MAHSC Strategy J2561

Partnership for the Patient - Bringing Benefit through Research, Education and Innovation

Strategy

MAHSC is a partnership between The University of Manchester, CentralManchester University Hospitals NHS Foundation Trust, Manchester MentalHealth and Social Care Trust, NHS Salford (Salford Primary Care Trust), SalfordRoyal NHS Foundation Trust, The Christie NHS Foundation Trust, UniversityHospital of South Manchester NHS Foundation Trust

Manchester Academic HealthScience Centre (MAHSC)

Sir David Henshaw

Chair, Board of Governors, ManchesterAcademic Health Science Centre and Chair,NHS Northwest

Manchester Academic Health Science Centre (MAHSC) Strategy

Preface

In May 2008, the Northwest’s Strategic HealthAuthority (SHA), NHS Northwest, publishedone of its most important reports, HealthierHorizons for the North West. It marked theculmination of a wide ranging clinical reviewof health services in the region and was theSHA’s formal response to Our NHS Our Future,the national review of the health service led byLord Ara Darzi.

Shortly after publication, the SHA beganworking with colleagues in The University ofManchester and NHS Trust partners toformalise and develop the Manchester bid tothe Department of Health for its AcademicHealth Science Centre. We were delightedwhen all the hard work and, most importantly,the long standing and strong foundations onwhich the partnership was built wasrecognised in formal designation by theSecretary of State for Health in March 2009.

The Manchester Academic Health ScienceCentre now offers us a real opportunity notonly to drive forward the quality of healthcarefor our local population through research andinnovation, but to play our role on the globalstage and attract the finest clinicians to ourregion.

Sir David Henshaw

Chair, Board of Governors, ManchesterAcademic Health Science Centre and Chair,NHS Northwest

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Foreword

Professor Alan North FRCP FMedSci FRS

Director, Manchester Academic Health Science Centre Vice President, The University of ManchesterDean, The University of Manchester, Faculty of Medical and Human Sciences

Today we face multiple global health issuesand, at times, potential conflicts: sophisticatedhealthcare but huge divides between thedelivery to the wealthy and the poor; lifespanextension through medical intervention but agrowing burden of care for an ageingpopulation; increasing healthcare costs butever growing public expectations and; majoradvances in medical research but poortranslation to the patient. Against thisextremely challenging back drop our vision isto be a leading global centre for thedelivery of innovative applied healthresearch and education into healthcare.

Our AHSC is not entirely new but is the resultof Manchester’s track record of achievementand history of collaboration and strategicmanagement of research. With the formationof the Greater Manchester Research Alliance in2004, and now MAHSC, our research hasbecome focused but at the same time is trulycity-wide with cooperation rather thancompetition between partners. MAHSC willbecome an integral part of partner Trusts andUniversity of Manchester business, bound by acommon governance structure to delivermeasurable and sustainable improvements inpatient outcomes and healthcare delivery.Lessons learnt both from our federatedstructure and from implementation will serveto influence the NHS and healthcaremanagement internationally.

The health of our local population is not whatit should be; Greater Manchester’s rates ofinfant mortality, cardiac disease, mental healthdisorders and cancer exceed the nationalaverage, and Manchester Local Authority hasthe lowest average male life expectancy (73 yr)in the UK. At the same time, however, thesegreat problems provide us with an idealenvironment for health research. MAHSC hasconsiderable strengths and assets: e-healthlinking between primary and secondary care;the Manchester Cancer Research Centre(MCRC); the Manchester Biomedical ResearchCentre; Phase I clinical trials units, includingthe world’s largest unit for cancer; medicaltechnology development via Manchester:Integrating Medicine and InnovativeTechnology (MIMIT); extensive NIHR local andcomprehensive research networks and; theGreater Manchester Collaboration forLeadership in Applied Health Research andCare (CLAHRC). All will contribute to thedelivery of our vision. However, we cannot doit alone and we will seek partnership withexternal stakeholders, including industry, toensure success.

Professor Alan North FRCP FMedSci FRS

Director, Manchester Academic Health Science Centre Vice President, The University of ManchesterDean, The University of Manchester, Faculty of Medical and Human Sciences

Manchester combines excellence in academia,clinical service delivery, research managementand education, with a population that hassome of the poorest health in the country. The health partners in Manchester haveworked together over ten years to realise theopportunities that this combination presentsand to deliver health and economic gains tothe population. This led to the launch of theManchester Academic Health ScienceCentre (MAHSC) in June 2008 anddesignation as one of the UK’s five AHSCs by the Department of Health in March 2009.

