Tag Archives: SPOT

Top SPOT for the Dundas Medal

In November 2022 we were delighted that the Dundas Medal was awarded to the team behind the SPOT app.

Photo by freestocks.org on Unsplash

The SPOT app aims to revolutionise the way that opioids are prescribed, reducing error, cost to the NHS and safeguarding patients and staff. SPOT is the only CE-marked, clinically validated equianalgesic opioid converter in clinical practice.

Born out of a genuine clinical need, SPOT creator, Dr Roger Flint, was inspired to create an app to help other junior doctors and prescribers switch opioids safely, after a position he found himself in two weeks after graduating from medical school. Dr Flint commented:

Two weeks after starting work as an FY1, out of hours and covering three wards, I was asked to review a patient that had been admitted earlier that week at the end of her life. She had been receiving analgesia through a PEG tube which then became blocked. When I reviewed her, she was unable to receive any analgesia. I was asked to switch her to a sub-cutaneous infusion. I didn’t know how to do this and I consulted the Scottish Palliative Care Guidelines. To a new prescriber, the choosing and changing opioid tables appeared complex and whilst I was desperate to relieve the patient’s suffering, I did not feel confident enough to perform the switch and risk using the wrong dose. I called my registrar for help. He advised me that he was unable to help me at present but that he would come as soon as he was able. In the end the patient waited until the night team started before she received her analgesia at the correct dose.

PATCH established the Dundas Medal in partnership with the The Royal College of Surgeons of Edinburgh, to recognise efforts to improve provision of palliative care for patients in hospital. The Dundas Medal is open to medical, nursing or paramedical individuals or teams working in any hospital setting in the UK.

Catriona Miller, Chair of PATCH commented:

We are so impressed and inspired by the excellent applications for the Dundas Medal each year as it continues to recognise those individuals and teams making a significant difference to palliative care provision in the UK. We have supported Dr Flint as he established the SPOT app and are delighted to see how well it has progressed and the recognition of this award helps to demonstrate its importance in the palliative care field. it will undoubtedly help clinicians safely prescribe opiate pain relieving medicine, reducing the risk of medication errors.  Well done to Roger and the SPOT team.

PATCH (Palliation And The Caring Hospital) is the first charity to specifically support 24/7 specialist palliative care for patients in Scottish hospitals. It does this by funding hospitals to provide resources such as dedicated beds, staff training, advisory services and research.

Dr Roger Flint awarded a prestigious Harvard HealthTech Fellowship.

In 2016, PATCH was the first organisation to fund Dr Flint in the development of his SPOT (Safer Prescribing of Opioids Tool) software as a medical device app.

Using the SPOT app

He has worked tirelessly to develop this achieving funding along the way from Lippen Care, Scottish Enterprise and Innovate UK.

He has published, in collaboration with a small group of scientist, researchers and clinicians, in the International Journal of Environmental Research and Public Health [1] and the Tayside Courier; presented at the centre of Advanced Palliative Care in the States, on BBC Radio and BBC the Nine[2]

SPOT has been cited by the Scottish Partnership for Palliative Care in Every Story’s Ending[3] as a recommended resource for prescribers. It has been recommended to the Scottish Government as a funding priority as part of their national palliative care strategy[4]. SPOT is published by Class Professional Publishing[5].

Most recently he has been awarded a prestigious Harvard HealthTech Fellowship which will enhance his future practice as a UK GP, particularly in medical leadership, innovation and patient safety.

SPOT supports prescribers to double-check their conversions of one strong morphine-like painkiller to another, at the patient’s bedside in palliative and end-of-life settings. It is the first such clinically validated opioid prescribing support tool available. It is in use in the Scottish Borders[6] and can be purchased through Class publishing

References and Footnotes

  1. Flint, R.; Buchanan, D.; Jamieson, S.; Cuschieri, A.; Botros, S.; Forbes, J.; George, J. The Safer Prescription of Opioids Tool (SPOT): A Novel Clinical Decision Support Digital Health Platform for Opioid Conversion in Palliative and End of Life Care—A Single-Centre Pilot Study. Int. J. Environ. Res. Public Health 201916, 1926. https://doi.org/10.3390/ijerph16111926
  2. End-of-life pain relief phone app trialled at Melrose care unit | BBC News, 14 Jun 2019.
  3. Every Story's Ending | Scottish Partnership for Palliative Care, report [Accessed 2 Mar 2022]
  4. Coronavirus (COVID-19): palliative care toolkit | Scottish Government [Accessed 2 Mar 2022]
  5. SPOT: The Safer Prescription of Opioids Tool | Class Professional Publishing [Accessed 2 Mar 2022]
  6. Supporting Opiod Prescription in NHS Borders: SPOT - The Safer Prescription of Opioids Tool

“SPOT” Safer Prescription of Opioids Tool

PATCH funded the prototype stage of SPOT – a novel application that can be used on a range of mobile devices including laptops, tablets and smartphones to calculate painkiller dosages.

Senior woman in a hospital bed having talking to male doctor with stethoscope and clipboard

SPOT (Safer Prescription of Opioids Tool) is a clinician-led, clinically validated, clinician decision support tool, devised by Dr Roger Flint who trained at Dundee University and Ninewells Hospital. The application is designed to to reduce opioid prescribing error.

A number of strong painkillers, morphine derivatives, are used in the management of patients with advanced illness or cancer. Converting from one painkiller to another requires care and is presently performed using paper tables of approximate equivalence.

As Dr Flint explains:

Two weeks after starting work as a doctor I was asked to switch painkillers for a patient who was very ill and towards the end of their life. It took me a long time to calculate the correct dosage. There was no way to double check my calculation, and I felt unable to prescribe the pain relief.  It was a sobering lesson and I was determined that no other junior doctor or patient should be put in the same position.

SPOT double checks such drug conversions. It is a CE marked medical device, and is undergoing clinical investigation in NHS Tayside. SPOT has the support of the University of Dundee, NHS Tayside, the Digital Health and Care Institute and Scottish Enterprise.

Further information

The Safer Prescribing of Opioids Tool (SPOT)