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Clinical Research Network South West Peninsula FRONTIER clinical research community newsmag South West GP s praised for bringing research to their patients Page 10 Powerful benefits of research Aerospace manager Adrian on educational and friendship benefits of research participation Page 6 ISSUE 03 OCTOBER/NOVEMBER 2017

CONTENTS Patient story: ADRIAN COOK EDUCATION AND FRIENDSHIP BENEFITS OF HEALTH RESEARCH South West Stroke survivor Adrian Cook says he has learnt a lot about his health condition and made new friends from taking part in clinical research studies. Motivated by wishing to help find better treatments for stroke patients, Adrian has participated in four studies since 2011. In 2016-17, 979 people were recruited onto National Institute for Health Research portfolio stroke studies in the South West of England. The Clinical Research Network for the South West Peninsula was ranked second highest recruiter out of all 15 Networks in England (adjusted for population) for this health specialty. Yeovil was the top recruiting small acute hospital in the country for stroke research studies. The clinical research Adrian has taken part in includes a five year study into good and bad cholesterol which involved having a blood test every six months; another one requiring a trip to a London hospital for an MRI scan and answering questions twice in two years and more recently a genetic blood test and the first randomised clinical trial comparing anticoagulation with antiplatelet treatment for cervical artery dissection in stroke. Adrian says the commitment he made as a research participant wasn t too demanding often involving giving samples, having tests and answering questions. He would do this activity during clinic appointments at his convenience. When Adrian had a stroke in December 2009 he was paralysed down the right side of his body, lost his ability to speak for three months and the damage to the left side of his brain also meant he could not spell. A positive person with a can do attitude, Adrian worked hard with physiotherapy exercise and set himself goals. He had a phased return to his work as a commercial manager in the aerospace industry and now works full time. Adrian has learned from scratch how to spell again and he is driving. In April 2017 Adrian walked 6.5 miles from St Ives to Zennor in Cornwall. 06 FRONTIER MAG ISSUE 03 OCTOBER/NOVEMBER 2017 FRONTIER MAG ISSUE 03 OCTOBER/NOVEMBER 2017 07 PATIENT STORY: Education and friendship benefits of health research FRONTIER clinical research community newsmag Clinical Research Network South West Peninsula South West GP s praised for bringing research to their patients Page 10 Powerful benefits of research Aerospace manager Adrian on educational and friendship benefits of research participation Page 6 FRONTIER Editor: Sophie Henderson MAG CRN SWP Communications Lead 01752 431947 ISSUE 03 OCTOBER/NOVEMBER 2017 sophie.henderson6@nhs.net Issue: OCTOBER/NOVEMBER 2017 A Stroke has a devastating impact on the patient and their families and yet despite the challenges of recovery, patients like Adrian never fail to inspire us when they give their time so generously to research. The developments to improve stroke treatment and quality of life for survivors are informed by research. We would never be able to make the advances being achieved in this field if it wasn t for the contribution of participants and support of their families. Yeovil Hospital research nurse Clare Buckley The Yeovil Hospital patient said: I would say to anyone they should put themselves on as many studies as possible. If they don t like the study then they always have the choice to turn it down. The benefits from taking part in research for me have been subtle but powerful. I have learned a lot about the causes, effects and recovery from stroke and made a load of friends. 02 CONTENTS 04 WELCOME TO FRONTIER 05 COULD A 39P SKIN PATCH REVOLUTIONISE STROKE TREATMENT AND INCREASE CHANCES OF SURVIVAL? 06 SOUTH WEST STROKE SURVIVOR ADRIAN COOK ON RESEARCH, EDUCATION AND FRIENDSHIP 08 DR BROWNE, CONSULTANT AT THE ROYAL CORNWALL HOSPITAL NHS TRUST, ON WHY THE SOUTH WEST IS A LEADER IN DIABETES RESEARCH 10 HIGH PRAISE FOR THE SW GP S BRINGING RESEARCH TO THEIR PATIENTS 12 GET INVOLVED PATIENT AND PUBLIC INVOLVEMENT OPPORTUNITIES I am Research: Joanna Ledger Senior Research Nurse Cornwall Partnership Foundation Trust Joanna s role in supporting the delivery of clinical research is to ensure that patients are offered the opportunity to participate in research and staff colleagues are supported to engage with research. She collates and records reliable data, shares her knowledge and skills to advise and encourage colleagues and promotes research being an integral part of clinical practice in mental health. A good day for Joanna is seeing patients enjoy their research experience and working alongside passionate and dedicated colleagues to improve clinical knowledge and practice. From a professional development perspective, Joanna receives regular training for specific studies and the opportunity to network nationally within clinical and academic environments. #iamresearch New NIHR Communications Strategy The new NIHR Communications Strategy, covering the period 2017-2022, is now available and will build upon the significant progress already made during the NIHR s first decade and introduce an approach to communications that will deliver a step change in levels of awareness for the NIHR. The goal ahead is to demonstrate to a wider set of audiences the positive impact that the NIHR delivers to the health and social Joanna says research gives patients hope and they often say they not only feel they are perhaps helping future generations from their participation but also personally are more reassured from the closer monitoring they receive whilst on a study. care system, patients and the public. Our mission is to ensure that all our stakeholders know about its existence and become familiar with the two strategic goals within that will guide all communications efforts from now on: 1 The value of the NIHR is recognised by the health and care system and Government 2 Stakeholders recognise a single NIHR 00 FRONTIER MAG ISSUE 03 JUNE-JULY 2017 03

