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Case Study 5. Pathology research led to an international reduction in rectal cancer recurrence and death by improving multidisciplinary clinical practice

Summary of the impact

Postoperative local recurrence affects 20-30% of patients with rectal cancer. Between 1993 and 2013, University of Leeds researchers identified the importance of pathology studies to show a disease-free margin around the excised tumour and how to predict this margin routinely and accurately using simple histopathology and preoperative MRI.

We also used photography in the pathological assessment of the quality of surgery and were instrumental in the adoption of modern techniques by professional organisations around the world.

Following adoption of our techniques in England and Scotland, local recurrence has halved with 10% better survival and cost savings of £60 million. Our methods have also become the gold standard in the treatment of rectal cancer patients around the world.

Submitting Institution

University of Leeds

Unit of Assessment

Clinical Medicine

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Oncology and Carcinogenesis

Design of a block cipher used in TETRA secure radio

Summary of the impact

Terrestrial Trunked Radio (TETRA) is a very well known, international specification for secure mobile radio and `walkie-talkie' communication, that is extensively used and relied upon by emergency and public safety services such as police, ambulance and fire services, as well as governmental and private bodies. The European Telecommunications Standards Institute (ETSI) began standardising TETRA in the 1990s and it is now widely used throughout the world. Foundations of its success include resilience and reliability, but security is a major feature, being underpinned by expert cryptographic design. In particular the authentication and key generation mechanisms in TETRA rely on a block cipher (HURDLE) which was designed by a team of cryptographers at Royal Holloway.

The work carried out at Royal Holloway underpins the integrity and security of TETRA safety- critical networks throughout the world to the present day. A secure design for emergency service communications minimises both the amount of disruption criminals can cause to service operations, and the amount of operational information such criminals can glean from eavesdropping, contributing to the safety and security of society as a whole as well as the economic benefits to manufacturers of TETRA-based equipment.

Submitting Institution

Royal Holloway, University of London

Unit of Assessment

Mathematical Sciences

Summary Impact Type

Technological

Research Subject Area(s)

Information and Computing Sciences: Computation Theory and Mathematics, Data Format

EDU03 - Developing a characterization of citizenship education in England and in other contexts

Summary of the impact

Research by Davies and others at York has clarified the views and understandings of stakeholders of `citizenship' in the context of citizenship education, and developed the case for an approach that has a strong conceptual core (inspired by political literacy and incorporating influences that emphasise communities and identities at local, national and global levels) and which is contemporary, public, participative, and reflective. Through UK and international networking and community building exercises this characterization of citizenship education has impacted on: curriculum policy discussions; classroom practice through the development of teaching materials; teacher educators including initial and in-service teacher education; and the work of professional organisations concerned with citizenship education in schools and beyond.

Submitting Institution

University of York

Unit of Assessment

Education

Summary Impact Type

Societal

Research Subject Area(s)

Education: Curriculum and Pedagogy, Specialist Studies In Education

Developing the evidence base in palliative care: from mapping to international policy and practice change

Summary of the impact

Research carried out in the International Observatory on End of Life Care (IOELC) at Lancaster University led by Professor Payne has played a major role in influencing the strategic direction of service and policy development globally. IOELC initiated the systematic collation of development data and delivered the first research-based international analysis of the development of palliative care. For example, research on access to opioids in 12 resource poor countries in central and eastern Europe via the ATOME project has delivered major impact, leading to significant changes in legislation and policy and improved access to pain medication, and palliative and end of life care for millions of people around the world.

Submitting Institution

Lancaster University

Unit of Assessment

Allied Health Professions, Dentistry, Nursing and Pharmacy

Summary Impact Type

Political

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services

Electron microscopy (EM) and nanobiology

Summary of the impact

The microscopy facilities in the Biomedical Sciences Research Institute of the University of Ulster have been vastly improved through our collaboration with FEI, the largest European EM manufacturer, which has led them to manufacture a cryostage dual-beam instrument of our design with unique capabilities, and to set up their European reference laboratory here. This has generated two further sets of impacts: collaboration and consultancy with various firms wishing to use our advanced imaging facilities, and advice to national, EU and global bodies on the novel cytotoxic hazards of nanoparticles, a major but optically invisible by-product of modern industry, and consequent public health risks.

