Sheffield Teaching Hospitals NHS Foundation Trust
Academic Directorate of Neuroscience
Research Strategy 2011
Version 1.0 FINAL
October 2011
• Historical perspective
The Neurosciences Directorate has been research active for many years, but this has been the domain of individuals with research interests rather than built into a cohesive directorate strategy. However since January 2011 we have set up the first Academic Directorate within STH as a model for the Trust to develop and grow across the organisation.
The Academic Directorate of Neuroscience is developing a strategy for research to ensure we are placed in a strong position to make BRU or BRC bids, as well as applications for industry and non-industry funded neuroscience research funding streams in the future. Academic Directorates are to be the foundation for the growth of strong research activeunits that are inclusive of our multi professional expertise and can compete ona national and international scale.
• Progress since the creation of the Academic Directorate of Neuroscience in January 2011
1. Management and Executive meeting structures changed to have a stronger emphasis on research and teaching and a more integrated approach to research and service delivery. Monthly meetings of the Academic Directorate Executive and Research and Teaching Executive have been established.
2. Identified our areas of strength and potential as 6 research themes (see Table 1) each with an appointed theme leader. The theme leaders have collated data from their theme have undertaken a SWOT analysis of the theme and have put together strategic plans.
3. Investment made in a directorate research co-ordinator (Jodie Keyworth) and management time (Carolyn Wilkie).
4. Appointed the Academic Director of Neurosciences (Pam Shaw).
5. Have developed a productive working relationship with the Joint Research office through a member of staffwho will have responsibility for the Neuroscience portfolio (Ram Patel).
Have ensured that the multi professional groups are considered and the Trusts Research Nursing Strategy is embedded into the development by inviting the Research Link Nurse for the H&N Group
6. Have begun the process of collating baseline data on research activity including: research active personnel; portfolio, commercial and non-commercial and non-portfolio studies; accrual figures; research funding; publications; impact and esteem indicators and capacity development.
7. Have set up a research advisory clinic to help new researchers develop the permissions needed to initiate new studies.
8. Have begun to identify key areas for development of infrastructure e.g. working within the Clinical Research Facility.
9. Have started a programme to stimulate new research and collaborations, bringing together interested parties from the NHS and the University sectors, with a series of research forums. The first in June 2011 was on dementia and others planned will be on the topics of Neuro-inflammation and epilepsy.
10. Have begun to develop financial plans to stimulate research and “pump prime” key strategic areas likely to attract grant funding.
11. Have formulated plans for addressing gaps in our research skills and critical mass.
12. Have begun to appoint new strategic positions e.g. Chair of Translational Neuropsychology.
13. Have appointed a Directorate Teaching Champion to work alongside the University Teaching Lead with the aim of further developing the quality of undergraduate teaching.
Research ThemesTheme / Theme Lead / Stage
(Basic, Translational, Clinical, Health Services Research, Industry) / Key research areas
1 / Epilepsy / Markus Reuber / Clinical / -Non-epileptic attack disorder
-Conversation analysis
-Epilepsy surgery
2 / Neuroinflammation / Marios Hadjivassiliou / Clinical / -Neurological aspects of gluten sensitivity
-Ataxia
-Idiopathic intracranial hypertension
3 / Neurodegeneration / Oliver Bandmann / Basic, translational, clinical, industry / -Molecular neuropathology
-Understanding basic disease mechanisms using model systems and gene expression profiling
-Neuroprotective therapy development –small molecule screening, gene therapy, nanotechnology
-Biomarker development
-Improvements in symptomatic management
4 / Neuro-oncology / Thomas Carroll / Translational, clinical / -Development of gene therapy for CNS disorders
5 / Neurovascular –
Theme Leads Marc Randall and Umang Patel / Medical:
Marc Randall
Surgical:
Umang Patel / Clinical, industry / -Trials in acute stroke, prevention and rehabilitation
-Unruptured aneurysms
-Stereotactic radiosurgery for AVMs
6 / Clinical trials - Industry Liaison / Basil Sharrack / Clinical, industry / -Multiple sclerosis
-Stroke
-Motor neurone disease
-New technologies e.g. diaphragm pacing, cough assist
Table 1: Academic Directorate of Neuroscience: key research themes
• SWOT ANALYSIS
Strengths
· Sheffield is a leading national centre for some neurological and neurosurgical disease areas e.g. multiple sclerosis, ataxia, MND, clinical communication research, functional neurology, epilepsy stereotactic radiosurgery.