FRONTIER MAGAZINE South West paramedics top recruiters to ground-breaking study hoping to revolutionise stroke care Pauline McGlone Deputy Chief Operating Officer Clinical Research Network South West Peninsula Welcome to the third edition of or e-magazine FRONTIER. Apologies it has taken a little while getting this to you but we have undergone a fair few changes as a local network in the last few months. Three paramedics from South Western Ambulance Service NHS Foundation Trust have been praised for the number of patients they have recruited into a trial looking at whether a 39p skin patch could revolutionise stroke treatment, significantly increasing the chances of survival. Paramedics Mary-Jean Tucker and James Wackford, based in Plymouth, and Christopher Abbott, based in Sherborne, have recruited 22 patients between them into the RIGHT-2 trial. I hope you will enjoy reading about all the great successes, good practices and achievements which are happening on a daily basis around the South West Peninsula. The stories and articles are testament to the continuing hard work of our staff across the region and the respect and trust our patients report on a continuing basis. Adrian, who has so kindly shared his story on page 6, is a shining example of that. This edition of FRONTIER really has a great celebratory feel showcasing just what a fantastic research community we have in the South West. I would, therefore, like to encourage you all to make sure you book tickets for our Research Network Forum on December 19th at Exeter Racecourse and get nominating yourselves or colleagues for our annual awards ceremony. We will look forward to continued success in the region for next year. Paramedic Chris Abbott, who has been involved in the trial since last October, said: Personally I got involved for two reasons; firstly I think it is important for all of us to be involved in trials like this that may help benefit patients in the future. Also I have a particular interest in stroke care after my wife had a stroke in 2005 so I have seen the long term effects of a stroke. Anything that has the ability to help improve outcomes has to be a good thing. World Stroke Day took place on Sunday October 29th and focused on stroke prevention, raising awareness of stroke risks and demonstrating the steps we can all take as individuals, professionals or decision makers to prevent stroke. The University of Nottingham study, funded by the British Heart Foundation and supported by the National Institute for Health Research (NIHR), is testing a plaster-like patch which is applied to a patient s shoulder or back whilst travelling to hospital via ambulance and administers the drug glyceryl trinitrate (GTN), which lowers blood pressure and opens up blood vessels. It is hoped the study will show the patch reduces the damage caused in the immediate minutes and hours following a stroke. Stroke is a blood clot or bleed in the brain which can leave lasting damage affecting mobility, cognition, sight or communication. It is a medical emergency which can cause permanent neurological damage, complications and sometimes death. Seven ambulance trusts across the country are taking part in the study, with South Western Ambulance Service NHS Foundation Trust paramedics having recruited 174 patients to date. Dr Martin James, stroke speciality lead for the NIHR in the South West, said: It s been great to work with paramedics from the South Western Ambulance Service on the RIGHT2 trial, which should help to answer an important question about whether lowering blood pressure in the first few hours after a stroke can reduce the disability that so often results. Hospitals in the South West already have a strong track record of research in stroke - and working with paramedics enables us to extend that research effort into the back of an ambulance on its way to hospital, because it s very likely that the earlier any treatment can be started, the greater the benefit to the patient. The RIGHT-2 trial is open to recruitment throughout the 13 live hospitals within SWASFT s patch until 31st May 2018. The ambulance service currently has 254 paramedics throughout the Trust who are signed up to participate in the trial. 04 FRONTIER MAG ISSUE 03 OCTOBER/NOVEMBER 2017 FRONTIER MAG ISSUE 03 OCTOBER/NOVEMBER 2017 05

