Open Session MEH Board
Joint Research (MEH and UCL IoO)
Produced by:
Professor Sir Peng Khaw & Professor Phil Luthert
Board of Directors Meeting
20November 2014
MEH Trust Board Report November 2014 – Joint Research (MEH and UCL IoO)
- Introduction
This paper provides an update on research funding and output performance across Moorfields Eye Hospital (MEH) and UCL Institute of Ophthalmology (IoO) to indicate the progress being made against implementation of the Joint Research Strategy (JRS).
2. Context Summary
This is the first full year of the JRS Implementation. The timing for the joint strategy is ideal in terms of positioning the organisations for the key future milestones including:
- National Institute for Health Research Biomedical Research Centre (NIHR BRC) & Clinical Research Facility (CRF) award renewals in 2016-17 worth potentially >£33M.
- Sir Jules Thorn Clinical Investigation Centre: New facility build for 2020 worth >£5M.
- Academic Health Sciences Centre (AHSC) of UCL Partners (UCLP) Eyes and Vision Programme.
- Working with the Crick Institute from 2015.
- Punching above our weight in translational medicine for the UK’s > £1.72Bn public sector research fund.
- Delivering on the UK life-science economy and Health to Wealth agenda.
The unified organisational vision and demonstrable championing of research excellence is pivotal to ensure that our global leadership position is maintained in life-changing research for patients.
Global competition is fierce and the scarcest resource is research talent. Keeping, developing and acquiring talent in areas of excellence or potential areas of excellence is the priority. Providing the right environment for such people to flourish is imperative.
Supporting Prof Sir Peng Khaw and ProfPhil Luthert in their leadership roles is the Joint Strategy Board (JSB) Chaired by Sir Roger Jackling and membership includes John Pelly, Declan Flanagan and Prof Alan Thompson (UCL). This Board oversees the prioritisation, resource deployment, progress and delivery of the joint research strategy.
The support mechanism for the JSB and the Researchers is the Joint Management Team comprised of the Moorfields Eye Hospital (MEH) and UCL Institute of Ophthalmology (IoO) managers, who operationalise, facilitate and deliver outputs and results.
3.Background
- Research Funding
Figure 1: Research Funding to MEH 2007 – 2014.
•The funding gap created by the phasing out of Department of Health (DoH) Culyer has been replaced by National Institute for Health Research (NIHR) funding (BRC, Research Capability Funding (RCF), Research Network (CLRN/LCRN)
•Growth in NIHR infrastructure / experimental medicine research funding has occurred year-on-year from 2011/12, driven by increased BRC funding (2012-17; including NIHR Rare Disease Translational Research Collaboration) and NIHR Clinical Research Facility funding from 2012.
•Greater than 75% growth in research funding to MEH since 2009/10. Greater than 50% growth in research funding to MEH since 2011/12.
•Funding to MEH from commercial partnerships has increased 6-fold since 2011/12 reflected by a 6-fold increase in commercial study number since 2010-11 (Figure 5).
Figure 2: Research Funding to IoO 2009 – 2014.
•IoO funding by sector is variable year-on-year, except for commercial funding which has been stable (at around £3m per year).
•Total funding mean is £19m per year (2009 – 2014).
Figure 3: Research Funding to MEH and IoO combined 2009 – 2014.
•Together, MEH and IoO have attracted over £130 million in research grants in the past 5 years.
- Study number
Figure 4: Increase in number of studies active at MEH.
•The total number of studies undertaken at MEH has increased by 25% since 2009/10.
Figure 5: Commercial study number increase from 2009 – 2014.
•We have delivered a 6-fold increase in commercial study number since 2010-11.
c. Patient recruitment
Figure 6: Increase in patient recruitment to MEH studies
•Patient recruitment to Moorfields / IoO research studies has increased year-on-year.
•Patient recruitment has increased almost 5-fold since 2010/11.
•We are performing a greater number of studies which is resulting in increased patient recruitment at MEH.
•The proportion of observational studies and has increased which recruit relatively high numbers of patients partly explaining 5-fold increase in recruitment over 5 years vs 25% increase in study number.
