Embedding impact in a Biomedical Research Centre through partnerships
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Presentation to Impact Coffee Club, Alzheimer's Society, 18th September 2017
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Embedding impact in a Biomedical Research Centre through partnerships
- 1. Oxford Biomedical Research Centre Embedding impact in a Biomedical Research Centre through partnerships Pavel Ovseiko 18 September 2017
- 2. My presentation today 1. Introduction to NIHR Oxford BRC 2. Impact of NIHR Oxford BRC 3. Partnerships for Health, Wealth and Innovation 4. Theoretical/conceptual framework 5. Bonus: 5-minute video
- 3. City of Oxford: home to university, hospitals, and MINI Cooper Population 150,000 including 30,000 full-time students
- 4. An Integrated NHS-University-Industry Health Science Campus >1,000,000 patient interactions >10,000 NHS staff 5,000 researchers
- 5. NIHR Oxford BRC – a partnership between Oxford University Hospitals National Health Service Trust (NHS) and Oxford University Oxford University Medical Sciences Division 5,500 staff 3,000 students £500 million p.a. Oxford University Hospitals NHS Foundation Trust 10,000 staff £900 million p.a. Oxford University 12,500 staff £1.3bn annual turnover National Health Service (NHS) 1.3m staff £100bn annual turnover NIHR Oxford Biomedical Research Centre £20m p.a. budget
- 6. “Unlinked partners” model of accountability for patient care, research, and education in England: funding accountability Source: Ovseiko et al. Improving accountability through alignment BMC HSR 2014 14:24 http://dx.doi.org/10.1186/1472-6963-14-24
- 7. NIHR Oxford BRC strategic partnership board: joint research, governance, and management arrangements Greenhalgh et al. Maximising value from a UK Biomedical Research Centre: study protocol https://doi.org/10.1186/s12961-017-0237-1
- 8. NIHR Oxford BRC catalysed NHS/University partnerships in wider health economy Greenhalgh et al. Maximising value from a UK Biomedical Research Centre: study protocol https://doi.org/10.1186/s12961-017-0237-1
- 9. My presentation today 1. Introduction to NIHR Oxford BRC 2. Impact of NIHR Oxford BRC 3. Partnerships for Health, Wealth and Innovation 4. Theoretical/conceptual framework 5. Bonus: 5-minute video
- 10. Impact of NIHR on clinical research (i.e. excluding pre-clinical) at research-intensive universities (no data available for hospitals) 0 50 100 150 200 250 300 2001-02 2002-03 2003-04 2004-05 2005-06 2006-07 2007-08 2008-09 2009-10 2010-11 2011-12 2012-13 2013-14 2014-15 £million Oxford University University College London Imperial College London Cambridge University King's College London Manchester University Liverpool University NIHR catalised translational research NIHR created Source: Higher Education Statistics Agency. Research Income in Clinical Medicine
- 11. Impact of NIHR Oxford BRC over five years, 2012-17
- 12. Surgeons have used a robot to operate inside the eye and restore sight - in a world first. A team at Oxford's John Radcliffe Hospital used the device, controlled via a joystick, to remove a membrane one hundredth of a millimetre thick. Patient Bill Beaver, 70, a curate in Oxford, said it was "a fairytale". Surgeons hope the procedure will pave the way for more complex eye surgery than is currently possible with the human hand. Twelve patients will undergo surgical procedures using the robot, in a trial funded by the NIHR Oxford Biomedical Research Centre.
- 14. Denmark's Novo Nordisk is to invest £115m over 10 years in a new science research centre in Oxford. Eventually employing 100 academics and scientists, the facility will work on new ways of treating type 2 diabetes. While the disease research and molecular biology will be done in Oxford, any new drugs or treatments will be developed and manufactured in Denmark and, although Oxford University will get some reward for any success, Mads Thomsen made it very clear that the lions share of any commercial spoils will go to the Danish company. Foreign companies and investors have been pouring money into the UK's top universities in recent years. In November last year, a fund set up to commercialise research at Oxford announced an additional £300m of funding - almost all of which came from China, Singapore and Oman.
