The Breastcare Centre at NBT offers patients, and people at risk of developing breast cancer, excellent patient centered care and the opportunity to participate in research. The centre has had a successful research team in place for a number of years delivering complex interventional studies.
I'm Dr. Lynn Jones and I'm a Consultant Radiologist at the Bristol Breast Care Centre at Southmead Hospital. My clinical work is quite varied, I see patients in clinic when they've been referred to us perhaps because they found a lump in their breast and they're concerned that it might be a breast cancer, so I'm one of the doctors who does an ultrasound of the breast and then goes on to do a biopsy of the lump using local anaesthetic and ultrasound guidance. I also work behind the scenes in a room like this interpreting mammograms and other more complex imaging tests. And in addition I work for the National Health Service Breast Screening Program in a similar role. The Breast Screening Program was set up to detect cancers early while they're still small and they can't yet be felt. And this is because we know that finding breast cancer early can save lives. The research that I'm leading here at North Bristol is trying to find a way to improve cancer detection for breast cancer. And my particular interest is in an imaging test called Fast MRI. Fast MRI is a magnetic resonance imaging or MRI scan and we want to see whether Fast MRI can be used as a screening test for some groups of women because it's much quicker than full breast MRI and we think it will be less unpleasant as a test to have. A lot of the preparation for this research has involved a great deal of talking to our patients and to members of the public and this has been very useful indeed. Because we're very lucky here to have a local charity called BUST and so they seemed like a sensible place to start and so I asked them how they had experienced at breast MRI and what they thought of it and I was really quite surprised and shocked that many of them had found it a very unpleasant experience. So since then we've been working together to try to improve that experience for other women in the future. So we've made a short film of what it's like to have a breast MRI and the films now available to watch on the North Bristol Trust website. And we've also updated our information leaflet to include a section written by our Clinical Psychologists on how to cope with having a breast MRI, so that while you're having it you can focus and manage to complete it to the end of the test. So once we done all that work with BUST, we then had a whole series of formal public consultation where we consulted members of the public about our research and how they felt it should be designed. And we've also recruited two members of the public to be on the committee that decides the direction that the research is going and what its priorities should be. So overall I've really been astounded that this whole consultation process people are just so keen to be helpful and so kind to us and willing to give their time and actually it's been a great benefit not just for our research study but I've also learned an awful lot about our service in general and I think that it's helped us to be able to improve that service for our patients and our clients.
We diagnose over 3,000 new cases of cancer and treat approximately 5000 new and recurrent cancers each year, making us one of largest cancer centres in the South West. The clinical trials team at North Bristol NHS Trust co-ordinates and support the delivery of clinical trials across a variety of cancers including, Haematology, Urology, Brain, Head & Neck, Upper Gastro Inrestinal, Colorectal, Breast, Lung & Skin cancer.
In 2017 North Bristol NHS Trust was designated a Myeloma UK Clinical Trials Network Accessory Site which means that our patients will have access to drugs that are not currently available on the NHS.
Diabetes and obesity:
The dedicated research team has an outstanding record in study delivery. Winners of the coveted Pharmaceutical Times Clinical Research Site of the Year award. The team have established innovative relationships with GP practices to help ensure every study is able to recruit to time and target.
Hello, my name is Liz Coulthard, I am a Neurologist and I specialise in Dementia and Huntington's disease. We were in a clinical service here in the Bristol Brain centre in Southmead Hospital. I see patients with Dementia, the commonest type being Alzheimer's, but also with all different types of other dementia's including very rare types. And I also run a Huntington's disease clinic. One of the critical things about our service is that we place research at the heart of the service, so when we see a patient we always think what is best for this patient clinically, what can I do for them, but one of the other things that we think is what opportunities are there for this patient to take part in research if they want to. So some of the research we do aims to find a treatment that will slow the progression of dementia such as Alzheimer's disease. Some of these trials are international trials that some of them are run by commercial companies. Other trials are academic and because I work for the University we are leading a trial called the RADAR trial, where we're giving a drug to people to see if we can slow the progression of Alzheimer's and there are around 20 sites around the UK taking part in this trial. Some of the other research that we do aims to understand a bit more about how dementia affects the brain. One of the aims of this is to try and see if you can diagnose dementia a bit earlier than it’s currently diagnosed because we think maybe we'll have to treat dementia earlier in the course of the illness to have a beneficial impact on people. So at the moment not only do we recruit people who have dementia, we also recruit people who are diagnosed with a pre-dementia state mild cognitive impairment. We know that some people with mild cognitive impairment will develop out the disease, but some won't. And one of the areas of our research is to identify people at this early stage who might be those that are destined to go on to get dementia so that we can offer them treatments. We recruit people with dementia but also we recruit healthy older people who made a few to develop dementia and it's really important that we have these recruits because these are the people where we may actually be able to alter things more. So we're very keen for people to take part in our research and it might involve a brain scan such as an MRI or it might involve some memory tests or it might involve sometimes things like EEG (their brainwave recording) but we always talk people through so they know exactly what to expect and then they let you know whether or not they want to take part.
