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2014-2015 NICE Scholars
Lead Enhanced Recovery Surgical Pharmacist
Central Manchester University Hospitals NHS Foundation Trust
Neetu graduated from the University of Manchester with a distinction degree in Pharmacy and subsequently undertook her basic training within the North West. In 2008, she moved to Addenbrookes Hospital in Cambridge and trained as an Independent Prescriber at King's College in London. In 2010, she was appointed as the Lead Clinical Pharmacist at the London Bridge Hospital and also undertook an MSc in Advanced Pharmacy, graduating with a distinction. In 2013, Neetu moved back to the North West to take on her current role. Most recently, Neetu has been awarded recognition as one of the first Royal Pharmaceutical Society faculty members in the country.
As the Lead Enhanced Recovery pharmacist, Neetu's role involves working strategically and in collaboration with various members of the multidisciplinary team to implement enhanced recovery pathways within different surgical specialities. The overall aim is to improve patient outcomes and patient experience with an
As a NICE scholar, Neetu aims to undertake a supported improvement project demonstrating the positive impact pharmacists can make in optimising medicines use and improving patient safety by the implementation of various NICE guidance and quality standards along enhanced recovery pathways.
Clinical Specialist in Falls Prevention and Management (Specialist Physiotherapist)
Gloucestershire Hospitals NHS Foundation Trust
Will works as Clinical Specialist in Falls Prevention and Management and is a Physiotherapist by profession. He is based at Cheltenham General Hospital in Gloucestershire. His role is split between direct clinical patient contact and non-clinical service development activities. Clinically, he works in a multidisciplinary falls assessment clinic as well as managing his own caseload of patients and triaging falls attendances at the Emergency Department. His countywide remit includes evolving the exercise continuum between NHS and Local Authority exercise classes, facilitating best practice within falls clinics and promoting the falls service pathway as a whole.
Will's Scholarship project will focus on the recently updated NICE guidance surrounding falls prevention in hospital in-patients. He aims to audit his organisation's current compliance with the guidance then develop and deliver education programmes aligned with new assessments and care plans that will allow the recommendations to be met.
Specialist Registrar in Nephrology
South London Rotation
Partha Das graduated from Guy's, King's and St Thomas' School of Medicine and Dentistry in 2003 with degrees in medicine and neuroscience and a diploma in the history of medicine before undertaking junior medical training at King's College Hospital and St Thomas' Hospital. He commenced specialist registrar training in nephrology and general medicine on the South Thames rotation in 2008. He is chairperson of the UK and Ireland Nephrology SpR Club which represents renal physicians-in-training nationally.
He spent a year working for the organisation NHS Kidney Care and with the Department of Health on a variety of quality improvement and service development projects. These focused on raising the standard of care for patients with kidney disease in England, reducing inequity, fostering shared learning between renal units and advising on national renal healthcare policy. He is currently reading for a Masters degree in Health Policy, Planning and Financing at the London School of Hygiene and Tropical Medicine and the London School of Economics and Political Science.
Partha is interested in the actors and drivers that shape health policy, decision-making behaviour of healthcare professionals, economic aspects of clinical guidelines and the public communication of medicine and science. His project with NICE will examine how primary care and secondary care professionals interact when managing chronic kidney disease (CKD) on the South Coast of England. The project is framed within the context of NICE clinical guidance for CKD and will assess its impact on patient outcomes, provider behaviour and resource use.
Addenbrooke's Hospital & University of Cambridge
Angelos is an academic clinical trainee in neurosurgery in Cambridge. His research interests include neurotrauma and cerebrovascular diseases. His research, which has received support from a NIHR Academic Clinical Fellowship, a Royal College of Surgeons of England Research Fellowship and a Raymond and Beverley Sackler Studentship, currently focuses on the effects of decompressive craniectomy on the injured brain.
Angelos is involved with the IDEAL Collaboration, an initiative which aims to improve the quality of research in surgery. Angelos strongly believes in making clinical research more accessible to trainees and all clinicians. He has been the elected academic representative of the British Neurosurgical Trainees Association (BNTA) since April 2012 and with colleagues from the BNTA, has led the establishment of a research and audit network for neurosurgical trainees in the UK (British Neurosurgical Trainee Research Collaborative).
Angelos will spend his time as a NICE Scholar focusing on the management of malignant middle cerebral artery (MCA) infarcts - the most devastating sub-type of ischaemic stroke in terms of high mortality and socio-economic consequences. The proposed project will be the first study to assess the uptake of NICE recommendations regarding decompressive
Foundation Year 1 Doctor
North West Thames
Mahiben is an Academic Foundation Doctor in North West Thames and is passionate about improving health system quality and efficiency. He serves as Advisor to Thomas Zeltner, Special Envoy of the World Health Organisation; advisor to governments on health policy implementation; Director of the World Surgical Association; and Chairman of the UK Medical Students' Association.
He studied preclinical medicine at the University of Cambridge, graduating with a triple First Class, read clinical medicine at Oxford University, where he was the youngest appointed Teaching Scholar, and was a Kennedy Scholar at Harvard University. Mahiben has over 40 academic awards, 40 peer-reviewed publications, and has presented his work across four continents. He has a strong interest in education, authoring three student-targeted medical books.
As a NICE Scholar, Mahiben will focus on the use of structured feedback in surgery. He will be collaborating with colleagues at Harvard University, Imperial College London and Oxford University, with the aim of developing national guidelines on implementing feedback to improve outcomes at the team and individual surgeon level.
NICE Assurance lead
Plymouth Community Healthcare CIC.
Mel Muller-Forster is NICE Assurance Lead for Plymouth Community Healthcare (PCH) supporting and facilitating the implementation and monitoring of NICE guidance within her organisation. Mel has a clinical background in Podiatry and has also completed an MSc Social Research. Mel is passionate about improving the quality of patient care through the application of
As a NICE Scholar Mel will be undertaking a project to explore PCH staffs' awareness and knowledge of NICE guidelines and understand more fully factors that are likely to facilitate or impede their implementation. The project will make recommendations for improving awareness, knowledge and implementation of NICE guidelines within PCH. Findings from this project may support other organisations to develop their NICE processes and implementation.
Dr Paula Murphy
Consultant Forensic Psychiatrist
St Andrew's, Northampton
Dr Paula Murphy studied medicine in Scotland and qualified as a doctor in 2001. She completed her foundation level training in Glasgow before moving to Melbourne where she worked for two years. She returned to the UK to do her basic psychiatric training on the Royal Free rotation in London before sub-specialising in forensic psychiatry on the South London and Maudsley rotation. Currently she works as a Consultant Forensic Psychiatrist at St Andrew's, a mental health charity providing specialised in-patient care. She works on a medium secure ward for male mentally disordered offenders. During her higher training, she was a ‘Prepare to Lead' candidate, a scheme aimed at preparing doctors for leadership roles. She completed a Masters degree in Public Health and Health Services Management at the London School Hygiene and Tropical Medicine in 2012. Her interests include clinical leadership, mental health policy and quality improvement. She is currently co-editing a handbook on Clinical Leadership and Management for Oxford University Press, in association with the Faculty of Medical Leadership and Management.
