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The BHP Starter Fellowship – a catch-up with Karl

Karl Payne

Dr Karl Payne is currently an NIHR funded Academic Clinical Lecturer in Oral & Maxillofacial Surgery and a Surgical Trainee in the West Midlands. He undertook a Birmingham Health Partners Starter Fellowship in 2018 – 2019 and, having shared his thoughts with us soon after completing his fellowship, is back to update us on his progress in the years since.

When we last spoke to you, you’d just completed your BHP Fellowship and had ‘taken a gamble’ to use it as the first year of your PhD. What is your research topic and how are you progressing?

My research topic continues to be focused on a liquid biopsy in head and neck cancer. Specifically using a simple blood test to detect tumour specific markers that can could pick up recurrence or metastasis earlier than conventional methods, and hopefully direct treatment in these groups. I’ve been using a novel platform to capture circulating tumour cells and do multi-plex proteomic analysis. For the first time we can interrogate up to 44 proteins on cancer cells derived from a patients blood, far beyond current standards. We are progressing well. I’ve run my first pilot cohort and we are planning a larger trial also incorporating genomic assessment of circulating tumour DNA. I’m excited, but then I would be, it’s my project!….

Do you feel the fellowship was advantageous to you in your PhD, compared with a traditional route? 

Firstly, it’s always advantageous to be paid! That might sound a bit clichéd, but any salary-funded fellowship buys you the opportunity to spend time doing research outside of clinical training. I think what sets the BHP fellowship apart is the integration within existing clinical academic pathways, while also recognising the need to support those aspiring academics who haven’t been able to get an academic post in their training but need that first bit of help to get some pilot data.

It depends what route you are taking and which specialty, but certainly in surgery it was invaluable to have that first year funded to be able to get another grant. I was successful in achieving a CRUK funded clinical doctoral fellowship – which I wouldn’t have got without the BHP fellowship. The support and training was great, but you only get out what you put in – really it gives you the chance to really spend time on your research and make connections within the University. I think there could be a bit more peer-to-peer mentorship, but we are working on that so watch this space!

Has the Fellowship helped with any challenges you might have experienced while completing your PhD?

Getting your first research fellowship or grant is really hard. I failed several times before being successful with the BHP fellowship. So the best thing I got from the fellowship was the confidence that I could make my project work and that others believed in me and my research. My first year in basic science research was challenging, so the fellowship taught me a bit of resilience and determination.

Has the Fellowship benefited your career or opened up other opportunities besides the PhD?

Any career is a constant progression, and none more so than a clinical academic career. These days when I talk to students, I try and make them understand that its not just about climbing the ladder, it is about enjoying each rung and getting the most out of each stage of your training. I view my PhD as a continuum of the BHP fellowship, and indeed my training as a whole. While we all want a good paper from our PhD, it isn’t really about what you’ve done or discovered, it is about your journey and learning from mistakes on the road to research independence. In that sense the fellowship has enormously benefited my career, but its only a piece in a big puzzle and I’ve been learning along the way. Although, it has to be said, I didn’t know that at the start so my focus at the time was to get maximum research output from one year and move on – that attitude has now changed.

What do you plan to do next?

I finished my PhD a few months ago and I have just started an NIHR-funded Academic Clinical Lecturer post in the University. This allows me to spend half my time on research, while still getting the chance to operate and complete my training. I’ve always been interested in teaching and training, so I am always trying to help others and give something back to the programme.

Last time we asked what advice you’d give to someone applying for the fellowship. This time, what advice would you give to someone on the programme – how should they prepare for their post-fellowship career?

  1. Plan ahead, BUT not too far ahead. Don’t lose sight of the short-term goals you need to achieve.
  2. Having said that, always start planning ahead early!
  3. The project you start with, either a fellowship or PhD, will likely not be the one you finish with. Things will almost certainly go wrong, so have a plan B, C, D….
  4. Finally, take the time to make friends and nurture research connections within the University. Both at your level and mentors just above you. Research is always a team effort.