Patient story: ADRIAN COOK EDUCATION AND FRIENDSHIP BENEFITS OF HEALTH RESEARCH South West Stroke survivor Adrian Cook says he has learnt a lot about his health condition and made new friends from taking part in clinical research studies. A The Yeovil Hospital patient said: I would say to anyone they should put themselves on as many studies as possible. If they don t like the study then they always have the choice to turn it down. The benefits from taking part in research for me have been subtle but powerful. I have learned a lot about the causes, effects and recovery from stroke and made a load of friends. Motivated by wishing to help find better treatments for stroke patients, Adrian has participated in four studies since 2011. In 2016-17, 979 people were recruited onto National Institute for Health Research portfolio stroke studies in the South West of England. The Clinical Research Network for the South West Peninsula was ranked second highest recruiter out of all 15 Networks in England (adjusted for population) for this health specialty. Yeovil was the top recruiting small acute hospital in the country for stroke research studies. The clinical research Adrian has taken part in includes a five year study into good and bad cholesterol which involved having a blood test every six months; another one requiring a trip to a London hospital for an MRI scan and answering questions twice in two years and more recently a genetic blood test and the first randomised clinical trial comparing anticoagulation with antiplatelet treatment for cervical artery dissection in stroke. Adrian says the commitment he made as a research participant wasn t too demanding often involving giving samples, having tests and answering questions. He would do this activity during clinic appointments at his convenience. When Adrian had a stroke in December 2009 he was paralysed down the right side of his body, lost his ability to speak for three months and the damage to the left side of his brain also meant he could not spell. A positive person with a can do attitude, Adrian worked hard with physiotherapy exercise and set himself goals. He had a phased return to his work as a commercial manager in the aerospace industry and now works full time. Adrian has learned from scratch how to spell again and he is driving. In April 2017 Adrian walked 6.5 miles from St Ives to Zennor in Cornwall. Stroke has a devastating impact on the patient and their families and yet despite the challenges of recovery, patients like Adrian never fail to inspire us when they give their time so generously to research. The developments to improve stroke treatment and quality of life for survivors are informed by research. We would never be able to make the advances being achieved in this field if it wasn t for the contribution of participants and support of their families. Yeovil Hospital research nurse Clare Buckley 06 FRONTIER MAG ISSUE 03 OCTOBER/NOVEMBER 2017 FRONTIER MAG ISSUE 03 OCTOBER/NOVEMBER 2017 07

FEATURE iabetes The top recruiting site in the SW enrolling 1,181 participants was the Royal Devon and Exeter NHS Foundation Trust. Twenty nine studies were conducted 18 of which were commercial. To deal with the increasing numbers of patients suffering from diabetes it s vital that both health professionals and patients embrace the opportunities offered by research to ensure diabetes does not engulf our health systems in years to come. Consultant Dr Duncan Browne Diabetes Clinical Specialty Lead for the Clinical Research Network South West Peninsula Dr Browne, a consultant at the Royal Cornwall Hospital NHS Trust, said the hard work and dedication of staff who strive to give as many patients as possible access to diabetes research accounts for why the South West is a leader in this field. He acknowledges that: None of our success would be possible without our patients who give up their time to participate in studies we offer. Participants often cite wishing to improve their own health condition but also to help future generations of patients living with diabetes. Whilst the South West may be a relatively rural, the population remains fairly static with high levels of regional pride which helps us in recruiting and retaining patients on long term studies. Dr Browne, whose first diabetes research activity started as a registrar, said research over the past decade has revolutionised our understanding of aspects of diabetes with a range of studies in different settings. Studies have looked at a diverse spectrum of diabetes related matters from long term cardiovascular outcomes which demonstrated the benefits of new classes of diabetes drugs and innovative techniques to improve the healing of foot ulcers to access to state of the art non-invasive monitoring devices not readily available as part of standard care. Notably there has been the ground-breaking academic research led by Professor Andrew Hattersley in Exeter. Keeping up to speed with diabetes research opportunities to be able to offer patients has been achieved through the Clinical Research Network South West Peninsula. The success of many research teams in the region has also resulted in them being approached directly by sponsors who want them to conduct new studies, he added. His motivation for offering patients the opportunity to participate in diabetes research is built on the evidence that shows that centres which are active in research provide better care for their patients with better outcomes, whilst individual patients who participate tend to also have improved outcomes and become more knowledgeable and motivated in terms of self-management of their condition. Dr Browne said: From a personal perspective being involved in research keeps me motivated and ensures the advice I give my patients is the most up to date possible. Diabetes, more than any other chronic condition is reliant on excellent selfmanagement of the condition by the patients living with it, be that by lifestyle changes or the monitoring of glucose and consequent intervention. Studies are already ongoing in how we best give advice to patients to help them manage their own condition but also how we can embrace new technologies to manage their elevated glucose levels. So what is on the horizon? Dr Browne commented: Diabetes research is a broad church and there are opportunities and unanswered questions in every aspect of the science and treatment of the disease. Unanswered questions include how to prevent Type 1 and Type 2 Diabetes. These areas are likely to remain a focus of research activity in the coming decade. However, with the millions of patients around the world developing diabetes each year the treatment of diabetes complications is likely to remain a focus of research for many years to come with the pharmaceutical industry investing billions in the development of new drugs to treat address unmet needs. 8 FRONTIER MAG ISSUE 03 OCTOBER/NOVEMBER 2017 FRONTIER MAG ISSUE 03 OCTOBER/NOVEMBER 2017 9

