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Oxford Medicine, the community and the NHS

Most patients in Oxfordshire come into contact at some point with a University medic.  The University’s clinical departments and the local health service are so interwoven that it is hard to say where one ends and the other begins. Many University medics are on joint-NHS appointments. Others head units or participate in NHS appointments. Some researchers have paid contracts with both the University and an NHS body. There are the many NHS consultants and GPs who hold honorary positions in the University and contribute to its teaching of medical students; some of these are also active in research within the University.  Many University staff undertake clinical and teaching and research duties, including responsibility for clinical trials under honorary contracts, within the NHS. The University also educates future healthcare professionals, undertake research into cures and treatments, and University staff and students care for patients.

The relationship between the University and the local health services has resulted in a close practical partnership in research, training and patient treatment – mainly based in the city, but also at other general and specialist units throughout the county.  Here are a few examples of where the partnership not only benefits patients in Oxfordshire but those throughout the NHS: 

 

The Medical Sciences Division

Alastair Buchan
Professor Alastair Buchan, Head of Medical Sciences

The aim of the University’s Medical Sciences Division in research is to be the best university biomedical institution in Europe and to be amongst the top five in the world, and, in the context of outstanding research, to deliver top-class teaching and patient care. The Division comprises more than 2200 academics and staff, 800 graduate students and 900 undergraduates; about 350 NHS Clinicians and GPs contribute to our teaching activities. In total over 2500 individuals are involved in research.

Find out more about the Medical Sciences Division

 

Rapid action on stroke

Peter Rothwell
Professor Peter Rothwell

One in ten patients who experience a minor stroke suffer a major stroke within a week but the EXPRESS study, led by Professor Peter Rothwell of the Stroke Prevention Research Unit in the Department of Clinical Neurology has shown that immediate treatment (using clot-busting, blood pressure-lowering or cholesterol-lowering drugs) cuts that risk by 80 per cent. If the EXPRESS study were rolled out across the UK, the number of strokes would be reduced by about 10,000 per year, saving the NHS up to £200 million in acute care costs alone. Shortly after Professor Rothwell’s work was published in 2007, the Department of Health announced a new National Stroke Strategy, which commits it to acting to improve stroke services across the country.

In 2009, a new Acute Vascular Imaging Centre was opened next to the John Radcliffe Hospital’s emergency department, providing patients with a fast assessment of the brain damage caused by their stroke, as well as research into new techniques of image capture and analysis.

Watch a short interview with Professor Rothwell

 

Diabetes

Oxford Centre for Diabetes, Endocrinology and Metabolism is one of the pioneers in establishing an effective partnership for clinical research and patient treatment in Oxford. The Centre moved to a three-sided building in 2003, symbolising the partnership between the University, the hospital trust and industry.  The building houses research laboratories, in-patient ward and a clinic that sees more than 30,000 out-patients a year. 

 

Cancer

The Richard Doll Building - home of the Cancer Epidemiology Unit
The Richard Doll Building - home of the Cancer Epidemiology Unit

The University has established a critical mass of epidemiologists, trialists, geneticists, and other cancer researchers.  The following are a few examples of University involvement in cancer research in recent years:

In developing new treatments the watchword is translation: how can research results be applied as better care for patients? One example is a collaboration between doctors and engineers at the Oxford Institute of Biomedical Engineering, conveniently housed in the same research building as the Institute of Cancer Medicine. High-intensity focused ultrasound is a non-invasive technique that can be used to destroy tumours. Dr Constantin Coussios and his colleagues have developed a way of simultaneously monitoring the tiny bubbles generated by the ultrasound wave, which help to distribute its destructive effect, in order to adjust the delivery of the ultrasound to maximise its impact on the tumour.

The late Sir Richard Doll helped save millions of lives by demonstrating that smoking greatly increased the risk of getting cancer (and many other diseases) and that stopping smoking worked remarkably well. Oxford researchers at the Richard Doll Building, are continuing to save lives by conducting large prospective studies of smoking, drinking, diet, obesity, hormone replacement therapy and other avoidable causes of cancer. They also conduct worldwide meta-analyses that combine hundreds of different studies of cancer causes, early detection or treatment – showing, for example, that breast cancer can generally be halved by combining radiotherapy, chemotherapy and hormone therapy.

 

MRI scanner

 

Elsewhere, Professor Peter Donnelly found genetic risk factors for breast cancer; Professor Adrian Harris pioneered drug therapies based on blocking the blood supply to tumours – now accepted as an effective strategy; and Professor Hermann Waldmann developed a monoclonal antibody therapy, Campath-1H, which is on the market as a treatment for chronic lymphocytic leukaemia.

The new Institute of Cancer Medicine comprises key teams in clinical pharmacology, cell biology, and radiation oncology and biology. It provides the nucleus for a network embracing researchers across the University with an interest in cancer. Professor Gillies McKenna, recruited to head the radiation oncology and biology team after a 30-year career in the US, says that Oxford is now unique internationally in the cancer field: ‘There’s no other centre of this size and scope.’

 

Patient reported outcome measures

A recent NHS review identified patients’ own perspective of their care as a key measure of the quality of NHS care. Isis Innovation recently entered into a licence with the Department of Health for the use of patient hip and knee scores developed at the University’s Health Services Research Unit and the Nuffield Orthopaedic Centre.  The Oxford questionnaire will shortly be available to the NHS. The results will be used to assess improvements in the quality of life for hip and knee patients receiving treatment throughout the NHS. 

 

Dame Fiona Caldicott

Dame Fiona Caldicott
Dame Fiona Caldicott

Dame Fiona Caldicott is an embodiment of the close relationship between the University and the NHS.  Dame Fiona is a distinguished psychiatrist and psychotherapist who has been Principal of Somerville College, Oxford since 1996. She also served as a University Pro-Vice Chancellor.  In 2009, she was appointed Chairman of the Oxford Radcliffe Hospitals NHS Trust having been acting Chairman since December 2008 and a Non-executive Director since 2002. She is a former President of the Royal College of Psychiatrists (the first woman President) and the immediate past President of the British Association for Counselling and Psychotherapy. Dame Fiona also chaired the 1996 NHS working party on patient confidentiality - its report led to the appointments of Caldicott Guardians in all trusts. Her appointment will be for a period of four years, to 8 March 2013.

 

Did you know arrow

A quarter of the 50 or so University or college buildings in the city centre have a Grade I listing.  All styles are represented: from the medieval and reformation periods to Palladian, Classical revival, high Victorian Gothic to the modern architecture of Arne Jacobsen at St Catherine’s College

Find out more in "Impact on the environment"