MAHSC serves an area of the North West ofEngland with enormous potential for health andeconomic gain. The population is large (3.5million in Greater Manchester, 11 million withina 50 mile radius) and stable (estimated 1.4%change to 2020). It is ethnically diverse (up to30% black and minority ethnic in some areas)and has some of the poorest health in thecountry; MAHSC embraces two of the mostdeprived Local Authorities in the UK (on Index ofDeprivation 2007 Manchester ranked, out of354, 4th most deprived, and Salford 25th). Wewill respond to this challenging environmentthrough the tripartite mission of research andinnovation, education and training andhealthcare. Research and innovation will beembedded as a driver of quality and productivityin alignment with the NHS Quality, Innovation,Production, Prevention (QIPP) framework.MAHSC will deliver added value to the activitiesof its founding partners by developing:

• An integrated health system for improvedand accelerated translational medicine:research and evaluation throughimplementation and adoption to sustainability

• A strategic approach to funding proposals,investment in research, infrastructure,training and education across the partners:avoiding duplication and maximisingefficiencies (eg e-health, bio banking, clinicaltrials unit, citizen scientist programme)

• Harmonised processes and standard operatingprocedures: joint working/offices and pan-MAHSC teams based on best practice

• A single point of access for external partnersand stakeholders: critical mass ‘offer’providing competitive advantage

• Cultural change responsive to research andthe uptake of innovation within the wholecommunity: ‘delivering the best andattracting the best’ virtuous circle created

MAHSC will achieve its vision through itspartners. It will not duplicate the effective andestablished assets of its partners (or thoseincluding its partners and the wider community)but will, instead, build upon them and extendtheir activities to other partners as appropriate.Foremost amongst these pan-partner assets are:

• Manchester Cancer Research Centre(MCRC) - lead for cancer

• Manchester Biomedical Research Centre(BRC) - lead for human development

• Greater Manchester Comprehensive LocalResearch Network (GMCLRN) – lead forevaluation (clinical trials)

• Institute for Health Sciences (IHS) andGreater Manchester Collaboration forLeadership in Applied Health Research andCare (CLAHRC) – lead for implementation

plus

• Northwest e-Health (NWeH)

• Manchester: Integrating Medicine andInnovative Technology (MIMIT)

• Wellcome Trust Clinical Research Facility

Partners

A forerunner structure (the GreaterManchester Research Alliance, established2004) created a strong foundation for this newpartnership by developing common research

governance and data sharing mechanisms.Successful outputs of the alliance andpartnership working included the ManchesterCancer Research Centre (MCRC), the six topic-specific Local Research Networks, theComprehensive Local Research Network(CLRN), and major inter-institution researchinitiatives such as the Biomedical ResearchCentre (BRC), the Collaboration for Leadershipin Applied Health Research and Care (GreaterManchester CLAHRC), Manchester: IntegratingMedicine and Innovative Technology (MIMIT)and the Wellcome Trust Clinical ResearchFacility (WTCRF).

MAHSC is a federation of seven foundinginstitutions, legally embodied in a companylimited by guarantee (CLG). The MAHSCpartners are: The University of Manchester(University), Central Manchester UniversityHospitals NHS Foundation Trust (Central),Manchester Mental Health and Social CareTrust (Mental Health), NHS Salford (SalfordPrimary Care Trust) (Salford PCT), Salford RoyalNHS Foundation Trust (Salford), The ChristieNHS Foundation Trust (Christie), UniversityHospital of South Manchester NHS FoundationTrust (South). Together the MAHSC partnersemploy 35,000 staff and have an annualturnover of £2.3 billion.

NHS Partners

The partners (three Acute Trusts, two SpecialistTrusts and one PCT) deliver a broad provisionof clinical care, including:

• Cancer (Christie)

• Mental illness (Mental Health with facilitiesat South, Central and North ManchesterNHS Trust)

• Neurology and Dermatology (Salford)

• Respiratory Disease (South)

• Maternal and Foetal Health, Cardiovascularand Musculoskeletal diseases (Central)

Our VisionTo be a leading global centre for the delivery of innovative appliedhealth research and education into healthcare.

In his report, “A Review of UK Health Research Funding”,Sir David Cooksey highlighted Greater Manchester as “an example of good partnership working to deliverworld class research for the benefit of patients, with a focus on key stakeholders, including industry andlocal/regional government”.

