The work of the HSC R&D Division is based on the principle that the best health and social care must be underpinned by knowledge, based on well conducted research, which can be used to support policy and practice and can be applied in the delivery of care.
Our funding has enabled researchers in Northern Ireland to gather the evidence they require to better support patients and the public. Below are some examples of the impact of research we have funded.
A new approach to weaning critically ill patients from mechanical ventilation across the UK
Critically ill patients having long periods of mechanical ventilation are at higher risk of morbidity. The research by Blackwood, McAuley and Clarke identified ways to optimise inter-disciplinary collaboration in weaning infants and children from mechanical ventilation and, by July 2020, nearly two-thirds (18/28) of UK paediatric intensive care units had adopted the protocolised weaning intervention that was designed based on this research. Without this research and the implementation activities, the approach to ventilator weaning practice in the UK would not be as collaborative or evidence based as it is currently.
Improving healthcare for children with cerebral palsy via surveillance
Surveillance of children with cerebral palsy (CP) and associated research undertaken by the Northern Ireland Cerebral Palsy Register (NICPR), held at Queen’s University Belfast, has:
- Enabled development of new services, providing specialist care and targeted rehabilitation to all children with CP in Northern Ireland (NI);
- Developed cost-effective tools to describe CP that have been adopted across NI and internationally, improving communication between healthcare professionals and families and reducing clinical assessment burden; and
- Informed UK and international standards of care, for example, NICE guidelines and a UK National Confidential Enquiry into Patient Outcome and Death (NCEPOD).
Improving treatment and quality of life for patients with Prostate Cancer through clinical research
Prostate cancer is now the most commonly diagnosed malignancy in the UK; 40,000 new cases and nearly 12,000 deaths estimated per year. Research at QUB has led and contributed to the following significant impacts:
- Contribution to the registration trial for the first FDA-approved alpha particle Radium-223 (Xofigo ®); resulting in prolonged overall survival and improved quality of life for men with metastatic castration resistant prostate cancer (mCRPC). Xofigo was licensed in 2013
- Access for prostate cancer patients to advanced radiotherapies (within trials) and subsequent introduction as standard care to the Northern Ireland Health Service i.e., SPORT and CHHiP
- Influencing treatment guidelines i.e., European Society of Urology; European Society for Medical Oncology; Irish National Cancer Strategy and NICE.
Transforming supportive cancer care for patients and families in Northern Ireland
This research has transformed supportive cancer care for patients and families in Northern Ireland (NI). It was instrumental in the launch of a GBP1,300,000 project ‘Transforming cancer follow up’ for NI. The evidence led to the implementation of a new model of cancer patient follow up, termed ‘A recovery package’, which included a holistic assessment, a treatment summary record, an individualised pathway and rapid entry back into the system. This model improved experience for over 10,000 patients by improving self management and reduced anxiety, travel time to appointments, need for dual speciality appointments and reduction in surgical review waiting times. This research also led to the co-design of an online support system www.cancercaringcoping.com that was integrated into services across NI providing support to 10,000 families per year and which has been adapted to support families affected by cancer in Australia and Vietnam.
Enhancing the health care experience for patients, families and nurses using eight key performance indicators
This programme of research, led by Ulster University, impacts on the health care experience for patients, families and nurses (beneficiaries) through the implementation of eight key performance indicators (KPIs), thereby addressing a deficit in how the quality of nursing care is measured. Implementing the KPIs generates data that nursing teams can use to critically evaluate the patient experience and make improvements to person-centred practice. The reach has extended across a range of clinical specialities, spanning the United Kingdom, Europe and Australia.
Impact can be evidenced in three areas:
- Enhancement of the health care experience for patients and families
- Enhancement of the health care experience for nurses
- Influencing strategy and policy
Changing policy, culture and understanding in dementia
It is estimated that one in three people born in the UK will develop dementia. Research from Ulster University has directly changed policy and practice in dementia care, and raised public understanding of dementia, across Northern Ireland (NI).
- Change to adult safeguarding policy: Ulster research has influenced the Department of Health’s (a) reform of adult care and support, (b) policy development in adult safeguarding, and (c) health and social care digital transformation programme.
- Change to care home culture: Our research has also resulted in significant improvements in care home culture across the region through the delivery of Ulster's My Home Life Leadership Support and Quality Improvement Programme.
- Change to public understanding of dementia: Incorporating our research into a play (‘The Songbirds’) has led to increased public understanding of dementia across NI (in over 2000 audience members).
Vitamin B2 (riboflavin) as a novel, non-drug, intervention for prevention and treatment of high blood pressure in genetically at-risk adults
Underpinning research at Ulster identified a novel role for the B-vitamin, riboflavin, as a non-drug solution for high blood pressure (hypertension) in genetically at-risk adults. Since 2014, a patent filing, protected in 12 countries worldwide, resulted in significant licensing agreements with:
Impact 1: Aprofol, a Swiss life science start-up, to develop a new product for eye health.
Impact 2: DSM, the world’s leading producer of vitamins, to develop a new product - a drug-nutrient combination - to treat hypertension.
The research was also used by the European Food Safety Authority (EFSA) to:
Impact 3: establish EU dietary recommendations for riboflavin to deliver health benefits for populations.
Impact 4: substantiate health claims used by food manufacturers.
Transforming Eyecare for Children with Developmental Disability
Ulster research has transformed eyecare for children with developmental disability. The research demonstrated that previously unrecognised visual impairments were prevalent among children with disability and that evidence-based eyecare delivered to children in special education settings conveys visual and educational benefit. The research has raised clinical and therapeutic best practice worldwide, through provision of an evidence base for the assessment, diagnosis, management and communication of eye and vision problems experienced by visually vulnerable children. As a consequence, children with developmental disability have benefited from an increased recognition of their eyecare needs and more targeted eyecare from clinicians and educators. This research enabled the commissioning of a nationwide in-school NHS eyecare service to comprehensively address the visual needs of all children in special educational settings in England.
Changing Policy and Practice in Suicide Prevention
Ulster University research on suicide deaths and unique features of suicidal behaviour in Northern Ireland has significantly shaped NI’s suicide prevention strategies. These include the refreshed Protect Life Strategy and the Protect Life 2 Strategy with GBP9,000,000 annual funding and the Towards Zero Suicide (TZS) programme in mental health services. UU's research with Samaritans Ireland led to optimisation of call management systems resulting in a “significant increase” in successful call attempts. This research also led to changes in national volunteer training, service coordination, and the delivery of services during the COVID-19 pandemic.
Developing psychological services and addressing the mental health impact of the Conflict in Northern Ireland
Ulster University research has enabled government to address the mental health effects of the Troubles conflict in Northern Ireland. Responding to UU Troubles-related mental health research, a Regional Trauma Network and a Victims and Survivors Service was established, receiving over GBP100,000,000 in funding and supporting 6,000+ individuals annually. UU transgenerational trauma research led to the commissioning of a EUR6,000,000 EU project targeting emotional wellbeing to promote peacebuilding in deprived areas of NI. Professor Siobhan O’Neill’s research led to her appointment as the Interim Mental Health Champion for NI, tasked with driving forward mental health service reform.