- 16. My presentation today 1. Introduction to NIHR Oxford BRC 2. Impact of NIHR Oxford BRC 3. Partnerships for Health, Wealth and Innovation 4. Theoretical/conceptual framework 5. Bonus: 5-minute video
- 17. Oxford Biomedical Research Centre A new cross-cutting theme focusing on partnerships Trish Greenhalgh theme leader
- 18. Oxford Biomedical Research Centre Two interconnected strategic objectives of the “Partnerships” theme To support the aims of the NIHR Oxford BRC through a set of co-ordinated cross-cutting platforms and activities designed to strengthen six types of partnership To generate new knowledge about the governance and activities of high-technology, multi-stakeholder health research partnerships
- 19. Oxford Biomedical Research Centre Key partnerships underpinning the NIHR Oxford BRC 2017–2022 Greenhalgh et al. Maximising value from a UK Biomedical Research Centre: study protocol https://doi.org/10.1186/s12961-017-0237-1
- 20. Oxford Biomedical Research Centre Partnerships with patients and the lay public to ensure relevance and accountability • The ‘Partnerships’ external advisory group has been established with a lay chair and strong representation from patients and citizens; • We will support all BRC research themes to integrate patient involvement and public engagement into all aspects of their research activity; • We will measure their success using metrics that allow comparison over time and across themes; • We will use benchmarking to improve their performance year on year.
- 21. Oxford Biomedical Research Centre Partnerships with clinical services to ensure rapid implementation of findings into practice • The ‘Partnerships’ theme will support scientists working closely with clinicians to design and undertake research studies through an integrated approach to ethics, PPI, literature review, statistics • We will include a work stream on knowledge translation and implementation science. • We will address implications of new drugs and service models for local commissioning and funding through partnerships with policymakers and payers.
- 22. Oxford Biomedical Research Centre Partnerships with industry to maximise opportunities for innovation • The ‘Partnerships’ will help to build networks and collaborations that enable co-production of knowledge, leverage additional funding for research, and enrich the training of early career researchers • We will increase economic and societal impact by helping to turn research ideas into marketable real-world innovations. • We will also explore ways of making conflicts of interest explicit and ensuring that value for private-sector partners is not achieved at the expense of the public good.
- 23. Oxford Biomedical Research Centre Partnerships across the NIHR research infrastructure to ensure programme-wide learning • The ‘Partnerships’ will engage with different elements of the NIHR infrastructure to promote the sense of shared endeavour and prevent individual research themes becoming isolated into silos. • We will concentrate our efforts on the Oxford regional innovation system and generate knowledge that supports and improves the effectiveness of the NIHR infrastructure as a whole.
- 24. Oxford Biomedical Research Centre Partnerships across academic disciplines to develop new avenues of research • The BRC provides exciting opportunities for interdisciplinary collaborations between biomedical scientists and academics from complementary fields, including statistics, economics, computer science, business studies, and the humanities and social sciences. • The “Partnerships” will do “research on research” to optimise the research process, improve the governance and ethics of research, train and support early career researchers, work with industry and government, and implement the findings of research in clinical practice.
- 25. Oxford Biomedical Research Centre Partnerships with policymakers and payers to shape the future of health services and health research • The role of payers in bridging the translational gap between research and clinical services is critical, especially in times of financial austerity, but to date has been relatively under- researched. • We will analyse how payers (national and local, public and private) fit with the wider ecosystem of healthcare and health research, and either facilitate or inhibit the translation of innovations into clinical practice. • We will develop Oxford BRC’s existing links to local and national policymakers and to international regulatory bodies for drugs, medical devices, clinical trials.
- 26. My presentation today 1. Introduction to NIHR Oxford BRC 2. Impact of NIHR Oxford BRC 3. Partnerships for Health, Wealth and Innovation 4. Theoretical/conceptual framework 5. Bonus: 5-minute video
- 28. Triple helix of university-industry-government Universities, industry and government are increasingly interdependent. Once separate, universities, industry and government come together and take on the elements of each other, e.g. universities commercialising research, industry doing basic science research, and government providing “public venture capital”. The triple helix is associated with higher level of innovation and wealth creation.
- 29. Mode 2 knowledge production Mode 1: universities function as ivory towers, pursuing research in isolation from wider society and economy, and producing knowledge which needs to be “translated” Mode 2: university engage with clinicians, managers, and patients and the public to produce knowledge that they need. There is less need for “translation” and dissemination, and so less research waste
- 30. Value co-creation A business strategy to engage multiple stakeholders in devising products and services to increase their value for everyone. Four key principles : •Stakeholders will not wholeheartedly participate in the co-creation process unless it produces value for them; •The best way to co-create value is to focus on the experiences of all stakeholders; •Stakeholders must be able to interact directly with one another (preferably face to face); •Engagement platforms are needed that allow stakeholders to interact and share their experiences.
