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New Birmingham Implant Retrievals Centre set to advance patient safety through understanding of implant failure

A new research partnership led by Birmingham Health Partners members the University of Birmingham and the Royal Orthopaedic Hospital NHS Foundation Trust (ROH) will formally launch on Monday 23 March, bringing together clinicians, engineers, regulators and industry to improve understanding of joint implant performance and failure.

Concerns around implant performance – particularly metal-on-metal joint replacements – have highlighted the need for robust evidence on implant behaviour. The Birmingham Implant Retrievals Centre will focus on analysing retrieved orthopaedic implants and associated tissue samples to identify why devices fail, how implants behave inside the body, and how patient safety can be improved through earlier identification of risk.

The University of Birmingham leads the centre in collaboration with Birmingham Health Partners, with ROH as the primary clinical partner. Additional partners include the Medicines and Healthcare products Regulatory Agency (MHRA), the US Food and Drug Administration (FDA), ODEP, Beyond Compliance, and industry collaborators.

University of Birmingham researchers are applying advanced engineering expertise to the study of retrieved implants, working closely with surgeons at ROH to understand how devices perform over time in patients. ROH is one of the UK’s largest centres for revision surgery and a global leader in orthopaedic oncology, providing access to a significant volume of patient data associated with revision procedures.

By coordinating retrieval, consent, and transfer processes between ROH and the University, implants and tissue samples can be analysed quickly using a comprehensive engineering pipeline including photography, microscopy, metrology and materials characterisation. This enables detailed insight into wear, corrosion, material degradation and failure mechanisms. The linkages with clinical data and close working relationships with clinicians, regulators and industry ensure actionable insight, closing the loop on implant life-cycle and future development.

The centre aims to answer critical questions including:

  • What trends exist in implant failure including surgeries that would be otherwise low-volume numbers at other UK hospitals – for example limb salvage)?
  • Why do failures occur?
  • What does a mechanically well-functioning joint look like
  • How can earlier identification of risk improve patient safety?

A key feature of the centre is its embedded infrastructure within ROH, which enables the routine collection of explanted devices and associated clinical data without requiring clinicians to do anything beyond their usual standard of care.

Expected outcomes include enhanced patient safety through earlier detection of failure risk, improved understanding of revision arthroplasty drivers, and evidence to support better screening and testing of both new and existing implant devices. Findings will feed into early warning systems and support compliance with guidance from organisations including NICE, MHRA, FDA, and ODEP.

Professor Michael Bryant, Professor of Tribology and Corrosion Engineering at the University of Birmingham, said: “We are delighted to partner with the Royal Orthopaedic Hospital on this important initiative. Routine explant analysis, robustly linked to clinical records and National Joint Registry data, is a vital component of evidence-based life-cycle evaluation for both established and emerging orthopaedic devices. Explant analysis has long been, and continues to be, a key tool for detecting potential device-related safety signals and root cause failure mechanisms, strengthening post-market surveillance, and ultimately enhancing patient safety.”

Professor Adrian Gardner, Research and Development Director and Consultant Spinal Surgeon at the Royal Orthopaedic Hospital, said: “While joint replacement implants – and therefore patient outcomes – have improved significantly, understanding why these implants fail is critical. We’re thrilled to be partnering with the University of Birmingham to bring this research to the Midlands, supporting local researchers with this essential work that will ultimately improve patient safety through the enhanced performance of joint replacement devices.”

Dr Andrew Robert Beadling, Assistant Professor in Biomedical Engineering at the University of Birmingham said: “Preclinical assessment for joint replacements and MSK implants relies on simplified, idealised conditions to determine artificial ‘benchmarks’ of performance. Because this testing doesn’t represent real-world conditions, it provides limited actionable information and is often unrelatable to clinical outcomes. The Birmingham Implant Retrieval Centre enables the study of retrieved implants so we can better design preclinical testing according to how devices fail in the field, improving patient safety.”

