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Midlands regional health partnership strengthened

Birmingham Health Partners and the West Midlands Academic Health Science Network (WMAHSN) – both based within the ITM – have reinforced their strong working relationship through the appointment of BHP Managing Director Dr John Williams to the WMAHSN board.

The appointment is part of a wider restructure which has seen four new strategic roles created, which reflect the priorities of the new five-year licence period for the WMAHSN – approved by NHS England last year as part of a ten-year vision to drive health innovation and stimulate economic growth.

Dr John Williams has a wealth of experience from a career in academia researching physiology, to a number of strategic positions in the professional biomedical sector at The Wellcome Trust and the Academy of Medical Sciences. These roles encompassed policy communication regarding major government reviews, launching strategic research initiatives as well as grant development and a strategic framework refresh of the Academy of Medical Sciences.

John’s broad range of experience and insight developed over his extensive career in the biomedical sector is of great benefit to both BHP and the WMAHSN. Working with the board and executive, he manages the relationships with and between partners, new and existing stakeholders and industry partnerships. Alongside this John plays a central role in creating and developing the BHP business plan and delivering strategic objectives set by the board.

Tony Davis, previously the Commercial Director with the WMAHSN, now becomes the Director of Innovation and Economic Growth. Kate Hall joins as the new Director of Implementation and Adoption. Rob Chesters will support them as the new WMAHSN Chief Operating Officer.

John and Kate will be joining the WMAHSN for two days a week while continuing their current roles at Birmingham Health Partners and UCL Partners respectively.

“The new appointments are great additions to the WMAHSN, each one recognised regionally and nationally for their contribution to healthcare and healthcare innovation.

“Our ambition is to stimulate the health and wealth of our region through innovation and so we wanted to take an innovative approach to our leadership model, creating a strong, high profile team that reflects the priorities of our new five-year licence and confidently navigates any challenges ahead.”

 Professor Michael Sheppard, Chair of WMAHSN

Initially set up in 2013 to encourage health innovation and stimulate economic growth, the national AHSN Network is made up of 15 regional organisations. In its first five years, the WMAHSN supported 3,000 companies and supported projects in 770 sites across the West Midlands that benefitted nearly 70,000 people.

Tony Davis has been with the WMAHSN since it was established in 2013.  As Commercial Director he has been leading on wealth creation and the innovation pipeline development for the organisation. Before his role at the AHSN, Tony was the CEO of Medilink West Midlands Ltd and the Chair of Medilink UK, promoting the life sciences industry to government organisations and helping SMEs in the marketplace to grow their business.

Kate Hall started her NHS career a ward clerk and since then has worked within and managed many hospital services. She has an extensive background as a senior manager having worked in a number of senior operational roles and is particularly interested in building capability for leadership and improvement, methods for effective implementation and adoption and sustainability of change.

Rob Chesters was previously the Senior Innovation and Research Manager at NHS England, within the Innovation, Research and Life Sciences Group. Prior to that, Rob was a Senior Innovation Manager at the NHS National Innovation Centre, part of the NHS Institute for Innovation and Improvement. He has a background in Innovation policy and adoption and has led the introduction of a wide range of technologies into the NHS. Rob is also experienced in Industrial Design specialising in Medical Product design, Assisted Living and Inclusive Design.

The new structure will come into effect in April 2019.

MedTech Foundation arrives in Birmingham

Research and innovation in medical technology has moved up a gear thanks to the launch of the MedTech Foundation – a group aimed at bringing together students, trainees and early career researchers to drive the translation of bench research to clinical practice.

The launch event was held at the Institute of Translational Medicine in January, hosted and supported by BHP founding members University Hospitals Birmingham NHS Foundation Trust, the University of Birmingham and the NIHR Trauma Management MedTech Co-operative (Trauma MIC). The evening saw the launch of a string of workshops targeting innovators from varying disciplines, and presented them with unmet needs in three clinical areas by experienced clinicians:

  • Vascular surgery
  • Colorectal surgery
  • Anaesthesia and critical care

The event was a great success and subsequent workshops will see attendees form groups and learn about various parts of innovation and development such as commercialisation, IP, branding and regulations. Each team will then produce a “solution” to one of the unmet needs presented by clinical experts, and pitch their idea to a panel for the chance to win seed funding and mentorship to further develop their medical device with the support of the Trauma MIC.