- 31. Adapted Value Co-creation model Greenhalgh et al. Maximising value from a UK Biomedical Research Centre: study protocol https://doi.org/10.1186/s12961-017-0237-1
- 32. My presentation today 1. Introduction to NIHR Oxford BRC 2. Impact of NIHR Oxford BRC 3. Partnerships for Health, Wealth and Innovation 4. Theoretical/conceptual framework 5. Bonus: 5-minute video
- 33. 5-minute video Source: Introduction to the NIHR Oxford Biomedical Research Centre. Available online at: https://youtu.be/_zuO3oEmZn4
- 34. Oxford Biomedical Research Centre Thank you pavel.ovseiko@medsci.ox.ac.uk
Hinweis der Redaktion
- Robert MacLaren, Professor of Ophthalmology. assisted by Dr Thomas Edwards, Nuffield Medical Fellow, used the remotely controlled robot to lift a membrane 100th of a millimetre thick from the retina at the back of the right eye of the Revd Dr William Beaver, 70, an Associate Priest at St Mary the Virgin, Iffley, Oxford. He is the first patient ever to undergo this experimental procedure. The Robotic Retinal Dissection Device (R2D2) trial is sponsored by the University of Oxford and funded by the NIHR Oxford Biomedical Research Centre with support from Oxford University Hospitals NHS Foundation Trust, which runs the hospital. Additional funding was provided by Zizoz, a Dutch charity for patients with choroideremia, a genetic form of blindness. The robot needs to operate inside the eye through a single hole that is less than 1 mm in diameter and it needs to go in and out of the eye through this same hole during various steps of the procedure, even though the eye may rotate. The device is designed to eliminate unwanted tremors in the surgeon’s hand – such as through their pulse – so tiny surgical manipulations can be safely carried out within the eye. The robot acts like a mechanical hand with seven independent computer-controlled motors resulting in movements as precise as 1000th of a millimetre in scale. In the case of Father Beaver, the patient for this first operation, a membrane growing on the surface of his retina had contracted and pulled it into an uneven shape. This leads to a distorted image, like looking in a hall of mirrors at a fairground. The membrane is about 100th of a millimetre thick and needed to be dissected off the retina without damaging it. Surgeons can just about do this by slowing their pulse and timing movements between heart beats, but the robot could make it much easier. Moreover, the robot could enable new, high-precision procedures that are currently out of the reach of the human hand. The surgeon uses a joystick and touchscreen outside the eye to control the robot whilst monitoring its progress through the operating microscope. This gives the surgeon a notable advantage as significant movements of the joystick result in tiny movements of the robot. Whilst robots have been developed for large scale surgery, such as in the abdomen, until now no device has been available that achieves the three dimensional precision required to operate inside the human eye. The device has been developed by Preceyes BV, a Dutch medical robotics firm established by the University of Eindhoven. Over the last 18 months, the Preceyes engineers and the team at the University of Oxford’s Nuffield Laboratory of Ophthalmology have worked together to plan this landmark clinical trial. This has resulted in the world first robotic surgery inside the human eye. On completing the operation, Professor Robert MacLaren said: 'There is no doubt in my mind that we have just witnessed a vision of eye surgery in the future. 'Current technology with laser scanners and microscopes allows us to monitor retinal diseases at the microscopic level, but the things we see are beyond the physiological limit of what the human hand can operate on. With a robotic system, we open up a whole new chapter of eye operations that currently cannot be performed.' Speaking at his follow up visit at the Oxford Eye Hospital, Father Beaver said, 'My sight is coming back. I am delighted that my surgery went so well and I feel honoured to be part of this pioneering research project.' Professor MacLaren added, 'This will help to develop novel surgical treatments for blindness, such as gene therapy and stem cells, which need to be inserted under the retina with a high degree of precision.' The current robotic eye surgery trial will involve 12 patients in total and involves operations with increasing complexity. In the first part of the trial, the robot is used to peel membranes off the delicate retina without damaging it. If this part is successful, as has been the case so far, the second phase of the trial will assess how the robot can place a fine needle under the retina and inject fluid through it. This will lead to use of the robot in retinal gene therapy, which is a promising new treatment for blindness which is currently being trialled in a number of centres around the world. This follows on from the successful gene therapy trials led by researchers at the Oxford Eye Hospital and includes developing treatments for retinitis pigmentosa, a genetic condition that is one of the most common causes of blindness in young people and age-related macular degeneration, which affects the older age group.