· Strong record of recruiting patients into clinical trials especially in multiple sclerosis and stroke. Mainly multicentre and network adopted trials. Excellent tract record of being able to attract key sponsors and deliver on target. Neuroscience delivers more than 30% of all commercial clinical trials at STH.
· Leading roles within topic specific networks e.g. Stroke and DeNDRoN and good relationship and support from SYCLRN.
· Established pathway of translational research from basic neuroscience through to phase 3 clinical trials in patients in some areas.
· Several examples of successful translational research leading to improved outcomes for patients. Several current therapies being lined up for “first into man” therapeutic trials.
· Large collection of optimally prepared biosamples in some disease areas.
· Excellent collaborative environment for working with basic scientists, and researchers from SCHARR and CHLARC, engineering, bioinformatics.
· Track record of programme funding from Wellcome Trust, MRC, NIHR in some areas.
· Good network of national and international collaborations.
· Good publication track record.
· Access to strong academic infrastructure e.g. in neuroimaging, neuropathology.
· SITraN infrastructure. Established transcriptomics, neurogenetics, cell and molecular biology, drug screening and gene therapy laboratories and newly established Bioinformatics team. Modelling disease in cellular and in vivo models for clinical translation.
· Excellent young clinician and basic science researchers are being attracted to Sheffield – good potential for capacity building.
· Some international prizes and awards.
· Close links with disease charities and patient organisations.
· The potential for local charities e.g. Neurocare and the Ryder Briggs Trust to help support/ pump prime clinical neuroscience research
Weaknesses
· Sheffield is not within the “golden triangle” of London, Oxford, and Cambridge where major funds tend to be concentrated.
· Some of our strong areas of research are not top priority for government and grant funding bodies.
· Low critical mass of research active staff compared to some of our competitors.
· Lack of academic staff in certain key areas e.g. stroke, dementia neurology/old age psychiatry – which are priority areas for funding.
· Some skill and manpower gaps for optimal research efficiency. Few areas where research strength includes basic, translational and clinical research elements. Some areas with strong clinical but no basic research e.g. stroke; others where strong basic, but little clinical e.g. Parkinson’s disease.
· Increasing time constraints on NHS staff to undertake research. Increasing bureaucracy involved in getting research projects started.
· Lack of pump priming funds to generate pilot data for grant applications.
· Small number of programme grant holders, internationally visible PI’s.
· More publications needed in highest ranking journals and with high impact/citation rates.
· Limited infrastructure to support clinical research (e.g. research nurses).
· Lack of a patient data-base to support research
· Difficulties perceived in using the CRF effectively
· In the Nursing Profession in STHT, a research culture is not currently in place and is therefore difficult/impossible for those nurses in a clinical role, wishing to undertake original research of their own to do so.
Opportunities
· Priority given by funding bodies to stroke, dementia, Neurodegeneration as well as translational approaches to Neuroscience. DOH dementia and stroke strategies.
· Interdisciplinary opportunities e.g. nanotechnology, assistive technology, health services research (SCHARR), neurovascular surgery.
· Maximise academic opportunities in local niche areas of clinical strength e.g. stereotactic radiosurgery gluten related neurological disorders.
· Links with strong overseas groups.
· SITraN – space, posts, funding opportunities.
· Great opportunities for interdisciplinary collaborations in Sheffield e.g. with SCHARR and Biomedical Science, Bioengineering.
· Several new posts to be appointed within SITraN e.g. Scientific Co-director, RNA processing, Stem Cell Scientist, Drug discovery expertise.
· Potential for Wellcome Strategic award.
· Support and interest from charitable organisations e.g. Neurocare and Sheffield Institute Foundation.
· Increased infrastructure and support for research by the creation of the Academic Directorate.
· The possibility of engaging some of our specialist nurses in research.
· Pharmaceutical companies are keen to forge partnerships with academic centres able to help in designing and conducting commercial trials to the benefit of patients and both parties.
· Some members of the Department of Neuroscience have already established excellent links with ScHARR and obtained NIHR funding– local expertise is therefore available which will help us to design clinical research projects and obtain funding.
· The ability to apply a successful area of research to other clinical problems e.g. clinical communication research extended from epilepsy to dementia.
