Hi all
pretty new to all this. I have pumped some into Deltex - looks like a strong product with good growth. Could be a steady gainer.
Does anyone else have this, and anyone have some research on it? Someone with more experience than me!
thanks in advance.
Grajul

The new planning guidance for the NHS was released by the NHS Commissioning Board over 24 hours ago.
Despite spending a considerable time on the internet trying to find out the specifics, I can only find the basics.
I appreciate it is a substantial document and probably due to the cost per copy, is somehow being kept to a limited number of persons or and organisations, but I would have thought Deltex would have obtains a copy by now.
Reviewing the little I have found, its full of the usual 'political speak', IE putting the patient first, more choice, more accountability, zero tolerance on infections, lowering death rates, blah, blah, blah.
The few thousand words I have read, both on the net and in several newspapers, reads just like a political manifesto, being full of great ideas with very little facts and figures.
I can't find anything re penalties for none take up of systems such as the CardioQ, but plenty of mention re rewards for improvement.
Early to say yet, but it is looking more like a carrot and stick approach without the stick.

I will give one glaring example.

In 2007 Doctors/Consultants were offered new contracts to deliver services at more unsociable times.
It was thought the this would mean more hours worked.
Figures now show that most are actually working less hours on the new contracts, and yet the only 'stick' being waved is a request that they keep their side of the bargain or the new contract bonuses of up to £70,000 per annum will be limited down to £40,000, (not bad, less work=£70,000, but still work less and it will =£40,000).

Why the hell have we had a situation for nearly 4 years where only one side keeps to a contract, with the other paying side (the tax payer, us) still splashing out the money, and then the only move suggested is to request the agreement is kept, or the reward is lowed.
The only reason is that they do not want to upset such a politically powerful group.

As for Deltex, if we don't hear some stick approach re none take up CardioQ soon, the sp will be heading only one direction, and it won't be up!

Not happy!

http://www.commissioningboard.nhs.uk/files/2012/12/cquin-guidance.pdf

I have spent a good hour looking through the draft report trying to find where I could knock it, and apart from the fact that there is still no mention of penalty costs for none compliance, it does mention benefits and sanctions should apply', so I will wait and see if the Stick matches the Carrot.

If the draft becomes the full blown report without much alteration (as suggested) then it looks very good indeed.
Of course the proof of the pudding etc!

When it comes to the Prequalification Criteria, IE in order for providers to qualify for CQUIN payments, they will need to satisfy at least 50 per cent of the pre-qualification criteria that apply to them, Deltex looks to have satisfied well beyond the 50%, in fact as we know they have been fully approved for NHS take up.
Also the uptake programme for the use of ODM or similar is recommended to be commenced in 3 months.
With this last statement surelly the sp for Deltex must start climbing upward, if not I fail to see what else can be done to fully infiltrate the NHS.
So sp to climb steadily untill end Feb then accelerate after is my best bet.

Time will tell of course.

Not posting again till after Xmas, so happy Xmas to you all.

Trading Update.

A good indication of how things are progressing.

It does though show 2 main areas that wind me up.

1 This section shows how the NHS procrastinate.

The ODM being selected as one of six high impact innovations to be implemented fully by the NHS in England, was originally expected to impact 2012 as the NHS had committed to launch a national drive to implement ODM or similar fluid management monitoring technology by early March 2012. However, the key details of the implementation plan were only published on 21 December 2012.
So launch expected March, not yet inplimented (remember the plan has only just been published)

2 Premier and Deltex Medical have agreed to undertake a second phase of collaborative research. This will involve implementing CardioQ-ODM and other enhanced recovery steps in colorectal surgery in a small number of Premier's hospital members, supported both by Premier's clinical change management experts and Premier's data management group. The objectives are to develop both a substantial body of real-life evidence of the clinical and cost effectiveness of enhanced recovery with CardioQ-ODM and clear guidance to hospitals on how to implement effectively the necessary changes.

Why the hell do they need yet more trails, research, the same is happening in Canada.

The CardioQ works. It saves lives and money, wheres the argument.

I do feel that Deltex are now firmly in the driving seat, and the future in the mid to far term looks very good indeed.
As to the near term, with a cash position of £0.7 million at 31 December 2012 (down from £1.3 mil in September), it won't take much more of a delay to require a further cash injection.

I expect the market to treat this latest RNS nuetrally.

