An exciting new chapter in NHS medical research in Oxford begins today (April 1) with the £113.7m renewal of the NIHR Oxford Biomedical Research Centre (BRC).
The BRC is a partnership between Oxford University Hospitals NHS Foundation Trust and the University of Oxford to fund medical research that can transform NHS care.
The BRC was established in 2007 with a competitively awarded grant of £57m from the National Institute for Health Research (NIHR), funded by the Department of Health to improve the health and wealth of the nation through research.
A further grant of £95.5m was awarded from 2012 to 2017 and in September 2016 it was announced the BRC would receive a further increase, £113.7m for 2017 to 2022.
This renewal will expand the number of research themes from 14 to 20 in areas such as cancer, genetics, diabetes, vaccines and stroke, and new areas such as obesity and respiratory.
Previous NIHR Oxford BRC-supported research has included:
- A project to replace bedside paper charts with “early warning” tablet computers to identify at risk patients at OUH hospitals.
- Support for research that developed an Ebola vaccine by the University’s Jenner Institute as part of an international consortium.
- Pioneered the use of whole genome sequencing – a process to decode a person’s complete DNA code – for rare diseases and cancer.
- Recruited 10,000 people to analyse stroke and mini strokes (transient ischaemic attacks or TIAs) trends, leading to discoveries in the risk of recurring stroke and a change in guidelines so minor stroke patients are assessed in 24 hours instead of four weeks.
- Supported the University of Oxford’s Acute Vascular Imaging Centre (AVIC) at the John Radcliffe Hospital to study the impact of stroke and heart attacks in real time.
- Funding for projects at the John Radcliffe Hospital to implant a “bionic eye” retinal implant into patients with retinitis pigmentosa and deliver a virus to replace missing gene in the retina of patients with choroideremia.
- A smartphone app with a Bluetooth enabled blood glucose meter for pregnant women with gestational diabetes to monitor blood glucose levels and send information to health professionals via a secure website.
Here, theme leaders set out their priorities for the next five years:
Professor Andrew Carr, Musculoskeleletal Diseases: “Our vision is to build on our strengths in the identification of where to target treatment and to develop drugs tailored to each patient’s individual needs in inflammatory joint disease, degenerative joint disorders and in rare bone diseases. We will also further develop Oxford’s promising tissue engineering implants and devices and regenerative medicine drugs for the benefit of patients.”
Professor Barbara Casadei, Cardiovascular: “Emergency diagnosis and classification of patients for immediate specialist treatment are central to the management of patients presenting with acute stroke or myocardial infarction. We will use state-of-the-art local and national resources to refine the management of patients with acute cardiovascular syndromes and test new drugs based on improved mechanistic understanding of chronic and inherited cardiovascular diseases in individual patients.”
Professor Derrick Crook, Antimicrobial Resistance and Modernising Microbiology: “Research supported by the BRC has developed a genetic test for tuberculosis that can diagnose the condition from a patient sample in as little as eight hours, compared to weeks using traditional methods. This technique is now being rolled out throughout the NHS and offers us huge opportunities to quicken diagnosis using genetic testing for other conditions such as joint or blood infections.”
Professor Anna Gloyn, Diabetes & Metabolism: “By 2025 there will be five million people with type 2 diabetes in the UK alone. We will capitalise on our world-leading expertise to improve our understanding of how to restore and preserve pancreatic islet cells, which produce insulin needed to control blood sugar levels, and evaluate approaches to manage and treat patients with non-alcoholic fatty liver disease, a major cause of liver failure in the UK.”
Professor Trish Greenhalgh, Partnerships for Health, Wealth and Innovation: “Partnerships are at the heart of the new Biomedical Research Centre. Our theme will work with patients and the public, for whose benefit research is ultimately targeted, and with clinical services, to hasten translation of research findings into new products and services. We will also work to bring together expertise across the BRC, academic disciplines, industry and Government.”
Professor Adrian Hill, Vaccines for Emerging and Endemic Diseases: “Vaccines have been science’s most efficient way of preventing diseases. Our theme will investigate a better vaccine for group B meningitis, and help develop new vaccines for Zika, pandemic influenza, tuberculosis, and prostate cancer. We will improve the effectiveness of a malaria vaccine we been trialling and try simplifying the UK’s childhood immunisation programme so children would need fewer doses.”
Professor Richard Hobbs, Multimorbidity and Ageing across Boundaries: “People living with multiple chronic diseases are a major challenge for the NHS, affecting one in three UK adults and accounting for half of GP appointments, 70% of overnight hospital stays and 70% of the NHS hospital budget. Our research will look at how to detect early, manage and treat some of the most common of these long-term conditions such as diabetes, hypertension, and depression.”