The Trust’s research group in antimicrobial chemotherapy (BCARE) have a track record spanning 45 years of excellence and international and national leadership in antibacterial therapeutics. In recent years this has expanded to encompass the impact of diagnostics on clinical outcomes. The Group have numerous links to commercial funders and an extensive international network of research collaborators.
Our neurosciences service is world leading in a number of clinical and research specialities include stroke, dementia, Parkinson’s disease, multiple sclerosis and Huntington’s disease. They work with National Institute for Health Research (NIHR) networks to deliver research excellence for patients with complex and varied needs.
I'm Neil Scolding and the Professor of Clinical Neurosciences here, which means that I spend roughly half my time seeing patients and half my time in research in Neurology. And our research interest in particular in our group is Multiple Sclerosis and the problems relating to that. And we've got a variety of research projects underway relating to Multiple Sclerosis. We're very much engaged in clinical trials looking at some of the new treatments and one of the very encouraging things is that there have been a lot of new treatments over the last 10 years or more in Multiple Sclerosis so that our ability to treat MS is really not very different to how it was when I first came to North Bristol some while ago. We see patients in the Brain Centre and the MS team there with the specialist nurses as well and physiotherapists and other support provide a full service really for patients with MS across the region and even across the UK with some specialist referrals. And one of the reasons that that people are being referred is to take part in various of the clinical trials. And then in addition to clinical trials of if you like conventional drug products as they emerge from the different companies. One of the other main areas of research in Multiple Sclerosis is in the development of stem cell therapies. So just along the corridor here we have our Multiple sclerosis and stem cell laboratories and we have a laboratory research program looking at stem cells and how they behave and what they might be able to do. And then literally just across the road from the laboratories is the Brain Centre where we see patients as well. And one of the things that we've been able to do in Bristol which has been a world for continues to be will leading research is in taking that laboratory research on stem cells and developing that program into a clinical program of stem cell research. So we completed a small clinical trial where patients own stem cells derived from the bone marrow we used and that we completed three, four, five, years ago now. And at present that's allowed us to move on to a larger clinical trial looking at eighty patients, again using their own stem cells, eighty patients with long-standing Multiple Sclerosis, trying to explore this what we think is a very important question of whether stem cells can be valuable in Multiple Sclerosis. We very much believe they will be and we believe that the research that we're doing will help to prove that and to bring about new treatments for this really very difficult disease.
North Bristol NHS Trust is a centre of excellence for the delivery of care for people with renal impairment. Our experienced research team works collaboratively with a number of other research teams including diabetes and cancer to deliver cross-functional complex studies in addition to studies focused solely within the renal service.
With over 15 years of commercial and non-commercial research. The research team led by Professor Maskell is one of the largest and most successful clinical and academic pleural research teams in the UK. For nearly a decade they have been designing and delivering practice-changing clinic trials, improving the lives of patients with mesothelioma, pleural infection, and pneumothorax.They have tested new devices designed to manage recurrent pleural effusions and pneumothorax, including a first in human trial which led to an international multi-centre randomised controlled trial (SEAL-MPE trial). The multidisciplinary team includes highly skilled and motivated research nurses, managers, clinical research fellows and clinical academics. The team has also successfully been awarded research grants of more than £5million.
The Trauma Research team undertake both commercial and non-commercial, national and international, device and ctIMP studies. An integral part of South West Regional Trauma Centre based at NBT, this highly skilled team are able to include patients in the crucial early phases post traumatic injury in a sensitive and caring manner.
Having delivered clinical excellence and research innovation working collaboratively with both drug and device companies, the North Bristol NHS Trust urology department now delivers the clinical service for the whole Bristol area increasing both our clinical and research potential. The department has an enviable position focussing world leading clinicians, dedicated research staff and a patient population invested in the development of future treatment options.