As a NICE Scholar, Paula will assess the barriers to the implementation of the NICE guidelines on Violence in her organisation. She also aims to develop guidelines on best practice for areas where little guidance exists within the current guidelines. Violence within psychiatric setings remains a signifcant issue and has wide implications
NIHR Clinical Research Associate in Infectious Diseases
Coventry & Warwickshire Partnership Trust / University Hospitals Coventry & Warwickshire
Amandip has a keen interest in service development and was selected as Clinical Leadership Fellow for the NHS Leadership Academy in 2012. During the 1-year programme run by the King's Fund and Universities of Manchester and Birmingham, he helped establish Leicester's first Outpatient Parenteral Antimicrobial Therapy (OPAT) service as a QIPP initiative, and obtained a PGC in Leadership and Service Improvement. Amandip is currently a post-CCT Clinical Research Associate for the West Midlands (South) CLRN. Based in Coventry, he is gaining experience in research development and delivery with an interest in HIV and tuberculosis (TB), and studying for a PGC in Research Methodology at the University of Warwick.
As a NICE Scholar
Specialty Registrar in General Surgery
Countess of Chester Hospital NHS Foundation Trust
Paul qualified from the University of Nottingham in 2006 before completing the Academic Foundation Programme in Trent Deanery. He followed this with Core Surgical Training in the North West obtaining his NTN in General Surgery in Mersey in 2010 where he has expressed subspecialty interests in Colorectal Surgery and Surgical Oncology. To further this interest he was awarded a Cancer Research (UK) Clinical Research Training Fellowship whereby he is currently reading for a PhD at the University of Liverpool; the focus of his research is predicting response to neoadjuvant therapies in metastatic and advanced colorectal cancer. He plans to return to full time clinical training in 2015 and subsequently aspires to a Clinical Lectureship.
His research interests are complemented
Paul's interest in NICE was sparked following the presentation of one of his audits as a Shared Learning Award at the 2013 NICE Annual Conference. He will spend his time as a NICE scholar working towards the development of Patient Reported Outcome Measures (PROMS) for colorectal cancer.
Head of Clinical Effectiveness
St Andrew's, Northampton
Lesley Wilson qualified as a Registered Mental Nurse in 1994 and after a clinical career predominately in the substance misuse field moved into Quality and Governance in 2004. While working in Quality and Governance Lesley has worked within acute, primary care and mental health settings giving a wide range of experience. As Head of Clinical Effectiveness for St Andrew's, a charity providing secure care for mental health, learning disability, autism and brain injury, Lesley is responsible for the implementation and monitoring of
A key challenge for an organisation such as St Andrew's is the highly specialised and complex needs of patients and the ability for clinicians to easily access the key and relevant best practice guidance and research evidence for their patients. As a NICE Scholar Lesley will work with the Charity's Clinical Directors to develop evidence based, diagnosis specific care pathways, which clearly detail treatment and therapeutic options. As the Charity's patients tend to have multiple diagnoses complex mental health needs the project will also aim to develop an online resource which will bring together guidance and research as well as advice on approved procedures and treatments within the Charity.
2013-14 NICE Scholars
Positions are those held on appointment as a NICE scholar
Clinical Research Fellow
University Hospitals of Coventry and Warwickshire/Warwick University
Tim's preclinical training began at St Andrews University with a BSc in medical science, where he was awarded numerous academic prizes, a Health Foundation Scholarship for research, and graduated with first class honours. Tim completed his medical degree at Manchester University in 2007, where he graduated from with honours. Following foundation level training in the North West deanery, during which he won 'Foundation house officer of the year' and chaired the North West Deanery's Foundation Years Council, Timothy was appointed an Academic Clinical Fellow (ACF) at University Hospitals of Coventry and Warwickshire (UHCW), supported by the National Institute for Health Research (NIHR). He has recently completed a Masters Degree in Trauma and Orthopaedics at the University of Warwick and was awarded a Royal College of Surgeons (Glasgow) Travel Fellowship for work in a musculoskeletal camp in India. He is currently taking time out of programme towards a PhD degree, which is aimed at developing an outcome prediction tool for patients considering a knee replacement.
As a NICE scholar Tim will assess the barriers to the implementation of the NICE guidelines for patients with knee osteoarthritis. By identifying and addressing barriers to implementation locally, and disseminating these finding widely, he hopes to improve patient care, based on the best possible evidence.
Public Health Specialty Registrar
County Durham Council
Jim Brown is a Specialty Registrar in Public Health and a locum GP in the North East of England. In Public Health, he has had placements in NHS South of Tyne and Wear, the North East Health Protection Unit and NHS County Durham and Darlington. In Public Health, he has been developing the NHS Health Checks programme in County Durham and Darlington, working with local CCGs to address the key health needs identified by the local Joint Strategic Needs Assessment, and working on a project to improve the quality of care for people with long term conditions. He led a health needs assessment of maternal obesity in South Tyneside.
Prior to working in Public Health, Jim was a GP working in County Durham, Newcastle upon Tyne and New Zealand, with an interest in diabetes care. He also worked in guideline and indicator development for NHS Clinical Knowledge Summaries. During this time, he earned a distinction in an MSc in Public Health and Health Services Research, which he undertook part-time, writing a dissertation on the impact of trial context on the efficacy of patient decision aids.
As a NICE Scholar, Jim will be working on a project to implement shared decision making in the care pathways for hip and knee osteoarthritis in County Durham and Darlington. Shared decision making improves patient experience, and may reduce unwarranted variations in healthcare practice and health care costs associated with more expensive, unwanted options. Patient decision aids - tools to implement SDM - can help to implement guidelines by bridging population-level research evidence with individual patient values.
Extremity Reconstruction Fellow
Imperial NHS Foundation Trust, London
Graham Lawton is an Army Burns and Plastic Surgery registrar on the Pan Thames rotation and is currently the Extremity Reconstruction Fellow at Imperial College Healthcare NHS Trust. He is due to start a Training Interface Group Fellowship in Reconstructive Trauma Surgery later this year.
He qualified from Guy's and St Thomas' Hospitals and then went onto complete his basic surgical training in Yorkshire. He was awarded his Fellowship of the Royal College of Surgeons in 2012.
Graham's scholarship will examine how we are treating open lower limb fractures in North West London, Pan-London Major Trauma Centre's (MTCs), in the network served by the Queen Elizabeth II Hospital Birmingham and finally nationally.
NICE is not due to publish guidance related to the assessment and management of major trauma until June 2015. However, evidence based professional standards regarding the management of open lower limb fractures already exist.
Aspects of these standards have been defined as key performance indicators (KPIs) and published as the British Orthopaedic Association Standards for Trauma (BOAST 4). The Trauma Audit Research Network (TARN) attempts to collect elements of the BOAST 4 dataset but uptake and acceptability is variable.
The aim is to to improve TARN uptake, acceptability and profile with specialties involved in limb reconstruction. Thereby allowing central National collection of data and monitoring of these KPIs and driving forward care of these severe injuries.
This scholarship will allow NICE to examine how guidance could be linked with data collection and performance assessment in a manner that will benefit both patients, clinicians and aid in the commissioning of these specialist services.
Specialty Registrar in Ear, Nose & Throat Surgery
Barking, Havering, Redbridge Hospitals NHS Trust
Reza Nouraei is a specialist registrar in Otolaryngology - Head & Neck Surgery at the London Deanery. He is currently based at Barking Havering and Redbridge NHS Trust and holds an honorary senior lecturership at Anglia Ruskin University. He studied oculomotor neurophysiology under Prof Roger Carpenter at Gonville and Caius College, Cambridge, and graduated with bachelors of medicine and surgery in 2002.
He undertook basic surgical training within the Hammersmith rotation in London. He was admitted as a member of the Royal College of Surgeons of England in 2007 and after a year's secondment as a management registrar at Charing Cross hospital, culminating in a Health Services Journal award in the category of Data-driven service improvement, was appointed as an academic clinical fellow in ENT surgery at the London deanery.