Professor Masud Husain, Neurological Conditions: “Some of the biggest healthcare challenges are posed by neurological disorders. Monitoring patients with conditions such as epilepsy or Parkinson’s disease in the community and responding to changes in a timely fashion has been hard. We’re going to bring together experts from different disciplines to tackle head on some of the most difficult areas of medicine to find innovative, new solutions for patient care.”
Professor Susan Jebb, Obesity, Diet and Lifestyle: “Two thirds of adults are overweight but even modest weight loss brings surprisingly large clinical benefits. We will study new weight loss programmes for specific groups of patients who are overweight to test whether this is an effective approach to manage their condition, potentially adding to, or even replacing, existing treatments.”
Professor Martin Landray, Clinical Informatics & Big Data: “Collecting, sharing and analysing vast amounts of clinical data is a hugely exciting opportunity to help researchers develop new tests and treatments. We are confident this will transform healthcare in the future.”
Professor Xin Lu, Multi-modal Cancer Therapies: “Although there has been great progress in improving treatments for several cancer types, many major challenges remain and we will be tackling two of the big hurdles: how to diagnose cancer earlier and how to tell which patients will benefit from which treatments. Our approach will link the latest molecular scientific techniques with innovative clinical trials and patient screening programmes.”
Professor Robert MacLaren, Surgical Innovation and Evaluation: “Surgical procedures, like medicines, have a critically important role in maintaining health. This is particularly the case for treating cancers and replacing body parts, such as diseased organs, joints and cataracts. The surgical research in Oxford seeks to explore new ways of improving surgical successes, by developing safer and more effective surgical procedures.”
Professor Stefan Neubauer, Imaging: “We will develop a variety of innovations, for example MRI techniques for high resolution assessment of metabolism and pH, the measure of how acidic or alkaline a substance is; ultrasound monitoring of foetal development and harnessing big imaging data from population studies. These techniques are expected to benefit patients and society, by improving diagnosis, treatment monitoring, increasing efficiency and saving healthcare costs.”
Professor Fiona Powrie, Gastroenterology and Mucosal Immunity: “Chronic inflammatory diseases such as inflammatory bowel disease and psoriasis are often complex in nature and difficult to treat. By characterising the cell types and molecules that associate with disease onset, progression and response to treatment, our work will reveal new places to target treatment so we can develop medicines tailored to each patient’s needs.”
Professor Ian Pavord, Respiratory: “The theme will focus on identifying common mechanisms involved in respiratory diseases. We hope this will lead to the identification of new treatment opportunities in definable groups of patients with asthma, chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis, pneumonia and pleural infection.”
Professor Peter Rothwell, Stroke & Vascular Dementia: “We are fortunate to already have many of the tools that we need to prevent stroke and vascular dementia. The challenge is not so much ‘how to do it’ but ‘how can we do it more effectively’? We therefore concentrate on studies to better understand known risk factors and to make more effective use of existing treatments.”
Professor Lionel Tarassenko, Technology and Digital Health: “Digital technologies have been making a huge impact on most sectors which affect our daily lives, from communications to transport and entertainment, but much less so on healthcare. Our theme is focused on delivering cost-effective improvements in patient outcomes through technological innovation. Biomedical engineers and clinicians will together develop digital health solutions, from smartphone apps for weight management during pregnancy to machine learning algorithms for identifying in-hospital patients at risk of serious deterioration.”
Professor Ian Tomlinson, Molecular Diagnostics: “Our aim is to refine the classification of disease at a molecular level so that we offer treatment strategies that work and have minimum side effects. To do this, we will explore how new techniques of molecular pathology and image analysis can be combined to identify specific groups of patients whose prognosis and response to treatment can be predicted accurately.”
Haematology and Stem Cells, co-theme lead Professor Paresh Vyas: “Blood diseases can be common, such as anaemia, and also rare but potentially devastating, such as blood cancers like acute leukaemia. There has been much progress in understanding the fundamental basis of many of these conditions. Our aims are to further deepen this knowledge base and, critically, harness it to improve treatments for NHS patients by engaging with patients and their families and through our national and international partnerships.”
Professor Hugh Watkins, Genomic Medicine: “We have exciting opportunities to use new advances in genomics to transform the way we care for families with genetic diseases – many of which currently go undiagnosed and untreated. We will draw on Oxford’s unique scientific and clinical resources to tackle important challenges in interpreting the vast amounts of information we can gain from the human genome, to ensure the greatest benefit for our patients.”