Good interview with Ewan Phillips.


http://www.proactiveinvestors.co.uk/companies/stocktube/1621/deltex-medical-ceo-discusses-traction-and-sales-growth-in-2013-1621.html

An interview that shows plenty of good news filtering through, with the only question missing was about cash flow.
I would have liked to see Ewan answer such a question, as if the cash flow continues at its last 3 month rate, it will only last for another 7 months.

To my mind, if Deltex can survive the next 7 months without having to raise funds they will be running clear.
That is why the market has concentrated on the cash in bank figure at the detriment to all the good news feeding through not just on the UK markets, but several spread around the world.

We are SO close, I just hope that we are close enough and downt fall at the last fence.

Director buying here, 3 to the tune of £225k. Encouraging eh Greekman.
2517

Hi George,

Agreed.

Yes, I know I need patience, but how much longer must we wait while the sp goes south.
4p down in the last 2 months.
6p down in the last 3 months.
9p down in the last 9 months.

In fact the sp is at its lowest for nearly 13 months.

Most of us, including my doubting self, still watch the sp mainly going one way, still wondering when something will happen.
By happening, I don't mean yet another RNS telling us how good the product is, or how yet another trial shows how much money, lives it will save, or how many NHS trusts are looking at the CardioQ.

Whilst still convinced of the products qualities, these qualities and promises of jam tomorrow, won't help keep the sp afloat much longer.

Just one example.
RNS 23/10/12.
The NHS South of England targets for fluid management are expressed in terms of numbers of patients a year treated per 100,000 of population and the targets set are:
150 patients per 100,000 in February and March 2013.

In the year end to Dec 2011, the CardioQ-ODM was used during surgery on circa 50 patients a year per 100,000 of population in NHS South of England.

So we need an increase here of 200% by end March.

Whilst I appreciate the NHS is still procrastinating and date lines were altered in December of last year (yet again), which is not Deltex's fault, it matters not who is to blame.
No sales mean either a static sp or a falling one.

What we need is sales!

I know most of you are still full of confidence that a break through is imminent, and you are probably right, but I just have this niggling feeling that Deltex might end up being one of those 'nearly made it' companies that fail not because of its product, but because not enough potential customers sign up to buy it.

Even if the USA or other none UK countries get further on board, I am starting to wonder if that will happen before Deltex have to go yet again cap in hand for what is starting to look more like a bale out, than cash for further investment.

Even in as short a space of time since my post on 18th Jan 2013, my confidence is slipping, as surely if the end of March target mentioned earlier for NHS South of England is to be met, we should have seen at least an RNS re increase in either monitors or probe sales, or both.
I appreciate that we don't need to know every substantial sales, that is not substantial, but it is only due to lack of such info that the sp is continuing to sink.
At least such an announcement would show that progress is being made, whilst without such info, we are left forever wondering.

Sill staying in, but edging a bit nearer the gang plank!

Link to todays release of Cquin Guidance.

http://www.commissioningboard.nhs.uk/files/2013/02/cquin-guidance.pdf

I could not believe the following statement on Page 2.

'Non-participation in any applicable national CQUIN scheme should result in non-payment of that proportion of CQUIN funding' (That's telling them).

How that reads is the funding is paid if there is participation, but not if there is none-participation.
I can't believe they had to spell out the bleeding obvious, no wonder the whole document is so gobbledygook speak!

So we have incentives, but again an absence of stick.
In the first daft document we were promised both carrot and stick, but unless I have missed it, the only stick is not having the carrot.
As NHS Trusts who use the CadioQ already save money, I fail to see how such a give but no take policy will work to our expected effect.
Sure a few NHS Trusts will now get on board, but without the stick, there is little more incentive than at present.
Don't hold your breath for any of the deadlines to be acheived either, as again where is the pressure to do so.
The whole document looks like a typical mish mash of government lackey, watered down missed opportunity, like most of their policies.
Marks out of 10, about 3 and thats being generous.
No wonder the sp is down again today.
Angry and disappointed, you bet I am.
So will stay in till end of March (perhaps) and then see just how much effect this document has!

NHS Satisfaction Survey Released Today.

Overall, satisfaction with the way the NHS across Britain runs nowadays fell by 12 percentage points from 70 per cent in 2010 to 58 per cent in 2011. This is the biggest fall in one year since the British Social Attitudes survey began in 1983.
And this was before the Stafford Hospitals report was released.

