̽��ֱ�� of Cambridge - ̽��ֱ��Healthcare Improvement Studies Institute

Vice-Chancellor’s Awards highlight research impact and engagement across Cambridge

zs332 — Thu, 07 Oct 2021 14:44:34 +0000

Academics from across the ̽��ֱ�� have been recognised in this year’s Vice-Chancellor’s Research Impact and Engagement Awards for their research into improving management of maternity emergencies during COVID-19, helping rural communities in India become agriculturally more sustainable and aiding the Government’s real-time COVID-19 monitoring.

Cambridge institute publishes ethical framework for asymptomatic COVID-19 student testing in HE institutions

cjb250 — Thu, 25 Feb 2021 13:40:09 +0000

̽��ֱ��use of asymptomatic COVID-19 testing is accelerating in a range of UK settings, including in higher education institutions. ̽��ֱ�� ̽��ֱ�� of Cambridge introduced a weekly asymptomatic testing programme for students in College accommodation in October 2020 as part of its efforts to reduce the spread of COVID-19. ̽��ֱ��programme, based on laboratory PCR tests facilitated by the national lighthouse laboratory network, involves pooling swabs from students in their households. If the pool tests positive, individual tests are performed for each participating student to investigate further.

Researchers at THIS Institute consulted students and staff at the ̽��ֱ�� on ethical issues relating to its student testing programme. Their views, combined with expert legal and ethical analysis, resulted in a new ethical framework aimed at helping higher education institutions make complex decisions about student testing programmes.

̽��ֱ��framework offers recommendations in nine areas:

Design and operation of the programme
Goals of the programme
Properties of the test
Enabling isolation
Choices regarding participation
Benefits, harms and opportunity costs
Responsibilities
Privacy, confidentiality and data protection
Communication

Professor Mary Dixon-Woods, Director of THIS Institute, said: “Higher education institutions must be certain that they can deliver asymptomatic COVID-19 testing programmes for students that are responsive to new evidence, policy and guidance, pandemic conditions, and views of their students and staff. This new ethical framework is intended to help leaders to think through whether asymptomatic COVID-19 testing is the right option for their institution, and to support good organisational decision-making around implementing testing programmes.”

Dr Caitriona Cox, NIHR Academic Clinical Fellow at THIS Institute and project lead, said: “ ̽��ֱ��framework and checklist are freely available and will hopefully act as valuable and timely resources for higher education institutions seeking ethically sound ways to keep people safe and support public health efforts.”

Supported by the Wellcome Trust, Dr Cox and colleagues consulted over 200 students and staff from the ̽��ֱ�� of Cambridge. Participants took part via an online questionnaire or interview. ̽��ֱ��consultation, conducted through Thiscovery, THIS Institute’s online research platform, gathered views about the asymptomatic COVID-19 testing programme. ̽��ֱ��consultation findings were integrated with ethical and legal analysis and expert discussion to produce an ethical framework and checklist.

̽��ֱ��framework, checklist and further information about the work is available on the THIS Institute website.

̽��ֱ��Healthcare Improvement Studies (THIS) Institute has today published an ethical framework for higher education institutions considering running asymptomatic COVID-19 testing programmes for their students.

Higher education institutions must be certain that they can deliver asymptomatic COVID-19 testing programmes for students that are responsive to new evidence, policy and guidance, pandemic conditions, and views of their students and staff

Mary Dixon-Woods

Nordin Ćatić

Testing kit

̽��ֱ��text in this work is licensed under a Creative Commons Attribution 4.0 International License. Images, including our videos, are Copyright © ̽��ֱ�� of Cambridge and licensors/contributors as identified. All rights reserved. We make our image and video content available in a number of ways – as here, on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.

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Physician, heal thyself: engineering a new National Health Service

Anonymous — Tue, 19 Mar 2019 11:00:00 +0000

Alongside the Chinese People’s Liberation Army, Indian Railways and Walmart, the NHS ranks among the world’s largest employers. In England, it treats more than 1.4 million patients every 24 hours and will this year spend £126 billion. But as communities gathered to celebrate the NHS’s 70th birthday in 2018, reports continued to emerge on the ailing health of this much-loved national institution.