- A public-private partnership of some of the world’s leading health organizations today announced that data from a Phase 1 study of a preventive Ebola vaccine regimen have been published in JAMA: The Journal of the American Medical Association. The results, the first published on the vaccine regimen, suggest that the regimen was well-tolerated by healthy volunteers and immunogenic (produced an immune response). Among the findings, 100 percent of participants in the study achieved an initial antibody response to Ebola, and this response was sustained 8 months following immunization. The study was led by the Oxford Vaccine Group at the University of Oxford Department of Paediatrics and took place in the United Kingdom. The Ebola vaccine regimen is being developed by the Janssen Pharmaceutical Companies of Johnson & Johnson, in collaboration with Bavarian Nordic. The regimen was first discovered in a collaborative research program with the U.S. National Institutes of Health (NIH). Clinical studies have been supported by grants awarded by Europe’s Innovative Medicines Initiative (IMI) to a consortium of leading global research institutions working with Janssen, which includes the London School of Hygiene & Tropical Medicine, the University of Oxford and Inserm, the French National Institute of Health and Medical Research. 'The Ebola crisis in West Africa left a huge human cost, we continue to see flare-ups of this disease, and the world needs to be far better prepared for the next major outbreak,' said Paul Stoffels, M.D., Chief Scientific Officer, Johnson & Johnson. 'This study suggests that Janssen’s investigational prime-boost vaccine regimen, if approved by regulators, could be an important tool in global strategies to help prevent another Ebola epidemic.' The Phase 1 study tested a vaccine regimen containing two components based on, respectively, AdVac® technology from Crucell Holland B.V., one of the Janssen Pharmaceutical Companies, and MVA-BN® technology from Bavarian Nordic A/S. Healthy volunteers were given one vaccine dose to prime their immune system, and then the alternative vaccine to boost their immune response, with the goal of evaluating the duration of immunity. Prime-boost vaccination is an established approach for the prevention of several infectious diseases. 'Recent evidence highlighting the persistence of the Ebola virus in bodily fluids, and the potential for sexual transmission from Ebola survivors, reinforce the importance of finding a robust and durable vaccine for this disease,' said Dr. Matthew Snape of the Oxford Vaccine Group and the study’s lead author. 'These results show that an initial immune response with AdVac immunization is enhanced by MVA-BN boosting, generating sustained immunity that has the potential to provide durable protection from Ebola in at-risk populations.' In the study, most participants were randomized in a blinded fashion to receive either vaccine or placebo, while some individuals were in an open-label group receiving vaccine. Among the randomized participants, 97 percent generated antibodies specific to Ebola four weeks after a priming dose with AdVac. Additionally, more than half of AdVac recipients developed Ebola-specific T cells, a key marker of cellular immunity. Validating the prime-boost concept, these immune responses were enhanced by administration of the MVA-BN booster dose, with 100 percent of participants generating Ebola-specific antibodies at 21 days post-boost, and 79-100 percent showing T cell responses depending on the dosing interval. Notably, 8 months following prime vaccination, 100 percent of individuals in the study maintained Ebola-specific antibodies, while vaccine-induced T cell responses persisted in 77-80 percent of those receiving the AdVac/MVA-BN regimen. 'Forty years after the discovery of Ebola, the world still needs an approved vaccine for this disease,' said Dr. Peter Piot, Director, London School of Hygiene & Tropical Medicine. 'A durable prime-boost vaccine could be a vital asset in efforts to proactively protect the general population in countries that are vulnerable to Ebola outbreaks. And in light of the persistent challenges that we are seeing with the Ebola virus, durability has become a particularly important goal for vulnerable populations such as health workers and the families of Ebola survivors.' 'First of all, this study provides important validation for the concept of a prime-boost vaccination strategy against this disease,” said Yves Levy, CEO, Inserm. “Additionally, these data indicate that the vaccine regimen can induce two types of immune response – antibody-based and cellular – which together may have the potential to confer long-term protection against Ebola. These results are highly significant findings in the fight against Ebola in which Inserm has been involved since the very beginning.' 'We are delighted to see such positive results produced by a consortium supported with grants from the Ebola+ programme,” said Ruxandra Draghia-Akli, Director, Health Directorate, European Commission, and member of the IMI Governing Board. “These and the many other Ebola studies underway with the European Commission and IMI support show that cooperation research and public-private partnerships can be formed with great speed to develop innovative solutions for today’s most pressing global health threats. Only by joining forces as an international community can we prevent, control, and end pandemics.' The Oxford study provides the first set of data from a total of 10 clinical studies that are being conducted on a parallel track across the U.S., Europe and Africa in support of potential eventual registration for the Ebola vaccine regimen. The first study of the vaccine regimen in a West African country affected by the recent Ebola outbreak began in Sierra Leone in October 2015.
