focusing on experimental medicine · 2014. 5. 1. · 5 focusing on experimental medicine what we...

Focusing on experimental medicine

A review of our progress

University College London Hospitals Biomedical Research Centre

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NIHR University College London Hospitals Biomedical Research Centre

Welcome from Professor Bryan Williams

We have just completed a busy, successful and exciting year for our National Institute for Health Research University College London Hospitals Biomedical Research Centre (BRC) with the implementation of our new strategy focused on experimental medicine and our substantial participation in a number of major national cross-BRC initiatives.

We have decided to produce this review to provide a succinct summary of the many activities of the BRC in a format that is accessible to the public. This report will be a regular feature and complements the extensive real time information already available on our BRC website www.uclhospitals.brc.nihr.ac.uk and my bi-monthly BRC Director’s newsletter.

As we now embark on a new year, I think it is time for us to be thinking about how we would like to see our BRC evolve beyond the current five-year term. We begin work now to shape the future direction of the BRC, which should

be bold and even more ambitious, and should align future major strategic funding awards towards tackling some of the unresolved ‘big questions’ in medicine. Big funding for big questions. Big questions aligned to the strengths and strategy of our NHS and university partnership, better leveraging of our undoubted strengths in physical sciences, engineering, chemistry, and imaging, disciplines that are set to shape future medical practice like never before. Big questions that signal our bold intent, a focus for collaboration, infrastructure developments, for industry partnerships and investment and for retaining and recruiting the best people. Big questions designed to stretch us, and inspire others, uncompromising in excellence and predicated on delivering better outcomes for our patients.

If the world-class strength of our NHS and university partnership can’t tackle the big questions, then who can? Who will? Developing these concepts and ideas will require major consultation with our researchers, our clinical staff, other BRCs/BRUs, our funding sources, our patients and the public. This dialogue is about to begin and I urge you to get involved in defining the big questions that will shape the future direction of our BRC.

Professor Bryan Williams Director, National Institute for Health Research University College London Hospitals Biomedical Research Centre

January 2014

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This booklet is about the work of the National Institute for Health Research (NIHR) University College London Hospitals Biomedical Research Centre (BRC). The booklet focuses on what the BRC has been doing in the past 18 months and the impact we have had in that time.

The NIHR awarded us renewed five-year funding from April 2012 of £110 million and we were tasked with focusing on experimental medicine.

Although our aim remains to speed up the translation of scientific discovery in our university into better treatments and care for our patients, this focus on experimental medicine marks a strategic shift.

The booklet will show what we have done with that money, our aims and what we have achieved so far. We hope it will demonstrate how government money is being put to good use in a bid to improve health and create wealth.

During this time, we reduced 17 research themes to four focused major research programmes – Cancer; Neurosciences; Infection, Immunity and Inflammation; and Cardiometabolic – as well as appointing a new BRC director, four programme directors and four operations mangers.

Our recent work includes:

• spending £6 million on selected high impact initiatives

• building new partnerships with pharmaceutical companies, medical devices companies and SMEs (small or medium enterprises)

• establishing the UCL BioResource to gather 10,000 DNA samples from volunteers and patients

• establishing fellowships and leadership courses for the experimental medicine researchers of the future

• setting up four lay panels to ensure patient and public input into our research and governance

• establishing BRC and industry workshops and showcase meetings

• setting up an innovation office for UCLH staff with promising ideas

• improving our structure

• reviewing our funding commitments.


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Background to our biomedical research centre

The National Institute for Health Research University College London Hospitals Biomedical Research Centre is a highly successful and influential partnership between University College London Hospitals NHS Foundation Trust (UCLH) and UCL (University College London).

By combining the strengths of UCLH – one of the largest and most successful NHS trusts in the UK – and UCL – ranked fourth in the QS World University Rankings 2013-14 and a leading biomedical research university – the BRC has become a world-class leader in translating fundamental biomedical research into clinical research that could transform patient care and save lives.

Government money from the NIHR is invested into the research infrastructure across UCLH and UCL including staff posts, equipment, facilities and training.

What we do

Our BRC takes innovations in basic science and helps translate them into actual treatments and therapies that will have an impact on patients and improve healthcare.