This work follows longstanding recommendations to improve monitoring of implant safety and outcomes. The partnership also represents a further formalisation of research collaboration between the University of Birmingham and the Royal Orthopaedic Hospital, strengthening translational research links between engineering and clinical practice.

The Birmingham Implant Retrievals Centre partnership will be officially launched with a kick-off meeting at the Royal Orthopaedic Hospital on Monday 23 March.

National childhood type 1 diabetes screening could prevent thousands of emergency diagnoses, Birmingham study shows

A landmark UK study led by researchers at BHP founder members the University of Birmingham – which involved tens of thousands of families – has shown that childhood screening for type 1 diabetes is effective, laying the groundwork for a UK-wide childhood screening programme.

Results from the first phase of the ELSA (EarLy Surveillance for Autoimmune diabetes) study, co-funded by charities Diabetes UK and Breakthrough T1D, are published today in The Lancet. 

The findings mark a major step towards a future in which type 1 diabetes can be detected in children before symptoms appear. Currently, over a quarter of children with type 1 diabetes don’t receive a diagnosis until they are already in diabetic ketoacidosis (DKA), a potentially fatal condition that requires urgent hospital treatment. Early detection can dramatically reduce emergency diagnoses and could give children access to new immunotherapy treatments that can delay the need for insulin for years.

Launched in 2022, ELSA is the first UK study of its kind, and tested childrens’ blood samples for autoantibodies – markers of type 1 diabetes that can appear years before symptoms.  

We know that risk rises sharply with the number of autoantibodies. Children without autoantibodies are unlikely to develop type 1 diabetes, while those with one autoantibody have a 15% chance of developing the condition within 10 years. Having two or more autoantibodies indicates the immune system has already started attacking the insulin-producing cells in the pancreas and it is therefore almost certain these children will eventually need insulin therapy. This is known as early-stage type 1 diabetes.

Among the 17,283 children aged 3-13 years who were screened for type 1 diabetes risk at the time of analysis: 

  • 75 had one autoantibody, signalling increased future risk. 
  • 160 had two or more autoantibodies but did not yet require insulin therapy, indicating early-stage type 1 diabetes. 
  • 7 were found to have undiagnosed type 1 diabetes with all needing to start insulin immediately.  

Families of children found to have early-stage type 1 diabetes received tailored education and ongoing support to prepare for the eventual onset of type 1 diabetes symptoms and to ensure insulin therapy can begin promptly when needed, reducing the chances of needing emergency treatment. Those with one autoantibody also received ongoing support and monitoring.

Some families were also offered teplizumab, the first ever immunotherapy for type 1 diabetes, which can delay the need for insulin by around three years  in people with early-stage type 1 diabetes. The first patient was treated at Birmingham Children’s Hospital, demonstrating the hive of cutting-edge diabetes activity in and around Birmingham Health Partners and the Birmingham health and life sciences district. Teplizumab was licensed by the Medicines and Healthcare products Regulatory Agency (MHRA) in the UK in August 2025, and is currently being assessed by the National Institute for Health and Care Excellence (NICE) to determine whether it should be available through the NHS.

As of November 2025, more than 37,000 families had signed up to the ELSA programme and, building on this strong foundation, the second phase of the research launches today. ELSA 2 will expand screening to all children in the UK aged 2-17 years, with a focus on younger children (2-3 years) and older teenagers (14-17 years). The research team aims to recruit 30,000 additional children across these new age groups.

ELSA 2 will also establish new NHS Early-Stage Type 1 Diabetes Clinics, providing families taking part in the study with clinical and psychological support and creating a clear pathway from screening to diagnosis, monitoring and treatment.

