Research strategy for RNOH-IOMS

Research strategy for RNOH-IOMS

David Marsh

Professor of Clinical Orthopaedics

Institute of Orthopaedics and Musculoskeletal Science, University College London

Royal National Orthopaedic HospitalStanmore, UK

Trust BoardApril 2008Trust BoardApril 2008

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

Outline Business Case

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 submission:“set out a clear commitment to support the work of the university and its partners in achieving AHSC status and strengthening the Orthopaedic Institute”

Academic Health Science CentreAcademic Health Science Centre

• Joint Academic Plan:– integration of UG and

PG education – R&D management

into IOMS– Research strategy

EXCELLENCE,INTEGRATION

EDUCATION

RESEARCH

CLINICAL

How are we going to fund this?

Research StrategyResearch Strategy

• Focused on musculoskeletal system but full spectrum

• 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

Basic scienc

e

Translational

Experimental

Clinical

trials

Health service

s researc

h

Tapping in to UCLTapping in to UCL

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

Basic scienc

e

Translational

Experimental

Clinical trials

Health service

s researc

h Innovative implant

design Cell therapy and tissue

engineering Disability and

improvement of quality of life

Building the musculoskeletal evidence base

Sarcoma medicine Cancer Institute

Centre for Ageing

Engineering

Musculoskeletal Consortium

UKCC

MRC NIHR

Basic scienc

e

Translational

Experimental

Clinical

trials

Health service

s researc

h

ARC, charities

EPSRCBBSR

C

FundingFunding

National Institute for Health Research - the new research environment

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

NIHR funding streamsNIHR 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

MRC Translational Research CallMRC 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

Cell-based therapyCell-based therapy

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

– Bone– Tendon– Cartilage

Stanmore Clinical Research FacilityStanmore 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

Research pipeline in cell-based therapyResearch pipeline

in cell-based therapy

Basic scienc

e

Translational

Experimental

Clinical

trials

Health service

s researc

hWhat 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

Integrated Academic Training Programme

Integrated Academic Training Programme

• Four Academic Clinical Fellows• Two Clinical Lecturers

Academic Research

Board

Research Governanc

e Committee

Research Committee

Education Committee

Trust Board

PPI group

UCL and Partners Health

Sciences Research Deanery

UCL Dean and Research Vice-

Provost

Research Support StaffResearch Support Staff

• Academic Clinical Centre of IOMS• MRC Clinical Trial Unit support• Chair of Musculoskeletal Epidemiology

– Alex MacGregor – starting Sep 08

• R&D Director and Manager (Joseph Datukasi)• Nerina – Head of Academic Business Development• SCRF staff• IT systems for research support – Simon Grange

Research GovernanceResearch Governance

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

MHRA InspectionMHRA Inspection

MHRA InspectionMHRA Inspection

Support we can offerSupport 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

Research GovernanceResearch Governance

Clinical Trials SupportClinical Trials Support

• Being tested by our iBSc & MSc students

Electronic Patient RecordElectronic Patient Record

05 06 07 08 09 10 11 12

Clinical Sen Lec

My tenure

Team building

MSK epidemiologist

BiostatisticianHealth economist

R&D DirectorR&D Manager

SCRF

Multidisciplinary MSc

Integrated Academic Training Programme

IT/governance supportMedical physics

Regenerative Medical Systems - UK

Joint academic strategy capacity building

05 06 07 08 09 10 11 12

NHS R&D

UCL

NIHR Applied Research Programme £2m

Pfizer fracture accelerating drug 500k

TSB grant 500k

MRC stem cells in nonunion 300k

Expenditure

Grant targetoverheads, contributions to salary, SCRF profit