Innovation UK > News > Healthcare > Improving health and wealth of the nation

The NIHR’s 12 Biomedical Research Centres (BRCs) are successfully turning laboratory-based discoveries into cutting-edge new treatments, diagnostic tools and other innovations. These include the world’s first successful gene therapy for a rare, inherited form of blindness, developed by a team from the BRC at the University College London (UCL) Institute of Ophthalmology and Moorfields Eye Hospital.

The NIHR BRCs are at the heart of all five Academic Health Science Centres (AHSCs) announced in March 2009. These are partnerships between leading researchers and frontline NHS staff to improve the transfer of pioneering new treatments into practice.

“We are committed to establishing the NHS as an internationally recognised centre of research excellence – supporting outstanding individuals, working in world-class facilities, conducting leading-edge research focused on the needs of patients and the public.”

Professor Dame Sally C. Davies, Director General of Research and Development, Department of Health

Revolutionising the treatment of type 1 diabetes

Mathematician Dr Roman Hovorka, Principal Research Associate at the Cambridge Comprehensive BRC, is responsible for programming the sophisticated mathematical calculations needed to make an artificial pancreas work exactly like a real pancreas.

He says: “Being part of a pool of experts at the BRC in Cambridge has enabled us to develop a prototype of an artificial pancreas to help people with type 1 diabetes, where the pancreas does not produce insulin needed by the body to control blood sugar. “If successful, this could reduce the need for repeated finger-prick blood tests and insulin injections, helping patients to avoid hypoglycaemia (episodes of low blood sugar), as well as saving NHS costs.

“The ‘pancreas’ consists of a subcutaneous sensor, which detects glucose levels continuously, feeding the results into a computer program that works out how much insulin is needed and delivers it via a small insulin pump.

“So far, overnight clinic tests on over 30 children, adults and pregnant women with type 1 diabetes show that the system can control blood glucose better than standard treatment. We are now working on a home system, which we plan to evaluate in a small pilot.”

From robots to telecare, 21st century healthcare is using increasingly high-tech solutions. Launched in July 2008, the NIHR’s Invention for Innovation (i4i) programme is speeding up the rate at which bright ideas for new hightech products are turned into methods of prevention, diagnosis and treatment.

The NIHR works with representatives from academia, the Association of British Healthcare Industries, small to medium-sized enterprises (SMEs) and other stakeholders to develop this area of its work. As well as a programme encouraging Future Product Development, the NIHR has set up two pilot Healthcare Technology Cooperatives (HTCs) in partnership with the Technology Strategy Board (TSB), Engineering and Physical Sciences Research Council (EPSRC) and the Medical Research Council (MRC). This brings together NHS staff, academics, the medical technology industry and others to concentrate on solving unmet clinical needs in these areas.

Robots for chemotherapy

David Leonard, Executive Lead Pharmacist, Aseptics and Clinical Trials, Imperial College Healthcare NHS Trust, says:

“The support of the NIHR Patient Safety and Service Quality (PSSQ) Research Centre allowed us to embark on an 18-month project to test a brand new robot for making up individual doses of chemotherapy. We were able to evaluate the system using research expertise based in the centre to support staff. The PSSQ Research Centre also helped us to increase the profile of the project and gave us the opportunity to carry out more tests than we would otherwise have been able to.

“The robot allows us to make up individual patients’ chemotherapy more efficiently, which cuts down waiting time for treatment – currently a great source of anxiety. It also reduces the risks of needle stick and repetitive strain injuries.”

IDENTIFYING PREDICTIVE BIOMARKERS

“A key factor in the successful introduction of new drugs for treating cancer will be the identification of robust predictive biomarkers. These will indicate which patients are most likely to derive benefit from novel targeted agents. The NIHR funding for our Experimental Cancer Medicine Centre is already contributing significantly in this context. We have now set up a system of analysing tumour tissue from all the patients (over 500 per year) referred to us for experimental phase 1 trials. Using Sequenom Mass Array technology, we are obtaining important data on genetic alterations in tumour cells, which are beginning to guide our choice of experimental therapy. Examples which are under very active study include the PARP (poly (ADP-ribose) polymerase) protein inhibitors, a powerful new type of anti-cancer drug. These have attracted considerable attention because of high levels of activity and low levels of toxicity in defined cancer populations.”

Professor Stan Kaye is an NIHR Senior Investigator, Professor of Medical Oncology at Cancer Research UK; Head, Section of Medicine, Institute of Cancer Research; and Head of the Drug Development Unit at the Royal Marsden Hospital.

The NIHR’s Challenge Fund for Innovation (CFI) is designed to stimulate a flow of novel ideas that can be turned into NHS products. The CFI also invests in other government departments, research councils and the private sector.

