Today’s Research, Tomorrow’s Care

Why research matters to youDr Peter Isaacs, R&D Director

Dr Megan Thomas, Associate R&D DirectorMichelle 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:– 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

• Historically research activity has taken place in:– Gastroenterology– Cardiology – with industry– Haematology– Endocrinology– Anaesthetics

• Research has expanded into:– 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

20010/11 target

The Trust has recruited high calibre clinical research staff:

• 9.5 funded sessions for consultant staff

• 24 WTE research staff– 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

CLOTS1A multicentre, randomised controlled trial of the

effectiveness of graduated compression stockings in the prevention of DVT and PE in

patients after strokeMarch 2001 – November 2008

CLOTS Trial 1Immobile Stroke patientDay 0-3 of admission

Routine care& Stockings

Routine care

Duplex of both legsat 7-10 days

Duplex of both legsat 7-10 days

Duplex of both legsat 25-30 days (optional)

Duplex of both legsat 25-30 days (optional)

Centralised6 month follow up

Centralised6 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 your friends and family about research

• Liaise with the Patient Reps

• Respond to our requests for help

•Inform your friends and family about research

•Liaise with the Patient Reps

•Respond to our requests for help

Thank you

Any Questions?

The next Foundation Trust Health Seminar will take place on

Monday 7th February 2011between 2 – 3 pm

The topic is: ‘The Importance of Donated Time and Money

and How Fundraising and Volunteering Benefits the Trust and its Patients’