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BHP members join new Mission for mental health research

BHP members the University of Birmingham, Birmingham Women’s and Children’s NHS Foundation Trust and Birmingham & Solihull Mental Health NHS Foundation Trust, are part of the Government’s new Mental Health Mission – designed to develop radical new treatments for mental health conditions.

The £42.7M investment into research aims to improve the speed and accuracy of diagnosis and increase the use of new technologies, as well as novel and targeted treatment approaches for those with mental illnesses – including young people at Forward Thinking Birmingham (FTB), the city’s unique 0-25s Youth Mental Health Service.

The Mission will be delivered through the National Institute for Health and Care Research (NIHR) Mental Health Translational Research Collaboration, a UK wide network of leading investigators specialising in mental health research.

In Birmingham, £9.9 million in funding will enable the establishment of the Midlands Translational Research Centre of Excellence, co-led by the Universityof Birmingham with Birmingham Women’s and Children’s Hospitals and Birmingham & Solihull Mental Health NHS Foundation Trust, with reach across the Midlands through the five years’ funding.

Research will focus on increasing recruitment to new studies to test and validate treatments in early psychosis, depression and children and young people. We will work with people with lived experience to comprehensively understand the best way to test novel treatments. There are also plans to train and support a network of new researchers, partners, NHS staff and young people in the Midlands.

Professor Rachel Upthegrove, Professor of Psychiatry and Youth Mental Health at the University of Birmingham and Mental Health Research and Development Lead at Birmingham Women’s and Children’s NHS Foundation Trust, said: “We’re delighted that the Government is making such a significant investment in mental health research. This funding will allow us to increase and lead large-scale early intervention trials aimed at delaying or preventing the onset of severe mental illness, and its impact, with evidence-based treatments and support.

“The Centre will put research where we need it most, focusing on young, superdiverse, and deprived populations, which may be unfairly missing out on access to research.”

Teams at the Research Centre will work with individuals with lived experience to understand the best way to test treatments. There are also plans to train and support a network of new researchers, partners, NHS staff and young people in the Midlands.  

Building on the priority healthcare missions launched in November 2022 as part of the Life Sciences Vision, the Mental Health Mission will promote collaboration across different sectors to bolster research and attract further investment from industry and research organisations.

Nationally, the Mental Health Mission will be chaired by Kathryn Abel and Husseini Manji. In a joint statement, they said: “We are delighted to be working together to make the new Mental Health Mission a truly revolutionary force behind mental health research. We want the Mission to create tangible differences to the lives of patients, both in the UK and internationally. Between us, we bring a wealth of experience in mental health research and innovation, and a commitment to genuine collaboration with patients, industry and healthcare staff.

“Bringing together the public sector, patients and industry as equal partners, the Mission will work with the Office for Life Sciences and the National Institute for Health and Care Research (NIHR) to support the NHS and NIHR to capitalise on its size and scope, and on the depth of its data resources. Alongside additional investment in mental health research and infrastructure, the Mission will foster a step change in the way we think about mental health, mental illness and its treatment. This will support development of the critically needed treatments across the spectrum of mental illness.

“We want the UK to be the most attractive place to conduct robust, high impact mental health research, ensuring people have access to the best, and newest, treatments. We are confident that the Mission will be unique in its ability to convene and challenge national partners to make this happen.”

 

£2m study aims to improve early stage ovarian cancer diagnosis

A £2 million study will see an advanced test used at GP surgeries in the West Midlands to diagnose early-stage ovarian cancer – potentially saving thousands of lives a year.

The project involves BHP members Sandwell and West Birmingham (SWB) NHS Trust and the University of Birmingham collaborating with Walsall Healthcare NHS Trust (WHT) and primary care provider Modality, to offer a blood test called ROMA to patients experiencing symptoms of ovarian cancer.

Signs of the disease include bloating, stomach pain, needing to urinate more often and always feeling full.

If symptoms persist or are severe, frequent or out of the ordinary, women are urged to see their GP where – usually – a CA-125 blood test will be carried out, which has around a 50% detection rate of early-stage cancer.

However, the advanced ROMA test used during this trial at Modality-run GP services in Walsall, Sandwell and West Birmingham, will identify key markers of this particular disease at an earlier stage.