Analysis by another national treasure, the BBC, revealed that nearly one in five hospital trusts were failing to hit any of their key waiting-time targets. Hospitals seemed to be lurching towards over-crowded A&Es, bed shortages and queuing ambulances unable to hand over their patients.

Two ̽��ֱ�� of Cambridge researchers have a grand vision to rethink the system to make it fit for the next 70 years – a vision that’s rooted in research with local patients and doctors.

Professor Stefan Scholtes works at Cambridge Judge Business School and Dr Alexander Komashie is at the ̽��ֱ��’s Engineering Design Centre. Both are engineers by training, both have spent the past 10 years studying different parts of the local healthcare system and both are passionate believers that, as researchers, they can help make the NHS better.

System design

̽��ֱ��NHS faces numerous challenges but the real test, says Komashie, is understanding how to design better delivery systems by working with patients. “That’s where engineering comes in,” he says. “Engineers excel in designing large systems that work well, from worldwide telecommunications networks to the Airbus A380. What motivates me is translating the engineering practice of a systems approach into healthcare.”

̽��ֱ��first step is understanding the system requirements. “It sounds obvious, but to design a system to do something you need to understand what it is you want,” Komashie explains. “In engineering, a lot of effort goes into defining what the system should do. When you understand that, you can ask how the system is set up to deliver it.”

Komashie has applied this systems engineering approach to adult mental health services within the Cambridgeshire and Peterborough NHS Foundation Trust (CPFT), and ran a series of workshops for patients and clinicians. Patients’ stories allow him to unpack each component of the delivery system and represent them in visual diagrams so that services can be improved in a systematic way. ̽��ֱ��project was funded and supported by the National Institute for Health Research (NIHR) East of England Collaboration for Leadership in Applied Health Research and Care (CLAHRC), hosted by CPFT.

“My goal is developing a new way of describing the system, and hearing people talk about their experience of care helps me understand it. If through patient and public involvement, we can get rich enough stories, it gives us a window into the system behind the story,” says Komashie, who has recently been awarded an interdisciplinary fellowship for research into health systems visualisation at ̽��ֱ��Healthcare Improvement Studies Institute (THIS Institute). “Hearing patients’ accounts of what matters most helps to ensure the system designs and delivers the support they need.”

Sarah Rae, CPFT Expert by Experience, worked closely with Komashie in bridging the gap between the academic researcher and the patient participants. “As workshop co-facilitator I gave the participants a better understanding of the research by helping them to make the connection between systems engineering and mental health,” she says. “Sharing my own lived experience of mental health also helped the participants feel more comfortable about describing their experiences authentically.”

Komashie is now taking the tools he developed in mental health and applying them to vascular surgery and spinal cord injuries at Addenbrooke’s Hospital in Cambridge and holistic neuropsychological rehabilitation at ̽��ֱ��Princess of Wales Hospital’s Oliver Zangwill Centre in Ely.

Working with GP practices

Headlines about NHS waiting times, bed shortages and ambulance queues invariably focus on capacity, which Scholtes argues is a misdiagnosis. “People say we’ve got a capacity problem but that’s wrong. We have a complexity problem. There are so many things going on simultaneously but pulling in different directions. Complexity is killing hospitals.”

At Addenbrooke’s, for example, where Scholtes spent three sabbaticals over the past 10 years, the hospital does everything from pulling wisdom teeth to multiple organ transplants. He argues that delivering this breadth of services in a system already at full stretch is impossible. Instead, hospitals need to be “decomplexified” by delivering most of their routine services in community settings.

It sounds simple, but it’s not. “ ̽��ֱ��problem is that there’s no landing space. We have 92 GP practices locally, so how can you move work currently centralised in a large hospital to 92 small businesses? It’s impossible. ̽��ֱ��only way to make headway is to scale up primary care so that it can take on more responsibility,” says Scholtes.

This is exactly what he’s doing with Granta Medical Practices, a large Cambridgeshire GP practice where he spent his most recent sabbatical evaluating the practice’s innovative operational and business model.

A critical barrier to change in primary care is the traditional GP partnership model, he says. By leaving GP partners with unlimited liability, the model creates risk aversion and hampers transformative change. In response, Granta is developing an innovative business model – an employee-owned trust akin to the John Lewis Partnership – which could enable it to deliver 70% of routine outpatient activity in the community and cut by 25% the number of emergency bed days among its patients.