Reza's main and long-standing clinical interest is in the management of voice, swallowing, and airway disorders, and in particular, managing adult laryngotracheal stenosis. He has published over 30 peer-reviewed publications in the latter area as part of a long-standing collaboration with Mr Guri Sandhu.
His other main interest is patient safety and in particular how health information and the coded hospital data can be used to improve it. The main focus of his NICE scholarship will centre on improving the quality of healthcare data in head and neck cancer surgery in order to enable Hospital Episode Statistics to provide meaningful clinical outcomes and quality surveillance.
NIHR Academic Clinical Lecturer in Infectious Diseases
University of Leicester/University Hospitals Leicester NHS Trust
Dr Manish Pareek qualified with honours degrees in medicine and epidemiology from the University of Birmingham before undertaking training in internal medicine and infectious diseases in Birmingham, London and Leicester. Between 2007 and 2011 he undertook, and completed, a four-year Medical Research Council funded MSc and PhD in the Tuberculosis Research Unit and the Department of Infectious Disease Epidemiology at Imperial College London. His thesis, which focused on the topic of tuberculosis and migration, resulted in several high-impact publications and was recently awarded the Barnett-Christie lectureship for excellence in original research. Following the successful completion of his doctoral work, Dr Pareek returned to Leicester where he was appointed as a NIHR Academic Clinical Lecturer and Honorary Specialist Registrar in Infectious Diseases at the University of Leicester and University Hospitals Leicester NHS Trust.
As a NICE scholar, Manish will make use of his extensive experience in the area of tuberculosis and migration to implement a pilot of primary-care based migrant screening for latent tuberculosis as per NICE guidelines in Leicester which has an ethnically diverse population with one of the highest rates of tuberculosis in the UK.
Specialty Trainee year 5 - Haematology
Royal Surrey County Hospital, Guildford, Surrey
Matthew trained in Medicine at Magdalen College, Oxford, from where he graduated in 2006. He is currently working as a specialist registrar in haematology on the South West London rotation. His interests span the whole spectrum of hospital haematology, from coagulation disorders to haemato-oncology, and especially the interface between haematology and other specialties.
Alongside this Matthew has a long-standing interest in identifying and overcoming barriers to change in healthcare. Accordingly his NICE scholarship project aims to examine the factors which have influenced the adoption of NICE recommendations regarding novel anticoagulant drugs. He hopes, in the process, to raise awareness of NICE and its guidance, and of the new anticoagulant agents themselves, among prescribers in his local area.
Consultant in Public Health
Greater London Authority
Lucy Saunders is a Consultant in Public Health working for the Greater London Authority and Transport for London. Lucy has a unique role integrating public health considerations into policy and practice in the transport sector across London. Lucy completed the Specialist Public Health training programme in London in 2012. During this programme she worked for the World Health Organisation, Department of Health, Greater London Authority, PwC, London School of Hygiene and Tropical Medicine, the Health Protection Agency and Islington PCT. Lucy developed a specialist interest in transport, planning and behaviour change during her training.
Lucy's first degree was an MA in Geography at University of Edinburgh. Prior to the Specialist Public Health training programme Lucy worked in the Public Health team at Southwark PCT and completed her Master degree in Public Health at Lund University, Sweden.
As a NICE Scholar Lucy will be disseminating the new NICE Guidance for Promoting Walking and Cycling across a range of stakeholders in London including local authorities, Transport for London and campaigners. The movement of Public Health responsibilities to Local Authorities on April 1st 2013 provides a new opportunity for engaging stakeholders with a role in transport and street environments. In London there is great potential for improving the health of the population and reduce inequalities through measures that increase walking and cycling.
Patient & Public Experience Lead
Dorset County Hospital, Dorset
Sarah graduated from the Florence Nightingale School of Nursing & Midwifery, Kings College London and has nearly twenty years of practical experience working in hospital and community environments as a mental health nurse in acute and crisis services. During this time she has led on a variety of projects focused on the patient experience of mental health services. This included leading on a borough-wide service improvement project based on the patient experience and Lean methodology at the South London & Maudsley NHS Foundation Trust and collaborating with the NIHR King's patient safety and service quality research centre to evaluate it.
Sarah currently leads on a number of projects to promote and improve the patient and public experience at Dorset County Hospital NHS Foundation Trust. This includes The Information Standard; an independent certification scheme for health and information producers supported by the Department of Health, Experience Based Design from the NHS Institute for Innovation and Improvement and the Department of Health's Friends and Family Test.
Sarah will spend her time as a NICE Scholar focusing on complaints and the patient experience of the NHS complaints process. She will be using the NICE patient experience quality standards to categorise complaints and identify themes of good and poor practice with focus on improving the patient experience. She will also be using the experience based design approach to support staff to explore the emotional impact of a complaint with a view to improving the complaint responses.
ST6 Specialty Trainee - Ophthalmology
Manchester Royal Eye Hospital
Reshma received her undergraduate medical training at the University of Glasgow, and later went on to undertake an MSc in Investigative Ophthalmology and Vision Science at the University of Manchester. Her MSc research project, (supervised by Prof David Henson and Miss Cecelia Fenerty) was on barriers to access to glaucoma care leading to blindness. Her findings were published in the BMJ.
Reshma is currently a final year specialty registrar in Ophthalmology in the North West Deanery. She has received a number of prizes for clinical and audit project presentations. She has a keen interest in teaching, trainee development and patient experience. She has undertaken advanced surgical training in Oculoplastics at Manchester Royal Eye Hospital, and will soon commence further subspecialty training in Acute and Primary Care Ophthalmology.
She was appointed to the Medical Leadership Programme of the North West Deanery this year and is reading for the MSc in Leadership & Service Delivery from Manchester Business School.
During her scholarship with NICE, Reshma will examine barriers to implementation of NICE guidance in the glaucoma pathway. She hopes to improve clinician understanding and engagement with this guidance in both a large teaching hospital and smaller district hospital, to derive shareable lessons to improve the quality of patient care nationally.
2012-13 NICE Scholars
Positions are those held on appointment as a NICE scholar
MBBCh MSc FRCS
James qualified in medicine from the University of Wales, College of Medicine in 2002. After basic surgical training in South Wales, he moved to South West England as a higher surgical trainee. He became a fellow of the Royal College of Surgeons of England in February 2012. He has published and presented internationally in both general and vascular surgery. He has a large teaching portfolio running courses on medical education and surgical trauma surgery.
His interest in the care of the patient with the diabetic foot has led to the work that will be undertaken during his time as a NICE Scholar. The South West has the highest amputation rate amongst diabetics and he plans to examine this as well as look into the risk factors for failure in patient undergoing infra-inguinal bypass surgery for peripheral vascular disease and diabetic foot disease.
Adanma Ezihe-Ejiofor MBBS, FWACS, FRCA
Specialist Registrar, Anaesthetics
Brighton and Sussex University Hospital NHS Trust
Ada completed her anaesthetic residency training in Nigeria before relocating to the UK and currently works as a 6th year specialist registrar in anaesthetics. Her UK anaesthetic training spans the West Midlands, Welsh and Kent, Surrey and Sussex deaneries. Apart from clinical duties she has on-going research interests, having previously held a Clinical lecturer/research post at the University Hospital of Wales in Cardiff. She has published and presented at national and international meetings. Ada is currently exploring cost containment and sustainable development themes as ways of improving efficiency in the NHS.
Outside the UK, Ada has maintained links with colleagues in Nigeria where she has regular teaching commitments. She recently started the IMPRACSE project of which she is Team Leader. IMPRACSE (IMproved Pain Relief After CaeSarean sEction) is a multicentre obstetric anaesthesia project which aims to develop a blueprint for improving post caesarean section pain management in a way that is practical and sustainable in an economically-challenged environment. It will be the first project of its kind in Africa.