•Patient recruitment increased significantly in 2012/13 and 2013/14 mostly due to six projects, each of which have recruited at least 200 patients, with one recruiting over 500 patients.
d. Quintiles / UCL Partners Prime Site performance
•UCLP Prime site was the world’s leading Quintiles prime site in 2013 based on recruitment of 792 patients to quintiles research studies.
Figure 7: 792 patients recruited onto Quintiles studies in 2013
•Moorfields is the top recruiter to Quintiles primesite studies in 2014, albeit to one high recruiting study.
Figure 8: MEH recruitment to Quintiles prime site studies in 2014.
e. Publication volume
Figure 9: Number of joint publications for MEH and IoO (2010 – 2014(to November 2014))
•MEH and UCL have the highest proportion of collaborative papers (RAND analysis 2002-2006) compared to all NHS Trusts in England.
•Our key strengths are in cataract, inherited eye disease, regenerative medicine, gene therapy and imaging research based on first author publication number.
•MEH and IoO are leading its competitors in inherited eye disease research.
•MEH and IoO are losing ground to its main competitors based on publication number in cataract, glaucoma, retina and AMD research.
4. Strategic areas
a. Major Research Themes
“It is the absolute peaks of excellence that create the reputation of the institution.”
•Endothelial cell biology: In this theme we are focusing primarily on how blood vessels form in health and disease and how blood vessels interact with other pathological processes, notably inflammation.
•Inflammation: Both at IO and in collaboration with colleagues at Bristol we have several programmes looking at how inflammation in different parts of the eye drives disease and how this might be blocked.
•Pathogenesis of retinal vascular disease: Here, the mechanism of age-related macular degeneration, diabetic retinopathy and other retinal vascular diseases are being studied with a view to developing novel approaches to diagnosis and treatment.
•Pathogenesis of inherited eye disease: As well as major programmes seeking the genetic causes of a wide range of eye disease much activity focuses on understanding how these gene defects cause disease.
•Gene therapy: The pioneering gene therapy programme has secured significant research funding over the year but needs considerably more to move forward from successful experimental proof of concept studies to clinical trials.
•Stem cell approaches to eye disease: Major programmes are addressing novel approaches to treating inherited and acquired retinal degenerations, corneal disease and glaucoma. In addition, we are leading in the use of stem cell technology and gene editing to study mechanisms of disease.
•Visual neuroscience: Here we are interested in understanding the detail of how the brain takes information from the retina and turns it into a visual percept of the world, how this degrades with disease and what might be done to improve vision in those with significant impairment.
•Tissue repair and Drug delivery: We are investigating mechanisms of tissue scarring which are involved in many blinding diseases and new ways to deliver drugs to the eye to prevent this scarring
•Ocular oncology: This is a relatively small theme which we seek to expand and that is looking at mechanisms of ocular tumour development and seeking to identify new ways of tackling this.
b.Research Talent
Attracting, training and developing premier research talent, to driveresearch output, discovery and innovation in new treatments
Our reputation has been established through the work of the researchers who havebeen and are based here. The intellectual capital of our staff is our most valuableR&D asset: without researchers there is no research.
We face an ever more competitive international market for research talent. For usto retain our top-ranking position, we need to identify the talent requirements for ourchosen strategic areas, and then attract, train and develop those select researchers.These plans will link to the Moorfields education strategy and Institute talentmanagement programmes.
•We have the opportunity to enhance investigator productivity.
•Detailed analysis to be presented later
c.Innovation through Integration
Goals & Progress:
•The joint management team has started the work up of materials designed to promote what we do, the skills that we have, the impacts we deliver, the partnerships we develop and the value we bring through the research work that happens. A wide internal consultation has begun and co-creation workshops started to draft the initial documents that will form the core of how we engage with our stakeholder groups. The communications team, the Moorfields way team and a NED are involved.
•Cross Institution Events are on the work agenda for 2015.
•There are robust ties with the eye bank and other areas in UCL such as the translational office, consulting and the EU Horizon 2020 office.
