Professor Philip Baker ProViceChancellor Head of the College

Professor Philip Baker Pro-Vice-Chancellor, Head of the College of Life Sciences, Dean of Medicine Non-exec director UHL Leicester’s Research Live: Becoming the Best in Research 2020 Sponsored by Leicester Precision Medicine Institute

The University of Leicester and the University Hospitals of Leicester NHS Trust Partnership President and Vice-Chancellor Professor Nishan Canagarajah has begun the University's strategy consultation - Shaping Our 2 nd Century “We are diverse in our make-up and united in ambition. We create, share and apply knowledge to make transformative change with all communities wherever they are. We are Citizens of Change” Leicester’s Research Live: Becoming the Best in Research 2020 Sponsored by Leicester Precision Medicine Institute

LEICESTERSHIRE ACADEMIC HEALTH PARTNERSHIP • • • Launch of Leicestershire Academic Health Partnership with UHL and LPT NHS trusts - will link excellence in research, education and health service delivery. To harness academic excellence and ensure the results of clinical research can improve clinical care across Leicester, Leicestershire and Rutland …. implement quickly to benefit local patients. . Priorities for the new partnership will include some of the big health challenges that are faced in the county, such as frailty in an ageing population, mental illness, minority ethnic health and healthcare data for research. Leicester’s Research Live: Becoming the Best in Research 2020 Sponsored by Leicester Precision Medicine Institute

Priorities for Biomedical Research • Personalised medicine, lifestyle, multi-morbidity, detection, prevention, treatment and rehabilitation • Ethnic health, integrating health and research data, health service research • Infectious diseases, respiratory health and the environment, anti-microbial resistance and food security • Mental health, psychology and behavioural neuroscience • Molecular mechanisms, structural and chemical biology • Genetics, Genomics, Genetic Epidemiology and Forensics Leicester’s Research Live: Becoming the Best in Research 2020 Sponsored by Leicester Precision Medicine Institute

Growing Collaborative Partnerships • • • • Leicester Precision Medicine Institute NIHR Biomedical Research Centre & Clinical Research Facility Leicester Academic Health Partnership Leicester Diabetes Centre Leicester Cancer Research Centre and Experimental Cancer Medicine Centre for Black and Minority Ethnic Health Research Leicester Real World Evidence Unit MRC-EPSRC East Midlands Breathomics Pathology Node (EMBER) Midlands HDR UK substantive site BREATHE – Health Data Research Hub for Respiratory Health Partner National Centre for Sport & Exercise Medicine Midlands Health Alliance East Midlands Academic Health Science Network Midlands Innovation Medilink (RDS) East Midlands – NIHR and RDS National Office, held at Leicester’s Research Live: Becoming the Best in Research 2020 Sponsored by Leicester Precision Medicine Institute

Supporting the development of Clinical Academics ACF progression • 47% of ACFs leaving our programme between 2012 -18 went on to Ph. D/MD • 8 of our ACFs have progressed to NIHR Clinical Lecturers posts in Leicester CL academic retention • 4 of our previous trainees are now substantive University Professors – Professor Salman Siddiqi, Leicester, CL 2009 -2013, Professor Pranab Haldar, Leicester, CL 2009 -2013, Professor Matt Bown, Leicester, CL 2003 -2010, Professor Mona Bafadhel, Oxford, CL 20 Honorary Titles conferred to research active UHL collaborators 2016 Lecturer 6 Senior Lecturer 29 Associate Professor 16 Professor 26 2017 Lecturer 10 Senior Lecturer 22 Associate Professor 32 Professor 6 2018 Lecturer 20 Senior Lecturer 11 Associate Professor 9 Professor 2 Leicester’s Research Live: Becoming the Best in Research 2020 2019 Lecturer 19 Senior Lecturer 31 Associate Professor 7 Professor 8 Sponsored by Leicester Precision Medicine Institute

Leicester Precision Medicine Institute Director: Professor Don Jones Leicester’s Research Live: Becoming the Best in Research 2020 Sponsored by Leicester Precision Medicine Institute