- The UK’s first minister for life sciences has praised biomedical researchers working across Oxfordshire. George Freeman MP was visiting the county today (Friday 18 Dec 2015) to find out more about work being carried out by the NHS and businesses locally as well as by Oxford University, and about how all three are working together to create new treatments and technologies. Starting at the John Radcliffe Hospital, Mr Freeman met Oxford University’s Regius Professor of Medicine Sir John Bell, Oxford University Hospitals NHS Foundation Trust Chair Dame Fiona Caldicott and Director of Clinical Services Paul Brennan, city council leader Bob Price and Local Enterprise Partnership Chief Executive Nigel Tipple, to discuss economic growth plans for the area and new approaches to integrated health care in the county. He was then briefed on the work of the National Institute for Health Research Oxford Biomedical Research Centre and the Oxford Genomic Medicine Centre, including research into intelligent ultrasound by Professor Alison Noble, the development of TB gene sequencing by Professor Derrick Crook, the creation of a tablet-computer-based track and trigger system for medical records by Dr Peter Watkinson and the NightstaRx project of Professor Robert Maclaren, as well as the WGS500 programme led by Professor Jenny Taylor, which sequenced 500 human genomes and has laid the ground for the UK's 100,000 genomes project. At the University of Oxford's Old Road Campus, Mr Freeman was briefed on the latest buildings being developed at the site, including the Big Data Institute, which will allow researchers to analyse millions of records to shed light on many health conditions, and the Bioescalator, which will support new and developing life science businesses, before finding out more about research at the University, one of Europe’s largest centres for biomedical research. While admitting an allegiance to traditional rival Cambridge, George Freeman expressed his pride at the work being done in Oxfordshire. He said: 'The Oxford Biomedical Campus is fast becoming a world class hub of the new technology and biomedical disciplines which are transforming twenty-first century medicine. Through government and local funding, the Oxford team are building a truly integrated campus with NHS, university and industry researchers pioneering the genomic, informatic and diagnostic breakthroughs which are making Precision Medicine a reality for NHS patients. With companies like Adaptimmune and Immunocore here in the cluster, I am very proud as the UK's first minister for life sciences (and a Cambridge man) to note that Oxfordshire is doing something special.'
- The UK’s first minister for life sciences has praised biomedical researchers working across Oxfordshire. George Freeman MP was visiting the county today (Friday 18 Dec 2015) to find out more about work being carried out by the NHS and businesses locally as well as by Oxford University, and about how all three are working together to create new treatments and technologies. Starting at the John Radcliffe Hospital, Mr Freeman met Oxford University’s Regius Professor of Medicine Sir John Bell, Oxford University Hospitals NHS Foundation Trust Chair Dame Fiona Caldicott and Director of Clinical Services Paul Brennan, city council leader Bob Price and Local Enterprise Partnership Chief Executive Nigel Tipple, to discuss economic growth plans for the area and new approaches to integrated health care in the county. He was then briefed on the work of the National Institute for Health Research Oxford Biomedical Research Centre and the Oxford Genomic Medicine Centre, including research into intelligent ultrasound by Professor Alison Noble, the development of TB gene sequencing by Professor Derrick Crook, the creation of a tablet-computer-based track and trigger system for medical records by Dr Peter Watkinson and the NightstaRx project of Professor Robert Maclaren, as well as the WGS500 programme led by Professor Jenny Taylor, which sequenced 500 human genomes and has laid the ground for the UK's 100,000 genomes project. At the University of Oxford's Old Road Campus, Mr Freeman was briefed on the latest buildings being developed at the site, including the Big Data Institute, which will allow researchers to analyse millions of records to shed light on many health conditions, and the Bioescalator, which will support new and developing life science businesses, before finding out more about research at the University, one of Europe’s largest centres for biomedical research. While admitting an allegiance to traditional rival Cambridge, George Freeman expressed his pride at the work being done in Oxfordshire. He said: 'The Oxford Biomedical Campus is fast becoming a world class hub of the new technology and biomedical disciplines which are transforming twenty-first century medicine. Through government and local funding, the Oxford team are building a truly integrated campus with NHS, university and industry researchers pioneering the genomic, informatic and diagnostic breakthroughs which are making Precision Medicine a reality for NHS patients. With companies like Adaptimmune and Immunocore here in the cluster, I am very proud as the UK's first minister for life sciences (and a Cambridge man) to note that Oxfordshire is doing something special.'