Our focus is on experimental medicine which tends to be ‘first in human’ studies such as research into new therapies and devices or the mechanisms of disease. By experimental medicine we mean early phase human translational studies focusing on:

• newtherapies(drug,immunologicalandcellbased)andnovel devices and first-in-man studies

• improvementsindiagnosis,treatmentselectionandevaluation of response – including diagnostics and medical technology

• repurposingoftherapies–takingestablished therapies and applying them to other diseases and clinical problems.

This kind of research needs specialist infrastructure and skilled staff, often based in dedicated clinical research facilities.

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What we want to doSince its inception, our strategy has been to speed up the translation of scientific discoveries into treatments and therapies that directly benefit patients.

In order to focus more on early stage experimental medicine, we have reorganised our structure in the past year to allow for more focus on our areas of world class strength, to build on our leadership and allow for more input from the public, and to develop even stronger links with industry as partners.

High impact initiatives – investing funds to ensure greatest impact on patient care

In September 2013, the BRC invested £6 million in six initiatives that we believe will have a high impact over the next four years in experimental medicine.

The BRC invited UCL and UCLH staff to submit bids for funding with the aim to find initiatives that had the potential to have a high impact on research and clinical care, could demonstrate tangible, achievable outputs over the next four years and involved creative ways of working in partnerships, especially with industry.

Funding awards include £1.2m over three years to set up a state of the art radiochemistry laboratory, bringing together biologists, chemists, imagers, engineers, physicists and clinicians in a new site to enable the production of novel imaging tracers for use in studies. Other awards include £0.7m over four years to establish UCL research space at the Stevenage BioScience Catalyst and £0.7m to establish a Computational Medical Imaging Infrastructure.

Director of the BRC Professor Bryan Williams says: “One of the things we’ve tried to emphasise is that there are

already many different funding streams available for people to undertake high quality fundamental, basic research, and the BRC is about filling the gap between scientific discovery and its application in patients. This happens in many ways, either in developing a better understanding of disease processes themselves, and developing new treatments, or in new ways of monitoring the disease process.”

Achieving our aims – the focus of our work‘Big data’ and genomics

The NHS holds and produces masses of information and data and the BRC has made it a priority to find ways of unlocking the unrealised potential of these large data sets, or ‘big data’ for research.

The NHS produces huge volumes of both structured and unstructured data. This data is so large and complex it is difficult to process using traditional database and software techniques. If researchers and health professionals could analyse these large data sets, within the appropriate data protection framework, it would open up incredible opportunities to evaluate and improve treatments and care.

For instance, bringing together the kind of information that is captured daily in healthcare settings with genetic information and detailed studies of the clinical phenotype will create enormous potential for research, enabling researchers to make real headway in unravelling the causes of many rare and common diseases and developing new treatments.

BRC director Professor Bryan Williams says: “This is unleashing the potential of anonymised NHS data that is

captured every hour of every day from millions of people, aligning that to information about their DNA and also more detailed information about the type of disease they have.”

The study of gene structures, known as genomics, is a crucial part of biomedical research. Studying the link between genes and disease requires not only close detailed laboratory science but also large amounts of data and access to large portions of the population. A key aim of the BRC’s work is to promote this access to genetic data.

UCL BioResource

The UCL BioResource is a major new initiative, aiming to gather 10,000 DNA samples from people with and without disease, to help researchers find out how genes influence disease.

The initiative marks a huge step in the fight against chronic diseases such as dementia, diabetes and heart disease as well as cancer and infectious diseases, and supports research into the link between genes, the environment, health and disease.

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The aim of UCL BioResource is to enlist 10,000 patients and volunteers from UCLH and other UCLPartners hospitals. Participants will be asked to give DNA, plasma or serum samples and to consent to being contacted in the future about trials they may be suitable for.

Samples will be securely stored together with information about the volunteer’s ethnicity and gender. Researchers can then identify individuals who could help them and invite them to take part in a particular study. This means it will now be possible to carry out valuable research into the mechanisms of diseases and the benefits and limitations of new treatments – research that was previously too costly or time-consuming.

UCL’s BioResource is one of seven centres in the nationwide NIHR BioResource project, which plans to have a collective core base of more than 100,000 participants by 2017.

Dr Kirstin Goldring, UCL Biobank and NIHR BioResource Coordinator, says: “The BioResource is important because traditionally when you are starting research projects or clinical trials, you have to go out and find both the correct patient and volunteer populations for that research study, trial or questionnaire.