As a NICE scholar, Ada will be conducting a research project looking at whether ultrasound examination can safely replace chest radiography after central venous catheter (CVC) insertion. It is estimated that over 200,000 CVC's are inserted in NHS hospitals per year. The NICE guidance issued in 2002 was responsible for the increased use of real-time ultrasound visualisation to facilitate CVC insertion into the internal jugular vein. Various studies subsequently demonstrated an improved safety profile when using ultrasound compared to the traditional landmark based technique for internal jugular vein CVC insertion. Ultrasound guided CVC insertion is now routine practice in the UK. With this improved safety profile is it still necessary to do a routine chest x-ray after CVC insertion in the internal jugular or subclavian vein or can ultrasound technology go even further? If ultrasound is shown to be a safe post procedure diagnostic tool this will obviate the need for routine post procedure radiography, avoid unnecessary patient exposure to radiation and minimize delays in starting therapy while waiting for radiography.
Siobhan is a Public Health Registrar in her 3rd year of training and currently on a two-year placement in the Cheshire and Merseyside Health Protection. Before joining the training scheme in 2009, she graduated with a 1st class Honours degree in Physiology and began her career in Public Health in the North East of England, where she led on a project looking at the prevention, identification and management of obesity among children across ten Primary Care Trusts. Siobhan then worked in young people's Health Improvement in Hartlepool, the Healthy Schools programme in Redcar & Cleveland, and then relocated to the Beacon award-winning St Helens Healthy Schools team in the North West of England, where she led on Food and Nutrition and Drugs Education. Her current role includes involvement in the management, control and investigation of outbreaks, providing public health advice on daily health protection queries, audits and a new project looking at vaccination for patients with chronic kidney disease. Siobhan achieved a distinction her Masters in Public Health in 2010, and recently published a paper and editorial from her dissertation on the relationship between socioeconomic status, substance use and wellbeing. Siobhan holds a second Masters degree; her dissertation was on children's perceptions of alcohol. She passed both the Faculty of Public Health Membership exams in 2011 and is currently Vice Chair of the FPH National Specialty Registrar Committee.
Siobhan's project will promote, measure, monitor and report upon the implementation of the NICE guidelines for identifying and managing tuberculosis (TB) among hard to reach groups in the Cheshire and Merseyside area. TB remains a significant public health issue, causing over 2 million deaths worldwide. In the UK, people from hard-to-reach groups are not only more vulnerable to the disease, but are also less likely to comply with treatment. The aim of this project is to agree with local stakeholders a vision for TB services that meet the needs of hard-to-reach groups and to examine what aspects of the NICE guidance are already in place, what gaps exist and what barriers and levers there might be to implementing the guidance locally. The results of this project will be useful to commissioners locally, but will also be fed back to NICE for wider dissemination to other areas also implementing the guidance.
Amy Ford is a Medical Oncology Registrar in Merseyside. She is currently taking time out of programme to study for a PhD within the School of Law, University of Manchester, as a NIHR Doctoral Fellow. Her research examines resource allocation in ‘exceptional circumstances' by Primary Care Trusts, from a legal and ethical perspective.
As a NICE Scholar, Amy is undertaking a project examining the variation in the uptake of drugs funded by the North West Cancer Drugs Fund, compared to the variation in the use of NICE-approved cancer drugs, within the same region.
Khushbu Lalwani works in Public Health in Bexley, South East London. Khushbu has led the Joint Strategic Needs Assessment (JSNA) 2010-12 between the NHS and the Local Authority. Khushbu is the principal lead for Public Health Governance in Bexley. Khushbu is a member of the local Clinical Quality Assurance Group, which now also incorporates public health as part of the transition of public health to local authority and other organisations. Khushbu has also led the redesign of the childhood immunisations and questioned the processes of this traditional intervention in the new and complex public health system (Vaccines in Practice, Feb 2012 edition).
As a NICE Scholar, Khushbu will bring together all the elements of NICE public health guidance related to prevention of diabetes and present evidence of local savings and benefits as well as the impact on other non-communicable diseases in Bexley. An important element of this work will focus on how organisations at Clinical Commissioning Group (CCG) level prioritise funds allocated to diabetes, and the proportion that should be allocated to prevention. Khushbu is engaging with the local diabetes network group to ensure endorsement of the project to reflect real local change. The result will be a 10-year prevention strategy between the Local Authority and the NHS to ensure alignment of resources to public health interventions for diabetes prevention in a borough significantly under-resourced for public health.
NIHR Academic Clinical Fellow in Paediatrics
Imperial College London/London Deanery
Dr Logan Manikam is a first year paediatric specialty trainee based at Barnet & Chase Farm Hospitals NHS Trust. He is also currently an ACF (Academic Clinical Fellow) based at Imperial College London undertaking research in paediatric allergy and respiratory medicine. His research interests in addition to these include a keen interest in public health, provision and delivery of effective interventions via evidence synthesis and supporting innovation in medical education.
He works in collaboration with Professor Monica Lakhanpaul (Institute of Child Health, UCL), an existing NICE Fellow, on numerous projects including the multifaceted multidisciplinary HSR NIHR funded Management and Interventions in Asthma study (MIA) in South Asians and the Department of Health-commissioned Spotting the Sick Child educational tool. He has published in peer-reviewed journals including commissioned publications and has presented both nationally and internationally.
As a NICE Scholar, Dr Manikam will conduct a national survey of junior doctors aimed to quantify the knowledge of junior doctors on NICE clinical practice guidelines (CPGs) and seek an understanding of their attitudes and the influence of their work environment and teaching on NICE CPGs. This will provide some insight into the attitudinal barriers and facilitators to implementing evidence-based practice (EBP) and following of NICE CPGs amongst junior doctors. Additionally, this will further guide NICE's effort in improving EBP teaching amongst junior doctors and development of its undergraduate educational tools in line with NICE's education strategy.
Lisa Peto is a Public Health Specialty Registrar based in the Oxford Deanery. She is currently working at Solutions for Public Health on an evidence review on osteoporosis screening for the National Screening Committee and a needs assessment and service specification for forensic children and adolescent mental health services for the Department of Health. She has also had placements at West Berkshire PCT, Bristol PCT and the Avon Health Protection Unit. Prior to joining the Public Health Training Scheme, she worked as a Research Reviewer and Analyst at the West Midlands Health Technology Assessment Collaboration Centre.
As a NICE scholar, Lisa will be conducting an audit on the implementation of the NICE guidance on promoting physical activity for children and young people across Oxfordshire. Oxfordshire is considered to have low levels of physical activity in children and young people and it is hoped the audit will help to determine reasons for this, as well as determining whether any gaps and variations in practice and provision of promoting physical activity exist, particularly between affluent and deprived areas in Oxfordshire. The project will also investigate any barriers local authorities and schools face in implementing NICE guidance.
Profile to follow.