Submitting Institution

University of Ulster

Unit of Assessment

Allied Health Professions, Dentistry, Nursing and Pharmacy

Summary Impact Type

Technological

Research Subject Area(s)

Physical Sciences: Other Physical Sciences
Engineering: Biomedical Engineering, Materials Engineering

Empowering mental health service users

Summary of the impact

Impact resulted from the unit's sustained research in the field, including the leadership of a large EU Framework 6 action project `EMILIA' - the Empowerment of Mental Illness Service Users: Lifelong Learning, Integration and Action, and the follow up project, PROMISE. The findings identified how to reduce social exclusion among people with serious mental illness through lifelong learning and by improving participation in service delivery, education and training, as well as paid employment. The research recommendations were included in a joint EU/WHO policy statement and subsequently rolled out across European Union Member States. The research impacted on the development of European and national policies regarding mental health service users and, through further knowledge transfer activities and the incorporation of the recommendations by a network of providers in 43 countries, also impacted on the profession and mental health service users directly.

Submitting Institution

Middlesex University

Unit of Assessment

Social Work and Social Policy

Summary Impact Type

Political

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services

Evaluating Health Technologies for Health Policy and Clinical Practice

Summary of the impact

Health Technology Assessment (HTA) is a systematic approach to evaluating the safety, clinical and cost effectiveness of a drug/medical intervention into the NHS. Research and practice of HTA enabled Liverpool University to significantly impact and influence national and international health policy by optimising NHS decision-making on drug adoption and other clinical interventions, as well as disseminating HTA expertise and application around the globe. Reach is both geographical and organizational, spanning the UK NHS, the European, African and Asian healthcare systems, as well as with members of the Pharmaceutical industry. Numerous populations, from patients of the UK NHS, to world-citizens, benefit as a consequence of the application of health economics research.

Submitting Institution

University of Liverpool

Unit of Assessment

Business and Management Studies

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services

Improving diagnosis and clinical care for rare inherited diabetes syndromes

Summary of the impact

Although individually infrequent, rare diseases collectively are a major health burden, particularly for individuals who suffer with conditions that are not routinely diagnosed or have no effective care pathways. Through the work of Professor Tim Barrett, the University of Birmingham is internationally recognised for translational research in rare inherited diabetes and obesity syndromes. This has had major impacts on patient care through gene identification for devastating multi-system syndromes; development of a unique international diagnostic testing service combining molecular testing with international clinical expertise; European reference centre status for three NHS highly specialised multidisciplinary services; and leadership of the European Registry for rare diabetes syndromes. Our national and international leadership for these previously poorly-served conditions has enabled sharing of best clinical practice, including development of clinics for Wolfram syndrome across the world.

Submitting Institution

University of Birmingham

Unit of Assessment

Clinical Medicine

Summary Impact Type

Health

Research Subject Area(s)

Biological Sciences: Genetics
Medical and Health Sciences: Neurosciences

Improving quality of care through general practice accreditation

Summary of the impact

Research conducted at the University of Manchester (UoM) has shaped the design of national systems of accreditation for general practice in the UK, Europe and beyond. Accreditation systems set standards that reflect key aspects of the organisational systems and processes in general practice that are needed to ensure delivery of good quality care. Accreditation systems also provide a kite mark of quality assurance and act as a platform for supporting continuous quality improvement. UoM developed indicators of quality in general practice structure and organisation and demonstrated how they could be used effectively to improve quality. Working in partnership with health professional organisations, governmental organisations and other universities, UoM used knowledge from the research to develop systems for general practice accreditation now used in the UK and across Europe.

Submitting Institution

University of Manchester

Unit of Assessment

Public Health, Health Services and Primary Care

Summary Impact Type

Societal

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services

Influencing EU and national policy on patient mobility within Europe

Summary of the impact

Research into cross-border patient care in Europe carried out by LSHTM has contributed substantially to shaping the 2011 EU Directive on Patients' Rights in cross-border health care. The research was cited in numerous policy documents and used extensively in consultations at EU and national level, feeding into the legislative process. Influential EU officials have explicitly acknowledged the importance of the research in the political process. The research team has also advised professional bodies in the health care sector as part of the consultation process.

Submitting Institution

London School of Hygiene & Tropical Medicine

Unit of Assessment

Public Health, Health Services and Primary Care

Summary Impact Type

Political

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services

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