Amy Norman, 44, from the West Midlands, was diagnosed with type 1 diabetes at the age of 13. She recently discovered via the ELSA study that her 11-year-old daughter, Imogen, is in the early stages of type 1 diabetes but has been able to slow its progression as the second child in the UK to access a breakthrough immunotherapy drug – teplizumab. She said: “Being part of the ELSA study has helped us as a family to prepare for the future in a way we never expected. Knowing what’s coming – rather than being taken by surprise – has made an enormous difference to our confidence and peace of mind.

“When I was diagnosed, I had no warning and ended up quite poorly in hospital with diabetic ketoacidosis (DKA). When Imogen’s diagnosis arrives, we hope that having this awareness will reduce her chances of experiencing DKA and the added trauma that comes from a sudden illness.

“Imogen took part in the study to further research and help others, but it has helped her too – being forewarned is being forearmed. She was always going to develop type 1 diabetes, but through ELSA we’ve been able to slow down the process and prepare – we know what is coming, but we’re not scared.” 

Lead researcher, Parth Narendran, Professor of Diabetes Medicine at the University of Birmingham, said: “We are extremely grateful to all the families who have participated in the study and generously given their time to help understand how a UK-wide screening programme could be developed. Together with Diabetes UK, Breakthrough T1D and NICE, we are working towards a future where type 1 diabetes can be detected in a timely manner, and families appropriately supported and treated with medicines to delay the need for insulin.

“We are also grateful to partners across the Birmingham health and life sciences district and beyond as well as the NIHR for the support they have provided in getting us to where we are.”

Dr Elizabeth Robertson, Director of Research and Clinical at Diabetes UK, said: “For too many families, a child’s type 1 diabetes diagnosis still comes as a frightening emergency. But that doesn’t have to be the case. Thanks to scientific breakthroughs, we now have the tools to identify children in the very earliest stages of type 1 diabetes – giving families precious time to prepare, avoid emergency hospital admissions, and access treatments that can delay the need for insulin for years.

“The ELSA study, co-funded by Diabetes UK, is generating the evidence needed to make type 1 diabetes screening a reality for every family in the UK. We’re incredibly grateful to the 37,000 families who’ve already signed up and urge others to get involved. Together, we can transform type 1 diabetes care for future generations.”

Rachel Connor, Director of Research Partnerships at Breakthrough T1D, said: “This is about rewriting the story of type 1 diabetes for thousands of families. Instead of a devastating emergency, we can offer time, choices, and hope. By finding children in the earliest stages, we’re not just preparing families, we’re opening the door to treatments that can delay the need for insulin by years. That extra time means childhoods with fewer injections, fewer hospital visits and more normality. Thanks to research like ELSA, what once struck as an unexpected crisis can become an actively managed healthcare process, changing the course of T1D for the better.”

The Research FIRST team at Birmingham Health Partners has played a pivotal role in the successful delivery of the ELSA study. Drawing on extensive specialist expertise, the team developed and implemented a robust, resilient database to support high-quality data capture and long-term study integrity.

Beyond technical delivery, the team also provided dedicated data management support throughout the project, ensuring rigorous standards, regulatory compliance and operational efficiency. They also offered oversight across key project activities, working closely with participating sites to support recruitment and ensure timely follow-up.

The team’s co-ordination and proactive problem-solving were instrumental in keeping the study on track. A further major achievement was the end-to-end management of dry blood spot testing kit dispatch, enabling sites to begin screening as quickly as possible after families signed up. This comprehensive project management has been critical in maintaining momentum and supporting the continued success of the study, enabling researchers to continue their work with confidence.

The findings from ELSA’s first phase signal a major step towards a future in which type 1 diabetes can be detected early, managed proactively, and potentially delayed through immunotherapy. ELSA demonstrates that childhood screening in the UK is feasible, acceptable to families, and capable of preventing emergency diagnoses. Continued research through ELSA 2 will assess how screening can be scaled across the NHS and evaluate its cost-effectiveness.