Division of Orthopaedic & Accident Surgery, University of Nottingham & Nottingham University Hospitals NHS Trust
Jeremy's interest in research stems from his first three degrees, all from the University of Edinburgh. His intercalated BSc(Hons) in Experimental Pathology was supported by a competitive Wolfson Intercalated Award, and he achieved first class honours. He was awarded his MBChB with honours, having passed each year with distinction. Amongst other undergraduate academic prizes, Jeremy secured Cancer Research UK funding for his elective at The Royal Melbourne Hospital. During Core Training in Plastic Surgery in the East Midlands (North) deanery, he completed the 'ESSQ' MSc in Surgical Sciences, which was awarded with distinction. He is now part of the teaching faculty for the University of Edinburgh/RCSEd ESSQ programme. While in the second year of his Core Training, Jeremy successfully obtained an ST3 National Training Number in Plastic Surgery in the Yorkshire & the Humber deanery. He is now out of programme (OOPR) to pursue this current project for a DM degree. In addition to a variety of publications and over 60 national and international presentations to date, he co-edits 'Core Surgery Journal'. He was part of the team of six surgical core trainees who devised and launched this journal, which aims to provide young surgeons with practical, real-world knowledge.
Jeremy's project investigates the long-term outcomes after different types of surgical intervention for Dupuytren's disease. It is hoped that the data from this multi-centre study will be of use in planning future RCTs. The project is supervised by Professor Tim Davis and Professor Brigitte Scammell, and has been kindly funded by the British Society for Surgery of the Hand.
Lecturer in Sociology
University of Sussex
Catherine teaches and researches on topics including health policy and practice, the growth of preventive medicine and methodology in both the medical and social sciences. She is interested in interdisciplinary work based on her own experience in a number of different social sciences and in the ways that other sciences produce knowledge and evidence. She joined the University of Sussex in 2007 and now teaches both sociologists and medical students on a range of courses. She is currently co-convenor of the British Sociological Association's Medical Sociology Group, which has been central to the development of this field since its foundation in the 1960s.
Catherine plans to spend her time as a NICE scholar looking at different sites where ordinary people's preferences and values are brought into the work of NICE. These might be included in discussions of ‘acceptability' in production of guidance of different kinds, and she is interested to understand what kinds of evidence are used to explore this issue. Analysis of the practice of guidance production will be used to map possible opportunities for the Institute to make greater use of evidence from the social sciences, and to stimulate debate among social scientists about such opportunities. In the same vein, she intends to relate NICE's own broader discussion of ‘social value judgements' to emerging work on the ethics and politics of public health.
2011-12 NICE Scholars
Positions are those held on appointment as a NICE scholar
Clinical Quality, Risk and Patient Safety Manager
Nottingham University Hospitals NHS Trust
Owen Bennett is a Clinical Quality, Risk and Patient Safety Manager at Nottingham University Hospitals NHS Trust. His background is in Nursing, having worked in various roles including coronary care nursing, as a Clinical Nurse Specialist in pain management, Clinical Governance Nurse, Practice Development Matron and Operational Matron. He commenced his current post in February 2009 leading on the trusts Clinical Effectiveness agenda and is also involved in a number of projects aimed improving patient safety. He is a member of the Royal College of Nursing.
Owen will spend his time as a NICE Scholar focusing on developing a mechanism in the trust to monitor NICE Inverventional Procedure activity (IPG) through integrating Clinical Coding and information systems including the Operating Room Information Management System (ORMIS). This is with a view to enabling the organisation and potenitally other trusts to analyse the number of interventional procedures undertaken, whether clinician(s) have been credentialed to under take the procedure and what the outcomes are for patients, post procedure. Coding of NICE interventional procedures will enable the development of appropriate costing (tariff) of NICE interventional procedures. It is his aim to publish the work as a result of this project.
Clinical Lecturer, Clinical Pharmacology and General Medicine
University of Nottingham and Nottingham University Hospitals NHS Trust
Mark Glover trained in pre-clinical pharmacology and clinical medicine at Gonville and Caius College, Cambridge. After clinical posts in Cambridge, Bedford and Nottingham he undertook a PhD in Clinical Pharmacology in Cambridge addressing the molecular mechanisms which regulate sodium trafficking in the distal nephron and which contribute to hypertension pathogenesis. His current research is focussed on the genetic basis of thiazide-induced hyponatraemia with clinical interests in hypertension, medical education and general (internal) medicine. He is a member of the MRCP (UK) Therapeutics group, is actively involved with therapeutics teaching, contributes to therapeutics textbooks and is an associate member of the Higher Education Academy. He has won young investigator prizes from the British Hypertension Society and has presented at meetings in Europe, North America and Australia.
Good clinical care and the safe use of medicines in practice is undermined by medication error. PSG001 (Technical patient safety solutions for medicines reconciliation on admission of adults to hospital) issued by NICE and the NPSA reflects the wealth of evidence suggesting that medication error frequently occurs at the time of admission of patients to hospital and is in many cases related to the quality of communication between primary and secondary care. Mark's NICE Scholarship, supervised by Dr Anette Freyer (Consultant in Acute Medicine and Clinical Pharmacology), will evaluate the impact of an initiative supported by the East Midlands Strategic Health Authority, Local Primary Care Trusts and Nottingham University Hospital's NHS Trust aimed at improving communication between the community and hospital. Specifically, a computer generated referral proforma, compatible with the principal systems in general practise promotes provision of a minimum dataset of information to accompany acute referrals of adult medical patients to hospital. The impact of the referral initiative and minimum dataset on the need for medicines reconciliation, medication error and health economies to the NHS will be assessed.
Specialist Registrar / Clinical Research Fellow
Leeds Teaching Hospitals NHS Trust / University of Leeds
Peter qualified in Medicine at the University of Edinburgh in 2003. After general clinical training he was appointed as Specialist Registrar in Medical Oncology in 2006 on the Yorkshire rotation, based at St James Institute of Oncology in Leeds. In 2008 he was awarded a Clinical Research Fellowship with the University of Leeds Clinical Trials Research Unit and also joined the Academic Unit of Health Economics at the University of Leeds as Associate Research Fellow.
His research interest is in the design and analysis of clinical trials which aim to inform pragmatic evidence based decision making for patients in the NHS, with a focus on cancer treatments. His research includes the use of Bayesian decision modelling early in drug development to inform later phase clinical trial designs. He is interested in all aspects of cancer treatment but his clinical trials research focuses on drug treatments for early breast cancer and the optimal management of frail or elderly patients with advanced gastric and oesophageal cancer.
Clinical research for new cancer drugs is predominantly designed to inform the decision to grant a drug license. Peter's work with NICE aims to identify and define the specific evidence requirements of reimbursement decision makers such as NICE. The objective is to make recommendations to clinical researchers on the design of research into new cancer drugs, maximising its ability to inform reimbursement decisions, not just licensing decisions, and measure their true value to patients and the NHS.
Specialist Registrar, Clinical Radiology
The Royal Liverpool University Hospitals NHS Trust
Amrita is a Specialist Registrar in Clinical Radiology at the Royal Liverpool University Hospitals NHS Trust. She completed her MBBS from Guy's, King's & St Thomas' Medical School and Intercalated BSc Management from Imperial College London. She then went on to complete her Basic Surgical Training and obtain her MSc in Surgical Technology from Imperial College London. She obtained her FRCR during her Clinical Radiology Training Programme in Mersey. She has always had a keen interest in research and was awarded the Royal College of Radiologists Kodak Radiology Fund Scholarship in 2008 and British Society of Interventional Radiology Research Grant Award in 2010. She went on to be appointed as the Membership and Events Co-ordinator of the National Trainee Committee at the British Institute of Radiology and is currently working as one of the authors on the first BIR publication on Single Best Answers FRCR Part 2A Book.