If a patient has tested positive, they will be referred to their local Trust to attend a new one stop clinic where they’ll see a consultant, undergo a specialist scan and then a further consultation where the results will be shared. They will be referred for further treatment if needed.

Speaking about the study, called SONATA (tranSforming Ovarian caNcer diAgnostic paThwAys), Sudha Sundar, Professor of Gynaecological Cancer at the University of Birmingham and Consultant Surgeon at SWB NHS Trust, said: “Ovarian cancer is rare and there is a need to increase the understanding and awareness of the symptoms associated with it among our population and GPs.

“We know that 90% of women diagnosed with ovarian cancer at stage one will survive, but this drops drastically to 15% if it is picked up during stage four.

“Research conducted with my team at the University of Birmingham found out that the ROMA test is significantly better than current tests (CA125 and ultrasound) used in both pre and postmenopausal women*.

“A previous study had found that the ROMA test detects up to 20% more early-stage cancers than the current test which only picks up 50% of early-stage cancers**. We are putting this research into practice by carrying out this trial.”

“With Modality-run GP surgeries trialling the ROMA test we will be able to establish if it is acceptable to patients and clinicians. By testing many samples across two large laboratories, we will be able to confirm whether the ROMA test has a higher chance of detecting this cancer earlier than the current CA-125 blood test used and whether implementing this across the NHS will be cost-effective.”

Leading on the project, Dr Aamena Salar, medical director for Modality Partnership Community Services, said: ‘Our aspiration is to transform the care of ovarian cancer by earlier detection and better outcomes for our patients.”

Nina Jhita, programme director at Modality, added: “This is true innovation; we (primary care) are delighted to collaborate with key system partners across the West Midlands to really make a difference to the lives of women while demonstrating how this solution can be scaled across the UK.”

The final part of the study will see 41,000 primary care samples sent to the Black Country Pathology Service and South Tyne and Wear laboratories to accurately establish whether using the ROMA test rather than CA125 will be cost effective for the NHS. The results from the study, funded by the NHS Cancer Programme and the Small Business Research Initiative, will be analysed and used to change the way this cancer is diagnosed in the future.

Professor Sundar added: “It’s an exciting study which is a great example of integrated working between all the organisations involved. We are looking forward to finding out the results so that we can change the way this cancer is detected in the future and drastically improve survival rates.”

*Abstract published in July 2023: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD011964.pub2/full
**Further information can be found here: https://pubmed.ncbi.nlm.nih.gov/27540691/

Funding boost for Birmingham rare disease research

BHP founder-member the University of Birmingham has been awarded a £500k Pathfinder Award from the medical research charity LifeArc which will support early-stage projects with a focus on translational development in rare diseases.

The successful projects have now been announced following an internal selection process. Research, conducted by the University of Birmingham and working across Birmingham Health Partners, will begin this spring.

Professor Timothy Barrett, Director of the Centre for Rare Disease Studies (CRDS) Birmingham, commented: “I am thrilled that our Centre for Rare Disease Studies at the University of Birmingham has been successful in securing a LifeArc Pathfinder Award. We are working closely with other organisations from Birmingham Health Partners; Birmingham Children’s and Women’s Hospital and University Hospitals Birmingham; to fund a number of impactful translational research projects through the fund. Our uniquely diverse patient population, and strength in partnership ensures that we are in the best possible position to drive forward research in rare diseases to accelerate progress and ultimately improve patients’ lives.”

Around the world, approximately 300 million people are living with a rare disease. A disease is considered rare if it affects less than 1 in 2000 people. Around 80% of rare diseases have a genetic component. They are often chronic, progressive, degenerative and frequently life-threatening with no existing cure.

Owing to the nature of rare disease, small patient populations make research challenging. Lack of scientific knowledge and quality of information on rare diseases can mean that misdiagnosis is common and treatment options may be limited.

The Centre for Rare Disease Studies supports basic and applied research, in order to build a pipeline of translational research from gene discovery to improving the diagnosis, clinical management and treatment of these disorders.