Two BHP members deepen collaboration to improve health provision

Aston University and Birmingham Women’s and Children’s NHS Foundation Trust (BWC) – both members of BHP – have deepened their strategic relationship by signing a Memorandum of Understanding to co-develop paediatric health initiatives.

The MoU also aims to develop the health services workforce of the future together, with a specific focus on course development and delivery, including placements. It will invest in shared posts that enable closer links between academia, education and healthcare provision, while also supporting honorary appointments and initiating collaborative projects to develop world-leading research and provision in the field of paediatric health and wellbeing.

Professor Aleks Subic, Vice-chancellor, Raffaela Goodby, BWC Chief People Officer (front row) sign the MoU, accompanied by colleagues from both organisations

The partnership will make the most efficient use of resources and reduce duplication by providing a range of shared services, as well as continuously developing new ways to work together, with a view to supporting innovation in the field of healthcare.

These activities will build on the existing joined up work taking place between Aston University and BWC via BHP, such as shared use of the MRI scanning services in the Aston Institute for Health and Neurodevelopment and joint research projects examining topics including epilepsy in children, eating behaviours and neurodevelopment.

Professor Anthony Hilton, pro-vice-chancellor and executive dean of the College of Health and Life Sciences at Aston University, said: “The signing of this Memorandum of Understanding formalises the existing relationship between our two organisations and represents a strong joint commitment to improving healthcare provision in our city.

“Working collaboratively enables us to bring together world-leading research with outstanding clinical provision, for the benefit of our students, patients accessing BWC services and our city and region. I look forward to developing the many ways in which our organisations can work together to improve healthcare provision in Birmingham.”

Matthew Boazman, deputy chief executive officer of BWC, said: “The partnership between BWC and Aston University represents a wonderful opportunity for us to ensure that Birmingham has access to world-class healthcare provision and that those entering the workforce are as ready as they can be.”

Birmingham partnership creates next generation of childhood cancer researchers

A groundbreaking local partnership has been announced in the UK’s fight against childhood cancer. Two BHP founder-members – Birmingham Children’s Hospital Charity and the University of Birmingham – have joined forces with The Azaylia Foundation to create the next generation of leaders in childhood cancer, collectively committing over £560,000 to co-fund two clinical PhDs in paediatric oncology.

Five new cases of childhood cancer are diagnosed every day, yet it receives less than 3% of all cancer research funding. This much-needed investment into the Azaylia Childhood Cancer PhD Fund will provide expert clinicians with the opportunity to undertake groundbreaking, world-class research into the early diagnosis of childhood cancer and more importantly find new and kinder treatments to improve survival rates.

Professor Pamela Kearns, Professor of Clinical Paediatric Oncology at University of Birmingham and Honorary Consultant Paediatric Oncologist at Birmingham Children’s Hospital, said: “We’re delighted to have funded the first two Azaylia childhood cancer clinical PhD scholars in paediatric oncology, thanks to an outstanding gift of over £280,000 from The Azaylia Foundation, which has been match-funded by University of Birmingham and Birmingham Children’s Hospital Charity. Parents always want to know, ‘why did my child get cancer?’ and ‘can you cure my child?’ we are now in a strong position to extensively research the answers to these questions.”

Mark Brider, CEO of Birmingham Children’s Hospital Charity, said: “Research into childhood cancer is essential to improve survival rates and discover safer treatments. It is an honour to partner with both our friends at University of Birmingham and The Azaylia Foundation to co-fund these much-needed paediatric oncology clinical PhD roles. Our collaboration will help create the next generation of leaders in childhood cancer and positively change the experiences and outcomes for our brave patients and families.”

Dr Anindita Roy, a trustee for The Azaylia Foundation and Associate Professor of Paediatric Haematology at the University of Oxford, added: “Paediatric oncology clinician scientists are rare. The Azaylia Childhood Cancer PhD Fund is a hugely positive step in facilitating change as now those who have seen first-hand the devastating realities faced by young cancer patients will be able to take their insights and ideas into the laboratory and then back into clinical practice.”

