Research strategy for RNOHIOMS

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Research strategy for RNOH-IOMS
Trust Board April 2008

• David Marsh
• Professor of Clinical Orthopaedics
• Institute of Orthopaedics and Musculoskeletal
  Science, University College London
• Royal National Orthopaedic HospitalStanmore, UK

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A joint IOMS-RNOH academic strategy is an
essential part of the Outline Business Case

• One of three stipulations in the letter from the
  SHA inviting submissionset out a clear
  commitment to support the work of the university
  and its partners in achieving AHSC status and
  strengthening the Orthopaedic Institute

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Academic Health Science Centre

• Joint Academic Plan
• integration of UG and PG education
• RD management into IOMS
• Research strategy

CLINICAL
EXCELLENCE,INTEGRATION
EDUCATION
RESEARCH
How are we going to fund this?
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Research Strategy

• Focused on musculoskeletal system but full
  spectrum

Health services research
Basic science
Clinical trials
Translational Experimental

• Five themes, building on track record and patient
  needs
• Innovative implant design
• Cell therapy and tissue engineering
• Disability and improvement of quality of life
• Building the musculoskeletal evidence base
• Sarcoma medicine

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Tapping in to UCL
Musculoskeletal Consortium

• Five centres in IOMS
• Bioengineering
• Tissue engineering
• Clinical academic
• Rehabilitation
• Pathology

• Innovative implant design
• Cell therapy and tissue engineering
• Disability and improvement of quality of life
• Building the musculoskeletal evidence base
• Sarcoma medicine

Engineering
Centre for Ageing
Cancer Institute
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Funding
UKCC
EPSRCBBSRC
MRC
NIHR
Basic science
Translational Experimental
Clinical trials
Health services research
ARC, charities
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National Institute for Health Research - the new
research environment

• Concentration of funded clinical research in
  fewer, larger centres
• Large research teams
• Epidemiology, health economics vital
• Many Trusts giving up and outsourcing research
  management
• Competition with all other specialities - fierce
• Priorities in cancer, neuro, endocrine, mental,
  children
• Role of rheumatology
• Research governance demands tighter

Transform or fade out
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NIHR funding streams

• Comprehensive biomedical research
  centresSpecialist BMRCsBiomedical Research
  Units
• Musculoskeletal in Oxford, Sheffield, Leeds
• Local Comprehensive Research Networks
• HTA, RfPB, NEAT, RISC
• Applied Research Programme Grants
• Technology Support Board

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MRC Translational Research Call

• 241m extra, most on translational research
• Bottlenecks
• Pan-UCL bid going in
• MRC Centre for Cell and Gene Therapy
• Stanmore hopefully to contribute cell therapy in
  the musculoskeletal system

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Cell-based therapy

• Clinical trials in ACI
• Preclinical work on bone, collagen
• Regenerative Medical Systems - UK
• Translational teams
• Bone
• Tendon
• Cartilage

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Stanmore Clinical Research Facility

• At present a joint venture between RNOHT and UCLB
  may change
• Goal is to facilitate rapid study design,
  costing, governance and conduct
• Both investigator-led and commercial
• All must be fully funded
• Building a clinical research network is crucial
• eg fragility fractures and drugs that enhance
  fracture healing

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Research pipeline in cell-based therapy
Health services research
Basic science
Clinical trials
Translational Experimental
What phenotype of cultured cells produces the
best clinical response?
Is it cost-effective to culture-expand cells
rather than use bone marrow?
Can we design new way ways of efficiently
expanding stem cells?
IOMS
RMS-UK
SCRF
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Integrated Academic Training Programme

• Four Academic Clinical Fellows
• Two Clinical Lecturers

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Academic Research Board
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Research Support Staff

• Academic Clinical Centre of IOMS
• MRC Clinical Trial Unit support
• Chair of Musculoskeletal Epidemiology
• Alex MacGregor starting Sep 08
• RD Director and Manager (Joseph Datukasi)
• Nerina Head of Academic Business Development
• SCRF staff
• IT systems for research support Simon Grange

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Research Governance

• MHRA inspection
• Duties of Principal Investigators
• Duties of RNOH as a sponsor
• Our IT solutions

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MHRA Inspection
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MHRA Inspection
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Support we can offer

• Training
• Executive GCP training
• Research Pack
• Best methodological practice in musculoskeletal
  research
• Governance
• Integration locally with Risk assessment
• Integration with Local Comprehensive Research
  Network
• Research
• Finding Research Partnerships
• Developing hypotheses and designing studies
• Finding funding sources

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Research Governance
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Clinical Trials Support

• Being tested by our iBSc MSc students

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Electronic Patient Record
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My tenure
Team building
Joint academic strategy capacity building
Multidisciplinary MSc
Integrated Academic Training Programme
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Expenditure
NHS RD
UCL
Grant targetoverheads, contributions to salary,
SCRF profit
MRC stem cells in nonunion 300k
Pfizer fracture accelerating drug 500k
TSB grant 500k
NIHR Applied Research Programme 2m