Type 1 diabetes is a serious and lifelong autoimmune condition affecting up to 400,000 people in the UK. It is caused by an immune system attack on the insulin-producing cells in the pancreas, meaning they can no longer make enough insulin. Rapid diagnosis of type 1 diabetes is essential to avoid life-threatening complications. 

For more information about ELSA or ELSA 2, visit elsadiabetes.nhs.uk/taking-part/

A year of growth, innovation and partnership

Following a year in which Birmingham Health Partners organisations won more than £70m of research investments from NIHR and other funders, signed a strategic partnership with ABHI, and launched its BHP People reward and recognition scheme – we’re pleased to publish our fourth annual review of activity for the period September 2024-August 2025. 

In their foreword, Professors Lorraine Harper (Managing Director) and Neil Hanley (Executive Director), said:

“The past 12 months have been exceptionally busy across Birmingham Health Partners. Our flagship Reducing Bureaucracy in Clinical Trials theme has gone from strength to strength and is complemented by the fantastic news we received in December – the success of our bid to lead one of the new NIHR Commercial Research Delivery Centres (CRDCs), which aim to expand access to clinical trials to some of the country’s most underserved communities.

“In June, we welcomed colleagues from the Association of British HealthTech Industries (ABHI) to Birmingham, where we signed up to a landmark strategic partnership focused on improving clinical outcomes, addressing health inequalities, and ensuring that health technologies are scalable and relevant to population health. We look forward to continuing collaborations with ABHI and its members.

“June also saw the opening of the Precision Health Technologies Accelerator (PHTA), the University of Birmingham’s flagship research facility and anchor tenants at the new Birmingham Health Innovation Campus. This represents a golden opportunity for BHP researchers to commercialise innovations, provide consultancy to SMEs, and collaborate across the ecosystem.

“Significant progress has also been made with our Patient and Public Involvement and Engagement (PPIE) theme, which brings together the excellent work of our individual member organisations and provides a comprehensive suite of resources to help enhance our collective PPIE practice to ensure the patient voice is not only heard, but helps to shape and direct research.

“As ever, we are immensely proud of the achievements of all our member organisations, some of which are captured in our case study round-up which represent a mix of initiatives directly convened by BHP, and examples of exceptional innovation and collaboration from across the partnership.

“The efforts of every individual involved in research continue to benefit patients, whether it is through improving cancer outcomes, enhancing mental health research, tackling inflammation and chronic disease, or improving maternal and perinatal health across our community.

“Finally, we extend our sincere thanks to our outgoing chair, Jonathan Pearson, for his guidance over the past two years. His leadership has been clear, and always centred on what matters – people. We are delighted that Jonathan will remain a key figure in BHP through his new appointment as Chair of Health Innovation West Midlands, which will no doubt benefit from his expertise.”

View and download the BHP Annual Review of Activity 2024-2025.

Professor Andrew Filer appointed Director of NIHR Birmingham Biomedical Research Centre

The National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre (BRC) has announced the appointment of Professor Andrew Filer as its new Director. Professor Filer takes over from Professor Paul Moss, who has served as Interim Director since June 2024.

Professor Filer is already co-lead of the BRC’s Inflammatory Arthritis research theme and brings a wealth of clinical and translational research experience to the role. His leadership will further guide the BRC in delivering cutting-edge research that transforms patient care across the region and beyond.

Professor Filer said: “I’m honoured to take on the role of Director at such an exciting time for the Birmingham BRC. Our BRC is built on a foundation of collaboration, innovation and clinical excellence. I look forward to working with our partners to ensure our research continues to make a real difference to patients’ lives.”

The NIHR Birmingham BRC is a cross-BHP collaboration, hosted by University Hospitals Birmingham NHS Foundation Trust (UHB) and delivered in partnership with the University of Birmingham and six associate academic and NHS partners across the region. It brings together clinicians, scientists and healthcare professionals to drive translational research improving outcomes for people with inflammatory diseases.