Are you interested in hearing more about the programme, coming to hear the project pitches, or being involved as a delegate or facilitator in future years? If so, register for further information or download the MedTech Foundation flyer.

Premier League footballers participate in new ground-breaking concussion study

Birmingham Health PArtners researchers from the University of Birmingham and University Hospitals Birmingham NHS Foundation Trust (UHB) have launched a new study funded by The Drake Foundation to review and potentially enhance concussion diagnosis in football.

This new study, supported by the Premier League Doctors Group, which is allowing access to players, is running throughout the 2018/19 football season. It involves saliva and urine samples being collected from injured Premier League players, as well as uninjured “control” players, by club doctors immediately post-match and at further time points over the course of a players’ recovery.

These samples are then being tested in BHP laboratories using a new ground-breaking test, called the ‘Birmingham Concussion Test’, which has been developed following a decade of research led by academic neurosurgeon Professor Tony Belli.

The test looks for molecules in the blood, saliva or urine known as microRNAs, which can act as biomarkers to indicate whether the brain has suffered injury. The patented technology from the University is being commercially developed in partnership with Mirna Diagnostics Limited which owns the global patent licence of these biomarkers.

This expands research also being carried out by BHP, which began in 2017 and is currently ongoing, testing the urine and saliva of concussed Rugby Football Union players.

This research is part of the ongoing REpetitive COncussion in Sport (RECOS) study, by BHP in collaboration with the National Institute for Health Research Surgical Reconstruction and Microbiology Research Centre (NIHR SRMRC).

In the future, it is hoped that the Birmingham Concussion Test could be used pitch-side and would have the potential to assist in return-to-play decisions or concussion diagnosis across sports, from grassroots to professional, in addition to military and other frontline settings.

Early and accurate diagnosis

Professor Belli explained: “Early and accurate diagnosis of concussion is one of the biggest challenges we face clinically and is particularly a major concern in the sporting world.

“This exciting new study is an important addition to the breadth of research we are undertaking into concussion and player welfare in sport more broadly.”

Dr Patrick O’Halloran, Sports Concussion Research Fellow at the University of Birmingham, Sport and Exercise Medicine Registrar at UHB, and Academy Doctor at Wolverhampton Wanderers FC, said: “This research has the potential to benefit professional, grassroots and youth level footballers alike, making the process for diagnosing concussion as effective as possible. Similarly, this may be valuable in other sports or for patients in NHS A&E departments.”

James Drake, Founder of The Drake Foundation, a not-for-profit organisation committed to improving evidence-based measures for the management of concussion injuries in contact sport, said: “We are delighted to fund this essential study in Premier League football. The conversation around concussion has come a long way in the last five years and scientific research such as this is essential in keeping our players safe.”

This latest study will also look to evaluate the effectiveness of the current Premier League Doctors Group Standard Operating Procedure for diagnosis of concussion. When a team doctor suspects a player has been concussed, the following data will be sought to accelerate and more accurately diagnose any potential concussion:

  • Pitch-side assessment
  • Video review of the incident at the pitch-side
  • Subsequent clinical reviews of the player after the match and in the days following the game
  • The time course and trajectory of recovery post injury

New sight-saving treatment for eye infection or trauma

Scientists at the University of Birmingham have developed a novel eye drop that rapidly reduces sight-threatening scarring to the surface of the eye.

The surface of the eye (the cornea) is usually transparent, but scars resulting from eye infection or trauma make it opaque causing blurred vision or in extreme cases complete blindness.

Their pre-clinical research, published in npj Regenerative Medicine, shows that within a matter of days the eye drop speeds healing, reduces scarring and improves corneal transparency compared to the current standard of care for Pseudomonas aeruginosa, an eye infection commonly associated with poor contact lens hygiene.