•The ACTIVETM team (Applied Clinical Trials in Vision & Eyes) led by Dr Jen Burr, DrCateyBunce and Prof Richard Wormald, is a major partnership with the UCL CTU and has made significant impact in the success of winning the large NIHR grants covered in the performance section of this paper.
•Working with Mary Sherry's team in clinical operations, we have research participation in the clinical transformation programme, which will develop the integration of research work happening at the heart of the clinical service in addition to the more specialist work happening in the CRF.
•Prof Sir Peng Khaw's work as UCLP lead for Eyes and Vision is now supported by Dr Julian Hughes, who recently joined research as Performance and Alliance manager to strengthen the drive for maximising results.
d. World-leading partnerships
Goals and Progress:
•There are several areas within partnership development including:
•Quintiles Prime Site. As the largest global clinical research organisationwe have partnered with them to grow our portfolio clinical trials.
•Partnership with Roche, to strategically develop new therapies at fundamental science level and pull them through to first in man studies in the CRF.
•Collaboration with a company called Bicycle Therapeutics (Cambridge) to explore opportunities to develop novel compounds to treatophthalmic disease.
•Existing long-term partnerships with Pharma and Biotech are ongoing. We are maximising the translational potential of these partnerships by linking laboratory and clinical research.
•Developing work with the TEVA Corporation. They already have a partnership agreement with the Cabinet office for £20M of investment for Chronic Illnesses of aging.
•The Ophthalmic Futures Event led by Keith Barton brings together key industry figures to explore partnerships and development opportunities.
•Recruited a new member of the research team to manage these Partnership and Alliance developments with the 'Health to Wealth' agenda as a key area of focus.
•Work with Queen Elizabeth Diamond Jubilee Trust on blindness in commonwealth
5. Enablers
Goals and Progress:
a. Attracting resources by delivering outstanding value for our funders:
•Appointment of Dr Jen Burr decision maker and panelist on the NIHR grants, who also mentors researchers at the joint site for the development of high quality research applications.
•Adnan Tufail leading on the EU grant partnership for 7M euros, Involving 17 countries.
•CRM database now live and ready for use as needed by research.
•PK & PL working in close partnership with MEC for the prioritisation of research requirements in new funding awards.
•Working with an agency and in liaison with the MEH Communications team for the work up of 'good news stories' to highlight research impact and success, due on stream by February 2015.
b. Insights from Informatics:
•Research funded an Applications Engineer for the Open Eyes Team. Several meetings with OE have outlined the requirements research have for OE and have co-developed with the OE team to design of a module for the future.
•We have created new links to the UCL Informatics Group.
•Full participation in the 100K Genome project and recent UCLP Genomics Medicine Centre bid.
c. Discovery Science Headlines
•Several studies addressing how the permeability of blood vessels is controlled at the molecular level. This is critical for the development of new approaches to controlling oedema (excess tissue fluid) in the retina.
•Refinements to tissue culture of stem cell derived Retinal pigment epithelial (RPE).
•Investigations into the control of normal and pathological blood vessel development involving Neuropilin 1 and Lrg1 and including major publications in Development, Developmental Cell, Journal of Experimental Medicine and Nature. (high impact journals).
•New insights into how mutations in genes controlling RNA processing cause dysfunction of RPE.
•Elucidation of how mutations in cone pigments cause disease.
•Many studies on the genetics of glaucoma, corneal disease and retinal degeneration including in Nature Genetics.
•Studies of how inflammatory signaling works in supporting (non-neuronal) cells of the retina known as Muller cells.
•Key study using stem cell technology to elucidate the mechanism of a retinal degeneration caused by mutations in the RP2 gene (Human Molecular Genetics). As well as being of intrinsic interest this study shows the power of using cells from patients with known mutations to understand disease processes in cell cultures.
•The demonstration of how a specific protein links junctions between cells to an intracellular system controlling cell survival. This is part of a large programme of work that helps us understand RPE disease (notably AMD) and certain categories of tumours.
•A study providing novel insights into how RPE processes rod outer segments.
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