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INNOVATION UK59 Improving the health and wealth of the nation through research Every patient deserves access to the best possible evidence- based health and social care. The National Institute for Health Research ( NIHR) was set up in 2006 to build the world- class health research system needed to deliver high- quality research and innovation across the NHS. The NIHR's 12 Biomedical Research Centres ( BRCs) are successfully turning laboratory- based discoveries into cutting- edge new treatments, diagnostic tools and other innovations. These include the world's first successful gene therapy for a rare, inherited form of blindness, developed by a team from the BRC at the University College London ( UCL) Institute of Ophthalmology and Moorfields Eye Hospital. The NIHR BRCs are at the heart of all five Academic Health Science Centres ( AHSCs) announced in March 2009. These are partnerships between leading research-ers and frontline NHS staff to improve the transfer of pioneering new treatments into practice. " We are committed to establishing the NHS as an internationally recognised centre of research excel-lence - supporting outstanding individuals, working in world- class facilities, conducting leading- edge research focused on the needs of patients and the public." Professor Dame Sally C. Davies, Director General of Research and Development, Department of Health Revolutionising the treatment of type 1 diabetes Mathematician Dr Roman Hovorka, Principal Research Associate at the Cambridge Comprehensive BRC, is responsible for programming the sophisti-cated mathematical calculations needed to make an artificial pancreas work exactly like a real pancreas. He says: " Being part of a pool of experts at the BRC in Cam-bridge has enabled us to develop a prototype of an artificial pancreas to help people with type 1 diabetes, where the pancreas does not produce insulin needed by the body to control blood sugar. " If successful, this could reduce the need for repeated finger- prick blood tests and insulin injections, help-ing patients to avoid hypoglycaemia ( episodes of low blood sugar), as well as saving NHS costs. " The ' pancreas' consists of a subcutaneous sensor, which detects glucose levels continuously, feeding the results into a computer program that works out how much insulin is needed and delivers it via a small insulin pump. " So far, overnight clinic tests on over 30 children, adults and pregnant women with type 1 diabetes show that the system can control blood glucose bet-ter than standard treatment. We are now working on a home system, which we plan to evaluate in a small pilot." Healthcare national institute for health research

60INNOVATION UKINNOVATION From robots to telecare, 21st century healthcare is using increasingly high- tech solutions. Launched in July 2008, the NIHR's Invention for Innovation ( i4i) programme is speeding up the rate at which bright ideas for new high-tech products are turned into methods of prevention, diagnosis and treatment. The NIHR works with representatives from academia, the Association of British Healthcare Industries, small to medium- sized enterprises ( SMEs) and other stakeholders to develop this area of its work. Robots for chemotherapy David Leonard, Executive Lead Pharmacist, Aseptics and Clinical Trials, Imperial College Healthcare NHS Trust, says: " The support of the NIHR Patient Safety and Service Quality ( PSSQ) Research Centre allowed us to embark on an 18- month project to test a brand new robot for making up individual doses of chemotherapy. We were able to evaluate the system using research expertise based in the centre to support staff. The PSSQ Research Centre also helped us to increase the profile of the project and gave us the opportunity to carry out more tests than we would otherwise have been able to. " The robot allows us to make up individual patients' chemotherapy more efficiently, which cuts down wait-ing time for treatment - currently a great source of anxiety. It also reduces the risks of needle stick and repetitive strain injuries." As well as a programme encouraging Future Product Development, the NIHR has set up two pilot Healthcare Technology Cooperatives ( HTCs) in partnership with the Technology Strategy Board ( TSB), Engineering and Physi-cal Sciences Research Council ( EPSRC) and the Medical Research Council ( MRC). This brings together NHS staff, academics, the medical technology industry and others to concentrate on solving unmet clinical needs in these areas. IDENTIFYING PREDICTIVE BIOMARKERS " A key factor in the successful introduction of new drugs for treating cancer will be the identification of robust predictive biomarkers. These will indicate which patients are most likely to derive benefit from novel targeted agents. The NIHR funding for our Experimental Cancer Medicine Centre is already con-tributing significantly in this context. We have now set up a system of analysing tumour tissue from all the patients ( over 500 per year) referred to us for experimental phase 1 trials. Using Sequenom Mass Array technology, we are obtaining important data on genetic alterations in tumour cells, which are begin-ning to guide our choice of experimental therapy. Examples which are under very active study include the PARP ( poly ( ADP- ribose) polymerase) protein inhibitors, a powerful new type of anti- cancer drug. These have attracted considerable attention because of high levels of activity and low levels of toxicity in defined cancer populations." Professor Stan Kaye is an NIHR Senior Investigator, Professor of Medical Oncology at Cancer Research UK; Head, Section of Medicine, Institute of Cancer Research; and Head of the Drug Development Unit at the Royal Marsden Hospital. Healthcare national institute for health research