Skip to main content

BHP’s health inequality lead set to head up NIHR Challenge Maternal Disparities Consortium

Written by Louise Stanley on . Posted in Birmingham Health Partners, Health inequalities, Maternal health.

Professor Joht Singh Chandan – BHP’s heath inequalities lead and Clinical Professor of Public Health at the University of Birmingham – has been announced as co-lead of a new consortium which will research inequalities faced by expectant and new mothers.

The new NIHR Challenge Maternity Disparities Consortium is led by nine UK universities, all aiming to tackle inequalities in maternity care while building capacity for further research to help improve services over time. The consortium will help support professionals who plan and deliver services for women and babies across both health and social care.

Professor Chandan said: “I am honoured to take on the role of co-lead for the NIHR Maternity Disparities Consortium. Tackling inequalities in maternity care is a critical priority, and this consortium brings together a wealth of expertise to drive meaningful change.

“Our goal is to address disparities before, during, and after pregnancy by focusing on research that leads to real improvements in care for families and their babies across the UK. I am particularly looking forward to learning from and working alongside the communities most affected by these inequalities, ensuring that their insights shape our work and lead to lasting, impactful solutions.”

Professor Chandan will be joined by co-lead Dr Victoria Hodgetts Morton from the University of Birmingham, Dr Beck Taylor from Warwick University, Professor Will Parry-Smith from Keele University and Dr Marion Gibbon from Birmingham City Council.

Professor William Parry-Smith, Professor of Obstetrics and Gynaecology at Keele University, said: “I’m pleased to be leading Keele’s contribution to this nationally important work. Research and capacity building undertaken by the consortium will tackle the problem of maternity disparities. We have the opportunity in the West Midlands to understand and to then make a real difference crucially to improving maternity outcomes.”

Dr Beck Taylor, Clinical Associate Professor in Public Health, University of Warwick said: “This new consortium is an unparalleled opportunity to tackle the persistent maternity inequalities affecting life chances across the UK. These unacceptable differences are felt particularly by communities in our own region, the West Midlands. This consortium the first of its kind, and we cannot wait to get started on this programme. As part of the consortium we’ll bring together the communities, professionals and researchers to drive the change that women, babies and society urgently needs.”

Professor Marian Knight, Scientific Director for NIHR Infrastructure, said: “We are delighted by the level of engagement shown by researchers with this important research priority. I am confident we have an exceptional consortium to tackle the challenge of maternity inequalities; working in partnership with existing NIHR funded infrastructure and programmes. We look forward to working with the consortium and their collaborators across the UK to develop the final plans for their ground-breaking new research projects over the next few months.”

Health Minister Baroness Gillian Merron said: “Every woman should receive safe, personalised and compassionate maternity care, regardless of background. We are determined to tackle the stark and unacceptable inequalities in maternity services and are working with NHS England to urgently improve care. Government-funded research like this is crucial to driving positive change.

“This is part of our mission to build an NHS fit for the future by harnessing the full potential of our research and life sciences sector.”

You might also be interested in:

BHP welcomes Birmingham Community Healthcare to strategic research alliance

Written by Louise Stanley on . Posted in Birmingham Health Partners, Health inequalities.

Birmingham Community Healthcare NHS Foundation Trust (BCHC) has become the sixth NHS member of Birmingham Health Partners – and its ninth overall – adding crucial community care to the city’s strategic health research alliance for the first time.

BCHC provides more than 100 core NHS community services for the 1.1m people in Birmingham, as well as specialist rehabilitation and dental services for the wider West Midlands population of 6.5m. Its vision is to provide the best care possible to support the people who use its services, many of whom are among the most vulnerable in our society, to live well in healthy communities.

The Trust is active in research, with live projects including the EPIC Neck Study – evaluating a new approach to exercise for people with persistent neck pain – and Move More, which is testing the feasibility of an app to help people with long-term disabilities to increase their activity levels. Both of these studies are being delivered collaboratively with BHP founding member the University of Birmingham, with whom BCHC also works closely at Birmingham Dental Hospital.

Professor Lorraine Harper, Managing Director of BHP, commented: “BCHC provides vital services to adults and children across the city and beyond. Being responsible for the healthy management of long-term conditions and chronic illnesses, and a strategic focus on promoting equity and reducing health inequalities, their values align perfectly with BHP’s strategic objectives. We are excited to extend our collaborations with BCHC across our membership for the benefit of the patients and communities we serve.”

Dr Robbie Dedi, Chief Medical Officer at BCHC commented: “We are on a challenging journey to improve the health of our communities whilst ensuring equitable access and outcomes. Joining with BHP provides a really exciting opportunity to expand the research and evidence base across this field and translate this into practice. We look forward to BHP supporting research capability of our teams so they can make a lasting impact on patient care within their fields.”

E-MOTIVE wins prestigious Trial of the Year Award

Written by Louise Stanley on . Posted in Clinical trials, Health inequalities, Maternal health.