The current standard of care for eye infection are eye drops containing antibiotics and corticosteroids to reduce inflammation, followed by intensive lubrication to prevent further damage to the eye during blinking. These treatments effectively sterilise the eye, although some patients are left with visual ‘hazing’ due to scars on the cornea.

The only option to correct this is costly and cumbersome surgical interventions, such as corneal transplants, which are fraught with risks of failure or rejection.

The Birmingham scientists, led by Professor Liam Grover, Director of the Healthcare Technologies Institute (HTI) at the ITM, and Professor Ann Logan from the University’s Institute of Inflammation and Ageing, have developed the eye drop which consists of a fluid gel loaded with a natural wound-healing protein called Decorin.

Professor Ann Logan said: “This innovative fluid gel in the eye drop is designed to retain the Decorin on the surface of the eye, and form a ‘therapeutic bandage’ that promotes scarless healing.”

Professor Liam Grover explained: “The fluid gel is a novel material that can transition between a solid and liquid state. This means it contours itself to the surface of the eye, is retained there, and is only slowly removed by blinking.”

This research has shown for the first time that the fluid gel has a therapeutic effect in its own right, and the researchers believe it forms a protective barrier that protects the surface of the eye from further damage caused by blinking. The fluid gel has been patented by University of Birmingham Enterprise.

Dr Richard Moakes, also from the School of Chemical Engineering explained: “We are now continuing our work to test and refine the formulation for this novel anti-scarring eye ‘bandage’.”

Dr Lisa Hill, from the University’s Institute of Clinical Sciences, said: “The anti-scarring eye drop has the potential to vastly improve outcomes for patients with eye infection and trauma. It could also help save many people’s sight, particularly in the developing world where surgical interventions such as corneal transplants are not available.”

Biomarkers identified to help diagnose heart condition

University of Birmingham researchers based at the Institute of Translational Medicine have found two biomarkers that could be used to identify a heart condition known as atrial fibrillation in patients who have three ‘clinical risks’.

Atrial fibrillation is the most common heart rhythm disturbance, affecting around 1.6 million people in the UK. Those with atrial fibrillation may be aware of noticeable heart palpitations, when their heart feels like it is pounding, fluttering or beating irregularly. Sometimes atrial fibrillation does not cause any symptoms and a person who has it is completely unaware that their heart rate is irregular.

Now scientists have identified patients are more at risk of atrial fibrillation if they have three ‘clinical risks’ – they are older aged, male and have a high Body Mass Index. These patients, say the scientists, could be screened for atrial fibrillation by testing their blood to see if they have elevated levels of two biomarkers – a hormone secreted by the heart called brain natriuretic peptide (BNP) and a protein responsible for phosphate regulation called fibroblast growth factor-23 (FGF-23).

The research was carried out by scientists from the Institute of Cardiovascular Sciences and the Institute of Cancer and Genomic Sciences at the University’s College of Medical and Dental Sciences and is published today in European Heart Journal.

First author Dr Winnie Chua said: “People with atrial fibrillation are much more likely to develop blood clots and suffer from strokes. To avoid strokes it is important for them to take anticoagulant drugs to prevent blood clotting. However, atrial fibrillation is often only diagnosed after a patient has suffered a stroke.

“Therefore it is important that patients at risk are screened so that they can begin taking anticoagulants to prevent potentially life-threatening complications.”

Joint First author Yanish Purmah added: “An electrocardiogram (ECG), a test which measures the electrical activity of your heart to show whether or not it is working normally, is usually used to screen patients for atrial fibrillation.

“ECG screening is resource-intensive and burdensome for patients therefore it is important that the right patients are selected for this type of screening

“The biomarkers we have identified have the potential to be used in a blood test in community settings such as in GP practices to simplify patient selection for ECG screening.”

Until now, most studies identifying biomarkers in patients with atrial fibrillation have been hypothesis-driven and involved the analysis of a single or small selection of blood biomarkers. In this study, the scientists analysed 40 common cardiovascular biomarkers in a cohort of 638 hospital patients who were recruited between September 2014 and August 2016.

