Bristol's research in 2014-15

In 2014-15, both universities performed strongly in health subjects in the Research Excellence Framework. The NIHR Collaboration for Leadership in Applied Health Research and Care West and a new synthetic biology research centre, BrisSynBio, launched.

NIHR CLAHRC West launches

The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West), hosted by UH Bristol, got off the ground in 2014. At its launch event in November Professor Dame Sally Davies, Chief Medical Officer for England, said: “You wouldn’t have won the CLAHRC if you didn’t do high quality research. And we do expect – and with Jenny Donovan as the leader I know it will be – the highest quality of research.”

Following their first call for projects and ideas in September, the portfolio of 27 projects the team will work on was announced in January. Several of these are projects put forward by Bristol Health Partners Health Integration Teams (HITs), as well as from partners in the wider CLAHRC West region.

CLAHRC West Director Jenny Donovan said: “The range and scope of this first round of projects submitted by the health community, including HITs, has been very impressive. The projects being taken forward show a wide range of activity, from evaluating existing or proposed services, to reviewing and building evidence, and all aim to improve health and care across the West. We look forward to working collaboratively with all our partners on these, and future, projects. The response to our first call was fantastic, and I would like to take this opportunity to thank all the research proposal and idea applicants who have helped us develop such an exciting programme of work.”

CLAHRC West has produced a thematic analysis of local health organisations’ strategic priorities and is examining the HIT model, to describe how forming HITs brings people together to improve health and health outcomes.

Synthetic biology research centre opens

A new £15 million synthetic biology research centre, BrisSynBio, opened at the University of Bristol in April 2015. The research carried out there will have many applications, including helping to speed up drug discovery and development.

Professor Dek Woolfson, Director of BrisSynBio, said: “This is an exciting day for us at the Universities of Bristol and the West of England. It represents the culmination of a lot of hard work over the past two years that brought together scientists and administrators with the vision and determination to deliver an internationally leading research centre for synthetic biology.”

The centre’s new equipment includes scientific robots, a state-of-the-art instrument for biological nuclear magnetic resonance spectroscopy, and a dedicated super computer. With these new facilities BrisSynBio will tackle research problems such as introducing enzymes that make antibiotics into bacteria and assembling proteins to make vaccines targeting dengue fever.

Cutting edge studies and ground-breaking findings

The NIHR Biomedical Research Unit in Nutrition, Diet and Lifestyle at University Hospitals Bristol NHS Foundation Trust (UH Bristol) and the University of Bristol has published a study exploring the link between diet and a reduced risk of developing prostate cancer. Led by Richard Martin, Professor of Clinical Epidemiology, the study team developed an index of nutrients associated with a reduction in developing this type of cancer: lycopene (a bright red constituent found in foods such as processed tomatoes), calcium and selenium.

Vanessa Er, a PhD student who worked on the project, explains the findings: “We found that men who had an optimal intake of these three nutrients had a reduction in risk compared to those who didn’t. It appears that men who had over 10 portions a week of lycopene-rich foods, actually had an 18 per cent risk reduction compared to those who had less in their diet. We also found reductions associated with vegetables, fruits and legumes.”

Whether or not patients see the same GP could affect how quickly bowel and lung cancers are diagnosed, according to a study led by University of Bristol. Symptoms of these cancers tended to be picked up more quickly if patients consulted an unknown doctor than if they saw their usual GP. But although seeing a known GP may slightly delay diagnosis, following-up new symptoms with the same doctor was found to result in a quicker diagnosis.

Study leader, Dr Matthew Ridd, a GP and Senior Lecturer in Primary Care at the Centre for Academic Primary Care, said: “These findings provide some evidence that GPs should follow up patients who present with potential cancer symptoms to make sure they receive a timely diagnosis. Interestingly, we also found that your regular doctor might not be the best person to spot those symptoms in the first place. So in some cases getting a second opinion from a different doctor could speed up the time to diagnosis.”

The Bristol Urological Institute at North Bristol Trust (NBT) was awarded £1.2 million in November to lead a major three year national multi-centre trial to evaluate the use of laser technology for benign prostate surgery. This funding is to trial a new type of laser which cuts and vaporises the prostate. This is an easier technique for surgeons and there is some evidence to indicate that patients may benefit from reduced blood loss and a faster return home after their operation.

A multiple sclerosis physiotherapy programme from NBT, based at the Bristol County Cricket Ground could be rolled out across Europe after achieving ground-breaking results. The fitness sessions at the BS7 Gym have helped people with the condition regain balance and movement skills and provided them with a forum to share experiences. The findings from the Bristol and Avon Multiple Sclerosis scheme gained recognition when presented at an MS conference in Norway and to the UK’s National Chartered Society of Physiotherapists and has now received interest from Italy, Spain and Germany.

The Elizabeth Blackwell Institute introduced the Research for Health Challenge in 2014, to encourage healthcare practitioners and University of Bristol researchers to work together to develop innovative thinking around clinical problems and healthcare delivery challenges. From this first round, the Institute supported five collaborations between clinicians and researchers from a range of areas such as engineering, experimental psychology, dental sciences and policy studies.

Bringing research to the heart of commissioning

The Avon Primary Care Research Collaborative (APCRC) works to strengthen the relationships between the NHS and local universities, and to promote research ideas. The team works with local commissioners to ensure decisions are based on sound and relevant evidence, and that evaluation is built into commissioning cycles. APCRC staff help identify areas where the knowledge base is sparse, and work to develop NIHR grant applications. APCRC now hosts 16 NIHR research grants worth £16.8 million, on behalf of Bristol, North Somerset and South Gloucestershire Clinical Commissioning Groups. Eight of these, worth £4.3 million, were awarded during 2014-15.