02 Manchester Academic Health Science Centre (MAHSC) Strategy

• E-Health using bioinformatics and electronicpatient records to link the primary andsecondary care sectors (Salford and Salford PCT)

• Pan-partnership strengths include Diabetesand Cancer

Through the unique joint R&D arrangementbetween Salford and Salford PCT (described intheir Ethos strategy), MAHSC has particularaccess to the 10 Greater Manchester PrimaryCare Trusts. These Trusts along with HealthR&D North West, the local NHS R&D SupportUnit, came together in 2005 to form theGreater Manchester Primary Care ResearchGovernance Partnership (ReGrouP). Regroupworks collaboratively to support andstreamline research management andgovernance in primary care research and it ishosted by Salford. In addition Salford has aleading role in Quality Improvement for NHSNorthwest as host to the Northwest AdvancingQuality Alliance (AQuA)

The NHS partners contribute considerableclinical research infrastructure: two accreditedPhase 1 Clinical Trials Units at Christie(expanding to become the largest in the world)and at South, out of only nine such units onTrust sites in the UK; the Manchester CancerResearch Centre (MCRC) based at Christie; theWellcome Trust Clinical Research Facility(WTCRF) including a paediatric unit on theCentral site; UK-leading e-Health initiatives(NWeH) and the Greater Manchester CLAHRCat Salford and Salford PCT; a BiomedicalResearch Centre (BRC) at Central and; a

Translational Research Facility and the GreaterManchester CLRN at South (MAHSC partnersare responsible for approximately 60-70% ofpatient recruitment within the network) . Thenational Mental Health Research Network(MHRN) Coordinating Centre is managed bythe University in partnership with the Instituteof Psychiatry, King’s College, London whileseveral of the Trust Partners host northwestregional or local networks including Dementiasand Neurodegenerative Diseases (DeNDRoN) atMental Health, Cancer (NCRN) at South,Diabetes (DORN) at Salford Royal, Medicinesfor Children (MCRN) at Central and Stroke(SRN) at Salford Royal.

At the time of designation, all but one ofMAHSC’s acute/specialist Trusts hadFoundation status and four were rated as“double excellent” for quality of service anduse of resources – these are both indicators ofexemplary financial and clinical performance.The 2008/09 Performance Ratings (QualityHealthcare Commission) have reaffirmed thequality of the NHS partners and indicate anoverall increase in performance from 07/08. Allare committed to advancing further excellencein patient care through active engagement inresearch and the uptake of innovation intoroutine practice. Each of the Trusts iscommitted to the principles of advancingservice quality by: bringing the standards of allTrusts up to and beyond those of the best;involvement of patients and users of healthservices from an early stage; recruiting the beststaff and providing Continuing Professional

Development (CPD); creating a researchfriendly clinical environment for patients andstaff; targeting initiatives to unmet clinicalneed; adopting robust implementationstrategies with agreed goals and metrics toassess achievement; working to ensuresustainability in a competitive clinical andcommissioning environment.

Additional information on each of the MAHSCmembers can be found at the followingwebsites:

www.manchester.ac.uk

www.cmft.nhs.uk

www.christie.nhs.uk

www.uhsm.nhs.uk

www.mhsc.nhs.uk

www.srht.nhs.uk

www.salford-pct.nhs.uk

In his report, “A Review of UK Health ResearchFunding”, Sir David Cooksey highlightedGreater Manchester as “an example of goodpartnership working to deliver world classresearch for the benefit of patients, with afocus on key stakeholders, including industryand local/regional government”.

While MAHSC has a limited foundermembership, it is committed to working withkey stakeholders across the GreaterManchester area and to extending thepartnership community to other NHS and HEIorganisations in due course.

Care Quality Commission Performance Rating 2008/9

Christie Central Mental Health Salford Salford PCT South

Quality of Services Excellent Good Good Excellent Excellent* Good

Management Excellent Good Fair Excellent Excellent* Excellent

*07/08 ratings. 08/09 ratings have been organised differently for PCTs and are not directly comparable but Salford PCT received the highest rating of‘Fully Met’ for Providing Services, Fair for Quality of Commissioning and Good for Quality of Financial Management.