Research projects that will benefit from the Pathfinder Award include:

      • The NEEDED Study (NanoporE Enhances Diagnosis in rarE Disease), led by Dr Hannah Titheradge, which will investigate the effectiveness of a new type of genome sequencing to identify rare diseases.
      • A proof-of concept study, led by Dr Nekisa Zakeri, which aims to develop a novel ‘off-the-shelf’ T cell immunotherapy capable of providing more effective treatment for patients with a rare liver cancer.
      • The CATCH Study (CArbalivefor the Treatment of CHoleastic Disease), led by Dr Palak Trivedi, looks into whether a new medical device can absorb toxins from the gut to reduce inflammation and scarring in primary sclerosing cholangitis; a rare progressive liver disorder for which no medical treatment has been shown to slow disease progression.
      • Dr Richard Tuxworth and Professor Zubair Ahmed, whose research in DNA damage in nerve cells has already resulted in patent applications covering pathways and mechanisms that could provide new therapies for neurological conditions and spinal cord injury, will now work with Professor Andrew Beggs and Dr Chiara Bardella to investigate the potential for one of these pathways (the ATM-Chk-2 pathway) as a basis for therapies to tackle rare neurological conditions that appear early in childhood.
      • Dr Sovan Sarkar’s study aims to improve the health of patients with rare childhood-onset forms of neurodegeneration by correcting the process of autophagy that normally removes undesirable cellular materials which is detrimental to brain cells called neurons.

Dr Hannah Titheradge, a Consultant in Clinical Genetics at Birmingham Women’s and Children’s NHS Foundation Trust, will investigate the effectiveness of nanopore sequencing – a new type of real time genome sequencing – on a larger group of patients. Previously tested on a very small sample, this new technology showed promise for improving our capability to diagnose rare diseases.

Nanopore sequencing reads more letters in an individual’s genome than the standard sequencing method used to diagnose rare genetic disorders. The NEEDED Study (NanoporE Enhances Diagnosis in rarE Disease) will explore a more detailed approach that could improve the percentage of patients who receive an important genetic diagnosis, which can help those patients and their families face their challenges feeling better informed.

Dr Hannah Titheradge commented: “Receiving a diagnosis can be an uphill challenge for patients with rare diseases and their families. These individuals often wait years for a final diagnosis, having undergone multiple tests and procedures. Having a diagnosis is very important because it helps these individuals better understand their health problems and plan for the future. Some genetic conditions are treatable, and a diagnosis is the first step towards accessing these treatments. We can also understand whether any other family members’ health may be affected. For these reasons, any advance that can be made in improving rare disease diagnostics is invaluable.”

Samira Fakire, Business Manager at LifeArc, added: “We hope that the Pathfinder Award will encourage more researchers to move into the rare disease space and promote the development of a translational culture – pushing more discoveries from the lab into meaningful real-world benefits for patients.”

New device provides early diagnosis for cardiac tamponade

A new diagnostic device, developed to monitor against post-surgery heart strangulation risk, has been introduced by a company formed by Birmingham cardiothoracic surgeon Hazem Fallouh.

Patients recovering from heart surgery can be at risk from a life-threatening condition – cardiac tamponade – where fluid builds up around the heart, strangling its ability to beat properly.

Fallouh Healthcare is developing the device to monitor cardiac patients after surgery, which is when cardiac tamponade usually strikes – and has received a £500k grant from Innovate UK.

Typically, cardiac tamponade happens late at night when the patient is in intensive care. Blood clots accumulate and compress the heart, reducing its ability to pump blood around the body.

Around 45,000 patients in the UK undergo cardiac surgery each year, and it is usually safe. However cardiac tamponade can come on quickly, and diagnosis is difficult as it can be confused with other causes of heart failure. As high as 3 in 10 of all deaths that immediately follow post-cardiac surgery are thought to be due to cardiac tamponade.

If missed, cardiac tamponade can lead to cardiac arrest which is resistant to CPR and requires immediate opening of the patient’s chest in the uncontrolled environment of the intensive care unit – a procedure that has a mortality rate (30-70%), and poor outcomes for those patients who survive.

Consultant surgeon Mr Fallouh, who has worked in many centres of excellence in the UK, invented the device to provide early diagnosis of tamponade, allowing a planned return to surgery to drain fluid and clots around the heart.

Called PerDeCT (Pericardial Device to monitor Cardiac output and diagnose Tamponade), it is the only device to diagnose cardiac tamponade, and provide cardiac monitoring at no extra cost.

In 2021, Dr Fallouh, who has previously commercialised two award-winning inventions in cardiac surgery, received the prestigious Techno-College Innovation Award at the 35th Annual Meeting of European Society of Cardiothoracic Surgery for PerDeCT, by panels of expert surgeons, cardiologists and medical devices and investment specialists.