· In some areas infrastructure is very supportive of research e.g. our state-of-the art video-telemetry unit; the infrastructure for stereotactic radiosurgery.
· Our epilepsy surgery programme is one of the largest in the country and is benefits from access to all diagnostic modalities which may be required (PET, SPECT, intracranial recordings, cortical stimulation, 3T MRI, Wada-testing, neuropsychological testing, motor context f-MRI).
· Our future large treatment studies will benefit from the fact that the Sheffield NEAD research programme is the largest in the country and best integrated into NHS structures.
· Securing a chair in stroke medicine with proven track record would allow development of theme by attracting additional funding to projects.
· The young stroke cohort and heart brain MDT provides retrospective and prospective opportunities to investigate this group of patients in more detail.
· The appointment of the Chair of Translational Neuropsychology and future academic post in dementia should allow cognitive research in stroke patients to develop.
· Harness the strengths from the diverse professional groups working in the academic Directorate to enhance research at all levels in the health and social care environment
Threats
· Financial climate which impacts on the Trust, the University and research funding bodies.
· Current lack of major NIHR funding and risk of being “left behind” in relation to other centres who have procured this.
· Delays in implementing and delivering research outcomes – need for departmental high quality administrative support.
· The administration and governance of clinical research at STHFT continues to place a heavy burden on researchers. Research governance processes in Sheffield have been slower and more cumbersome than in most UK centres. The appointment of a Research Coordinator has helped but not alleviated this problem sufficiently.
· Increasing overhead costs of running commercial trials will inhibit clinicians from taking part in this type of research.
· Lack of adequate time allocation in job plans of NHS staff to support this high quality clinical research effort.
· The arrangements for the financial management of non-commercial research grants at STHFT remain problematic.
· Loss of the cardiovascular BRU and its obvious links to stroke medicine.
· Clinical pressures in the stroke service especially with non- stroke patients and time pressures on the clinicians in the Hyper-acute pathway limits opportunity and willingness to recruit into stroke trials.
· Lack of pilot data to apply for NIHR and MRC funding schemes
· Limited neuropsychology lab facilities for expansion of postgraduate research in dementia.
· Lack of an establish pathway/procedures for recruitment of dementia patients into research studies.
ONE YEAR TARGETS FOR THE ACADEMIC DIRECTORATE OF NEUROSCIENCE
· Agreed one year and 5 year strategy in place by autumn 2011.
· Collation of baseline data required to assess performance and progress in research and teaching by autumn 2011.
· Assignment of key roles and tasks within the Research and Teaching Executive by autumn 2011.
· Appointment of strategic new posts with high quality clinical researchers: Stroke Medicine and Neurodegeneration are the initial priority areas.
· Intelligent research portfolio development in line with government and funding body strategies e.g. DoH Stroke and dementia strategies and European neuroscience initiatives.
· Demonstrate improvement in key research metrics by summer 2012.
5 YEAR TARGETS FOR THE ACADEMIC DIRECTORATE OF NEUROSCIENCE
· Address current research skill gaps e.g. so that we have research strength from basic through to clinical research in key strategic areas of research strength.
· Develop a Neuroscience Biomedical Research Unit with external funding.
· Become the best regarded regional Clinical Neuroscience department in the UK, with more stable critical mass in key areas.
· Improve research and teaching performance year by year.
· High impact collaborations.
· Exploit and effectively translate research opportunities – to achieve improved outcomes for patients. Be able to demonstrate the impact of our research effort.
· Nurture the development of our clinical and science based junior researchers e.g. with prestigious fellowship awards.
· Develop a diploma course in clinical neurology which will attract clinical fellows to contribute to research within the Directorate.
• COMMON STRATEGIC GOALS FROM THE RESEARCH THEMES (for further detail see individual research theme strategy documents)
· Exploit rich areas which could form the basis of high quality clinical research e.g. young stroke cohort; post-stroke cognitive impairment
· Exploit high quality collaborations locally, nationally, internationally.
· Appoint academic positions to strengthen key strategic areas e.g. Chair of Stroke Medicine; Neurodegeneration (PD or dementia) Neurology.
· Exploit inter –theme areas e.g. First seizure and ischaemic stroke; vascular dementia; astrocytes in Neurodegeneration; neurosurgery and medical physics.
· Extract the research potential from areas of government priority for research e.g. stroke and dementia; translational neuroscience research/ experimental medicine.