It has also been shown there were 3,000 more deaths than expected at five NHS trusts, including two in East Anglia, which are now under investigation.

Its a pity the NHS Trust Managers (sic) did not spend more time looking at how to improve patients treatment and care, than looking at budget cutting, no matter what the cost to human life and suffering.

But hang on a minute.

I wonder if they have ever heard about the CardioQ, a device that has been proven to do all three, IE cut cost, suffering and most important of all, saves lives.

Perhaps somebody should tell them!

But sarcasm aside, you would think that with such a system that could, at this time of low NHS esteem, be a tool that these trusts could use to the benefit of themselves (which appears to be more important than the patients) for positive publicity.

A headline such as.

An NHS Trust has shown that whilst cutting costs, they have also been able to reduced the death rates, would be a change from, 'More avoidable deaths' headline.

Mind you, I'm not to one paid such inflated salaries to sit in an office all day, looking at graphs, and making policy decisions that have nothing to do with care of patients but more about tick sheets!

From the RNS released 23 October 2012.
NHS South plan to implement ODM.

150 patients per 100,000 in February and March 2013.
200 patients per 100,000 in the NHS financial year starting 1 April 2013.

With the above added to the NHS requirements for Fluid Management , surelly sales to NHS trusts or at least to NHS South should have increased in the last few months, weeks.
If they have to any significant number then we should be informed as such sales would be sp effecting, especially as the lack of news is having such a negative effect of late.
So I can only conclude that little is happening.

Yes I know that patience is required but just how much longer for this trickle effect to gather momentum.

Share Price in Oct 2012 at time of NHS South Plan ....24p.
SP Nov 2012.... 27p.
SP today a lowly.... 17.50p.

Questions need asking and answering.

We all know the NHS budget is 'ring fenced' and I don't expect todays budget to change that, but I also feel that the NHS slice of the pie will not increase, therefore with increase costs and the effect of inflation, it will put more pressure on the NHS to save some of the zillions of pounds that they waste every year.

I have an idea, a small contribution to savings could easily be made by instructing all NHS Trusts to take up the CardioQ.

Of course we all know that such instructions, albeit, weak instructions without the fear of those promised penalties have already been issued, but I am hoping that pussy footing around with a stick that has about as much effect as a piece of 'wet celery' (that term is for Allo, Allo fans, remember the sexy Yvette) will finally be more forceful.

Probably a forlorn hope!

Sales up (always good) 7.5% to £6.8m.

My question is, are sales rising fast enough?

Margins are also up in main markets but operating loss increased by £0.7 mill due to launching of sales to new distributors, and although £2.5 mill was raised in new equity in Jan, with a cash position at year end of £0.7 mill, allowing for no change since, cash postion at best is £3.2 mill, so with a cash burn slowing by a minute amount of £0.7 mill, it does make one wonder when we are going to see a profitl.

It's only current developements that are keeping me in (jam tomorrow).

Major market development project established in USA with Premier Inc

Implement ODM & enhanced recovery in up to five hospitals

Disseminate implementation programme to >50% of US hospitals within two years

Working with NHS hospitals which plan to increase CardioQ-ODM usage significantly

Implementation of NICE guidance on CardioQ-ODM

Introduce dedicated trainer model into UK super-users

Installed base of new CardioQ-ODM+ over 150 and growing

Surgical probe sales growth in early 2013 in all direct markets

But with 2,800 CardioQ-ODM systems in use in hospitals worldwide, surely by now the profit margins should be sufficient to be making the company more money than at present, so it is only me that wonders just how/when Deltex will be in profit.

So, I will stay invested (only a token amount left anyway) for a few more months to see it the proposed turn around comes to fruition.

Will be interesting to see if the results effect the sp today.

Single biggest day drop for ages.

Come on Deltex, show us some decent new contract figures before the sp sinks even lower.

It goes to show how the market is looking at Deltex and yesterdays results, yes the company is growing but most like myself obviously feel that it is not growing quick enough.

As most on here know, I have been in Deltex almost from conception (the companies not mine, although sometimes it feels that long), and we are in a position today where most of us thought we would be about 3 years ago.

The hare and the tortoise fable springs to mind, the problem being that at 65, at the speed this tortoise is going I am wondering who will get to the finish line first, me or the tortoise!