The device consists of a probe and a balloon, which is placed in the pericardium (the sac around the heart) during initial surgery, and measures cardiac efficiency (cardiac output) as well as predicting the development of tamponade, by looking at the trend in the relationship between balloon inflation and cardiac efficiency. It can be withdrawn through the skin after the patient is recovered.

The intellectual property in the form of a patent is assigned to Fallouh Healthcare Limited.

Fallouh Healthcare is a startup with a mission to deliver smart solutions to unmet needs in order to deliver safer and more effective cardiothoracic surgery.

The company has now taken up residency in Unit 9, a short-term medical technology incubator funded by University of Birmingham Enterprise, the Greater Birmingham & Solihull Local Enterprise Growth Hub and the West Midlands Combined Authority to provide flexible, low-cost facilities for medical research, proof of concept and prototyping activity.

The delivery of the Innovate UK project is in collaboration with University Hospitals Birmingham NHS Foundation Trust (UHB) and the University of Sheffield. The funding from Innovate UK will allow Fallouh Healthcare to build a prototype and conduct a usability study at UHB’s Queen Elizabeth Hospital site, the Medical Device – Testing and Evaluation Centre (MD-TEC).

Birmingham BRC receives £30m boost to improve treatment of inflammatory diseases

Increased funding for the renewed NIHR Birmingham Biomedical Research Centre will enable continuation of major developments around inflammatory diseases and new technologies and systems

The NIHR Birmingham Biomedical Research Centre (BRC) has been awarded more than £30 million in funding from the National Institute for Health and Care Research, a major funder of global health research and training, to support world-leading research into inflammation – including the development of new diagnostic tools and treatments for those with cancer, liver and heart disease, and many more illnesses.

The centre brings together multiple BHP members – including leading NHS providers led by the University Hospitals Birmingham NHS Foundation Trust and academic institutions led by the University of Birmingham – as well as other organisations working closely with charities and businesses. Its aim is to support research into inflammation which causes or worsens many common long-term illnesses including arthritis, liver disease and cancer.

This new investment represents an almost threefold increase in funding for the NIHR Birmingham BRC and will enable researchers to focus on eight areas of illness including heart disease, women’s health, and common complications from inflammation. Researchers will also be empowered to consider new tests and biomarkers for disease, health technologies including stem cells and gene therapy, patient experiences and data science.

Professor Phil Newsome, Director of the NIHR Birmingham BRC, said: “Inflammation plays a central role in many health conditions, with millions of people in the UK alone experiencing inflammatory diseases such as arthritis and bronchitis. This significant increase in funding will enable us to provide an outstanding environment for world-leading clinical research and allow us to make a step-change in our work tackling different forms of cancer, trialling new drugs for liver disease, and dealing with antimicrobial resistance.”

Patients will benefit from the increased funding thanks to the BRC’s collaborative research that has seen nearly 1,000 clinical trials and informed UK clinical guidelines.

Researchers will look at eight themes to continue to understand and help patients manage inflammation-based diseases including cancer, arthritis, and liver disease. The investment of the NIHR funding in biomedical research will enable clinicians, researchers, patients and supporters to find new treatments such as the development of new immunotherapies, which are types of cancer treatments to support the body to fight cancer.

Professor David Adams, Director of BHP, commented: “The investment from NIHR is hugely important for researchers working across the BRC partner institutions, to continue to tackle some of the critical health themes that affect our region. The funding will allow us to deliver new therapies and diagnostic tests for a range of chronic inflammatory diseases for which we currently have few effective treatments.”

Professor Lucy Chappell, Chief Executive of the NIHR, said: “Research by NIHR Biomedical Research Centres has led to a number of ground-breaking new treatments, such as new gene therapies for haemophilia and motor neurone disease, the world-first treatment for Creutzfeldt–Jakob disease, a nose-drop vaccine for whooping cough, and the first UK-wide study into the long-term impact of COVID-19.

“This latest round of funding recognises the strength of expertise underpinning health and care research across the country and gives our nation’s best researchers more opportunities to develop innovative new treatments for patients.”

