Today’s Research, Tomorrow’s Care
Why research matters to you
Dr Peter Isaacs, R&D Director
Dr Megan Thomas, Associate R&D Director
Michelle Stephens, R&D Manager
Joanne Howard, Clinical Research Nurse Manager
Why Research Matters
• All of us have high expectations of the
NHS and its ability to offer the most
cutting-edge care
• Delivering the best possible health
care relies on doing the best possible
research
• Research:
– Underpins the quality of all health services
– Contributes to new advances in conditions and
treatments
– Makes a vital contribution to improved health
outcomes
• In research-active hospitals benefits
are felt by:
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All patients
Staff
Facilities
Culture
Blackpool has largely un-researched populations:
• 12th most deprived local
authority in England
• Large temporary population
• 7th worst nationally, 2nd worst in
the North West for teenage
pregnancy
• 2nd highest suicide rate in males
nationally, 4th highest across both
genders nationally
• 4th highest estimated percentage
of smokers in the North West
• Mortality from cardio-vascular
disease is in the worst 10% of the
North West
• Approx 500 deaths from cancer
each year, in the worst 10% in the
North West
• Blackpool Teaching
Hospitals is research
active
• Supporting a mixed range
of studies – multicentre &
international, including:
interventional, medicines
/ devices and
observational studies
• Working with a variety of
sponsors - NHS,
universities, charities and
pharmaceutical
companies
Research projects
160
140
120
100
80
60
40
20
0
2003/04 2004/05 2005/06 2006/07 2007/08 2008/09 2009/10 2010/11
Studies ongoing
Studies approved
• Historically research activity has
taken place in:
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–
–
–
–
Gastroenterology
Cardiology – with industry
Haematology
Endocrinology
Anaesthetics
• Research has expanded into:
–
–
–
–
–
–
–
–
–
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Stroke
Obstetrics & gynaecology
Critical care
Emergency Medicine
Ophthalmology
Oncology
Microbiology
Orthopaedics
Cardiothoracic
Paediatrics
• Allowing the Trust to build its
research profile across a wider
number of therapeutic areas
Good site to recruit patients
Patient Recruitment
2010-11 Patient Recruitment
1200
1200
20010/11 target
Patients Recruited
1000
1000
800
800
600
600
400
400
200
200
0
0
2008/9
2009/10
20010/11
Apr-10 May-10 Jun-10 Jul-10 Aug-10 Sep-10 Oct-10 Nov-10 Dec-10
Monthly Recruitment
Accumulative Recruitment
The Trust has recruited high calibre clinical research staff:
• 9.5 funded sessions for
consultant staff
• 24 WTE research staff
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–
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Research Nurse Manager
Senior Research Nurses
Research Nurses & Midwives
Clinical Trials Administrators
Senior Pharmacy Clinical Trials
Technician
– Pharmacy Clinical Trials
Technicians
• Research Management and
Governance Staff –
— R&D Manager
— R&D Officer
— R&D Administrator
NIHR CRN North West Exemplar Programme
• Three Exemplar Studies
running in the pilot.
• Opportunity to:
– Streamline systems and
processes for issuing NHS
Permission
– Benchmark performance
against bigger Trusts
– Work with new
pharmaceutical companies
in new areas
– Showcase what we can do
– NHS permissions and
recruitment
Good NHS Permission Times
• R&D Approval in:
– 37 days
– 43 days
– 49 days
• First patient recruited
in:
– 180 days
– 105 days
– 2 days - recruited the
first global patient!
• Achieved Exemplar
standards – rolling out to
all commercial studies
• Blackpool on the map for:
– Senior level and board
engagement in R&D
– Streamlined research
governance processes
– Communication and
Teamwork
– Good demonstrable results
for NHS permission
– First global patient
recruited
• Exciting plans for a new
Clinical Research Centre
for 2011
Research has improved the outcomes for
stroke patients
• Almost half of patient’s admitted to hospital
with stroke develop a Deep Vein Thrombosis
(DVT)
• DVT can:
– cause further complications
– increase the risk of bleeds with anti clotting drugs
• NICE guidance recommended the use of
graduated compression stockings
The Study
CLOTS1
A multicentre, randomised controlled trial of the
effectiveness of graduated compression
stockings in the prevention of DVT and PE in
patients after stroke
March 2001 – November 2008
CLOTS Trial 1
Immobile Stroke patient
Day 0-3 of admission
Routine care
& Stockings
Routine care
Duplex of both legs
at 7-10 days
Duplex of both legs
at 7-10 days
Duplex of both legs
at 25-30 days (optional)
Duplex of both legs
at 25-30 days (optional)
Centralised
6 month follow up
Centralised
6 month follow up
Outcome Measures
• DVT on doppler ultrasound
• Pulmonary Embolism (PE)
• Skin Damage
• Follow up at 6 months
Results
• Thigh length compression
stockings were not
effective in the
prevention of DVT and PE
in stroke patients.
• Skin damage to legs was
higher with patients who
wore stockings than those
who did not.
• Thigh length graduated
compression stockings
were not well liked by
stroke patients.
Implications For Clinical Practice
• Staff on the stroke unit
no longer use stockings
• This change in practice
will save the NHS around
£7 million and 320,000
hours of nursing time.
• NICE guidance amended
January 2010
CLOTS 3
Intermittent Pneumatic
Compression
Patient and Public Involvement in Research
Who are we talking about?
• People who use health
and social care services
• Informal carers and
families
• Organisations
representing the users of
NHS services and
community groups
• YOU !
Why have PPI in Research?
• Leads to better
research
• Clearer outcomes
• Faster uptake of
new evidence
What involvement?
At every stage……….
• Set research
priorities
• Identify the
important questions
that health and
social care research
needs to answer
• Give your views on
research proposals
alongside clinicians,
methodologists,
scientists, other
professionals
• Help assess
proposals for
funding
• Take part in clinical
trials and other
health and social
care research
studies, not just as
subjects but as
active partners in
the research process
• Publicise the results
What can you do today?
• Complete a form with your contact
details
• Indicate how you would be happy to be
involved
• Indicate which areas/conditions you are
particularly interested in
What can you do in the future?
••Inform
Informyour
yourfriends
friendsand
and
family
about
family about research
research
••Liaise
Liaisewith
withthe
thePatient
Patient Reps
Reps
• Respond to our
•Respond
our
requeststofor
help
requests for help
Any Questions?
Thank you
The next Foundation Trust Health Seminar will
take place on
Monday 7th February 2011
between 2 – 3 pm
The topic is:
‘The Importance of Donated Time and Money
and How Fundraising and Volunteering
Benefits the Trust and its Patients’