“Having a panel of participants who are patients and healthy volunteers, who have already been screened and who are willing to participate in research, makes it easier for us to find the appropriate participants for all these studies. Recruiting such a large panel also means we are able to support a wider variety of studies in lots of different areas.”

Recruitment to the UCL BioResource began in July 2013 and by the end of December it had secured over 400 participants, the vast majority of whom are patients.

Recruitment so far has mostly been undertaken by nurses going into specific clinics but the BRC now plans to widen

recruitment, for example by sending information out to GPs.

Professor Nick Wood, director for our BRC’s Neurosciences programme, says: “The government has announced a number of funding initiatives about genomics into the NHS and a lot of that will be done through the BioResource infrastructure – sequencing patients from the BioResource, putting genetic results through the BioResource database. One will see an awful lot of activity over the next three to five years on that score.”

Next generation sequencing

Next generation sequencing is a technique that allows researchers to look quickly and cost effectively at each individual part of the DNA molecule in all of the genes and whole genome.

Before the development of this new technology, which has revolutionised biomedical research, researchers used gene sequencing techniques that were expensive and slow. BRC investment has enabled UCL researchers to buy a next generation sequencer and offer a supplemented service to research groups across UCL and UCLH. The result is the acceleration of research into human disease and a much better understanding of the genetic causes of diseases.

A team of researchers, led by Professor Henry Houlden, uses the sequencer for exome sequencing. They take a person’s blood, extract DNA, enrich certain sequences and over a 7-10 day period, sequence all protein encoding genes. The data is then analysed.

So far, they have sequenced more than 1,100 exomes for groups across UCL and results have allowed them to begin to unravel the genetics of common diseases, such as Alzheimer’s disease, and also rare diseases such as inherited

ataxia (a group of neurological disorders affecting balance, coordination, and speech) and dystonia (a movement disorder causing the muscles to contract and spasm involuntarily).

Professor Nick Wood says: “It’s a way of speeding up and having better accuracy in genetic capture. The first genome was sequenced in 2001 and that cost about three billion dollars, but with next generation sequencing, you can sequence a whole genome for about three to five thousand dollars.

“The challenge – and this is where it’s really important for the BRCs to get together – is how we understand those variations in terms of human disease. It has massively increased the speed at which we can find genes.

“We have found a number of genes with BRC reported research in the last few years – dementia genes for example – so it definitely has had a direct impact on finding genes that mean something to peoples’ diseases. The challenge is to work them up so that they can become useful as clinical tests.”

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Rare diseases

Research into rare diseases is a key priority for our BRC. A rare disease is one that affects fewer than five in 10,000 of the general population and it is estimated that in the UK 6% (approximately 3.5 million) of the population will be affected by a rare disease at some point in their lives.

UCL, the NIHR biomedical research centres and the academic health science centre UCLPartners (UCLP) serve a patient population of over six million across the North Thames region, approximately 0.5 million of whom will have a rare disease. Our research is extensive and diverse with more than 100 clinical academic research groups investigating more than 350 rare diseases.

BRC Director Professor Bryan Williams says: “We have abundant access to people with rare diseases, many of whom are cared for by our NHS specialist hospitals partnered with UCL and our BRCs. Many of these diseases have distinct features and if we can understand the genetic basis of some of these diseases and why some of these people have been affected, not only do we have a better chance to develop treatments for them, but many common diseases are a variation on rare diseases so it can give you

insight to mechanisms that are relevant to more common diseases too.”

UCL’s first rare diseases conference took place in February 2013 and in July the UCL Rare Disease Steering Committee welcomed around 100 attendees to the UCL Rare Diseases Elevator Pitch workshop at the Wellcome Collection.

At the workshop, academics, industry representatives, business managers and delegates from external funding bodies met to learn about the challenges of orphan products – drugs developed specifically to treat a rare medical condition – and the key criteria for successful partnerships.

The workshop also offered future industry partners a platform on which to engage with UCL rare disease researchers and to help establish industry/academia partnerships that will help to translate innovative research into medicines for patient benefit.

Researchers into rare diseases can apply to the BioResource for next generation sequencing of their DNA samples to help them with their work.

BRC input into Genomics England

The BRC is a major contributor to the pilot of the ambitious national Genomics England (GEL) project to sequence the genomes of up to 100,000 children and adults with a variety of diseases over the next five years.

The GEL project, run by the Department of Health’s company, Genomics England, is designed to gain knowledge and understanding of the mechanisms of diseases.