These studies include one led by the University of Bristol’s Professor Chris Salisbury, which considers alternatives to face to face consultation in general practice. Another is an evaluative research project led by Professor Sarah Purdy, of the effectiveness of care bundles to improve hospital care and reduce hospital readmission for patients with chronic obstructive pulmonary disease (COPD). A feasibility trial led by Professor Di Harcourt at the Centre for Appearance Research at the University of the West of England, investigates a novel web-based therapy for young people who feel they have a visible difference in their appearance. And a programme development grant led by Professor Sarah Purdy will investigate ways to reduce hospital bed days in older populations.

Bristol, North Somerset and South Gloucestershire CCGs have signed up to the Association of Medical Research Charities Research Charter. APCRC is working with the CCGs to embed the charter in their activities, which demonstrates the CCGs’ commitment to the broader research agenda, and to the use of research and evidence in their work.

Another record Research Capability Funding award for APCRC

APCRC was awarded £1.15 million of Research Capability Funding (RCF) for 2015–2016, on behalf of the local Clinical Commissioning Groups. This is the highest award to any primary care organisation in England – and substantially more than APCRC has ever received before.

Peter Brindle, Research & Development Director for APCRC, said: “Once again this award is a testament to the excellent working relationships we have with our local universities and to the exceptional quality of their research teams. We will now use this RCF to continue to grow research while also delivering increasing value to our commissioning community. In particular, this means increasing our activity around supporting service evaluation, evidence-informed commissioning and non-research innovation bids.”

Improving participation and clinical engagement in mental health research

The Avon & Wiltshire Mental Health Partnership NHS Trust (AWP) launched Everyone Included – Research for All in March last year, to routinely inform service users about relevant research opportunities they could take part in. An innovative and inclusive approach to research recruitment, the NIHR Clinical Research Network: West of England has endorsed Everyone Included and is encouraging all its partner organisations to adopt a similar approach.

In February 2015 AWP launched its Research Link Coordinator programme, to help embed research clinically. The programme seeks to bridge the gap between research, clinical practice and evidence-based design. The initiative is aimed at clinicians looking to develop their research capabilities, with funding provided to cover up to half a day per week of individuals’ protected time for research related activity.

A shared approach to patient and public involvement

In the West, local health networks are already benefiting from an innovative and possibly unique approach to patient and public involvement (PPI). Bristol Health Partners, NIHR CLAHRC West, the West of England Academic Health Science Network and the Clinical Research Network: West of England have agreed to use a single PPI strategy group and team to guide, co-ordinate and develop PPI projects and expertise in the region. This PPI function is run through People in Health West of England.

From mapping existing PPI resources and groups, training professionals and the public and creating easier access to involvement opportunities, the PPI team has had a busy first year, and the value of a shared PPI strategy group has already been felt. The public contributors are influencing the partners in a strategic way and are part of their governance arrangements. The group has led on developing good practice standards for operational issues such as the payment of public contributors, the process of selection and management of the different roles that public contributors take on. This approach to PPI will be evaluated as part of the research and evaluation agenda of NIHR CLAHRC West.

Recognition for Bristol’s health research and teaching excellence

Bristol’s universities performed strongly in the 2014 Research Excellence Framework (REF), particularly in health related subjects. The REF recognised the University of Bristol’s health research as world leading and internationally excellent. The impact of its research in both clinical medicine, and public health, health services and primary care is ranked first in the UK; it is home to one of the UK’s best dental schools, and its health research environments are among the best in the country.

The University of the West of England (UWE) submitted 50 allied health professions, nursing and biomedical staff to the REF, the most UWE has ever submitted, resulting in research income of £1.5 million annually for this unit of assessment alone.

UWE, which has the largest NHS university training contract in the UK, has also won several significant contracts from Health Education South West to deliver healthcare education for the community and primary care workforce and return to practice.

NIHR has funded the Institute of Biosensing Technology at UWE as one of eight Healthcare Technology Co-operatives (HTCs) across England. Each HTC acts as a centre of expertise, focusing on a clinical area of unmet need for NHS patients.

In May Andy Ness, Professor of Epidemiology at UH Bristol’s Dental Hospital, was given the prestigious National Institute for Health Research senior investigator award. Senior investigators are the NIHR’s pre-eminent researchers and represent the country’s most outstanding leaders of clinical and applied health and social care research.

In August two scientists from University of Bristol’s Children of the 90s longitudinal study were named by Thomson Reuters as among ‘the world’s leading scientific minds’, whose publications are among the most influential in their fields. They are Professor George Davey Smith, Scientific Director, and Dr Wendy McArdle, Head of DNA Collections. The report, The world’s most influential scientific minds: 2014, lists 3,200 people across 21 fields who have published the highest-impact work that is most frequently acknowledged by other academics. Only the top one per cent of scientists are selected for inclusion in the report.

Open Bionics founder Joel Gibbard, based at UWE, won a prosthetic innovation award in December, from the Limbless Association for his work developing 3D printed robotic hands for amputees.

January saw the appointment of UWE Professor Candy McCabe to the new post of Florence Nightingale Foundation (FNF) Chair in Clinical Nursing Practice Research, created in collaboration with the FNF and the Royal National Hospital for Rheumatic Diseases (RNHRD) and the NHS Foundation Trust in Bath. Candy is Professor of Nursing and Pain Sciences at UWE and a Consultant Nurse at the RNHRD, where she leads on the Trust’s Complex Regional Pain Syndrome Service.