As a NICE scholar, Amrita will carry out a transfer of training validation study of a virtual reality simulator for training in the nephrostomy procedure. Imaging-guided needle puncture procedures are routinely performed by radiologists, using hand-eye coordination to direct needles, wires and catheters to perform liver biopsy, nephrostomy and abscess drainages. Currently the visuo-spatial and manipulation skills required are learnt in a traditional apprenticeship model; however Working Time Directives limit in-hospital work hours of trainees, reducing the time and case mix available to train. Some animal and fixed models can reproduce some of the training objectives, though they are an imperfect substitute for the ‘real patient' experience. Application of a nephrostomy simulation to training requires evidence of efficacy. Validation studies provide evidence to support the use of simulator training and assessment of percutaneous needle puncture skills, potentially shortening the early learning curve, removing basic skills training from patients and improving patient safety and efficiency in the NHS.
Where are they now?
Amrita is undertaking a breast fellowship at Northwick Park Hospital as part of her final radiology training year at University College Hospital London. She has progressed to become a founding member of the Faculty of Medical Leadership and Management as well as winning a place on the prestigious NHS London mentoring scheme - Prepare to Lead 2012-13.
As part of her NICE research, Amrita is currently working in collaboration with Springer Science and Radiologists in the UK and USA to write the first comprehensive Textbook of Healthcare Simulation.
Clinical Lecturer in Public Health Medicine and Specialty Registrar in Public Health
University of Liverpool/Liverpool Primary Care Trust
May Moonan is a Clinical Lecturer in the Department of Public Health and Policy at the University of Liverpool, where she is pursuing a doctorate and training to be a consultant in Public Health Medicine. After completing a medical degree at Imperial College, May undertook a senior house officer rotation and obtained her MRCP. It was whilst working in London hospitals that she began to fully appreciate the impact of social factors (determinants) on patients' health, and develop an interest public health. Deciding to make this her career, she took up a Specialty Registrar post in Public Health in 2007 in the Mersey Deanery. May enjoys teaching and mentoring medical students, and promoting the development of healthcare professionals as Chair of the Mersey Medical Leadership School. Her research experience to date includes an exploration of how decision-makers use evidence in making policy decisions, and involvement in a WHO Collaborating Centre study tracking the impact of universal policies on the social determinants of health and health inequities.
May will spend her time as a NICE scholar evaluating the effectiveness of two different approaches to the implementation of a national preventive programme; universal (everyone receives the intervention) or targeted (only high risk people receive the intervention). The Healthy Start Programme in the North West of England will provide the backdrop to the study. May plans to explore barriers to the use and implementation of the relevant NICE guidance that underpins and promotes the use of Healthy Start vitamins in pregnant women and pre-school children. The aim of this work is to find innovative ways of overcoming these barriers and increase the use of NICE guidance. May will be working with commissioners, health care professionals, representatives from local authorities and members of the public. The findings from this project should be of value to other regions of England and have relevance in other areas of public health policy implementation.
Specialist Registrar in Clinical Radiology
Plymouth NHS Trust
Dr. Patrick Rogers is a specialist registrar in Clinical Radiology on the Peninsula training scheme (South west), where he started in 2009. He graduated from Bristol University and completed the academic foundation programme in Bristol in 2009. He currently works in Exeter and is completing his Fellowship in the Royal College of Radiology.
Patrick will spend his time as a NICE scholar looking at patient's perception of the risk from radiation in medical imaging. Diagnostic imaging is being used with increasingly frequency within healthcare, and yet it is not without risks. The dose from a representative CT scan of the chest, abdomen and pelvis is about 10 millisieverts (mSv) for UK adults giving an average risk of fatal cancer of 1 in 2000 (Health Protection Agency). A recent American study stated that for a female, aged 20, 1/250 would get cancer from a multi-phase CT of the abdomen pelvis. The project intends to find out how the public could become involved in managing these risks. For instance, the question has recently been raised as to whether patients should give consent for CT examinations. Patrick intends to survey the public to help determine the merits of this approach, amongst other options.
Speciality Registrar, Public Health, Oxford Deanery
Thames Valley Health Protection Unit
Mohit Sharma is a third year Specialty Registrar in Public Health in the Oxford Deanery. After completing surgical training with MS (University of Mumbai) and MRCS (Glasgow) and a wide clinical surgical experience, he won a place on the Public Health Training Programme. Projects in Public Health have involved facilitating engagement between commissioners (Primary Care Trusts) and NICE through the Commissioning Support, Appraisals Service. He has also worked with the Priorities Support Unit to support local and regional priority setting in South Central England.
As a NICE scholar, Mohit will work with NICE and commissioners to promote engagement of commissioners in the formulation of NICE guidance. This will involve the consideration of current arrangements to identify what works well and to build upon this experience to ensure engagement with future commissioners for the benefit of patients. He will be supported in this by Dr Don Sinclair. Mohit believes that this engagement is critical to ensuring that NICE guidance results in improvements to clinical practice for best patient outcomes and optimal resource use across the NHS.
Public Health Registrar
NHS Sustainable Development Unit
Dr James Smith is a public health registrar in the East of England. James qualified and worked as a GP prior to commencing public health training. While working in his previous placement in NHS Bedfordshire, James worked on a range of projects including most recently supporting the setting up of Health and Wellbeing Boards in Bedfordshire. James is a NHS East of England Clinical Leadership Fellow (2010-11). He is a member of the Royal College of General Practitioners and will be becoming a member of the Faculty of Public Health in 2011.
James's career aims centre on improving wellbeing through preventing disease, reducing inequalities and supporting the transition to a sustainable health system. The NHS Sustainable Development Unit, where he is currently based, provides leadership, expert support and technical guidance across the NHS and health system in relation to sustainability. James' work with NICE will be focussed on researching methodological developments that will enable broader approaches to evaluating health care.
Where are they now?
James continues to work as a public health registrar. He is currently based at the Centre for Diet and Activity (CEDAR) in Cambridge where he is working on supporting the translation of research into practice. James continues to focus on the links between sustainability and health. In addition to working at CEDAR, James coordinates a national network of public health registrars working on sustainability. He also sits on the advisory group for the sustainable COPD care project run by the Centre for Sustainable Healthcare.
Clinical Lecturer, Translational Medicine
Cambridge University Hospitals NHS Foundation Trust
Laurie Tomlinson is a clinical lecturer and specialist registrar in nephrology working at Addenbrooke's Hospital. Her academic work relates to the overlap between chronic kidney disease, blood pressure and cardiovascular disease on a clinical research and translational level. She has previously completed a PhD, published papers and leads several ongoing research studies in this area. In addition, she has a keen interest in how research evidence is translated into health policy.
This has led to development of the project that she will undertake as a NICE Scholar, investigating the relationship between rates of prescription of angiotensin-converting enzyme (ACE) inhibitors and hospital admissions with acute kidney injury, at both a local and national level. Although the evidence from clinical trials supports widespread use of ACE Inhibitors to slow progression of renal disease, recent research suggests that the benefits on a population level may be unclear. This project aims to investigate how routinely collected data can be used to provide feedback on the outcomes of guideline implementation, an idea that may have implications well beyond nephrology. The project is kindly supported by the Renal Association and supervised by Martin Roland, Professor of Health Services Research and Ian Wilkinson, Reader in Clinical Pharmacology at the University of Cambridge.
Where are they now?
I am still a Clinical Lecturer in Translational Medicine at Addenbrooke's Hospital but have been so inspired by my NICE scholarship that I have also been working on related epidemiological projects at the London School of Hygiene and Tropical Medicine. The results of the project I have worked on through the scholarship are extremely interesting and I am currently writing these up for publication and will be presenting them at the Renal Association in June 2012. The results will form the basis of funding applications later this year to develop my work looking at how the results of clinical trials relate to real-life patients and what this means for the risk: benefit ratio of drugs on a population level, particularly with regard to kidney disease.