The project will introduce high-tech DNA mapping for rare diseases and cancer patients and will link that new data to the patient’s medical records. This information should

give clinicians a new advanced understanding of a patient’s genetic make-up, and allow more targeted treatment with the right drugs, so-called personalised medicine.

In a good example of successful cross-BRC initiatives, staff and facilities at the clinical research facilities at UCLH, Great Ormond Street and Moorfields Hospitals are being deployed in a co-ordinated approach recruiting and taking blood samples from over 700 patients and their relatives with rare genetic diseases.

Professor Nick Wood, programme director for Neurosciences for the BRC says:

“There are several challenges and one is, can you deliver on such a big project? Also, can you then find the diseases affected by genes and I suspect the answer will be yes. Some of those will be relatively easy to find and some will be tricky.”

One complicated issue that will need to be dealt with is what is done with the information. Professor Wood says: “I could sequence your genome and find you are carrying a gene that is increasing your risk of certain cancers or heart disease and you might want to know that and modify your lifestyle or take out insurance, but do I tell you or do I say, ‘I don’t really know what they mean for you yet, so I won’t tell you’? It’s complicated. It’s important to think about how we roll that out and implement it into the NHS.”

Making use of the information we already have

• The BRC is supporting the establishment of the Computational Imaging Infrastructure. This is a key investment in building the capacity and facilities to make use of the NHS’s massive imaging data sets. BRC-supported Computational Imaging Infrastructure will develop common software analysis platforms to link

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imaging across UCLH and UCL. The trust and university already have excellent imaging skills. By providing state of the art open source software libraries for the development of medical imaging processing systems, the Computational Imaging Infrastructure will ensure these skills are translated into the clinical arena to improve diagnosis and image guided therapy.

• The BRC is also investing £0.3m over four years in the Farr Institute of Health Informatics Research at UCL, which was established in 2013 with funding from the UK Medical Research Council. The BRC is funding recruitment of a clinical lead to develop a biomedical informatics platform at UCLH/UCL. This platform will be made up of a collection of computer programs designed to support translational research by allowing existing clinical data to be re-used for research purposes and by providing links to new sources of data.

• The BRC is part of a major new health informatics programme announced in November 2013 that will allow the collaborative sharing of routinely collected NHS data to facilitate more effective clinical research. Under the programme – the National Institute for Health Research Health Informatics Collaboration (HIC) – the five large BRCs (including our BRC) will work together to make NHS clinical data more readily available and accessible to researchers, industry and the NHS community. The informatics infrastructure will focus on five scientific themes, with UCLH leading on critical care and participating in projects on ovarian cancer, hepatitis C and acute coronary syndromes.

• The BRC is investing £0.7m over three years into a project to develop a linked population and bioinformatic resource for drug target and biomarker prioritisation for human disease. Biomarkers are measurable

characteristics that reflect the severity or presence of some disease states and can be used as an indicator of a particular disease state or the probable effect of treatment on a patient if a disease already exists. The project will allow the BRC to profile potential drug targets arising from UCL academic research. This work should be of interest to collaborations with the pharmaceutical industry as information from the project will help in decisions about which new molecules should be developed into new drug treatments. It may also help identify new uses for existing medicines.

Partnerships with enterprise and industryThe future of biomedical research very much depends on building partnerships with industry, and over the last 18 months the BRC has been helping to drive a culture change across UCLH/UCL to encourage clinicians and academics to think differently about the value of partnership with commercial organisations.

In particular partnerships with pharmaceutical companies, medical devices companies or SMEs (small or medium enterprises) hold huge promise.

Partnerships can enable us to marry UCL and UCLH expertise with the expertise, facilities and compound banks of chemicals that sit within drug companies.

The BRC is also keen to join up our expertise and facilities to ‘repurpose’ some existing medicines. Often pharmaceutical companies have safe drugs that have been developed to treat one disease that might actually be very effective in treating another disease. By identifying potential new uses

for drugs, which we call ‘repurposing’, we can develop new treatments very cost-effectively.

BRC Chief Operating Officer Dr Nick McNally says: “This is all about delivering patient benefit and investing in infrastructure and partnerships which have a strong potential of delivering patient benefit in terms of better health outcomes in the future.”

Stevenage BioScience Catalyst

The BRC is investing £0.7m over four years to enable UCL to take up laboratory space at the Stevenage BioScience Catalyst and fast track the development of new treatments.

