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Author: Louise Stanley

Possible new disease targets for children with arthritis revealed by first-of-its-kind study

Groundbreaking research by a team from BHP’s Birmingham Children’s Hospital and the University of Birmingham – working with UCL and Great Ormond Street Hospital – has revealed important clues into what is driving disease in children with arthritis.

Cutting-edge techniques have allowed scientists to uncover the unique architecture of cells and signals inside the joint as inflammation takes hold, for the first time.

Published in Science Translational Medicine, the study investigated juvenile idiopathic arthritis in children – caused by the immune system mistakenly attacking joints – which affects more than 10,000 children in the UK. It causes swelling, stiffness and pain in the joints over years or decades, leading to damage of the joints and long-term disability. While there are pain management treatments available, which in some cases achieve remission, there is no cure – and it can take time to find which treatment works for each person. Treatments don’t work in the same way for every child, suggesting there are hidden differences between individuals that we are yet to fully understand.

Deepening the scientific and clinical community’s understanding of the condition is vital if more effective treatments are to be found, and undertaking biopsies in young children provides a new way forward. The study’s potential has been advocated for by families of children with arthritis, who agreed that the procedure would be acceptable to families, especially compared to living with a chronic inflammatory disease.

In a world first, tiny tissue samples were collected from the joint lining when children were having medicine injected into the joint, which were then analysed with advanced imaging and gene-profiling technologies. The fine resolution maps of the joints revealed differences between children of different ages and cell changes in those with more severe disease – creating unique cellular ‘fingerprints’ which may help researchers understand why some drugs work better for some children, and not others. The joints of children with arthritis also looked significantly different to those with adults, demonstrating the need to understand arthritis in children better.

Mapping out the networks of cells in the joint revealed a barrier layer (pink), with immune cells (navy) flooding in through blood vessels (light blue), which increase in number as the disease continues

Professor Adam Croft, Versus Arthritis Professor of Rheumatology at the University of Birmingham and chief investigator of the study, said: “We know how frustrating it can be for families and young people to find a drug that best works for their arthritis. Finding ways to better predict which medicines will be beneficial for a particular child would mean we were able to treat the disease more rapidly and effectively. To achieve this goal, we first needed to understand what cells make-up the lining of the joint where the inflammation occurs. Equipped with that knowledge, we can now start to tackle the next challenge, determining how these cellular fingerprints within the joint tissue can help us predict which drug will work best, ensuring we give the right drug, to the right child, at the right stage of their disease.”

Professor Lucy Wedderburn, University College London Great Ormond Street Institute of Child Health and Consultant of Paediatric Rheumatology at Great Ormond Street Hospital said: “This study represents a real step change in our work with children and young people who live with arthritis, and has been a huge team effort. Rather than having to rely on blood tests which often do not tell us accurately what is happening in the joint, we can now directly analyse the joint lining, across different types of childhood arthritis and different ages. Our findings show that younger children have different types of immune cells invading their joints compared to older children. Samples from children with arthritis looked different to adult samples, with a different make up of immune cells, blood vessels and distinct connective tissue cells. This suggests that treatments may need to vary depending on age and shows why we can’t just extend studies from adult studies to understand arthritis in children.”

The study was funded by the Medical Research Council, Versus Arthritis, National Institute of Health and Care Research, Great Ormond Street Hospital Charity, amongst others, and delivered through the National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre (BRC).

Instrumental to driving this research forward was Dr Eslam Al-Abadi, a study investigator from the Birmingham Women’s and Children’s Hospital NHS Foundation Trust, who sadly passed away before publication. His incredible efforts in seeking to improve the care of children with this disease are gratefully acknowledged.

Integrated clinic pilot shows potential to cut costs while improving care for children in deprived areas

New research suggests that integrating health and early years support could ease pressure on NHS services while delivering better outcomes for families.

Undertaken by the Birmingham Health Partners (BHP) Evaluation Service, a detailed assessment of the Sparkbrook Children’s Zone (SCZ) in Birmingham found indications that integrating health care with early years and family support in deprived communities may be a cost-effective alternative to standard primary care.

The model-based economic analysis shows that children and young people accessing the SCZ clinic were less likely to attend A&E and require social care support compared to those receiving standard care, with an average cost saving per patient of £44 – achieved mainly by reducing referrals to children’s social care and emergency health services.

Sparkbrook, one of Birmingham’s most deprived neighbourhoods, is the first area to pilot this joined-up approach. The clinic brings together primary care, early years services, and family support under one roof, aiming to provide more holistic and preventative care.

Dr Mark Monahan, Lecturer in Health Economics at the University of Birmingham, explained: “Rising rates of child poverty, mental health issues and emergency hospital use show that our current systems aren’t working well enough for children and families in deprived areas. This pilot shows real promise in delivering better outcomes at lower cost, but we urgently need further evaluation to build the evidence base.”