Public Health Information Analyst
NHS South West Essex
Elozona Uzoegwu Umeh is an Epidemiologist and works as a Public Health Analyst with NHS South West Essex. She has worked in a variety of settings both abroad (HIV Incidence study in preparation for a clinical trial in West Africa with the International Partnership on Microbicide), Infection control where I reviewed the surveillance system for alert organism notification within Community services, cancer mortality review which feed into an Essex wide campaign for lung cancer and other cancers for GPs, and other healthcare professionals. She is currently working on an asthma needs assessment in South West Essex as well as participating in other different projects within the PCT.
She will spend her time as a NICE scholar to audit the implementation and impact of the NICE obesity guidance also looking into the new outcomes framework for obesity and weight management programs alongside what services the PCT plan to devolve to the new commission consortia and local authorities.
2010-11 NICE Scholars
Positions are those held on appointment as a NICE scholar
Core Surgical Trainee
Queen Victoria Hospital NHS Foundation Trust
Riaz Agha is Founder, Managing and Executive Editor of the International Journal of Surgery, Council Member for the Committee on Publication Ethics (COPE) and the Section of Plastic Surgery at the Royal Society of Medicine. He sits on the board of the Elsevier Editorial System Advisory Board, the Map of Medicine Fellows Board and the Association of Surgeons in Training. He sits on the Web Committee for the World Association of Medical Editors. He has a 1st class honours degree in Anatomy and has won over 25 academic prizes and published over 30 papers.
Riaz's NICE Scholarship research work "Towards National Surgical Surveillance" looked at an interdisciplinary area of research encompassing public health, public policy and surgery. He gathered data from Acute NHS Trusts on six standardised metrics for surgical surveillance recommended by the WHO. This data was analysed together with HSMR and NPSA incident reports. The research enabled quantification of disease burden, tracking of mortality rates and benchmarking of outcomes, allowing analysis of the effects of new interventions, acting as an early warning system for poor outcomes, guiding health system programming, policy and assessment.
Where are they now?
Dr Agha will be an Specialty Registrar (ST5) in Plastic Surgery in the London Deanery from April 2015.
Dr Agha launched the International Journal of Surgery: Case Reports, Elsevier's first open access journal, which is indexed in PubMed Central. In 2012, he launched Annals of Medicine and Surgery, a journal dedicated to trainee physicians and surgeons. Dr Agha has presented his scholarship work at the ASiT, ASGBI and HTAI conferences and his research has been accepted for publication.
Specialist Registrar, Clinical Radiology
Southampton University Hospitals NHS Trust
After graduating from Oxford University, he completed his basic surgical training and MRCS examinations whilst on the St Mary's Hospital (Imperial College) Basic Surgical Training Programme and the FRCR whilst on the Clinical Radiology Training Programme at Wessex. In 2009, he was awarded the Specialist Registrar Scholarship by the British Society of Interventional Radiology and was appointed as Chair of the National Trainee Committee at the British Institute of Radiology. He has authored several medical books, including the undergraduate textbook Radiology at a Glance (Wiley-Blackwell), released internationally in 2010.
As a NICE Scholar, Rajat looked at the relation between warfarin use and the incidence of bleeding complications with NICE guidelines for Transrectal Ultrasound-guided (TRUS) biopsy of the prostate. An audit project conducted in 2003-2004 at Southampton General Hospital found there was no significant increase in risk in bleeding complications with warfarin use when undergoing six TRUS core biopsies of the prostate. In 2008, new NICE guidelines recommended that ten TRUS core biopsies of the prostate should be performed following recommendations by the Prostate Cancer Risk Management Programme.
As a Scholar, Rajat conducted a re-audit project at Southampton General Hospital to evaluate whether the increased number of TRUS core biopsies of the prostate continued to pose no increase in risk in bleeding complications with warfarin use.
Where are they now?
Rajat is undertaking a fellowship in musculoskeletal radiology at Chelsea and Westminster Hospital in 2012. Following completion of his NICE project, he has written a scientific paper which has been accepted for publication in Clinical Radiology. Rajat won an international research scholarship to present at the Radiological Society of North America's Annual Meeting in 2011 and has been appointed as National Representative for Leadership and Management at the Academy of Medical Royal Colleges' Trainee Doctors Group.
Anaesthesia and Intensive Care Medicine
Sheffield Teaching Hospitals NHS Trust
Alastair Glossop is a specialist registrar in Anaesthesia and Intensive Care Medicine, having graduated from Nottingham University in 1999 and undertaken postgraduate training in both General medicine and Anaesthesia. He currently works within Sheffield Teaching Hospitals NHS Foundation Trust. His main areas of clinical interest are noninvasive ventilation, weaning, tracheostomy care, governance and risk management.
As a NICE scholar, he will evaluate the role of noninvasive ventilation (NIV) following extubation of critically ill patients and also patients who have undergone major surgery. It is known that prolonged invasive ventilation - either in the intensive care unit or operating theatre - carries a significant risk to patients and may be associated with increased morbidity and mortality. It has been proposed that using NIV following extubation may reduce the need for reintubation and thus improve patient outcomes. Although this has been studied in several different clinical situations there is no clear consensus on which patient groups benefit from the use of NIV following extubation, and if there is any impact on patient outcomes or financial end points. With the support of NICE, Alastair will conduct a systematic review of the use of NIV following extubation and appraise the trials and evidence already available to assess the impact of using NIV on patient morbidity and mortality and also any financial implications of avoiding prolonged spells in critical care units. It is his aim to produce a formal review paper containing guidelines for using NIV following extubation that could be applied widely across NHS organisations - to reduce the amount of time patients spend on invasive ventilation, reduce their risk of ventilator associated complications, and potentially reduce the financial burden to the NHS that is associated with prolonged critical care therapy.
Where are they now?
Following the completion of his scholarship, Alastair was appointed as a consultant in Anaesthesia and Intensive Care medicine at Sheffield Teaching Hospitals. He has published several papers concerning the use of NIV, and the results of his NICE scholarship project (which examined the use of NIV post extubation) were presented at the European Society of Intensive Care Medicine. He is currently part of a joint British Thoracic Society / Intensive Care Society group that are developing guidelines for the management of type II respiratory failure, and has been chosen as a reviewer for the National Review of Asthma Deaths board for 2012.
Academic Clinical Fellow in Radiology
Sheffield Vascular Institute
Following the completion of the MRCS surgical exams, Stephen Goode completed a 3 year PhD in Vascular Surgery and was accepted onto the North Trent Radiology Training scheme working inthe Sheffield Vascular Institute, Northern General Hospital in Sheffield. Stephen's Scholarship project was based around carotid artery stenting (CAS), an interventional radiology technique that was introduced as an alternative to carotid endarterectomy (CEA) for the treatment of carotid stenoses. NICE Interventional procedures guidelines 191 recommend that all CAS cases undertaken in the UK should be entered onto the UK National Carotid Stenting Registry, a database held by the British Society of Interventional Radiologists.
Stephen's work as a NICE Scholar was based around analysis of this national registry with the intent of publishing outcomes and analysis relevant to the NHS, through peer-reviewed publications and a formal registry report for the BSIR. The project was directly relevant to any future review of this procedure by NICE and was directly relevant to policy making guidance on the future of CAS.
Specialist Registrar, Public Health
NHS North Lancashire and NHS North West
Sakthidharan has worked in a variety of settings including the Primary Care Trust (PCT), Health Protection Agency and the Strategic Health Authority. He led and contributed to a wide range of strategic and operational healthcare initiatives including being the improvement advisor to a safety node collaborative to reduce hospital related venous thromboembolism in the North West, leading a cancer awareness survey, developing a region-wide plan to implement the national stroke strategy, instituting a public health strategy for an acute hospitals trust, initiating a childhood accidents prevention scheme in partnership with a unitary authority, pioneering the programme budgeting approach to influence the commissioning of mental health services and devising a prioritisation framework to aid investments in his PCT.
