieved across the NHS nationally (1). Wound Care provision for patients with chronic wounds has a high cost to the NHS, estimated at £3billion per annum. (2,3).

Entec Health has an active NHS partnering programme which involves informing and engaging NHS stakeholders on the advantages of adopting digital wound assessment and wound informatics to address this “clinical excellence and cost-effectiveness gap” in wound management. The Silhouette system (ARANZ Medical) helps clinicians to capture, document and share digital wound images and objective, quantified wound healing data across a care pathway to support improved clinical practice, patient experience and service transformation. 

Entec Health is collaborating with innovator clinical champions and NHS Trusts to embed Silhouette as an enabler technology for evidence-based care and open up opportunities to improve the cost-effectiveness and efficiency of managing patients with chronic and acute wounds. 

The Partnership with NHS Award category is sponsored by West Midlands AHSN. You can find further details via the link.

Book a Silhouette demonstration and discussion meeting with Entec Health:

Contact Us

Download the Silhouette Prospectus to learn more:

Download Silhouette Prospectus 

 Download Electronic Data Capture for Wound Care paper:

See Electronic Data Capture Devices for Wound Care article

Download Silhouette King's Diabetes Foot Care Case Study:

Download KCH Early Adopter Case Study



  1. The need for EU standards in wound care: an Irish survey. Moore Z, Cowan S. (2005).
  2. Wounds UK, 1(1): 20-8.The Smith and Nephew Foundation: Skin Breakdown – The Silent Epidemic. Posnett J, Franks P.J. (2007). The cost of skin breakdown and ulceration in the UK. Smith and Nephew Foundation, Hull.
  3. The resource costs of wound care in Bradford and Airedale primary care trust in the UK. Vowden K, Vowden P, Posnett J. (2009). Journal of Wound Care; 18: 93- 102.
  4. The use of electronic data capture devices in wound care settings. J.Fletcher, Wounds UK 2012, Vol 8, No 4
  5. Going Digital, case study of early adopter experience with Silhouette, Kings College Hospital NHS Foundation Trust, Diabetic Foot Clinic, London, UK. M.Bates, March 2013, Online Case Study Publication, NHS High Impact Innovations Showcase.

Health Service Improvement Champion & Coach

Entec Health is delighted to announce that Kate Pym will be supporting the organisation as a Health Service Improvement Champion & Coach. Kate Pym is an Accredited Healthcare Manager with the Institute of Healthcare Management, an Accredited Trainer with the Institute of Leadership and Management and a Registered and Certificated DiSC Trainer.

Before establishing herself as an independent consultant, Kate built a successful career over 20 years in the Pharmaceutical, Private Health and Social Care sectors. 

Kate brings strong experience and expertise in health service redesign, transformation projects, leadership, market access and strategic management. Kate has worked with senior NHS and Social Care commissioners and stakeholders across the UK, in a variety of services including dialysis, oncology and community care.

Kate will be working alongside Achala Patel, Managing Director, Entec Health to support the company's healthcare clients on realising clinical, patient and organisational benefits of the Silhouette digital wound assessment and information management system.

The Silhouette System (ARANZ Medical) is an innovative and enabling technology which supports improved clinical effectiveness and efficiency for wound management pathways in both primary care and secondary care settings. Entec Health is an appointed distributor to ARANZ Medical for Silhouette in the UK.

Visit Silhouette website 

 “I am thrilled to be working with Entec Health, a  thought-leader and innovator in health technology.  Achala is an inspiration and demonstrates real vision in her mission to support transformation of wound management practice.  Entec Health has a patient-centred approach to health innovation which heralds great things for collaborative service improvement. It is always a great privilege to work in the development of health services with an overall objective of improving patient lives.”  commented Kate Pym,  an appointed Health Service Improvement Champion & Coach for Entec Health

Achala Patel, Managing Director, Entec Health added "I am really delighted and excited to have Kate Pym join our mission -  Entec Health's key goal is to collaborate with our clients to drive health innovation, enabled through technology solutions. Kate's passion and expertise in designing and delivering health service improvement strategies will be a major asset for us and our clients."  

Read more, J Fletcher Wounds UK article

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