The Stevenage BioScience Catalyst is the UK’s first open innovation bioscience campus, located next to GlaxoSmithKline (GSK), which pioneers a unique culture to drive early stage life science developments. The Catalyst focuses on developing novel therapeutics, biomarkers, cell technologies and screening.

By establishing a presence at the Catalyst, industry-ready UCLH/UCL projects will be able to access drug development expertise and facilities. Projects will work alongside and have access to the experienced development groups within GlaxoSmithKline and a rapid route for product materialisation and entry into early stage clinical trials.

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The BRC has also invested £0.6m into three exemplar projects.

The BRC also supported a successful bid by UCL for a £3 million slice of £50 million Higher Education Funding Council for England (HEFCE) funding as part of a push to work in partnership with industry to make sure our biomedical discoveries are developed into products.

This funding will enable UCL to work at the Catalyst with our BRC partners at the University of Cambridge to identify new candidates for therapeutic drugs and the processes for manufacturing them.

The approach at the Catalyst will mean both industry, and university and NHS employees will be exposed to the operations of a major pharmaceutical company. Laboratory researchers who are exposed over time to industry objectives will have a clearer understanding of what drives industry in trying to make new medicines.

BRC Chief Operating Officer Dr Nick McNally says: “It will open peoples’ eyes on either side of the equation to what are the drivers, priorities and pressures in each sector and therefore how we can improve on our partnership building.”

New alliances

In the past year, the BRC has supported a drug discovery alliance between UCL neuroscience and the global pharmaceutical company Eisai Pharmaceuticals, with the aim of discovering novel therapeutics.

Under the agreement, researchers from both organisations will work together to investigate new ways of treating neurological diseases such as Alzheimer’s, Parkinson’s and other related disorders.

The aim is to identify and validate novel drug targets and develop new therapeutics and evaluate them in proof-of-concept trials.

Research is likely to be carried out at UCL’s new Leonard Wolfson Experimental Neurology Centre, with Eisai providing drug discovery and development resource and relevant expert knowledge.

Eisai is also funding a PhD studentship at UCL for projects in neuroscience including three year’s funding for tuition fees, a stipend and a research allowance.

Drug breakthroughs

The BRC has invested £1 million in preparatory work for a trial of a drug to treat Alzheimer’s disease.

The aim is to trial a drug known as CPHPC developed by Professor Sir Mark Pepys, Director of the UCL Wolfson Drug Discovery Unit. CPHPC almost completely depletes circulating serum amyloid P component (SAP) and removes all SAP from the cerebrospinal fluid.

Professor Martin Rossor, Director of the NIHR Queen Square Dementia Biomedical Research Unit, has designed a clinical trial of CPHPC, known as the DESPIAD study, which will be conducted at UCL’s Leonard Wolfson Experimental Neurology Centre.

Sir Mark and Professor Rossor have been invited to apply for an MRC Development Pathway Funding Scheme award to fund the clinical study and the aim is for the 3-4 year study to start this year.

BRC support has enabled other research by Sir Mark Pepys, including research into systemic amyloidosis (a disorder resulting from abnormal protein deposits in body tissues); DNA vaccination for HIV; and C-reactive protein inhibition for cardiovascular and inflammatory diseases.

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Research infrastructureRadiochemistry lab

The BRC is setting up a high spec radiochemistry laboratory to enable researchers to develop new ways of manufacturing radiotracers for use in nuclear imaging.

The new lab – to be built in the next year – will enable scientists to develop and manufacture radiotracers to the high standards needed for use in clinical trials.

Radiotracers are small amounts of radioactive material used in imaging the body. Radiotracers enable researchers to observe the disease process happening. Once the tracer has been administered, specialised PET/MRI (Positron emission tomography/magnetic resonance imaging) is used to detect the radiation throughout the body.

The new lab will enable researchers to use radiotracers they have produced themselves rather than had manufactured elsewhere to carry out first in man studies. Work at the lab will focus particularly on developing novel tracers for use in UCLH’s PET/MRI facility which is the only facility of its kind in the UK and one of the few in Europe.

BRC Director Professor Bryan Williams says: “The hospital has the only PET MRI scanner in the country at the moment. This is a combined scanning tool that allows you to apply PET, which uses special tracers that look at metabolism and when used alongside MRI, also look at structure. This provides leading edge imaging for many disease areas, including cancer and neurology.