To obtain the results, the scientists combined traditional statistical analysis with completely new and innovative machine learning techniques.

Senior author Dr Larissa Fabritz said: “The research outcomes were surprising. While BNP is already a known and widely used in clinical practice biomarker, the results around the effectiveness of the FGF-23 biomarker was an unexpected and new finding. FGF-23 is only currently used in a research based environment, but we have shown how its use could be invaluable in a clinical setting.”

Corresponding author Professor Paulus Kirchhof, Director of the University of Birmingham’s Institute of Cardiovascular Sciences, said: “We hope that, as the result of our findings, more people with what can often be a silent disease are diagnosed so that any complications can be prevented.”

Funded by the University of Birmingham, the research was supported by CATCH ME, an EU-funded consortium led by the University of Birmingham, the British Heart Foundation and Leducq Foundation. The research was carried out in collaboration with Sandwell and West Birmingham Hospitals NHS Trust, University Hospitals Birmingham NHS Foundation Trust, the European Society of Cardiology, The German Atrial Fibrillation NETwork (AFNET), and Health Data Research UK.

Professor Metin Avkiran, Associate Medical Director at the British Heart Foundation (BHF), added: “Atrial fibrillation increases the risk of stroke, a serious condition that causes over 36,000 deaths in the UK each year, but is often detected too late. This research has used sophisticated statistical and machine learning methods to analyse patient data and provides encouraging evidence that a combination of easy-to-measure indices may be used to predict atrial fibrillation.

“The study may pave the way towards better detection of people with AF and their targeted treatment with blood-thinning medicines for the prevention of stroke and its devastating consequences.”

The research, which began in 2013, is ongoing and next steps will involve follow-up appraisals of the patients recruited to the study in order to further improve the prevention and treatment of atrial fibrillation.

ITM centre becomes part of the National NIHR BioResource network

The Centre for Rare Diseases at the Institute of Translational Medicine has this week become part of the NIHR (National Institute for Health Research) BioResource network. The BioResource team at will be led by Dr Graham Lipkin while Humeira Hafsa, research nurse, will take on the role of Clinical Trials Coordinator.

The NIHR BioResource for Translational Research in Common and Rare Diseases is a national resource of samples collected from patients and members of the public who have volunteered to be recalled for research, based on their genotype and phenotype.

When patients are recruited, Humeira will collect a range of blood samples and add them to the national ‘biobank’ for future use in research. Being involved in biobanking is obviously optional – patients can opt in and out as it suits their lives and condition.

Possible candidates will be identified by Humeira and then approached to become involved and given further information when they come in for an appointment with their own consultant. If interested they will then meet with Humeira who will talk more about the system before signing them up and taking samples.

The NIHR BioResource provides researchers with unprecedented access to highly characterised patients with common and rare diseases, as well as volunteers from the general population. Patients and the public can volunteer to provide a DNA sample and information about their health, lifestyle and family history. Following genomic and phenotypic characterisation, specific individuals can be recalled, on a national basis, to participate in both academic and industry-led early translational (experimental medicine) research studies.

Humeira has been a research nursing assistant for two years, previously assisting in various trials. Before moving across to research she worked as a Health Care Assistant on the wards and started off as an apprentice in business and administration at UHB.

The NIHR BioResource has been established through a partnership with NHS Blood and Transplant, and builds on the expertise of NIHR Biomedical Research Centres and NIHR Clinical Research Facilities.

Over 100,000 people have already been recruited to the NIHR BioResource and up to 50,000 new participants will be recruited each year. The NIHR BioResource is also increasing the number of study participants available through recruitment of people with selected conditions, such as inflammatory bowel disease, fatty liver disease and up to 100 rare diseases.

The NIHR BioResource uses information on people’s genotype, phenotype or both, to match them to research studies that are looking for volunteers with and without health conditions. By joining, you will be helping researchers investigate and understand why some people have a disease. If you would like to join the NIHR BioResource, email: nbr@bioresource.nihr.ac.uk.