The landmark E-MOTIVE study, led by University of Birmingham researchers and coordinated by the Birmingham Clinical Trials Unit, as been awarded ‘David Sackett Trial of the Year Award’ by the Society of Clinical Trials, recognising the importance of the findings and the potential impact as the simple, low-cost approach is rolled out around the world, dramatically improving maternal health across the globe. The trial tested a package of low-cost interventions that resulted in a 60% reduction in heavy bleeding following childbirth.

Each year the award goes to a randomized, controlled trial published in the previous calendar year that is considered to improve the lot of humankind and provide the basis for substantial, beneficial change in healthcare, amongst other criteria.

“This has been the largest set of nominations for the Trial of the Year Award in all my time on the committee. We received numerous nominations for worthy trials, from around the world and across a large number of clinical disciplines – including obstetrics, emergency medicine, infectious disease, and cancer. We had a challenging time as a committee to choose a winner” said Andrew Cook, Chair of the SCT David Sackett Trial of the Year Committee.

Postpartum haemorrhage (PPH), or severe bleeding after birth, is the leading cause of maternal deaths worldwide. It affects an estimated 14 million women each year and results in around 70 000 deaths – mostly in low and middle-income countries – equivalent to 1 death every 6 minutes. The E-MOTIVE study found that objectively measuring blood loss using a simple, low-cost collection device called a ‘drape’ and bundling together WHO-recommended treatments – rather than offering them sequentially – reduced severe bleeding by 60%, and women were less likely to lose their life.

Dr Adam Devall collected the award, on behalf of the E-MOTIVE team, from the Society of Clinical Trials 45th Annual Meeting, in Boston, USA, and said: “I’m honoured to accept the Trial of the Year Award on behalf of the E-MOTIVE project. E-MOTIVE was a huge international team effort, and this award speaks to the dedication of teams at each of our 80+ sites. More high-quality clinical trial evidence is desperately needed for pregnancy and maternal health so we’re delighted to receive this recognition of our work and the impact it will have on deaths from PPH.”

Professor Arri Coomarasamy, who led the E-MOTIVE trial and is the Co-Director of the WHO Collaborating Centre on Global Women’s Health at the University of Birmingham said: “This new approach to treating postpartum haemorrhage could radically improve women’s chances of surviving childbirth globally, helping them get the treatment they need when they need it”.

You might also be interested in:

Birmingham Health Partners announces theme leads to drive strategy

Written by Louise Stanley on . Posted in Birmingham Health Partners, Clinical trials, Health inequalities.

The second city’s clinical-academic alliance, Birmingham Health Partners, has appointed three strategic theme leads to support the implementation of its new five-year mission: to work together, transforming Birmingham’s healthcare through high impact innovation.

Taking the new role of Health Inequalities Lead, Dr Joht Singh Chandan is a Clinical Associate Professor in Public Health at the University of Birmingham where his research focuses on identifying and addressing health inequalities – with a particular interest in abuse and violence prevention inspired by many years of working as a voluntary police officer.

As the UK’s third-poorest city, with a diverse ethnic profile and socioeconomic demographics, Birmingham experiences significant health disparities. Joht will develop a detailed action plan for improving population health in the city, underpinned by his experience of issues that impact widely on health and wellbeing; factors that prevent early detection; and barriers to accessing healthcare.

Joht said: “We shouldn’t see reducing health inequality as just the responsibility of public health bodies. The determinants of inequality are so interlinked that not only can we not tackle issues in isolation, we can’t tackle them as one institution. Working across the partnership and linking health data platforms, we’ll be able to work in a much more representative and inclusive way to improve physical and mental health outcomes for our local communities.”

Tasked with optimising data integration across the partnership, Professor Simon Ball has been appointed Academic Lead for Data. A Consultant Nephrologist, Simon has had various roles in developing electronic health care records and using data to improve patient care and support research. His other roles currently include Associate Director for the Midlands Health Data Research UK and Senior Responsible Officer for the West Midlands Secure Data Environment (WMSDE).

Simon said: “NHS Trusts in Birmingham were among the first to adopt electronic health records systems, meaning we have access to a wealth of data – including blood tests, scans and biopsies – spanning several decades. This can provide valuable insight into an array of diseases, health conditions and care pathways – but only if it is integrated. Working together, BHP and the WMSDE can ensure our data is analysed, learnt from and used to optimise healthcare across our region.”

Leading the ‘Reducing Bureaucracy in Clinical Trials’ programme is Amy Smith, an experienced Senior Programme Lead with considerable experience in clinical trials across multiple BHP NHS Trusts and NIHR infrastructure. The programme responds to the challenges identified by Professor Adam Tickell and Lord O’Shaughnessy, ensuring patients in Birmingham get access to clinical trials more quickly. 

Amy said: “I am very proud to be leading this exciting project which showcases BHP as a leader in clinical trials.  Through trust, transparency, and collaboration we will harness the extensive knowledge and expertise within BHP, delivering improved setup times. Ultimately our aim is to make trials accessible to a diverse range of patients, quicker – increasing our attractiveness to funders and industry partners.”