SOUTH WEST GP S PRAISED FOR BRINGING RESEARCH TO THEIR X PATIENTS It really is an honour to be Highly Commended in these awards - not just for me, but the whole Beacon team who work extremely hard to give our patients the opportunity to take part in research studies. A South Devon practice and young Plymouth GP received high praise at a prestigious national award s ceremony for their contribution to clinical research. The achievements of the Bovey Tracey and Chudleigh Practice were recognised at the Royal College of General Practitioners Research Awards, run in partnership with the National Institute for Health Research (NIHR), in October at the annual awards ceremony held in Liverpool. Picking up the Practice Award, the South Devon team at Riverside surgery in Bovey Tracey and the Tower House surgery in Chudleigh were praised for demonstrating excellence and innovation in delivering NIHR research in primary care. The practice is currently involved in five research studies looking at conditions including kidney disease and arthritis. The practice research team has recruited 70 people to participate in clinical research studies already this financial year and were highly commended last year for having the highest number of people recruited in Devon through their GP practice to research trials and the whole of the Clinical Research Network South West area from Somerset to Cornwall and the Isles of Scilly. The First5 award recognises GPs in the first five years of their career who demonstrate an emerging interest and experience in delivering NIHR research within a primary care setting. Beacon Medical Group, which serves 40,000 patients across five sites, is currently involved in three clinical research studies in areas including arthritis, gastroenterology and cardiovascular conditions. Research is a core function of the NHS and integral to continuing to advance treatments and care for patients. Beacon has decided to offer research opportunities to its patients because, put simply, evidence shows that patients cared for in a research-active organisation have better outcomes. Applicants were required to outline their contribution to NIHR Clinical Research Network Portfolio studies with particular weight being attached to the range and number of patients in NIHR Clinical Research Network studies; how patients have been engaged and informed of new opportunities to participate in clinical research; their contribution and innovative methods used in the successful delivery of clinical research studies. Lisa Gibbons, primary care research lead for the NIHR in the South West, said: These are fantastic achievements and very well-deserved. The contribution that both the Bovey Tracey and Chudleigh Practice team and Dr Bray at Beacon Medical Group have made to clinical research is very worthy of celebration by providing their patients with opportunities to take part in the latest clinical trials they are giving them access to the latest treatments and technologies available for a broad range of health conditions. Dr Tim Bray, Research Lead GP at Plymouth s Beacon Medical Group, was also highly commended at the awards in the First5 category. Dr Danny Thomas, the practice research lead, said: We are very proud to have won this award. This is a great reflection of all the hard work and commitment from our research team, the practice staff, and most importantly the patients who have generously volunteered to be part of our research work. Research adds interesting variety to my role as a GP and enables me to be part of the wider medical community. As a practice it helps keep us up-to-date and contribute to the leading edge of medical progress. It builds teamwork across clinical and non-clinical roles, and encourages staff to develop new skills. It allows patients to be engaged with their healthcare and contribute a real difference to the lives of other people with their health conditions. Since its inception in 2006, the NIHR has significantly increased the scale of clinical research in the NHS, particularly through the NIHR Clinical Research Network. The enthusiastic engagement of NHS clinicians is an essential condition for sustaining and building on this success; particularly given the many competing demands on clinician time and resources. As part of the application process the applicants had to set out what activities they planned to carry out in the future to improve research delivery. 10 FRONTIER MAG ISSUE 03 OCTOBER/NOVEMBER 2017 FRONTIER MAG ISSUE 03 OCTOBER/NOVEMBER 2017 11