As a NICE Scholar, he was based in NHS North West and worked closely with the members of the North West stroke alliance and the three stroke networks in the region, to develop a system that enables benchmarking and improvement of stroke services in delivering the NICE quality standards for stroke. A core activity of this project was promoting awareness of the NICE quality standards to frontline staff.
University of Warwick/University Hospital of Coventry and Warwickshire NHS Trust
When appointed, Rebecca Kearney was working within the Warwick Orthopaedic research group, part of Warwick Medical School, a collaboration between the academic and clinical department at The University Hospitals of Coventry and Warwickshire NHS Trust. Within this role, Rebecca worked as a member of a research team to answer questions on the clinical effectiveness of orthopaedic surgery. She completed an MSc in trauma and orthopaedic surgery and gained an Arthritis Research Campaign AHP fellowship, to complete a part-time PhD in the area of Achilles tendon rupture rehabilitation.
Rebecca's project was developed in response to 2009 NICE guidance on the use of autologous blood injection for tendinopathy. NICE concluded that evidence on the safety and efficacy of autologous blood injection for tendinopathy was inadequate in quantity and quality. Working within a specialised NHS clinic for tendon pathologies, combined with the academic expertise of the Warwick orthopaedics research group, Rebecca responded to these NICE recommendations by carrying out a pilot randomised controlled trial to answer the question ‘is there a difference in patient reported functional outcome scores (VISA-A scores) and complications at six months between patients managed with autologous blood injection and patients managed with an eccentric loading programme?' This work was also supported by the Chartered Society of Physiotherapy.
Where are they now?
As a NICE Scholar, Rebecca Kearney engaged with the guideline development groups, interventional procedures and technology appraisal committees. Rebecca's project has since been published on the NICE shared learning database and presented at a national physiotherapy conference. It is currently being submitted to funders for consideration of a full trial in this important area. These professional development activities also contributed to the successful completion of Rebecca's PhD on Achilles tendon rupture rehabilitation.
Speciality Registrar, Public Health
On appointment Mark Lim was a third-year Specialty Registrar in Public Health in the East of England Deanery, having previously completed the South Thames Paediatric Senior House Officer rotation and gained Membership of the Royal College of Paediatrics and Child Health.
As a NICE Scholar, Mark examined the impact of NICE guidance on programme budgets. In particular, he investigated whether there have been any desired programmes or interventions that have been ‘displaced' by NICE Guidance. Answering such a question required very careful costing and a comprehensive list of desired and existing services. Mark approached the question within the context of the Mental Health Programme Budget within NHS Bedfordshire. The Cambridge Collaboration for Leadership in Applied Health Research and Care (CLAHRC), which focuses on Mental Health, also kindly supported this work.
Kuan Huei Ng (Kelvin)
Specialist Registrar, Clinical Pharmacology and Therapeutics
University Hospitals of Leicester NHS Trust
Kelvin Ng graduated from Guy's, King's and St Thomas' Hospitals School of Medicine in 2002. Having completed his core medical training in London and Leicester, he was appointed as a Specialist Registrar in Clinical Pharmacology and Therapeutics at the University Hospitals of Leicester NHS Trust in 2007. Apart from his clinical duties as a physician with an interest in cardiovascular and general internal medicine, he is actively involved in clinical research and medical education. He has published in peer-reviewed medical journals on predictive cardiac biomarkers and writes for medical textbooks. He has an interest in health economics and the cost-effective utilisation of healthcare resources.
Kelvin's project for the NICE Scholarship entailed examining the impact of the clinical guidance on the Assessment of Chest Pain of Recent Onset. He focused predominantly on the impact of the guidance on Rapid Access Chest Pain Clinics and the expanding role of non-invasive CT-based cardiac imaging. He assisted in the implementation of the guidance locally in Leicester and facilitated the design of a prospective database to assess the performance of different cardiac investigative strategies on meaningful quality outcome measures.
Where are they now?
Dr Ng is currently a Stroke Neurology Fellow based at the Population Health Research Institute at McMaster University in Ontario, Canada. His research interests include the use of novel selective anticoagulants for the prevention of ischaemic strokes in atrial fibrillation.
Research and Development Manager
Northern School of Child and Adolescent Psychotherapy/Leeds Partnerships Foundation Trust
Tom is a Speech and Language Therapist by training with a particular practical interest in working with individuals with mental health and learning difficulties across the lifespan. Following completion of a PhD at the University of Sheffield which examined social interaction in children on the autism spectrum, Tom worked in academic settings before joining NSCAP/Leeds PFT in August 2009. His remit at NSCAP is to develop a research capacity within the organisation, and accordingly he is involved in a number of research projects related to the development and evaluation of appropriate, accessible and effective multi-agency mental health services for the most complex of children, young people and families.
In Tom's Scholarship project, he examined the implementation within Child and Adolescent Mental Health Services (CAMHS) of NICE's clinical guidance for managing moderate/severe depression in adolescents. Tom worked closely with practitioners and service users across three regional CAMHS to map care pathways for adolescents with profiles of more intractable or complex mental health needs that include depression as a component. He then conducted detailed semi-structured interviews with practitioners and service users in these services to examine three related issues: firstly, how and why care pathways varied between these specific services; secondly, any apparent practical or organisational barriers to the implementation of NICE's guidance in these services; and thirdly, the involvement of individual service users within these services in decision-making about their own care.
Academic Clinical Fellow in Paediatric Emergency Medicine
Leicester Royal Infirmary
On appointment Damian Roland was a fifth-year paediatric specialist registrar based at the Leicester Royal Infirmary, undertaking subspecialty training in Paediatric Emergency Medicine. Damian was also an ACF (Academic Clinical Fellow) with protected academic time to design a thesis proposal. Damian's research interests are based around developing clinical and education strategies to assist illness recognition in children. He is also an active trainee representative and Chair of the Royal College of Paediatrics and Child Health Trainees' Committee.
The NICE Feverish Illness in Children guideline contains a visually appealing traffic light system of key signs and symptoms to guide appropriate management. It also provides clear guidelines on providing effective "safety net" advice for those children felt to be appropriate to discharge. An audit of his department showed variation in the quality of junior doctor's record keeping in respect of managing risk in a child with fever. It was also noted that the documented rate of providing safety net advice fell from 70.9% to 55.9% between doctors in July and August respectively, despite a thorough induction programme for all new starting doctors in August. The objective of Damian's study was to improve the documentation and provision of safety net advice by doctors assessing children with a fever who are new to an emergency department. The work aimed to improve local performance and also to produce a manual for other departments to use to improve their induction programmes.
Where are they now?
Dr Roland presented the findings of his scholarship at the 2011 NICE conference having been nominated for a shared learning award. His work demonstrated that a bespoke but brief induction package significantly increased safety net advice given to parents by junior doctors. As part of his PhD, this work is being taken forward to examine metrics of performance that can be used to identify junior doctors who may be demonstrating risk taking or risk adverse behaviour in their management of patients. In conjunction with this, a specific e-learning intervention for the NICE feverish Guideline has been designed and will be utilised in a multi centre trial starting in August 2012. Dr. Roland continues to work with NICE on improving awareness of NHS clinical evidence in medical students and also on developing mobile technologies to improve access to key clinical guidelines. He has been appointed to the GDG for the feverish illness guideline update.