The analysis showed a lower proportion of emergency department visits among SCZ patients (1.7%) compared to those in standard primary care (2.9%), driven by earlier intervention and integrated support, with SCZ patients were 40% less likely to attend A&E than those in standard care. This reduced reliance on emergency and social care services translated into significant potential savings, even with the limited data currently available. Early Help services embedded in the clinic were a key driver of cost-effectiveness by addressing complex family needs earlier.

While these findings are based on preliminary modelling, the results support NHS England’s ambition to develop more community-based, joined-up care models for children and young people.

The study also highlights the need for more robust and long-term data to support the national roll-out of similar models. It calls on policymakers, researchers and practitioners to work together to address evidence gaps and ensure these innovations are scalable, sustainable and capable of tackling entrenched health inequalities.

The Birmingham Health Partners Evaluation Service was established in 2022 to provide time-sensitive, formative evidence on innovations in healthcare and capacity building. It carries out rapid and effective service evaluations, often running in parallel with service implementation; helps spread learning to other sites; and helps build local capacity for in-house evaluations.

New partnership with ABHI places Birmingham at the forefront of healthtech innovation

A new strategic partnership with the Association of British HealthTech Industries (ABHI) will see Birmingham Health Partners (BHP) work collaboratively to unlock innovation, accelerate research translation, and improve health outcomes across one of the UK’s most diverse regions.

ABHI is the UK’s leading industry association for health technology (HealthTech), supporting its members – including both multinationals and small and medium sized enterprises (SMEs) – to save and enhance lives through developing products from syringes and wound dressings to surgical robots, diagnostics and digitally enhanced technologies.

This new Memorandum of Understanding (MoU) between ABHI and BHP reflects a shared ambition to better connect the HealthTech industry with the academic and clinical excellence embedded across Birmingham and the wider region. The partnership will provide a more coordinated route for HealthTech companies to access world-leading expertise, infrastructure and patient insight, enabling technologies to be developed and evaluated with relevance to real-world settings.

Members of ABHI and BHP meet in Birmingham to formalise the MoU agreement

The agreement signposts BHP as the “front door” to the region – a clear entry point for HealthTech and life sciences companies looking to collaborate across the city’s extensive ecosystem which boasts globally ranked academic institutions and attracts significant health and life sciences research funding.

Importantly, Birmingham’s population provides a powerful testbed for innovation. As one of the youngest and most ethnically diverse cities in Europe, with a stable and rooted population, it offers the opportunity to generate insights and outcomes that are both locally relevant and globally applicable – presenting a unique opportunity to develop and scale interventions that reduce health inequalities and improve access for underserved groups.

Women’s health and mental health have been highlighted as critical areas of focus, with both ABHI and BHP committed to closing gender health gaps through innovative approaches and technology-enabled, whole-person models of care – as well as helping to reimagine mental health care, deliver earlier interventions, and support more equitable outcomes.

The partnership will measure success against three overarching priorities:

  • Demonstrating measurable improvements in clinical outcomes.
  • Ensuring that technologies are scalable and relevant to population health, not just individual conditions.
  • Addressing inequalities in access and experience of care, in support of a fairer, more resilient health system.

This collaboration builds on recent findings from the Health Innovation Network’s Size of the Prize analysis, which highlights the £278 billion economic potential that healthcare innovations could unlock if adopted at scale. It reflects ABHI’s strategic commitment to nurturing regional partnerships that not only drive economic growth, but also deliver tangible improvements in people’s lives.

Main image caption Executive Director of Birmingham Health Partners, Professor Neil Hanley, and ABHI Chief Executive, Peter Ellingworth, sign the MoU agreement

New evaluation sheds light on virtual wards in Birmingham and Solihull

A new study by the Birmingham Health Partners (BHP) Evaluation Service has provided timely insights into the early implementation of virtual wards (VWs) across Birmingham and Solihull, identifying critical enablers – as well as barriers – to their success.

Commissioned by University Hospitals Birmingham and led by researchers at the University of Birmingham’s Department of Applied Health Sciences, the evaluation explored virtual wards introduced under the NHS England VW programme – focusing on services supporting patients with frailty, respiratory conditions, recent surgery, and musculoskeletal issues, with a detailed analysis of the respiratory VW designed for early supported discharge of COPD patients.

The study comprised four distinct workstreams: qualitative research to understand the factors influencing VW design and development; surveys and interviews to recognise the experiences and perspectives of staff; evaluation of patient outcomes; and a health economics analysis to assess the cost-effectiveness of the respiratory VW vs usual care.

Key findings highlight the importance of consistent referral pathways, the urgent need for interoperable IT systems, and the value of digital tools tailored to varying levels of patient literacy and connectivity. The report also stressed the need for more staff training, clearer communication with patients and carers, and greater involvement of frontline staff and patients in shaping future services.