nvolvement PATIENT AND PUBLIC FREE Improving Healthcare through Clinical Research Online Course now open! A Massive Open Online Course (MOOC) is due to run again in November and is open for registration. The four week online course is free and aims to answer some pertinent questions, including: 'How are treatments and cures discovered?' 'What is the impact of clinical research?' 'How do we undertake clinical research?' 'Why do we do clinical research?' Registered learners have access to the MOOC materials for two weeks after the course has finished. You can sign up now to register for the MOOC by clicking here. Ali is a registered nurse with eight years of experience as a Research Nurse Specialist. She has supported the delivery of commercial and non-commercial clinical trials across a range of disease areas within a busy district general hospital. She now works as a Research Delivery Manager for the NIHR in the South West where she is responsible for enabling and supporting the delivery of clinical trials in disease areas such as dermatology, ENT, infectious diseases, musculoskeletal disease, ophthalmology, paediatrics, reproductive health and childbirth. Q: Why do you think Patient & Public Involvement and Engagement (PPIE) is important? A: Clinical Research is most successful when there is effective collaboration between all groups that are involved in the research process from the concept of an idea through to the dissemination of results. Patient and public involvement and engagement is integral to all stages of the process. Their expertise and experience is invaluable. This is clearly summarised in the following quote: No matter how complicated the research, or how brilliant the researcher, patients and the public always offer unique, invaluable insights. Their advice when designing, implementing and evaluating research invariably makes studies more effective, more credible and often more cost effective. Dame Sally Davies Chief Medical Officer for England VIDEO LINK - https://www.youtube.com/watch?v=4sok8ca6mqk A Q&A with Ali Potter our Patient and Public Involvement and Engagement Lead for the NIHR in the South West Q: Why should people get involved in PPIE? A: To ensure that research is designed to benefit patients through the delivery of well-designed studies that capture high quality data which can drive evidence based practice and improve outcomes for future generations. Patient and public involvement also enable patients to choose to take part in research that is relevant to their condition and to the impact that it has on their quality of life on a day to day basis. Q: How can people get involved in PPIE in the region? Examples of PPIE activities that people can be involved in across the region include: Supporting research awareness events that promote the benefits of clinical research to patients, carers and the public (eg. International Clinical Trials Day, Patient Support Groups, Clinical Trial Symposium) Support national initiatives such as the I Am Research' campaign Assist and work with researchers to identify key research questions and review patient facing documents that are developed for clinical trials Be a resource for patients, carers and the public thinking about taking part in research Support the development and implementation of the NIHR PPIE agenda through participation at regional PPIE meetings as a lay representative You can contact Ali by emailing alisonpotter@nhs.net Devon Federation of Women s Institute hold sell-out health research event The Devon Federation of the Women s Institute held a Health Research Matters Day on October 18th in Exeter. Around 100 people attended the sold-out event, held at the Kenn Centre in Kenford, to listen to a number of different talks from well-renowned research clinicians and staff from across the county. Heather Penwarden, DFWI Health and Care Rep, said the event was inspired by past presentations on research which have always stimulated lots of interest and debate. She said: This year we decided to focus the whole day on health research and to offer opportunities for members, their family and friends to sign up for a range of local studies. There was so much interest in the day that we were oversubscribed for the venue we had booked and sadly not everyone that wanted to could attend. Those that were lucky enough to get to the day were suitably motivated by the speakers to show active interest in the studies and hopefully this will lead to a good number going on to become volunteers. Each member will go back to their own WI s Heather Penwarden DFWI Health rep and give a report on the day and from that family and friends will get to hear about it and so the ripple of WI communication will move out. Inspiring others is something that women of the WI are good at doing. All we need is a cause worth inspiring others about! Taking part in health research and making a difference for future generations ticks all the boxes of such a worthy cause and we are grateful for this opportunity to take an active part in seeking to improve the health and lives of generations to come. Ali Potter, Research Delivery Manager and Patient and Public Involvement and Engagement Lead for the NIHR in the South West, attended as a guest speaker. She said: Patients and the public are key to ensuring delivery and design of clinical trials. The patients and public are the experts often living with or caring for families and friends with long term medical conditions. The challenges that they face, day to day, that impact on their quality of life, should not be underestimated. They should be involved in prioritising the research ideas and informing study design and delivery to ensure that research is focusing on developing interventions that will have a positive impact on the health outcomes of future generations. 12 FRONTIER MAG ISSUE 03 OCTOBER/NOVEMBER 2017 FRONTIER MAG ISSUE 03 OCTOBER/NOVEMBER 2017 13