Leicester Institute of Structural & Chemical Biology (LISCB) • • Structure and mechanism of macromolecular complexes Structure based drug discovery and design Single molecule techniques Chemical biology, probes and compound libraries Leicester’s Research Live: Becoming the Best in Research 2020 Sponsored by Leicester Precision Medicine Institute

Cardiovascular Sciences Two themes: Cardiovascular Precision and Stratified Medicine (Biomarkers, Genomics and Imaging) Drug/Device: Discovery, Intervention and Clinical Trials (Preclinical translational and clinical trials) Key strategic infrastructure: BHF Cardiovascular Research Centre Van Geest CVS Biomarker Facility Van Geest CVS Research Fund NIHR Biomedical Research Centre (CV Theme) BHF Accelerator Award BHF Infrastructure: Mass Spectrometry; Cardiac Imaging BHF Chair in Cardiology (NJS) BHF Chair in Cardiac Surgery (GM) NIHR Research Professor (GMc. C) George Davies Chair in Vascular Surgery (RS) Mayer Chair in Renal Medicine (JB) Multiple programme level grant awards Leicester’s Research Live: Becoming the Best in Research 2020 Sponsored by Leicester Precision Medicine Institute

Respiratory Science Lung disease, Asthma and Eosinophils, COPD, Pulmonary Rehabilitation, TB, mask technology and diagnosis of lung infection, new treatments and stratified therapies, T cell immunity and smooth muscle in airway disease. Funding sources are varied and include UKRI, charities and NIHR amongst others. Continued significant levels of trial activity with support from biotechnology and pharmaceutical organisations. Leicester’s Research Live: Becoming the Best in Research 2020 Sponsored by Leicester Precision Medicine Institute

Diabetes Research Centre Co-directors Melanie J Davies and Kamlesh Khunti • significant NIHR infrastructure including BRC, ARC, CRN diabetes specialist lead, NIHR programme grants, CRF • Broad range of clinical research from experimental studies in lifestyle to complex interventions, new therapies & multimorbidity • In the past year generated £ 12 million in research income & 122 publications in high impact journals • Leicester’s Research Live: Becoming the Best in Research 2020 Sponsored by Leicester Precision Medicine Institute

Data Science Artificial Intelligence and Machine Learning • Big data applications • Business Intelligence • Complex modelling; data fusion, data integration and scaling • Data applications and decision support tools • Data capture and data creation • Data curation, database development, data discovery • Data storage and indexing • • • Data inter-operability research and solutions Evaluation and development of novel technologies Human- Computer interface; psychology and behaviour Statistical and other multidimensional analytical approaches Visualisation techniques Leicester’s Research Live: Becoming the Best in Research 2020 Sponsored by Leicester Precision Medicine Institute

Centre for Environment, Health and Sustainability (CEHS) Founded in 2018, CEHS is an initiative by the University of Leicester to develop new areas of research that build on existing work in environment, health and sustainability. Director: Anna Hansell, Dept. Health Sciences Deputy Director: John Gulliver, School of Geography/Geology The research team, based largely in the George Davies Centre, comprises staff from a range of departments at Leicester, who also collaborate with a wide range of other organisations. Leicester’s Research Live: Becoming the Best in Research 2020 Sponsored by Leicester Precision Medicine Institute

Infectious diseases and AMR Le. MID - Leicester Microbiology and Infectious Diseases Research Network To advance interdisciplinary understanding of the nature of microbes and their impact on health and environment • • Bacterial Disease and Immunity Antimicrobial Drugs and Resistance Phage Biology and Genomic Variation Interventions & devices Leicester’s Research Live: Becoming the Best in Research 2020 Sponsored by Leicester Precision Medicine Institute

Mental health, psychology & neuroscience • • Child & adult mental health Clinical and social psychology Psychiatry & applied research Ethnic minority groups CSN – Centre for Systems Neuroscience Professor Rodrigo Quian Quiroga Leicester’s Research Live: Becoming the Best in Research 2020 Sponsored by Leicester Precision Medicine Institute