Dr James Morrow, CEO of Granta Medical Practices, describes how Granta Medical Practices has gained enormously from working closely with Sholtes and his colleagues at the Cambridge Judge Business School: “Several of our senior clinicians have participated in formal educational programmes through the Judge and have brought back insights and skills from other sectors. Stefan’s sabbatical with the practice has refined and clarified our thinking around not just service delivery and user-experience but also helped with developing our longer term strategic goals as we embark on a period of rapid health system reform.”

But how can transforming Granta help the NHS as a whole? This is where the ̽��ֱ�� comes in, says Scholtes, who hopes to establish a Primary Care Innovation Academy, drawing on research expertise from across the ̽��ֱ��.

̽��ֱ��Academy would provide leadership and management training for GPs, practice managers and lead nurses, and also ensure that interventions taken to transform the local primary care system are robustly evaluated. As such, it would add to the ̽��ֱ��’s increasing capacity in creating the evidence base for improving healthcare. For instance, THIS Institute is focusing on how to improve quality and safety across the system.

A “radically different” NHS

Addenbrooke’s Hospital itself has been transformed over the past three decades with a major emphasis on recruiting clinical academics in partnership with the ̽��ֱ��, who split their time between practising medicine and carrying out research.

Professor Patrick Maxwell, Head of the School of Clinical Medicine, explains: “Clinical academics have been central to the development of tertiary referral services and a major trauma centre. This has helped to create an excellent district and regional hospital with outcomes that are among the best in the country. Currently our priorities include improving prevention and early diagnosis of diseases, so that fewer patients need hospital services.”

Meanwhile, in January 2019, the NHS released its new 10-year plan, which included aims to boost ‘out-of-hospital’ care through increased investment in primary medical and community health services.

All in all, Scholtes believes that, by the time the NHS reaches its 80th birthday, it could look radically different: hospitals could be doing 60% of what they do now by focusing on cases that can only be treated in hospital and on cutting-edge treatments and research, while more integrated, scaled-up primary care practices will be taking full responsibility for out-of-hospital care.

“If this work is successful, it has the potential to bring the local health economy back onto a sustainable path by establishing a new model of primary care that can be scaled throughout the NHS,” he concludes. “It’s ambitious – but we can do it.”

̽��ֱ��National Health Service turned 70 in 2018 – but, amid the celebrations, its health is faltering. By working closely with local hospitals and GPs, researchers at Cambridge ̽��ֱ�� are developing bold new ideas they believe will help the NHS thrive for decades to come.

If this work is successful, it has the potential to bring the local health economy back onto a sustainable path by establishing a new model of primary care that can be scaled throughout the NHS

Stefan Scholtes

Emily

̽��ֱ��right tool

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Cambridge Science Festival returns for milestone 25th year

Anonymous — Fri, 25 Jan 2019 15:48:27 +0000

Celebrating its 25th year, the Festival runs for two weeks from 11-24 March and explores the theme of ‘discoveries’. An impressive line-up of acclaimed scientists includes microscopist Professor Dame Pratibha Gai, Astronomer Royal Professor Lord Martin Rees, 2018 Nobel prize winner Sir Gregory Winter, geneticist Dr Giles Yeo, statistician Professor David Spiegelhalter, engineer Dr Hugh Hunt, marine biologist and author Helen Scales, THIS Institute Director Professor Mary Dixon-Woods, futurist Mark Stevenson, and science presenter Steve Mould.

̽��ֱ��full programme is teeming with events ranging from debates, talks, exhibitions, workshops and interactive activities to films, comedy and performances, held in lecture theatres, museums, cafes and galleries around Cambridge. There are events for all ages and most are free.
With so many events on offer, audiences will be spoilt for choice. Some of the biggest events in week one include:

Is technology making us miserable? (11 March). Virtually every interaction we have is mediated through technology. Despite being ‘always-on’, are we any better off? Are we better connected? Or is technology making us miserable?
Putting radioactivity in perspective (12 March). Following a renewal of electricity generated by nuclear power, Professors Ian Farnan and Gerry Thomas, Imperial College London, discuss radioactivity in the natural world and the outcomes of decades of study on the health effects of radiation. Could these research outcomes reset attitudes towards radiation and the risks?
̽��ֱ��universe of black holes (13 March). Christopher Reynolds, Plumian Professor of Astronomy, describes how future research into black holes may yet again change our view of reality.
̽��ֱ��long-term perspective of climate change (14 March). Professors Ulf Büntgen, Mike Hulme, Christine Lane, Hans W Linderholm, Clive Oppenheimer, Baskar Vira, and Paul J Krusic discuss how we investigate past climate and the challenges we face in applying this to the policy-making process.
Catalytic activation of renewable resources to make polymers and fuels (15 March). Professor Charlotte Williams, ̽��ֱ�� of Oxford, discusses the development of catalysts able to transform carbon dioxide into methanol, a process which may deliver more sustainable liquid transport fuels in the future.
Does the mother ever reject the fetus? (15 March). Professor Ashley Moffett discusses fetal rejection and explores new discoveries that show that there are multiple mechanisms to ensure there is a peaceful environment in the uterus, where the placenta is allowed to grow and develop to support the fetus.

Top picks for the second week include:

Cambridge gravity lecture: Sir Gregory Winter (18 March). Sir Gregory is a molecular biologist and 2018 Nobel Laureate best known for his work on developing technologies to make therapeutic monoclonal antibodies. His research has led to antibody therapies for cancer, rheumatoid arthritis and multiple sclerosis.
Discoveries leading to new treatments for dementia (18 March). Professor of Clinical Neurosciences and Associate Director of the UK Dementia Research Institute, Giovanna Mallucci discusses how new research leading to insights into dementia and degenerative brain diseases may lead to new treatments.
Improving quality and safety in healthcare (19 March). THIS Institute Director Professor Mary Dixon-Woods looks at the challenges to improving quality and safety in healthcare and considers why it’s so hard to answer the question: Does quality improvement actually improve quality? With Dr Fiona Godlee, Editor in Chief of ̽��ֱ��BMJ.
Immunology: the future of medicine? (19 March) Professor Clare Bryant and a panel of Cambridge immunologists discuss how understanding disease triggers may enable entirely new approaches to treating and potentially preventing disease.
Polar ocean: the dead end of plastic debris (19 March). An estimated 80% of all the litter in our oceans is plastic, and a significant concentration of plastics debris is found in both polar oceans. ̽��ֱ��impact of this debris on the sensitive polar ecosystem could be profound. Pelagic marine ecologist Dr Clara Manno, British Antarctic Survey, explores the current research and existing situation in the polar regions.
Reluctant futurist (19 March). Old models for healthcare, education, food production, energy supply and government are creaking under the weight of modern challenges. Futurist Mark Stevenson looks at the next 30 years and asks, how can we re-invent ourselves for the future?
Adolescent mental health: resilience after childhood adversity (20 March). Adolescence is characterised by huge physiological changes as well as a rapid rise in mental health disorders. Around 45% of adolescent mental health problems are caused by childhood difficulties but fortunately not all who experience difficulties develop mental health disorders. Dr Anne-Laura van Harmelen discusses mechanisms that may help adolescents with a history of childhood difficulty to become more resilient.
Making algorithms trustworthy (21 March). Increasingly, algorithms are being used to make judgements about sensitive parts of our lives. How do we check how their conclusions were arrived at, and if they are valid and fair? Professor David Spiegelhalter looks at efforts to make algorithms transparent and trustworthy, using systems that make predictions for people with cancer as an example.
On the future: prospects for humanity (22 March). Professor Lord Martin Rees argues that humanity’s prospects on Earth and in space depend on our taking a different approach to planning for tomorrow.

This year’s Cambridge Science Festival also celebrates significant milestones in science, including the 200th anniversary of Cambridge Philosophical Society, Cambridge’s oldest scientific society, and 150 years since the publication of the modern Periodic Table.

Speaking ahead of the Festival, Dr Lucinda Spokes, Festival Manager, said: “We are tremendously proud of this year’s programme due to the variety of events and the calibre of our speakers from a range of institutions and industries.

“Alongside the meatier topics we have an array of events for all ages and interests across both weekends. We have everything from the science of perfumery and how your mood affects your taste, to a science version of 'Would I Lie to You?'