“You can, for example, look at a lesion, see whether it’s metabolically active and that might indicate that it is a

tumour, so you get more diagnostic information than simply doing an MRI.”

This kind of work requires skilful chemistry to label metabolic traces and UCL has leading expertise in PET tracing chemistry.

“The frustrating thing was that we did not have the capacity to use our own tracers because we didn’t have the GMP (Good Medical Practice) grade facilities to actually work up those new innovative models and tracers to put them into patients. The BRC has fixed that.”

Phenotyping clinic

The BRC has allocated half a million pounds towards establishing an adult cardiovascular phenotyping clinic in partnership with the UCL Institute of Cardiovascular Science and UCLPartners.

Phenotyping involves identifying the observable characteristics of an organism, such as shape, size, colour, and behaviour, that result from the interaction of its genotype with the environment.

The clinic is an area dedicated to research, which includes a laboratory and provides space for specialist cardiovascular research staff and an academic diabetes research team, research fellows and graduate students.

The clinic provides a base from which to carry out research into adult vascular physiology, supporting essential research within the cardiometabolic domain involving heart disease and metabolic disorders such as diabetes.

Clinical Research Facility

The NIHR/Wellcome Trust Clinical Research Facility (CRF) at UCLH is a purpose-built environment for early phase clinical trials and other research projects. The facility provides beds, a laboratory, a dispensing pharmacy, and specialist staff, all dedicated to clinical research.

The CRF provides researchers with a specialist environment where they can conduct their studies as safely, effectively and efficiently as possible. Research taking place at the CRF focuses on understanding the causes of human disease and the effects of new treatments, tests and devices. Some of the trials will be of new drugs being used for the first time in human volunteers. At any one time the facility hosts over 50 research projects involving innovative treatments.

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Training researchers and the next generation of investigatorsUCL’s integrated Academic Careers Office (ACO) is led by the BRC’s education and training lead and supported by the BRC.

The BRC has an ambitious programme of research and clinical academic training aimed at supporting researchers and developing a new generation of experimental medicine researchers. This programme is supported by a cross-cutting education and training programme delivered through the integrated Academic Careers Office. The mission of the Academic Careers Office (ACO) is to promote, support and develop all aspects of academic and clinical academic careers in the School of Life and Medical Sciences (SLMS) and the BRC.

Highlights of the ACO’s major initiatives include:

UCL BRCs-Francis Crick Clinical Fellowship scheme

The BRC has funded new clinical research fellows working on experimental medicine. The Francis Crick Institute is a major new research biomedical institute currently due to open in 2015 and will house around 1,400 scientists.

MiniMD

MiniMD is a two-week intensive course for non-clinical scientists. This free course is designed to give participants first-hand experience of what their work could do in a clinical setting.

The first course, run in collaboration with London Cancer, focused on breast cancer. Participants experienced different aspects of the cancer care pathway including a hospice, an operating theatre, radiotherapy suites, out-patients, chemotherapy, and histology.

ACO director Professor Geraint Rees says: “We did it as an experiment and sought feedback to see if people liked it and saw value. The feedback was fantastic and we are now going to repeat that on an annual basis. That’s about

the BRC delivering innovation and trying to change the trajectory of individuals in basic science career pathways to make them oriented more towards translation.”

Experimental medicine conferences

We are developing a series of high profile experimental medicine conferences to build interactions within the BRC programmes and between the programmes and external audiences.

Two conferences are planned for 2014, one for our Cardiometabolic Programme, and another on ‘Experimental medicine in a pandemic’.

Tomorrow’s leaders

The ACO is offering up to eight BRC faculty staff the opportunity to attend a senior leadership programme at the UCLH NHS Staff College. The ACO and UCL’s School of Life and Medical Sciences (SLMS) in collaboration with UCL Organisation Development have also developed a bespoke Future Leaders programme for SLMS staff who show excellent leadership potential.

The ACO has also secured a Wellcome Trust Clinical PhD programme which involves funding of around £6.5 million from the Wellcome Trust. The first cohort who will come to UCL as clinical PhD students are being recruited.

Professor Rees says: “What we do is talent management. Our remit is to set up and lead new programmes for postgraduate research training, bring the community we’ve got together and increase the quality of existing programmes, innovate in new ways of training and develop the leaders of the future in the life and medical sciences.