Facilities, Equipment and Infrastructure • • Advanced Imaging and Electron Microscopy (Multiple) Multi-Omics Core Facility (Adrian) PROTEX (Henry Wellcome) Histology Facility (LRI) Category 3 Containment Facility (Maurice Shock Building) John and Lucille van Geest Biomarker Facility (Glenfield) High Performance Computing Leicester’s Research Live: Becoming the Best in Research 2020 Sponsored by Leicester Precision Medicine Institute

Preclinical Research Facility (PRF) • • • State of the art, high health status barrier animal facility Transgenic Laboratory Pre Clinical Imaging suite Ultra high-field small animal MRI Ultrasound and micro-CT Category 3 suite Surgery Behaviour suites Quarantine facility Zebrafish & Locust Facilities Leicester’s Research Live: Becoming the Best in Research 2020 Sponsored by Leicester Precision Medicine Institute

Research culture • • Supporting our Early Career Researchers Open Research and responsible use of metrics Equality, Diversity and Inclusion Public Engagement Leicester’s Research Live: Becoming the Best in Research 2020 Sponsored by Leicester Precision Medicine Institute

Becoming the Best Our Quality Strategy John Adler Chief Executive UHL Leicester’s Research Live: Becoming the Best in Research 2020 Sponsored by Leicester Precision Medicine Institute

Leicester’s Research Live: Becoming the Best in Research 2020 Sponsored by Leicester Precision Medicine Institute

Quality improvement, it’s role in a ‘learning system’ Colin Moorhouse, Head of Quality Improvement, UHL Leicester’s Research Live: Becoming the Best in Research 2020 Sponsored by Leicester Precision Medicine Institute

Our work often starts with a problem or a question: What is it ? Leicester’s Research Live: Becoming the Best in Research 2020 Sponsored by Leicester Precision Medicine Institute

What do you see? First Trial or Solution?

Is this human factors? A useful Change?

Innovation? A solution? A trial? Or?

Getting ready for a new trial – test of change!?

A solution?

Has it worked?

Should we stop this trial?

Myths and Facts: What is QI ? • • • Generalisable knowledge Knowledge Translation – KTA Science of Improvement Implementation Science Knowledge of execution Knowledge on the effects of improvement – on leadership, teams and culture Leicester’s Research Live: Becoming the Best in Research 2020 Sponsored by Leicester Precision Medicine Institute

Layers and Relationships Implementation Science

Ref: Perla R, Lloyd P, Provost P, et al Seven Propositions of the Science of Improvement 1. The science of improvement is grounded in testing 2. 3. 4. 5. 6. 7. and learning cycles The philosophical foundations are pragmatism Embraces a combination of psychology and logic Considers the contexts of justification and discovery Requires the use of operational definitions – real world Employs Shewart’s theory of cause systems Systems theory directly informs the science of improvement - Leicester’s Research Live: Becoming the Best in Research 2020 Sponsored by Leicester Precision Medicine Institute

Which mechanism works with what context? How does implementation work? How does QI work?

Measurement for Research Purpose To discover new knowledge Measurement for Learning and Process Improvement To bring new knowledge into daily practice Tests One large "blind" test Biases Control for as many biases as possible Stabilise the biases from test to test Data Gather as much data as possible, "just Gather "just enough" data to learn in case" and complete another cycle Duration Can take long periods of time to obtain results Many sequential, observable tests "Small tests of significant changes" accelerates the rate of improvement

Complex intervention: Defined IT’S A COMPLEX COLLECTION OF TOOLS, PROCESSES AND BEHAVIOURS THAT INTERACT WITHIN A CONTEXT OR SET OF CONDITIONS CONTEXT MECHANISM OUTCOME

PATHWAY ELEMENT CONTEXT MECHANISM OUTCOME Discharge before 12 noon Trial A C 1 M 1 O 1 Discharge before 12 noon Trial B C 2 M 2 O 2 Discharge before 12 noon Trial C C 3 M 3 O 3

