About RENOIR HIT

The Retinal Outreach, Integration and Research Health Integration Team (RENOIR HIT) built on Bristol Eye Hospital’s existing regional, national and international strengths. Bristol Eye Hospital has a national profile for the delivery of high quality and cost-effective clinical services.

Before becoming a HIT, the team had already identified the need to seamlessly integrate research with service delivery and innovation. Uniquely, Bristol Health Partners requested that the team apply for HIT status, which was awarded to the group in December 2012.

The number of patients treated for retinal conditions had increased dramatically, due to new treatment options, an ageing population and a significant increase in the number of people with diabetes.

The HIT’s work built on the successful integration of clinical research and patient treatment areas for retinal conditions in a dedicated facility at the Bristol Eye Hospital (BEH). Creating this unit allowed the BEH to combine research and clinical care and provide more treatment options for patients. The number of patients taking part in research trials increased significantly since the new integrated facility opened at the Bristol Eye Hospital.

RENOIR used that existing, highly regarded service as the springboard for new outreach clinics at convenient locations for patients, allowing the NHS to treat more people closer to home. This gives more patients across the region access to ground-breaking drug and clinical research trials, improving patient choice and making new drugs available to people who might not otherwise have access to them. The number of patients treated for diabetic macular oedema and retinal vein occlusion saw a threefold increase from November 2013 to February 2014 as a result of changes implemented through RENOIR.

Aims and objectives

RENOIR HIT’s strategy was to implement research-driven service delivery, and to engage the patient voice, staff and commissioners in developing those services.

The HIT built on its regional, national and international strengths to:

• Respond innovatively in design and delivery of optimal and cost effective care to the escalating clinical need (macular degeneration, diabetic retinopathy)
• Develop research and NICE informed care pathways
• Use outreach clinics to provide equity of care across our community
• Create opportunities for access to research trials for all
• Enable a care delivery audit through IT developments, to fully appraise outcomes
• Further enhance the unit’s multidisciplinary team, through training in the use of modern imaging developments and IT
• Further engage with industry (pharma, imaging and devices sectors, large companies and SME) for development of cost effective care delivery

Who was involved

The leading experts in retinal conditions in Bristol were involved in the team. The HIT Delivery Group was made up of:

• HIT director: Professor Andrew Dick, Professor of Ophthalmology , NIHR Biomedical Research Centre (BRC) Theme Lead for Inflammation and Immunotherapeutics
• Jenny Holly / Alice Woolstenholme, Assistant Divisional Manager Division of Surgery, Head and Neck
• Richard Lee, NIHR BRC Lead for Experimental Medicine
• Clare Bailey, Consultant Ophthalmologist, Director of the Retinal Research and treatment unit (RTRU)
• Clemence Rouquette, RENOIR Project Manager
• Julie Cloake, Outreach Development Nurse
• Steve Neilson, Imaging Technical Lead
• Representative from local CCGs
• Representation from Novartis Pharmaceuticals UK

How patients and the public were involved

The work of the HIT to integrate research and care meant many more patients were involved in the team’s research than ever before.

Other ways patients and the public are involved included:

• Patient satisfaction questionnaire
• Consultation with relevant patient groups
• Third sector representation involvement including Vision North Somerset and the Macula Society, a patient support charity. Bristol Eye Hospital also has well-established links with the local RNIB

Projects and activities

The HIT’s projects included:

• Developing outreach clinics
• Using staff more cost-effectively
• Using new information technologies in service delivery
• Developing care pathways for patients with retinal disorders

Find out more about the team’s projects and activities.

Other collaborations and partnerships

The retinal team at Bristol Eye Hospital are recognised both nationally and internationally for leading innovations in clinical research and service delivery through partnership, including:

• Development of research driven clinical care pathways: The Retinal Treatment and Research Unit at BEH, and the University of Bristol, has a formal alliance with Moorfields Eye Hospital NHS Foundation Trust and University College London’s Institute of Ophthalmology, which was established through a National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) award in 2012
• A Consortium Agreement between the National Eye Institute (NEI) of the United States National Institutes of Health (NIH) and our NIHR BRC
• Our seamless overlap between service and research has significantly increased our research activity (and thereby income), broadening treatment options for patients. Consequently, our research unit has generated £242,000 in profits in 2012/13, a 72 per cent increase from 2011/12, and this has been directly reinvested in service expansion and improvement, including staffing and equipment purchases

Bristol also leads nationally in the development of new models for efficient and cost-effective clinical service delivery, stimulated by a rapid expansion in commissioned therapies for high prevalence retinal diseases.

Contacts

To find out more, please contact:

• Bristol Eye Hospital
  Clinical Research Unit (Level 2)
  Lower Maudlin Street
  Bristol
  BS1 2LX
  Tel: 0117 342 4770