While the health economic analysis showed promise, it also exposed significant data gaps – including length of stay and readmission rates – that need to be addressed to fully assess the cost-effectiveness of virtual wards.

Dr Ian Litchfield, Senior Research Fellow at the University of Birmingham, said:
“Virtual wards offer an exciting opportunity to deliver care more flexibly and closer to patients’ homes. But for them to work at scale, we need to move beyond enthusiasm and address the real-world challenges around infrastructure, communication, and equity. This evaluation is a first step towards designing services that truly meet the needs of patients and staff alike.”

The findings will inform future development of virtual ward models, not only in the Birmingham and Solihull Integrated Care System but across the wider NHS landscape.

The report can be downloaded from https://www.birminghamhealthpartners.co.uk/for-researchers/evaluation-service/

It also appears in the Journal of Medical Internet Research – https://www.jmir.org/2025/1/e75406

ENDS

The Birmingham Health Partners Evaluation Service was established in 2022 to provide time-sensitive, formative evidence on innovations in healthcare and capacity building. It carries out rapid and effective service evaluations, often running in parallel with service implementation; helps spread learning to other sites; and helps build local capacity for in-house evaluations.

Promising new steroid drug could offer safer arthritis treatment

Early research has found that a new steroid drug, used for treating Duchenne Muscular dystrophy, has shown significant promise in treating inflammatory diseases such as rheumatoid arthritis.

Research published in Rheumatology revealed that Vamorolone, a glucocorticoid, showed to be just as effective as standard glucocorticoids to treat inflammation but with minimised negative side effects.

Glucocorticoids are some of the most widely used drugs to treat patients with a diverse range of inflammatory diseases. Unfortunately, whilst they effectively reduce inflammation and pain, they can also cause severe side effects. These include muscle and bone loss that can increase the risks of falls and fractures.

Vamorolone is a unique metabolism-resistant steroid approved by the FDA which appears to provide significant anti-inflammatory benefits while causing fewer harmful effects on muscle and bone.

The study, funded by the Foundation to Eradicate Duchenne and utilising mouse models with chronic rheumatoid arthritis, shows Vamorolone could be a promising alternative treatment for patients living with the disease.

Dr Rowan Hardy, Associate Professor in Steroid Metabolism and Signalling at BHP founder-member the University of Birmingham, said: “If Vamorolone is effective in patients with rheumatoid arthritis, it would allow us to better control disease activity, whilst preserving muscle and bone to reduce the risks of fractures and falls.”

The study team have now secured further funding with the Foundation to Eradicate Duchenne that will allow the research team to better understand the processes whereby Vamorolone is able to protect muscle and bone in patients with inflammatory disease. 

Through their involvement with the Birmingham Rheumatology group under Professor Adam Croft, and the NIHR Birmingham Biomedical Research Centre’s Inflammatory Arthritis Theme, the team will now work with clinicians to examine the possibility for new clinical trials to examine Vamorolone in rheumatoid arthritis patients. 

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BHP announces exciting new role for its outgoing Chair

Birmingham Health Partners (BHP) has announced its Chair, Jonathan Pearson, will be stepping down at the end of his two-year term in September 2025, following his appointment as Chair of BHP member Health Innovation West Midlands (HIWM).

A highly experienced health business leader, Jonathan has chaired BHP for the past 18 months and has overseen significant progress and growth within the partnership – most notably, a new five-year strategy and the addition of Birmingham Community Healthcare NHS Foundation Trust as its ninth member.

Professor Lorraine Harper, Managing Director of BHP said: “We are incredibly grateful to Jonathan for his strategic leadership of BHP during a period of substantial change for our organisation, and look forward to continuing to work with him in his new role as Chair of our member HIWM.”

Professor Neil Hanley, Executive Director of BHP and Pro-Vice-Chancellor and Head of the College of Medicine and Health at the University of Birmingham, said: “I would also like to thank Jonathan for his hard work, enthusiasm and friendship over the last couple of years. Jonathan’s appointment to HIWM is a great opportunity to further strengthen relationships and partnerships across the West Midlands, and we are delighted that he will continue to contribute to Birmingham’s health and life sciences in his new role. He has a passion for healthcare innovation that sits at the heart of the Government’s ambitions for the NHS. We will soon begin our search for Jonathan’s successor, a process which will be led by Professor Sir Bruce Keogh.”

Jonathan commented: “I would like to thank the BHP Board, Neil, Lorraine and all the BHP team for their support and their excellent work in leading and reshaping the partnership over the last two years.  I wish BHP ongoing success and I look forward to continuing to work with the partnership in my new role.”

HIWM is one of 15 Health Innovation networks across England, working in partnership with NHS trusts, SMEs, care homes and universities to implement new healthcare and life sciences innovations at scale and pace. By enabling the healthcare system to take advantage of innovations that can help to save time, money and lives, HIWM is working to bring the West Midlands the future of health and social care, today.