Monitor knowledge use Select, tailor, implement interventions Assess barriers to knowledge use KNOWLEDGE CREATION Knowledge Inquiry Synthesis Product tools Adapt Knowledge to Local context Evaluate outcomes Sustain knowledge use Identify problem Identify, review Select knowledge Action Cycle (Application) KTA Cycle

Professional Development and Learning: Directly Linked Ref: Batalden & Davidoff Better Patient Outcomes Better Professional Development Better System Performance

Context and Knowledge: Our Complementary work “We don’t need to know how you got your result, just tell us when we can see the benefits. ” – sound familiar? Black-box testing is a method that examines the functionality of an approach/method without knowing what the essential ingredients are or how they are working together. Leicester’s Research Live: Becoming the Best in Research 2020 Sponsored by Leicester Precision Medicine Institute

Shared understanding about Context What is the environment or setting like: • STRUCTURAL – Team – are you? Power within, Accountabilities and Responsibilities under what conditions do you see matron? • POLITICAL – Who’s resources/people are these that are involved. Who’s leading what? • CULTURAL – What is culture in each team? They cannot all be the same, so what is common and core really? Beliefs and ways of doing things. Leadership styles by whom to whom?

Agents and Agency

Habits of an Improver Ref: Bill Lucas

QI and Patient Participation Involvement (PPI) and Research – finding shared groups

Recognition, Publishing and Awards • SQUIRE 2 – Project write up format • Explore opportunities – how? • Joint publishing from research to translation/implementation and spread – e. g. IHI, BMJ, Bio. Med Central ……. . • Joint funding through QI routes – The Health Foundation, This Institute grants and awards

Life QI: An Introduction Where people improve healthcare, together. Leicester’s Research Live: Becoming the Best in Research 2020 Sponsored by Leicester Precision Medicine Institute

Questions? Leicester’s Research Live: Becoming the Best in Research 2020 Sponsored by Leicester Precision Medicine Institute

QI Case Study Linzy Houchen-Wolloff Senior Research Associate/ Therapy Research Lead Leicester’s Research Live: Becoming the Best in Research 2020 Sponsored by Leicester Precision Medicine Institute

Background • Team Time Out Day in March 2019. • 2 teams formed to discuss a QI project.

Project 1 Problem= Lack of CERS research visibility Primary drivers e. g. audit current presence/ impact, write SOP Aim: Implement a written strategic standard operating procedure (SOP) for research dissemination by April 2020 Secondary drivers e. g. create CERS twitter page, staff to attend health literacy training

Project 1: Dissemination Outputs so far @Cers. Research 1 st tweet 25 th Sep 2019. 236 followers. + all team have individual accounts. + study accounts for multicentre trials. Web presence

Name: Project 1: Dissemination Outputs so far Date completed: Are you attending the next CERS meeting? : If no, can you give an update on any projects/ your studies please: Media checklist for publishing research findings Since our last meeting have you published any papers? Since our last meeting have you submitted an abstract to a conference? Or heard the outcome of a previous abstract submission. Since our last meeting have you submitted any grant or fellowship applications? Or heard the outcome of a previous grant/ fellowship submission. Since our last meeting have you been invited to speak, chair or teach at any events? GOAL AUDIENCE MEDIUM

Project 2 Problem= Decreased membership in current CERS Patient and Public Involvement (PPI) group Primary drivers e. g. recruit new members when the complete rehabilitation classes/ research studies Aim: To increase CERS PPI membership by 20 individuals by April 2020 Secondary drivers e. g. create new info material for prospective members, explore use of remote engagement

Project 2: PPI Outputs so far

Project 2: PPI Outputs so far

Next steps • Project 1: Implement SOP and audit the impact (e. g. Twitter followers, REF/ H index/ RG score, new starter checklist, site file audit). • Project 2: Audit PPI engagement group numbers (and population types) on an ongoing basis.

Thanks to the 2 teams, interested stakeholders, PPI members and the R&I Communications Team

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