The Birmingham Biomedical Research Centre is made up of the following BHP member organisations:

  • University Hospitals Birmingham NHS Foundation Trust
  • University of Birmingham
  • Sandwell and West Birmingham NHS Trust
  • Birmingham Women’s and Children’s NHS Foundation Trust
  • Aston University

Working closely with partners:

  • Birmingham Community Healthcare NHS Foundation Trust
  • Keele University
  • University of Oxford

First Midlands research collaboration to focus on patient safety

Expectant mums and anyone needing emergency treatment will both benefit from funding for new research to improve patient safety and reduce the risk of harm.

BHP founder-members the University of Birmingham and University Hospitals Birmingham NHS Foundation Trust will be establishing the first research collaboration focused on patient safety based in the Midlands, thanks to new funding from the National Institute for Health and Care Research. The announcement made today by the Department for Health and Social Care will see £3.4m invested in world-leading research that supports patient safety in maternal and acute care settings.

The newly announced NIHR Midlands Patient Safety Research Collaboration (PSRC) will bring together NHS trusts, universities, and private business to evaluate how digital tools can support clinical decision making and reduce risks for patients.

Professor Alice Turner is a Professor of Respiratory Medicine in the Institute for Applied Health Research at the University of Birmingham, Honorary Consultant Respiratory Physician at University Hospitals Birmingham, and Co-Director of the NIHR Midlands Patient Safety Research Collaboration along with Professor Richard Lilford, Professor of Public Health at the University of Birmingham.

She commented: “Patient safety is at the forefront of every clinician’s mind and runs at the heart of the whole healthcare system. The power of new technology available to us means that we can address one of the ongoing areas of risk for patients, which is effective communication and clinical decision making.

“Thanks to the new funding from NIHR and with the support of partners, the new collaboration will be looking at how digital tools can make a real difference to reduce risks and support patient safety in the key areas of acute medicine and maternal health.”

Acute Care

Patients requiring emergency medical care in acute services will benefit as new digital decision-making tools could improve prescribing and personalised management.

Thanks to the funding, the NIHR Midlands PSRC will trial digital clinical decision support tools which will provide smoother flow of information between healthcare professionals in acute care. Working with acute care hospitals, primary care providers and the West Midlands Ambulance Service, the researchers will review how the digital tools can reduce risks of patient harm at key points in acute care management.

Professor Elizabeth Sapey, Director of the Institute of Inflammation and Ageing at the University of Birmingham and an Honorary Respiratory Consultant at the University Hospitals Birmingham said: “The vision is that every healthcare professional involved in a patients journey in acute care has access to the same information, the same decision-making support, and is able to both spot and flag any point where patients might be at increased risk of harm.

“We know that a disproportionate number of medical errors happen in acute services, and around half of patients experience a clinical error in what can be a complex journey. As acute care becomes more heavily relied on, it is critical that we use technology available to us to ensure that our patients are kept safe and risk is managed.”

Maternal Health

Mothers and babies will benefit from the new research collaboration to look at how digital tools can support antenatal decision making.

The collaboration will examine the effectiveness of clinical decision-making tools to recognise risks among expectant mothers, particularly among marginalised groups who experience worse outcomes and quality of care compared to the general population.

Professor Shakila Thangaratinam, Co-Director of WHO Collaborating Centre for Global Women’s Health at the University of Birmingham and Consultant Obstetrician at the Birmingham Women’s Hospital said: “Maternal and perinatal mortality reports in the UK have highlighted that there are real issues when it comes to identifying and responding to risk. One of the key priorities is identifying early in pregnancy those mothers who need the extra support and care, thereby ensuring that women receive individualised care during pregnancy.

“With this new funding from the NIHR, we can evaluate how digital tools can help clinicians ensure that no mum falls ‘through the net’ in identifying risk, and ensure every family receives the right level of support.”

Partners involved in the NIHR Midlands Patient Safety Research Collaboration

  • University Hospitals Birmingham NHS Foundation Trust (BHP)
  • University of Birmingham (BHP)
  • Birmingham Women’s and Children’s NHS Foundation Trust (BHP)
  • Health Innovation West Midlands (BHP)
  • NHS Birmingham and Solihull Integrated Care Board
  • University of Warwick
  • University of Aberdeen
  • Clevermed Limited
  • West Midlands Ambulance Service University NHS Foundation Trust
  • Shrewsbury and Telford Hospital NHS Trust