The launch of the Azaylia Childhood Cancer PhD Fund celebrates the one-year anniversary of The Azaylia Foundation, a charitable organisation created by ex-footballer Ashley Cain and Safiyya Vorajee following the tragic passing of their daughter, Azaylia Diamond Cain, of leukaemia in April 2021. The Azaylia Foundation’s immediate ambition is to help fund up to 10 clinical PhDs across the UK within two years.

Safiyya Vorajee, left, and Ashley Cain, right, with members of the BWC paediatric oncology team

“Born well, live well, die well” – BHP publishes report of activity 2020-2022

Following the expansion of its membership with three new partners, BHP has published its first report of activity covering September 2020 to August 2022.

Download the Birmingham Health Partners Report of Activity 2020 to 2022 pdf (4MB)

In publishing this report for our member institutions, stakeholders and influencers in the West Midlands and further afield, BHP highlights its progress in aligning the strategic objectives of its NHS and university partners to address major health challenges faced by the Midlands region and beyond.

Ed Smith, BHP’s chair, commented: “Our starting point has been to create a values-based partnership with key organisations in the city-region that allows us to deploy our research, innovation and healthcare capabilities to deal with major health issues. The problems encountered by the large socially- and ethnically-diverse population of the Birmingham region are similar to those faced nationally and globally, with health inequalities – driven by social determinants – leading to multimorbidity and chronic physical and mental ill-health.

“To address such deep-seated problems, it is increasingly recognised that we need health science clusters, based in large regional populations, that harness research and innovation to patient care. By integrating shared capabilities unselfishly and collaboratively, BHP is forming a powerful regional cluster to address health inequalities while also driving economic development – thereby contributing to both UK and global knowledge-based outcomes.”

Professor David Adams, Director BHP, added: “We hope that readers of this report will understand both the role played by BHP and the opportunities the partnership provides to support health innovation in our region. We aim to enhance the endeavours of individuals, teams and organisations by focussing on collaborating across institutional boundaries.

“As this report sets out, we have made substantial contributions over the last year including on training, funding, and health data and digital delivery. We are also proud of our convening role which brings together wide-ranging multidisciplinary expertise to deliver research that matters for our population and which promotes a wider innovation landscape.”

    Download the Birmingham Health Partners Report of Activity 2020 to 2022 pdf (4MB)

    Birmingham consultant academic appointed national haematology lead at NIHR

    Dr Gill Lowe, a haematology consultant at University Hospitals Birmingham and Honorary Senior Clinical Lecturer at the University of Birmingham, has been appointed as National Institute of Health and Care Research (NIHR) National Haematology Specialty Lead.

    The NIHR is the government’s major funder of clinical, public health, social care and translational research, with a mission to “improve the health and wealth of the nation through research” and a budget of over £1.2 billion in 2020–2.

    In her role as a consultant at UHB, Dr Lowe treats patients who have blood clotting disorders, blood problems relating to pregnancy , and immune blood disorders. Additionally, she works within Research Development and Innovation at the Trust as Deputy Clinical Director of Research. She completed a PhD looking at patients with inherited platelet disorders within the University’s Birmingham Platelet Group between 2010-2013, and continues to lecture in haematology.  She is particularly interested in integrating clinical research in to everyday practice, and in provision of education in her clinical field.

    The main aim of her new role at NIHR is to be able to promote and offer clinical research studies to all patients as part of their routine care.

    Dr Lowe commented: “I’m very excited to have been appointed National Haematology Specialty Lead. Over a number of years, I have been involved in the great work of the Haematology National Specialty Group, and I look forward to continuing to be part of this.

    “There is a lot of scope to improve research for certain patient groups, such as those with sickle cell disease, and trials of new drug treatments for thrombosis. It is incredibly important that we keep patients at the heart of research.”

    She will commence the role on 31 October 2022.

