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Research by the University of Huddersfield has helped shape policy and practice in the field of surgical site infection (SSI) and wound management. It has contributed to best practice guidance and helped to raise practitioner, industry and public awareness of the importance of effective clinical interventions in infection prevention, tissue viability and wound care. These efforts, recognised by numerous awards, have been supported by significant industry engagement and the successful development and use of on-line tools to share best practice, promote evidence-based care and highlight the value of an inter-disciplinary approach to the problem of SSI.
The PCI is a carefully designed Head & Neck (H&N) cancer pre-clinic consultation checklist and comprises aspects of care and outcomes that patients might wish to raise with the multi-professional healthcare team. The PCI is an innovative and effective tool whose development has been optimised for touch screen devices. (Full details on use of the PCI is given at http://www.patient-concerns-inventory.co.uk/PCI/Home.html.) The PCI has improved patient experiences of clinic consultations, helped development of quality indicators and improved professional practice. The impact of the programme of work has led to its wider implementation nationally as exemplified by its adoption by the British Association of Head and Neck Oncologists (BAHNO), its inclusion in the National H&N Cancer dataset, its emerging use internationally, and its development in other chronic conditions.
It is estimated that there are over a quarter of a million patients with chronic wounds in the UK, and the cost to the NHS is approximately £2-3 billion per year (approximately 3% of NHS budget), with an additional £85-100 million costs as a consequence of psychological disorders associated with chronic wounds. Wounds can place a substantial clinical, social and economic burden on individuals and society. Research examining the relationship between pain and stress and wound healing has had significant benefits for patients with chronic and acute wounds; it has improved clinical practice in wound care; it has led to the development of new wound dressing materials which reduce the pain and stress associated with dressing change; and has brought economic benefits to the business that initially commissioned the research.
Between 1996 and 2013 researchers at Swansea University evaluated service initiatives and changing professional roles associated with the management of patients with debilitating gastrointestinal disorders. This work showed the clinical and cost effectiveness of two main innovations: open access to hospital services for patients with inflammatory bowel disease; and increased responsibility for nurses, particularly as endoscopists. Our evidence has had a broad, significant impact on: national policy through incorporation in NHS strategies, professional service standards and commissioning guides; service delivery through the provision of increasing numbers of nurse endoscopists and the wide introduction of nurse-led open access to follow-up; and patient care, as documented in sequential national audits in 2006, 2008 and 2010.
As a result of research on moisture sensing, Professor Patricia Connolly developed and successfully clinically trialled a disposable, sterile, moisture sensor which enabled real-time measurement of the moisture level in a wound without disturbing the dressing. Ohmedics Ltd was spun out in 2009 to market the disposable sensor and associated hand-held meter. The system, known as WoundSense™, gained the CE mark in 2010. The device is available commercially and is in use in hospitals in Saudi Arabia and Qatar, is starting to penetrate international markets, and had first sales to the NHS in the UK in 2012. The system is being piloted for use with remote monitoring `telehealth' technology. The British military currently (July 2013) have the system in clinical trial for monitoring of complex trauma wounds. The creation of Ohmedics has given specialist employment to 6 people in the company and helps support another 4 skilled jobs at UK contract manufacturers.
A Cardiff researcher has led an International 15 year programme resulting in multiple novel findings which have led to changes in the recommended diagnosis and treatment of acquired haemophilia A (AHA). The research has, for the first time, allowed the comparison of immunosuppressive regimens for inhibitor eradication and comparison of the efficacy of treatment strategies to control bleeds. Studies led directly to the production of UK and International guidelines on the management of AHA with 14 of the 18 specific recommendations in the UK guideline being underpinned by Cardiff-led research.
King's College London (KCL) researchers have created, refined and validated the Palliative care Outcome Scale (POS), a tool that measures the physical, psychological, spiritual and information needs of patients at the end of their lives and their families. The POS has had an outstanding impact on clinical competencies and knowledge, and has underpinned an international collaboration to develop standards for palliative care outcomes. The POS is embedded increasingly in everyday clinical practice, improving the care of patients affected by advanced conditions and providing support for their families. The POS, widely used regionally and nationally in the UK to evaluate and improve the quality of care, has been culturally adapted for use in 20 European Union countries, and in Africa and other countries around the globe.
Professor David Becker and colleagues at UCL's Department of Anatomy (now Cell & Developmental Biology) identified the gap junction protein Connexin43 (Cx43) to be a new therapeutic target for wound healing. Becker then developed NexagonTM, a topically applied antisense gel that knocks down Cx43 production, and both accelerates the healing of acute wounds as well as stimulating healing in chronic wounds. He co-founded a company, CoDa Therapeutics, to develop this technology. The company has raised $42m in finance and has completed good manufacturing practice (GMP) manufacture, toxicity testing and Phase 1 safety trials for both skin and eye indications. It has recently completed both Phase 2a and 2b clinical trials for venous leg ulcers. Nexagon has been given approval for compassionate use on a number of occasions and, in 2009, Nexagon gel was granted Orphan Drug Designation by the Food and Drug Administration in the US for treatment of persistent epithelial defects of the eye.
Research at Hull into hypersensitivity of the airways has provided novel insights into the epidemiology and causes of cough, and its burden on patients. This was achieved by the development of novel methodologies that allow the rigorous and objective testing of new and existing drugs. Patients benefit through the online provision of a diagnostic tool, and Proctor & Gamble have successfully exploited the cloned cell receptors in their drug development programme resulting in a new range of pharmaceuticals for cough. The work has underpinned the standardisation of cough challenge methodology through incorporation in national and international healthcare guidelines leading to a widespread improvement in patient treatment.
In response to inadequately designed assessment systems for patients recovering from orthopaedic surgery, researchers from the University of Oxford developed a series highly reliable and sensitive patient recorded questionnaires, known as the Oxford Scores. Providing a set of standardised outcomes for appraisal and on-going monitoring of patients, the Oxford Scores enable the informed assessment of clinical outcomes. Used to predict and detect early failure of poorly performing surgical interventions, the Oxford Scores have been adopted by health providers and regulators worldwide, leading to policy and treatment guideline changes and significant improvements in the quality of life of patients.