Clinical health partnerships

In this collaboration, our European Xenopus Resource Centre works with the Wessex NHS Genomic Medicine Centre to explore and improve our understanding of the links between genetic changes in DNA and rare genetic diseases (RGDs).

Rare genetic diseases (RGDs) affect 1 in 17 people at some point in their life – a total of 3.5 million people in the UK every year. The majority of people affected are children, and only 30% of undiagnosed RGD patients survive their 5th birthday —. but diagnosis of RGD increases 5-year survival rates to 80%.

We’re analysing anonymised data from the 100,000 Genomes Project to identify rare disease genes and to develop treatment studies to improve the lives of patients locally and globally. As of 2020, we’ve successfully analysed 10 rare disease genes and identified the genes leading to two new rare genetic diseases. Our European Xenopus Resource Centre was awarded £1.5 million by the Wellcome Trust in 2018 and this supports our work in improving the diagnosis of rare genetic diseases.

This partnership benefits healthcare by:

• Researching methods of advanced diagnosis in RGD patients
• Contributing to computational databases used around the world to identify and treat RGD patients

Our work on patient deterioration is done in partnership with Portsmouth Hospitals University NHS Trust (PHU) — and led to the development of the National Early Warning Score (NEWS) by the Royal College of Physicians (RCP).

Early warning score systems convert a patient’s vital signs measurements into a measurement of their risk of acute illness. NEWS has been adopted by all NHS hospitals and ambulance services. The vital signs measured include:

• Respiration rate
• Oxygen saturation
• Systolic blood pressure
• Pulse rate
• Level of consciousness
• Temperature

Data analysis conducted by our researchers led to the development of NEWS by the RCP in 2012. NEWS 2, developed in 2017, has received formal endorsement from NHS England and NHS Improvement to become the early warning system for identifying acutely ill patients – including those with sepsis – in hospitals in England.

NEWS2 was the only adult early warning score mentioned in the May 2020 guidance issued by the World Health Organisation (WHO) for the clinical management of patients with suspected or confirmed COVID-19. It was recommended for "the recognition and escalation of treatment of the deteriorating patient".

The partnership benefits healthcare by:

• Standardising assessment and responses to acute illness
• Highlighting the urgency of need of treatment in patients
• Creating a pragmatic approach to early warning measurements that can be deployed across all healthcare systems
• Providing knowledge and expertise to organisations and individuals that want to use NEWS

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Frequency of Observations (FOBS) is a collaboration between our researchers in Clinical Outcome Modelling, Portsmouth Hospitals University NHS Trust (PHU), the University of Southampton and Oxford University.

Vital sign observations include measurements of patient heart rate, blood pressure and temperature. In the NHS, it’s recommended that these observations are combined into a single score (the afore-mentioned NEWS score) that can be used to monitor whether a patient's condition is deteriorating. Taking observations can interfere with a patient's rest and sleep but changes spotted early can help medical staff provide early treatment and avoid serious consequences including death of the patient.

In this partnership, we’re using measurements from 2 hospitals to inform how often observations should take place, and if there is evidence to support increased observations in patients with a high NEWS score. The aim is for this evidence-based protocol to be safe and achievable across all acute NHS hospitals.

The partnership benefits healthcare by:

• Helping nurses to make better use of their time
• Improving the patient experience
• Developing an evidence-based protocol for monitoring vital signs

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The HAVEN Project is a collaboration between the University of Portsmouth, Portsmouth Hospitals University NHS Trust (PHU), Oxford University and Oxford University Hospitals NHS Foundation Trust.

Deterioration of patients regularly goes unnoticed in hospitals and can lead to treatment delays and serious consequences that may include death. Patient demographics, lab results and vital sign recordings are also often all stored on different hospital databases and not always visible together.

The aim of the project is to develop a hospital-wide IT system that stores all this data and uses it to create a continuous risk assessment for all hospital patients. Risk prediction algorithms can then be developed and tested to show a patient’s pathway from the first signs of deterioration to admission to an intensive care unit (ICU).

The HAVEN project was funded by the Health Innovation Challenge Fund, a joint venture supported by the Wellcome Trust and the Department of Health.

The partnership benefits healthcare by:

• Giving clinical staff the tools to identify, rank, review and treat patients at risk
• Determining the best way to present the risk information to support decision making in clinical staff
• Reducing treatment delays for patients showing signs of deterioration

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The Missed Care Project (Nurse staffing levels, missed vital signs observations and mortality in hospital wards) is a collaboration between the University of Portsmouth, Portsmouth Hospitals University NHS Trust (PHU) and the University of Southampton.