The Institute’s Challenge Fund partners include:

• Assisted Living Innovation Platform of the Technology Strategy Board (TSB);
• Knowledge Transfer Partnerships programme (TSB);
• Medical Futures competition;
• MATCH-PLUS (Multi-disciplinary Assessment of Technology Centre for Healthcare) research collaboration funded by NIHR and the EPSRC;
• Rapid Detection and Identification of Infectious Diseases Innovation Platform (TSB); and
• the Science and Technology Facilities Council (STFC).

Through the NIHR, the Department of Health is piloting a new Small Business Research Initiative with the TSB. A first call for pilot proposals in the area of healthcare infections was issued in October 2008. Working with the pharmaceutical, biomedical and medical devices industries is a key part of the NIHR’s work.

NIHR is the bridge between industry and NHS-facilitated research. Many of the treatments and solutions developed by our researchers can only achieve mass production and roll-out across the NHS with help from industry.

The NIHR’s Clinical Research Network matches patients and public volunteers to clinical studies in the NIHR portfolio. Studies are either fully funded by the NIHR or co-funded with partners such as the MRC, medical charities like the Wellcome Trust, and life sciences industries. Most importantly, the NIHR’s work is making a difference to patients in a very real, tangible way. Their needs, their experiences, their testimony, is what drives the NIHR. Their individual stories are at the same time, heart breaking and heart warming, inspirational, poignant, joyous and every emotion inbetween. They are at the heart of NIHR’s work.

NEW HOPE FOR GLAUCOMA SUFFERS

“Monitoring internal eye pressure – intraocular pressure or IOP – is an essential part of glaucoma management. But as this pressure constantly varies throughout the day, measuring it, as now happens, just two to three times a year is insufficient for effective disease management. As a result, 15% of those diagnosed lose their eyesight within 15 years even though they are under care.

“To help address this problem, with the help of £100,000 from the NIHR, we have developed a soft contact lens device with built-in pressure sensors, which can monitor IOP over at least a 24-hour period. In the long term we hope the lens will be capable of both managing and treating glaucoma through the delivery of IOP-lowering medication, which can be stored within the contact lens and released if pressure rises above a certain threshold. “The money from NIHR’s i4i programme has enabled us to optimise the design and to check its feasibility. The work also includes experimental validation and a limited clinical trial.”

Structural engineer Dr Ahmed Elsheikh is Senior Lecturer in Structural Engineering and leader of the Ocular Biomechanics Group at the University of Dundee. His research could revolutionise treatment for glaucoma, the most common cause of irreversible blindness, which affects 500,000 people in this country.

About the NIHR

The National Institute for Health Research provides the framework through which the research staff and research infrastructure of the NHS in England is positioned, maintained and managed as a national research facility. The NIHR provides the NHS with the support and infrastructure it needs to conduct first-class research funded by the government and its partners alongside high-quality patient care, education and training. Its aim is to support outstanding individuals (both leaders and collaborators), working in world-class facilities (both NHS and university), conducting leading-edge research focused on the needs of patients.

For more information, visit: www.nihr.ac.uk

MAKING A REAL AND TANGIBLE DIFFERENCE

Joshua Pratt, aged two, is one of 310 children whose life has potentially been transformed by NIHR’s randomised controlled trial of ion-exchange water softeners for the treatment of atopic eczema in children.

Joshua’s mother Jo says: “Just after birth, Joshua developed eczema. He had raw, weeping skin all over his face and patches over the rest of his body. It was terribly distressing for him and the rest of our family. We found out about the SWET trial when our GP referred us to Queen’s Medical Centre in Nottingham. We wanted to join it because we were keen to do anything that might help Joshua and other children with eczema.

“We had a water softener – a big box installed under the sink that we had to load with blocks of salt for 12 weeks to remove minerals from the water. We also had a special watch called an Actiwatch for Joshua to wear to see how much he fidgeted at night (a measure of the discomfort the eczema was causing him). “A nurse monitored Joshua’s skin while the softener was in place and then again for another four weeks after it was removed. Joshua’s skin was masses better and since the softener was taken away he has remained eczema-free, although obviously we don’t know for certain whether this was because of the softener.

“Research like this is definitely money well spent and it is good to think that something so simple could help other babies and young children to avoid the misery Joshua went through.”

The trial that Joshua was involved in was led by Professor Hywel Williams, an NIHR Senior Investigator. Professor Williams directs the Centre of Evidence Based Dermatology at Nottingham. He founded and is now director of the Nottingham Clinical Trials Unit and was chair of the Research for Patient Benefit programme for the East Midlands from 2006 to 2009. He has published more than 250 peer-reviewed papers and three books, and raised over £7 million in noncommercial grant funding for investigating skin diseases.

He says: “As a dermatologist, I’m extremely proud to be a Senior Investigator. It’s made me so much more committed to spreading the word about research among the dermatology community. It’s a way of saying research is everybody’s business. It’s not just for academics working in universities and colleges, it’s for all of us.”