My name is Marcus Drake I am the Professor of Urology and I work at the University of Bristol and Southmead Hospital. We're very lucky because Urology is a fascinating specialty, it covers the kidneys, the bladder, the prostate, stones in the waterworks and of course male sexual function. Now within Southmead Hospital there are three huge government funded studies. There is the upstream trial that's looking at the urodynamic testing of men who are considering whether to have prostate surgery. What does the test bring? Is it appropriate to be doing this sort of tests to understand water work symptoms in men? We're also looking at conventional prostate surgery compared with a new sort of laser operation, which is better. They're both good at relieving blockage but are there differences in the side effects? And this study will tell us exactly that. And our other huge study is looking at incontinence in men who've had prostate surgery in the past, a minority of men do suffer incontinence, then they may need some sort of surgical treatment. So we're looking at the benefits of a new operation called the male sling in comparison with the more established artificial sphincter and that we'll be reporting in three years’ time. Of course we have a whole range of studies but one of the biggest studies ever run in Urology was run from Bristol and that was the PROTECT study looking at prostate cancer and specifically what is the best treatment surgery, radiotherapy or medications. Of course we contribute to a whole range of trials run in other centres and we're extremely active at contributing to a whole range of studies and I feel that this is one of the most beneficial aspects of treatment within Southmead is the opportunity to contribute in an area where Southmead really excels and is recognised worldwide.
The Bristol University Musculoskeletal research team are based at North Bristol NHS Trust. This partnership enables clinicians and researchers to closely collaborate both locally and internationally to deliver high quality research based on our multidisciplinary expertise. The Avon Orthopaedic Centre has a long history of being one of the leading centres in the country for research and innovation in orthopaedic care.
Women & Children:
The Women and Children’s Research Unit conducts research that aims to improve the care of women and children using Obstetrics and Gynaecology services. This includes pre-conception services though to postnatal care. The Unit collaborates widely with other disciplines and professions, as well as with women and their companions, to develop ground-breaking research and care, for our patients and throughout the NHS.
My name is Dimitrios Slassakos, I'm a Consultant Senior Lecturer in Obstetrics. My name is Christy Burden and I'm a Senior Lecturer in all subjects. So without a team we are living in large and very comprehensive portfolio start, so a large number of studies to improve the outcome of pregnancy so that we can have healthy mothers and healthy babies as well both from a physical and a psychological point of view. So for example, we investigated a lot the management and outcome of women who have bleeding around the time of birth. First of all can we prevent women from bleeding around the time of birth with the IMOX study which is one of the largest studies ever to be performed on the topic. We have completed some studies to see if we can improve communication and teamwork when women do have some bleeding. And soon with funding from the National Institute of Health Research we are about to start the COPE study started to see what is the best treatment for women experienced bleeding around the time of birth. Another part of our research is focusing on women who have a bad pregnancy outcome and how we can improve care for them afterwards. So for example, with the insight studying with a Lancet stillbirth series we investigated how to improve care for these women and now what about to start the number of studies to see what are the basic principles so that women can get good care after a bad pregnancy outcome globally, so not just in the UK. Now within that portfolio studies were also investigating how to improve parental involvement and Christy has some more details. Since I've been leading on the stearic of the PARENT study which has been looking at parental involvement in the review process after the death of a baby. And the PARENT study has been looking at developing the process and then implementing the process here at North Bristol and also in Manchester. So the aim of the study is to improve the review process that happens after a baby dies and this really aligns with the government targets at the moment to try and reduce the number of stillbirths by 50% by 2025. So our research has been really front-leading in this area. And other research that I've been very much involved in and we're driving now North Bristol has been managing women with high-risk pregnancies and maternal medicine complications. And one is that that this is looking at a cute kidney injury in pregnancy. So this is known to be a real problem outside pregnancy but in pregnancy we're seeing an increasing problem with acute kidney injury, due to our more complex population, but we don't know how to define this well. So a study that we starting in the summer will be looking at how to define this and looking at you what the incidence is. Christy, how do you think on the mantle on medicine fits in with our portfolio? I think we've always looked at how to manage women and who have complex medical problems and high-risk pregnancies and adverse pregnancy outcomes, I think it fits in perfectly with what we're trying to do and trying to expand and improve our care for all women. Because you know lots of women are having more complex problems in pregnancy now and this will be a problem in the future.