    Professor Matthew Brookes, Clinical Director of the NIHR Clinical Research Network West Midlands added: “It is great news for our region that Dr Lowe will now be leading nationally on Haematology research, as well as continuing to lead on this on a local level across the West Midlands. We very much look forward to continuing to work with Dr Lowe.”

    Professor Roy Bicknell, Director of the Institute of Cardiovascular Sciences at the University of Birmingham said: “The appointment Dr Lowe to this role demonstrates the sector leading excellence in cardiovascular work taking place in Birmingham, and the benefits of a close partnership between NHS Trusts and academia. Dr Lowe completed her PhD in 2013 with the Birmingham Platelet Group and her ongoing work with the group, and commitment to clinical research is supporting leading research to improve treatments and outcomes for people with blood disorders and thrombosis”.

    Tim Jones, Chief Innovation Officer, said: “We are very pleased that Dr Gillian Lowe has been appointed to this national role which builds on her excellent work at UHB not only in caring for our patients but also her pivotal  role in supporting research and education both within Haematology but also more widely across the Trust. It is a well-deserved appointment and we wish her well in her new role.”

    AI engineering technique offers solution to patient-specific knee implants

    Researchers at BHP founder-members the University of Birmingham and University Hospitals Birmingham have used a technique called Generative Design to produce a knee implant that can be used to treat osteoarthritis.

    A proof-of-concept paper – describing in detail the comprehensive workflow of design and advanced manufacturing processes for a generatively-designed, patient-specific bone fixation device – has been published in Progress for Additive Manufacturing by the BHP members working in partnership with design software specialists AutodeskManufacturing Technology Centre (The UK National Centre for Additive Manufacturing).

    Generative design uses artificial intelligence (AI) and machine learning to design parts that are absolutely optimal for their end use when manufactured, and this study is the first known application of Generative Design to a biomedical implantable device.

    Using this technology in medical applications is advantageous for several reasons. For example, knee arthritis is currently treated with implants that are only manufactured in a limited number of shapes and sizes. Although the use of new 3D printing techniques to make implants designed to an individual patient is emerging, this doesn’t take into account the constraints imposed by surgical planning, or the patient’s weight or activity levels. These are important elements to understand how a patient’s anatomy and a knee implant will interact and are crucial to both implant design and post-surgical rehabilitation.

    Generative design however allows the implants to be biomechanically specific, so the implant is tailored to the load it will be bearing. This also allows the end product to be lighter, less prominent and minimally invasive, which means the patient will heal more quickly, and is also less likely to need revision surgery.

    In the new study, researchers set out how the design produced by Autodesk’s software can be manufactured and processed into a functional prototype, including how much of the process can be automated.

    Postgraduate and lead researcher, Mr Sanjeevan Kanagalingam, of the University of Birmingham, said: “The ‘one-size-fits-all’ approach used in knee surgery to treat osteoarthritis can result in major complications, primarily due to overengineered implant designs and therefore limits surgical adoption and patient outcomes. This AI integrated design interface allows us to configure tailored surgical planning parameters and take personal biomechanical information into account, and synergistically combine it with the embedded manufacturing intelligence to model medical-grade titanium implants that are specific to each patient.”

    Principal Investigator and Senior Lecturer, Dr Lauren Thomas-Seale, also at the University of Birmingham, added: “The combination of the academic, industrial and clinical knowledge of the team working on this project, and the vast design space offered by Generative Design, has yielded implant designs beyond anything that has been seen before. Such an approach, noting the diversity of the project team, has enabled the development of a design process which can take into account the many differences between patients, for example the variation between male and female body mass.”

    The next steps will be to mechanically test the devices to see how much they bend and flex under loads. If successful, the team will eventually move on to clinical testing.

    Kanagalingam concluded: “This generative design approach not only increases the patient-specificity of bone fixations but also serve as a novel, versatile framework in the design of load-bearing patient-specific implants for the hips, shoulders and maxillofacial surgeries”