Previous studies have noted that inadequate nurse staffing levels are a factor in poor care, preventable deaths and increased death rates in hospitals. Recent studies have started to look into ‘missed care nursing’ as a key factor leading to negative patient outcomes. ‘Missed care nursing’ is defined as nursing care that was needed but not done.

Instead of relying on nurses to self-report the care they give, the Missed Care Project used direct measurements of the recorded time of vital signs measurements to explore how nurse staffing levels related to missed or delayed observations.

The results of the study in one hospital showed a clear link between a lower-than-average registered nurse staffing level and an increased risk of death. There was also a link between a higher-than-average healthcare assistant staffing level and an increased risk of death.

The partnership benefits healthcare by:

• Working to reduce patient deaths in hospitals
• Informing the planning of NHS staffing levels
• Highlighting the importance of increased patient observations
• Showing that healthcare assistants are not as effective as registered nurses in monitoring patient deterioration

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Under the leadership of Dr James Brown, the University of Portsmouth works in collaboration with Queen Alexandra Hospital to explore links between bacterial colonisation and enteric glial cell function and to improve training and early detection of neoplasia.

This partnership is researching the important role likely played by glia in inflammatory conditions such as ulcerative colitis and Crohn’s disease as well as functional disorders such as irritable bowel syndrome and polyp formation. They're also researching the reliability and effectiveness of advanced endoscopic imaging techniques.

The partnership benefits health research by aiming to:

• Identify the precise role of glia in a broad range of intestinal pathologies
• Improve training and early detection of neoplasia such as dysplastic changes within Barrett's oesophagus and the detection of diminutive polyps within the colon

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The Dental Academy is a modern, primary-care based school that trains General Dental Council-registered and qualified dental care professionals, and offers comprehensive oral and dental healthcare to the public. It's run as a partnership between Faculty of Dentistry, Oral & Craniofacial Sciences at King's College London, whose dental students are also trained at the Dental Academy in Portsmouth.

Research at the Dental Academy focuses on delivering evidence-based healthcare to patients and the community, and on improving the quality of dental education.

The global team of postgraduate researchers, research associates and research clinicians work on areas such as:

• Children's oral health
• Dental care for new and expecting mothers
• Oral health within the older community
• Community outreach dental activities

The partnership benefits:

• Students who can train in teams in modern clinical facilities that replicate those in real NHS dental practices
• The public who can receive free dental health services in exchange for professional experience for our student dental nurses, hygienists and therapist
• Schoolchildren and the homeless community through preventative and educational workshops on good dental care run by our students

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In this partnership, multiple University faculties work alongside clinical scientists, microbiologists and surgeons from Queen Alexandra Hospital to explore the natural formation of microbiological biofilms on implants.

Prosthetic joint infection (PJI) is one of the most common reasons for failures of hip and knee reconstruction or replacement, and corrective revision surgery can lead to added patient suffering and health risks as well as increased costs to the NHS.

This partnership is a step towards reducing these risks. Researchers are using DNA/RNA sequencing and 3D phase-contrast X-ray microscopy approaches to explore biofilm formation on prosthetics and identify novel biomarkers that can be used in the early prediction of infection in patients with orthopaedic implants.

This partnership benefits patients and the NHS by:

• Reducing additional suffering and risks caused by corrective revision surgery
• Improving the lives of those with prosthetic joint infection
• Reducing the costs of corrective surgery

The Academy of Safety Science and Practice is based at the University and works on national and Wessex based professional safety projects.

The partnership aims to increase the understanding of safety in all its professional and practical dimensions. The work of the Academy is based on practice-based clinical research and teaching. The partnership will have strong industry links with Healthcare, Aviation, Nuclear and FTSE 100 companies, with regard to operational safety learning in industry.

The partnership benefits people and communities by:

• Supporting and contributing to the national safety agenda in healthcare and other professions
• Helping individuals and organisations understand, implement and improve their safety and culture
• Supporting and mentoring research around learning from harm, safety, organisational reliability and resilience, crises and disaster management
• Providing up to date teaching materials and publications on safety
• Undertaking research in the field of operational safety and learning from potentially harmful situations, disaster and crisis management and high reliability in organisations
• Encouraging and mentoring safety research projects