Professor Kiran Patel, Chief Medical Officer at UHB, said: “Professor Filer is passionate about integrating patient-centred approaches and high-quality discovery science to drive innovation. I am delighted he has taken on this role, and I am sure he will provide effective leadership to our incredibly successful NIHR Birmingham BRC.”

Professor Neil Hanley, Pro-Vice-Chancellor and Head of the College of Medicine and Health at the University of Birmingham, added: “I’m really excited by Andrew’s appointment. It really does reflect the strength of clinical research leadership in Birmingham. His vision and energy will be instrumental for the next phase of the BRC’s mission to deliver inclusive impact, health improvement and economic growth.”

Dr Victoria Day, Head of Infrastructure at the Birmingham BRC, commented: “Andrew brings deep knowledge of the NIHR landscape and a long-standing commitment to patient-focused research. His leadership and collaborative approach will be key to driving the Birmingham BRC forward and delivering meaningful health impact.

“I would like to take this opportunity to sincerely thank Professor Paul Moss for his support during his time as Interim Director. His leadership and commitment have contributed to the many achievements we’ve made during this period.”

Professor Andrew Filer is a Professor of Translational Rheumatology in the Department of Inflammation and Ageing at the University of Birmingham. A Fellow of the Royal College of Physicians, he holds a PhD in immunology and is an Honorary Consultant Rheumatologist. He is internationally recognised for his work in early inflammatory arthritis, particularly in developing novel imaging and biopsy techniques to study disease mechanisms and improve diagnosis.

He co-leads the Birmingham Early Arthritis Clinic and has pioneered the use of musculoskeletal ultrasound and ultrasound-guided synovial biopsy in clinical research. His research focuses on Synovial cellular biology, disease stratification, and the development of targeted therapies for rheumatoid arthritis. Professor Filer is a passionate advocate for integrating patient cohorts with high-quality basic science to accelerate translational impact.

BHP’s health inequalities lead awarded prestigious NIHR Research Professorship

Our health inequalities theme lead Professor Joht Singh Chandan – from the University of Birmingham’s Department of Applied Health Sciences – has been awarded one of six prestigious NIHR Research Professorships by the National Institute for Health and Care Research (NIHR).

As the NIHR’s flagship award for leading researchers, this Professorship is highly prestigious and supports individuals with an outstanding track record of applied health and care research to undertake high-impact work that will shape the future of healthcare in the UK and beyond.

Professor Chandan was recognised last year as the youngest clinical professor in the UK, bringing extensive expertise across the fields of violence against women and girls, maternal health, and public health, especially addressing health inequalities in underserved communities. Most recently, he has been announced as the co-lead of the NIHR’s new Challenge Maternity Disparities Consortium bringing together nine UK universities with the aim of tackling inequalities in maternity care. Professor Chandan retains a longstanding commitment to advancing research, policy and practice in these critical areas, with work that has shaped national conversations for vulnerable populations.

“I’m deeply honoured to receive this NIHR Research Professorship,” Professor Chandan said. “Violence against women and children is one of the greatest public health challenges of our time, and survivors deserve a healthcare system that truly listens, understands, and responds to their needs. This award will allow me to work alongside individuals, families, and communities affected by violence to co-produce a more trauma-informed and equitable NHS – helping to build safer, more supportive services for everyone affected by violence.”

The five-year Research Professorship award includes funding for research costs, a leadership development programme, and support for building a research team. It is designed to strengthen the UK’s capacity for world-leading applied health research and ensure that discoveries are rapidly translated into practice.

This new professorship will enable Professor Chandan to work closely with survivors of violence to close the gaps between them and avenues of support such as local authority settings and the NHS. This work is undertaken with a view to expanding this work nationally, building research capacity, and helping to create safer, more supportive, and informed healthcare services for survivors of violence.