Overhyped POS imho , get out and buy something decent.

Good luck.

Todays RNS.

On looking at the RNS heading I was very disappointed because my first thoughts were, here we go again, another none contract bit of news.

But on starting to read the contents my optimism very quickly went straight upward.

What a great boost for Deltex.

Whilst our NHS Trusts have been sitting at their desks sucking their proverbial thumbs in an effort to make any sort of a decision regarding the CardioQ, the USA have taken the leap of faith that our pathetic decision makers have been procrastinating for far too long.

At a reimbursement of $101 for every use of a probe they are obviously putting each use as a monetary value higher than the reimbursement figure.

As Ewan Phillips states The USA is by far the world's largest potential market for our products, so with that in mind I would presume that the main concentration is now targeted in the USA and other none UK markets.

If the NHS now finds itself at the bottom of the supply list they have only themselves to blame as its yet another expample of 'made/invented in the UK' being advantaged by none UK countries.

I still feel that with a more aggressive management we could have been in this position earlier, but that is just my view as for all I know the management have been pushing as much as possible so I won't be pushing that line again unless I see indications that back my beliefs up.

I just hope the media grab hold of this, both for the positive effect on Deltex and the negative effect on NHS Trusts.
A list of NHS Trusts that have and have not adopted the CardioQ for use in their trust areas.

Todays RNS must surely push the sp up around the 18 to 20p range and if it results in a steady stream of similar good news in the following months, the sp could/should easily justify an sp of 30p plus by end of the year.

I have no hesitation in saying, 'A very well done to the Deltex Team'.

Can't believe that the sp has hardly moved.
It just goes to show that when confidence falls and apathy sets in it takes more that a bit of dynamite to move something from a norm.

Lets just hope the big boys that are already in increase their holdings and those who are watching and waiting feel that now is the time to get on board.

I think there is so little stock held by PI's that they can have a far less effect on the sp that they would have had say 2 to 3 years ago, athough even then the influence would not have been much more.

Deltex Medical Group (LON:DEMG) has had a significant breakthrough in the US that should encourage physicians to use the company’s oesophageal Doppler monitoring (ODM) system.

The US Centres for Medicare and Medicaid Services (CMS) has granted ODM its own unique code for physician reimbursement.

The code means that any doctor using ODM on a CMS patient will get paid within weeks under an automated payment system. Previously it has taken two to three years before a physician starts to be paid consistently, the statement from Deltex revealed.

In addition, CMS has set a standard amount of US$101 that it will reimburse US doctors for each use of an ODM probe in either surgery for patients requiring intra-operative fluid optimisation or for ventilated patients in intensive care.

Cracking the US market would be very lucrative for Deltex and the decision by CMS is a major step towards achieving that goal. Where established locally at adequate levels of US$80 per patient or higher, physician reimbursement has been associated with achieving the company's best levels of growth in the US, Deltex said.

"This is a very significant development for Deltex Medical. The USA is by far the world's largest potential market for our products,” declared Ewan Phillips, Deltex’s chief executive.

“The establishment of routine and meaningful payment of physicians for using ODM secures a cornerstone of our strategy to create widespread demand for our products in the USA. In the short term we also expect to see increased demand for evaluating our products," he added.

http://www.proactiveinvestors.co.uk/companies/news/55642/deltex-medical-group-makes-medicaid-breakthrough-in-us-55642.html

Todays news should result in a huge increase in sales in the USA at least.

From todays AGM.

It will be stated that, 'To date we have seen considerable variation in NHS Trusts' awareness of the new requirements '.

Unbelievable that some NHS Trusts are still unaware of such an important issue as the national drive by the National Health Service ('NHS') to implement intra-operative fluid management.

I would have thought that these trusts would have received stacks of bumf from such a bureaucratic body as the NHS, so 3 questions have to be asked.

1 If the mangers of these trusts are not aware, why not.

2 What the hell are these overpaid jobworthies being paid for if they are not aware of what should be such a basic part of their jobs.

3 What is the NHS doing about it.

I can guess the answer to number 3, absolutelly zilch.

My previous comment re carrot and no stick policy is obviously correct.

So far trades look very good, especially comparing the usual daily volume.

It looks like the market is taking todays RNS as more positive than I am, as I looked at the RNS as only slightly posative.
Lets hope the sp starts to gather some momentum and sustains same!