“We’re trying to do something special to find out where our talent is and then manage and promote it.”


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Patient and public involvementThe BRC has been working hard to embed the active involvement of patients and the public in the research it supports and in the way the BRC itself operates.

Patient and public involvement (PPI) leads to better research, by making sure research better meets the needs of patients, is more rigorously and effectively conducted, and leads to treatments that are taken up more quickly.

We have established a lay panel in each of our programmes. These groups of lay people meet on a regular basis and are available to review research proposals and design. A lay representative sits on each of our programme boards.

The BRC secured £20,000 from the Wellcome Trust to set up a PPI bursary to fund and encourage PPI initiatives. We have also secured funding to provide a service for researchers submitting grant applications with the aim of giving grant applications a better chance of success and providing models of good practice.

The BRC runs training sessions for researchers on PPI and induction sessions for lay people who will be working with us.

New ideasInnovation is fundamental to the aims of the BRC. The BRC has set up the UCLH Innovation Office to help UCLH staff develop inventions, innovative products or services which have application beyond the trust.

The office provides an advice and support service specifically for UCLH staff with ideas or solutions that have a direct effect on patients or patient care. These solutions may be a product, piece of equipment, or service such as a training tool, medical device or a piece of software, and may have commercial value.

The service has proved highly popular and examples of ideas brought forward by Trust staff include:

• software that allows hands free manipulation of medical images in sterile environments

• reducing the transmission of bacteria via computer keyboards

• an integrated telephone triage service staffed by expert multiple sclerosis nurses to make care management easier.

Focusing on BRC structuresThe BRC has made fundamental changes to its structure in the past year and condensed activities from the previous theme structure into four programmes:

• Cancer

• Neurosciences

• Cardiometabolic Science

• Infection, Immunity and Inflammation.

This structure reflects our strengths as well as aligning with the UCLH clinical board structures and the UCL academic domains.

Professor Bryan Williams was appointed BRC Director and programme directors were appointed for each of the four programmes: Professor David Linch; Professor Nick Wood; Professor Derek Yellon; and Dr Emma Morris.

BRC Chief Operating Officer Dr Nick McNally says: “We transformed the BRC and have got it much more focused on our areas of strength. The focus has been achieved through leadership and through our structures – focusing on those four areas of world-class strength and we’ve reallocated money in line with that.”

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FundingBRC funding comes from the Department of Health’s National Institute for Health Research (NIHR). When the BRC was awarded a further £100 million, it was tasked with the need to focus more on experimental medicine and to develop closer working and partnerships with industry.

In 2012, the BRC carried out a review of its existing funding structure and commitments and began to use a new resource model that incentivises world-class activity and rewards leverage.

In light of the BRC’s new strategic focus on experimental medicine, the BRC reviewed the research it funds. Research activity falling outside of the new BRC strategy has been moved onto alternative appropriate funding streams.

We have simplified the methodology used to allocate funding for NHS Support Costs and reviewed the BRC overheads.

The net effect of our financial review was to identify a significant increase in the core budgets for research.

Our programmes have started to fund new initiatives that are in line with the principle that BRC funds must, wherever possible, be used to leverage grant and industry research income.

We have also allocated £2.5m to the BRC Education and Training Programme to help retain, attract and train the most promising next generation of clinical scientists in experimental medicine.

Funding is also going towards core experimental medicine infrastructure, including the BRC leadership and operations teams, the Joint Research Office, the BioResource and the Industry Liaison Management Team.

Around £10m has been allocated to support the high impact, experimental medicine initiatives.

Dr McNally says: “An important part of what we do now is to use our BRC infrastructure, funding and resources to leverage the resources of other organisations. Typically, what we are starting to achieve are some great results in opening up the UCLH/UCL partnership to collaboration with industry.”

With some high profile pharmaceutical companies leaving or threatening to leave the UK, the government is promoting a life sciences agenda that aims to attract companies back.

The BRC believes it has a key role in helping to drive culture changes from within academia and the NHS to show industry that we are keen to work with them and to think openly about what partnerships can deliver in terms of health gains, but also create wealth.

Tangible results and achievements of the BRC

• Between 2011 and 2013 there was a 9% rise in the number of new early phase clinical trials approved at UCLH and a 35% increase in the number of commercial contract clinical trials approved.

• Four times more research stories have been published on the BRC website over the last 12 months following the appointment of a Communications and PPI (Patient and Public Involvement) Officer to help researchers prepare their work for the wider media.