Despite growing awareness, significant gaps remain in the support of survivors of violence within healthcare systems. Further research is urgently needed to develop evidence-based interventions, improve service accessibility, and ensure that care is both trauma-informed and culturally sensitive for those from underserved communities. Professor Chandan also co-leads the NIHR Global Health Research Group on Violence Against Women and Children, which brings together researchers and practitioners across eleven countries to share learning and develop scalable solutions, ensuring that insights from the UK inform, and are informed by, global efforts to tackle violence.

Professor Lucy Chappell, Chief Executive Officer of the NIHR and Chief Scientific Adviser at the Department of Health and Social Care, said: “I am delighted to welcome this new cohort of NIHR Research Professors. As well as recognising individual excellence, these awards are a strategic investment in our research leadership across health, social care and public health.

“I look forward to seeing the positive impact of these awardees’ research and leadership across major health and care challenges.”

NIHR Research Professorships are among the UK’s most prestigious career development awards. The awards are focussed on translating into real world impact. The 10 Year Health Plan recognised the need for research and innovation to be integrated into health and care practice.

NIHR Research Professors combine their academic roles with professional practice. They provide a crucial link between research and the delivery of health, social care and public health services, driving the implementation of evidence-based improvements that address key health and social care challenges.

Top rating for Birmingham’s NIHR Integrated Clinical Academic Training programme

The Integrated Clinical Academic Training (ICAT) programme led by BHP founder-member the University of Birmingham, has been rated joint top alongside the University of Oxford.

Birmingham’s ICAT programme is one of 36 across the country, with its NIHR funding complemented by posts supported by fellow Birmingham Health Partners member organisations. It provides opportunities for medical and dental graduates to have dedicated research time alongside their clinical training and NHS commitments and is critical to developing the future clinical research workforce, supporting clinicians to pursue research interests alongside clinical practice.

The University excelled in the recent NIHR funding competition, being awarded 28 Academic Clinical Fellow posts and 13 Academic Clinical Lecturer posts, for the period 2026 and 2027.

“We are proud to be one of the largest of the 36 NIHR ICAT programmes in the country, with 116 current trainees, ranging from pre-doctoral Academic Clinical Fellows to consultant level, postdoctoral Birmingham Health Partners award holders. Our relationships with NHS trusts across the region through BHP stand us apart from many of the other ICAT programmes and this partnership is integral to building regional research leadership capacity,” said Professor Kristien Boelaert, ICAT Academic Lead and Professor of Endocrinology at the University.

Earlier this year, the Medical Schools Council highlighted a trend in declining numbers of clinical academics and called for intervention to safeguard the future of medical research and education. The Government’s 10 Year Health plan recognises the importance of embedding research across healthcare to drive reform and attracting early career clinicians to academia is essential to increase those numbers.

Commenting on the importance of Birmingham’s contribution, Professor Boelaert explained: “It’s not just that we have an impressive number of posts here in Birmingham – our career development initiatives, research culture and peer support activities make up the full package. Our Research Retreat was also highlighted as very beneficial, along with outstanding feedback via our trainee experience survey.”

Since Birmingham’s ICAT Programme launched in 2015, 55 of our 86 NIHR Academic Clinical Fellows (64%) have progressed to clinical research training fellowships or other academic posts and 55 of 73 our NIHR and locally-funded Clinical Lecturers have progressed to senior academic positions (75%), including 17 as research-active consultants.

Find out more about our programmes:

  • BHP Starter Fellowships, allowing individuals to start their research career providing cost to cover one year’s salary to undertake a Master’s by Research
  • Clinical Academic Research Partnerships (CARP), to support individuals continue their research careers while delivering clinical service providing salary funding for two programmed activities (PAs) – or 8 hours per week – of protected research time for two years
  • New Consultant Scheme, providing salary funding for two programmed activities (PAs) – or 8 hours per week – of protected research time for three years
  • BHP Clinician Scientist, 50:50 appointments providing an academic consultant post linked with one of our NHS trusts to develop individuals as successful independent clinical researchers