“One of my personal top picks are the open days at the various institutes and departments based at the West Cambridge site on Saturday 23 March. As always, the site is hosting some truly fascinating events, everything from the future of construction and how to make Alexa smarter, to how nanotechnology is opening up new routes in healthcare, and state-of-the-art approaches to low-cost solar energy and high-efficiency lighting solutions.

“A Festival of this magnitude would not be possible without the help from many people; we thank all our scientists, supporters, partners and sponsors, without whom the Festival would not happen. Most of all, we thank the audiences – there are more than 60,000 visits to the Festival events every year. We very much look forward to welcoming everyone from all ages to join us in March to explore the fabulous world of science.”

You can download the full programme here.

Bookings open on Monday 11 February at 11am.

This year’s Festival sponsors and partners are Cambridge ̽��ֱ�� Press, AstraZeneca, MedImmune, Illumina, TTP Group, Science AAAS, Anglia Ruskin ̽��ֱ��, Astex Pharmaceuticals, Cambridge Science Centre, Cambridge Junction, IET, Hills Road 6th Form College, British Science Week, Cambridge ̽��ֱ�� Health Partners, Cambridge Academy for Science and Technology, and Walters Kundert Charitable Trust. Media Partners: BBC Radio Cambridgeshire and Cambridge Independent.

̽��ֱ��2019 Cambridge Science Festival is set to host more than 350 events as it explores a range of issues that affect today’s world, from challenges around climate change policy, improving safety and quality in healthcare, and adolescent mental health, to looking at what the next 25 years holds for us and whether quantum computers can change the world.

We have everything from the science of perfumery and how your mood affects your taste, to a science version of 'Would I Lie to You?'

Dr Lucinda Spokes

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Black researchers shaping the future

ta385 — Wed, 10 Oct 2018 09:32:12 +0000

Read the full story here

As the UK marks Black History Month, researchers from across the ̽��ֱ�� talk about their route to Cambridge, their inspiration and their motivation.

̽��ֱ�� of Cambridge researchers

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£42m new research institute to boost evidence on improving care in the NHS

cjb250 — Wed, 31 Jan 2018 00:26:59 +0000

̽��ֱ��Healthcare Improvement Studies Institute (THIS Institute), led by the ̽��ֱ�� of Cambridge, is made possible by the largest single grant ever made by the Health Foundation, an independent charity. ̽��ֱ��new institute is founded on the principle that efforts to improve care should always be based on the best quality of evidence. Some of that evidence will be created by NHS patients and staff themselves, using innovative citizen science methods in large-scale research projects.

Director of THIS Institute Professor Mary Dixon-Woods, said: “If you ask people to describe the future of healthcare, they might describe a shiny vision of new treatments and technologies. These kinds of innovations are important. But how healthcare is organised and delivered, including its basic systems and processes, has perhaps just as much impact, and sometimes more, on patient outcomes and experience.”

Dr Jennifer Dixon, Chief Executive of the Health Foundation, said: “ ̽��ֱ��UK population clearly wants a high quality and sustainable NHS into the future. Understanding what works, in which contexts and why, is crucial, as is obtaining that evidence fast so it can be acted on. There couldn’t be a more important time to do this, and that is why the Health Foundation has put its money where its mouth is.”

One way the institute will create the evidence-base is through citizen science. Using methods already used in other areas such as biology and astronomy, THIS Institute is building a digital platform to crowdsource research ideas and collect research data from NHS staff and patients, including their opinions on the right indicators of quality of care and their views on equipment design.

Professor Dixon-Woods, Director, THIS Institute, adds: “Tackling healthcare challenges needs to involve a greater variety of people with diverse experience: the institute is looking for expertise in new places. Some of this expertise will come directly from patients – us, you, me – working alongside healthcare staff and other professionals such as engineers and designers.”

̽��ֱ��institute will be based at the Cambridge Biomedical Campus, alongside Cambridge ̽��ֱ�� Hospitals NHS Foundation Trust and world-leading research institutes. It is made possible by a ten-year grant from the Health Foundation, whose mission is to bring about better health and healthcare for people in the UK.

Press release from ̽��ֱ��Healthcare Improvement Studies Institute.

A new research institute launching today is seeking to create a world-leading asset for the NHS by improving the science behind healthcare organisation and delivery.

DSC09477-2

kristin klein

̽��ֱ��text in this work is licensed under a Creative Commons Attribution 4.0 International License. For image use please see separate credits above.

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