• Over 400 participants have been recruited to the UCL BioResource initiative, donating their DNA samples and consenting to be contacted at a later date about research studies they may be suitable for.

• The BRC secured £20,000 from the Wellcome Trust for the development of patient groups and a bursary funding pot.

• The BRC now has 176 industry collaborators and the top six companies are: Astra Zeneca; Eli Lilly; GlaxoSmithKline; Janssen-Cilag; Novartis; and Pfizer.

• The UCL Academic Careers Office has secured around £6.5 million from the Wellcome Trust for a Clinical PhD programme. The first cohort is being recruited and will come to UCL to be clinical PhD students.

• The BRC awarded £6 million to six high impact initiatives.

• A new BRC website (www.uclhospitals.brc.nihr.ac.uk) was launched and a new BRC e-Newsletter started and circulated to over 2,000 staff.

• The UCLH Innovation Office was set up to work with trust staff to develop their ideas for improving quality of care for patients.

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• A pivotal clinical trial involving a drug shown to have a positive effect in cancer patients has been developed and early details have been published on the BRC’s website.

• BRC studies have been published in high-impact titles such as Nature, Nature Science, The Lancet, and the New England Journal of Medicine showing the outcomes of BRC work.

• UCL won the International Collaboration of the Year award in December 2013 at the Times Higher Education Awards, for the University of Zambia-University College London Medical School (UNZA-UCLMS) Research & Training Programme, led by BRC-supported Professor Alimuddin Zumla.

• The Academic Careers Office ran a highly successful ‘MiniMD’ training course for non-clinical scientists to see what their future work could do in a clinical setting.

• A series of high profile experimental medicine conferences are planned to begin in 2014.

• Half a million pounds had been allocated by the BRC’s cardiometabolic programme towards establishing an adult phenotyping clinic – in partnership with the UCL Institute of Cardiovascular Science and UCLPartners to allow research into adult vascular physiology.

• Drug industry representatives are showing interest in work being done by UCL researchers into rare disease following a successful conference held in summer 2013.

• The Academic Careers Office is to launch an academic clinician website/blog in early 2014.

• Purchase of a next generation sequencer has enabled researchers to sequence over 1,100 exomes.

The futureOur BRC focuses on encouraging and promoting work to help experimental medicine translate into future clinical practice and better patient care.

Much of what we have done over the last 18 months has focused on making use of the massive amounts of data produced by the NHS and scientists, speeding up the process of research by providing state of the art facilities and working closely with industry. We envisage this work reaping rewards not only in the near future but in many years to come.

As the BRC progresses, it is starting to identify the ‘big questions’ in research. BRC Director Professor Bryan Williams says: “I want our BRC to be distinctive. It’s a health orientated programme and it’s not specifically just about funding individuals and their projects, but about targeting major funding at research that is going to address big questions and change medicine.

“We need to be even bolder and identify the big questions. These would ideally be aligned to areas in which we have demonstrable strengths and graft seamlessly onto the strategic direction of the university and the NHS Trust.

“I have asked all the four big programmes – Cancer, Neurosciences, Cardiometabolic disease, and Infection, Immunity and Inflammation – to think what would be three or four big questions that your programme would want to address. I want those questions to resonate with the public.

“By setting out our stall and creating awareness of our big questions we can begin to recruit the best and leverage grant income from major funders and engage more effectively with industry. We will be challenging the boundaries.

“This kind of ground-breaking thinking about new ways of tackling disease is a perfect example of the BRC’s ambition – translating scientific discovery to improve patient outcomes. Tomorrows medicine today for our patients at UCLH.”

The National Institute for Health Research University College London Hospitals Biomedical Research Centre is a partnership between University College London Hospitals NHS Foundation Trust and UCL (University College London) and is part of the National Institute for Health Research.

Photography: David C Bishop, Medical Illustration Services Angus Hubbard, Loaded Productions NHS Photo Library

Design: Susan Rentoul Design

www.uclhospitals.brc.nihr.ac.uk

@UCLHresearch

www.uclh.nhs.uk

www.ucl.ac.uk

1st Floor, Maple House 149 Tottenham Court Road London W1T 7NF

Telephone: 020 7679 6639

January 2014

focusing on experimental medicine · 2014. 5. 1. · 5 focusing on experimental medicine what we...

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