Improving screening in underrepresented groups for genetic condition with heart complications

Written by Louise Stanley on . Posted in Early diagnosis and detection, Health inequalities.

Researchers from across BHP are collaborating with community groups and Amicus Therapeutics to improve screening and diagnosis of Fabry disease, a rare and inherited condition where complications affect the heart muscle, and can lead to premature death.

Through the project, the team – from University Hospitals Birmingham NHS Foundation Trust and the University of Birmingham – has begun to build advisory groups in collaboration with community leaders, healthcare professionals and patients from black, South Asian and other minority ethnic groups. These advisory groups will support researchers to understand patient perspectives on possible barriers to diagnosis, as well as possible approaches to breaking down these barriers. Once further funding is secured, these approaches will be trialled locally in Birmingham, a super-diverse city.

The incidence rate of Fabry disease in the general population is reportedly around 1 in 100,000, although this is likely an underestimate of its true prevalence. Although Fabry disease is very rare, as a genetic condition, patient’s family members have a higher likelihood of the disease that the wider population. Therefore, family screening and mapping is an important tool to identify more cases.

Identifying Fabry disease is important, since the earlier that a patient is diagnosed the better the prognosis for treatment. There are several therapies available, including enzyme replacement and methods to make the faulty enzyme that causes Fabry disease work better, all of which are more effective if started earlier. Without treatment, patients may develop significant cardiac, renal and cerebrovascular complications.

Project lead Richard Steeds, Honorary Professor of Cardiovascular Medicine and Deputy Director of Clinical Research within the Institute of Cardiovascular Sciences at the University of Birmingham and Consultant in Cardiovascular Imaging at University Hospitals Birmingham, explained: “Previous work has shown that Black, South Asian, and other minority ethnic groups, as well as patients from lower socioeconomic groups, are underrepresented in our clinic in Birmingham, despite it being a very diverse city. This knowledge helped us to identify a need for further research to understand and overcome specific barriers to family screening that are more prevalent within minority ethnic groups. If we can address these barriers, then we can support more people to benefit from beginning treatment for this rare condition sooner. Working with members of different community groups is essential to making this work.”

It is well established that minority ethnic groups face health inequalities from language barriers, lower health literacy and cultural difference that contribute to stigma and fear of discrimination that can impact on help seeking behaviours. These inequalities can lead to poorer health outcomes, so addressing them is vital.

Fabry disease can often take many years and several doctors’ appointments to diagnose because many of the symptoms are also attributed to more common causes. Family screening has the potential to help identify more cases sooner.

Some of this work has been funded through a collaboration project with Amicus Therapeutics.

You might also be interested in:

AI – safe and effective for everyone: new standards released by BHP members

Written by Louise Stanley on . Posted in Health inequalities.

An international initiative called STANDING Together – led by BHP founder-members University Hospitals Birmingham NHS Foundation Trust, and the University of Birmingham – has released new standards ensuring that medical artificial intelligence (AI) systems are developed with appropriate health datasets.

The STANDING Together recommendations ensure that the full diversity of people that AI systems will be used for, is represented in health datasets. This is imperative as AI systems are less likely to work well for people who aren’t properly represented in datasets – and may even be harmful. People who are in minority groups are particularly likely to be under-represented in datasets.

The recommendations provide guidance on collecting and reporting details such as age, sex, gender, race, ethnicity, and other important characteristics, and have been developed following a two-year research study involving over 350 people from 58 countries, including patients, researchers, healthcare professionals, industry experts, and regulators. They also recommend that any limitations of the dataset should be transparently reported to ensure that developers creating AI systems can choose the best data for their purpose. Guidance is also given on how to identify those who may be harmed when medical AI systems are used, allowing this risk to be reduced.

The research has been conducted with collaborators from over 30 institutions worldwide, including universities, the UK medicines regulator (the Medicines and Healthcare products Regulatory Agency, MHRA), patient groups and charities, and small and large health technology companies. The work has been funded by The Health Foundation and the NHS AI Lab and supported by the National Institute for Health and Care Research (NIHR).

Lead researcher Dr Xiaoxuan Liu, Clinical Scientist in AI and Digital Health Technologies at the University of Birmingham, explained: “AI models are underpinned by data, which captures a wealth of information. When dealing with health data, this information can unfortunately include existing health inequalities. These inequalities can come about in many ways, including underrepresentation of particular groups, or as a reflection of structural biases within wider society. It is vital that anyone using data to develop new innovations (including AI) are aware of any biases, and that they are accounted for. As we move towards an AI-enabled future, we can ensure these technologies don’t just work on average, but that they work for all.”

Dominic Cushnan, Director AI, Imaging & Deployment at the NHS AI Lab, said: “The lack of diversity and inclusivity in our current datasets are major challenges in our ability to ensure AI in health and care works for everyone. These standards are an important step towards transparent and common documentation of represented groups in our data, which can support the responsible and fair development and use of AI.”

The recommendations are available open access at www.datadiversity.org/recommendations to support the development of safe, effective and equitable AI tools for healthcare.