The University of Manchester, RAE 2008,National Rank - Quality

1st

Cancer

Nursing and Midwifery

Dentistry

Sociology

2nd

Pre-clinical and Human Biological Sciences

Primary Care

Pharmacy

Development Studies (Brooks World Poverty Institute)

3rd Biological Sciences

4th Cardiovascular Medicine

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MAHSCKey to the MAHSC partnership

The University of Manchester

Central Manchester University Hospitals NHSFoundation Trust

Manchester Mental Health and Social Care Trust

NHS Salford (Salford Primary Care Trust)

Salford Royal NHS Foundation Trust

The Christie NHS Foundation Trust

University Hospital of South Manchester NHS Foundation Trust

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Our strategy is to produce a healthcare systemacross MAHSC driven by world class researchand innovation, with quality at its core, andunderpinned by excellence in training andeducation.

These are combined with a reach into, andengagement with, a broad healthcareenvironment where research and innovationcan be implemented and assessed to supportthe following seven goals:

Goal One:Improve the health and wellbeing of thepopulation through the development andapplication of innovative healthcare andresearch

Goal Two:Disseminate innovation in technology and carenationally and internationally.

Goal Three:Educate effectively in all aspects of healthcare,healthcare management, and biomedicine insupport of workforce development.

Goal Four:Lead on quality of care and publicinvolvement.

Goal Five:Partner more widely and more beneficially withthe commercial sector.

Goal Six:Contribute significantly to innovation,enterprise and economic development in thecity region and the North West of England.

Goal Seven:Attract the best national and internationalhealth researchers and healthcare workers.

Our goals are aligned to national, regional andlocal strategies and reviews including Our NHSOur Future (Department of Health), OLSBlueprint (Office for Life Sciences), HealthierHorizons for the North West (NHS Northwest),Regional Science & Innovation and BionowStrategies (Northwest Development Agency),Prosperity for all (Greater Manchester CityRegion Strategy) as well as the individualstrategies of each of the MAHSC members.Alongside a fundamental focus on theimprovement of healthcare, MAHSC willcontribute actively to economic developmentand the international competitiveness andconnectivity agenda.

To underpin delivery we have three buildingblocks:

Governance, Organisation andManagement: a federated approach withharmonisation of processes based on bestpractice

Clinical Themes: leading capabilitiescombined with strong communication andcross working across the translational medicinespectrum

Enabling Infrastructure: pan MAHSCresource and alignment with nationalprogrammes supported by fully trained staff

Introduction

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1.2 MAHSC will bridge the FirstTranslational Gap by:

• Developing a programme of facilitatedworkshops that bring together clinicians andresearch scientists to bridge the gapbetween invention/discovery and clinicalneed.

• Developing an integrated clinical trials unitacross all partners accessible via a singleportal to coordinate clinical trials facilitiesand enable studies from biomarker to first-in-man.

• Improving the relevance of research, usingthe MIMIT model (healthcare technology),by targeting cross disciplinary researchexpertise and discovery to unmet clinicalpriorities utilising clinically based ‘siteminers’, pilot project development andactive management.

• Developing our e-Health infrastructure toprovide access to anonymised linked recordsfrom all aspects of NHS care for thepopulation

• Moving discovery from bench to bedsideusing our “know how” from existingpartnerships including our well developedvehicles for exploitation of innovation.

• Partnerships with the healthcare industryand key multipliers at local, regional andinternational level eg the RegionalDevelopment Agency’s (NWDA) BionowCluster, Knowledge Transfer Networks(KTNs) and the Technology Strategy Board(TSB), Association of the BritishPharmaceutical Industry (ABPI), BioindustryAssociation (BIA), Association of the BritishHealthcare Industries (ABHI), Medilink andUK Trade and Investment (UKTI).

1.3 MAHSC will bridge the SecondTranslational Gap by:

• Providing a coordinated approach to improvedquality health care and health through researchand innovation around a series of nineacademic sections. These will comprise: fiveclinical academic sections that relate to thepopulation challenges and partner expertise,three cross cutting enabling sections, and aneducation and training section.

• Enabling the Clinical Academic Sections todevelop guidelines and protocols that permitand support changes in practice. These alignwith the SHA’s strategic recommendation forservice delivery across several areas whichinclude staying healthy, long-term conditionsand mental health. Translational approacheswill encompass guided self–care and newmodels of chronic disease management as wellas more traditional activities associated withthe ‘bench to beside’ descriptor for the firsttranslational gap.

• Each clinical section will span thecontinuum of innovation fromidentification to fulfilment of unmetclinical need, from basic science discoveryto high quality clinical service. However, itis not envisaged that each section willdeliver across the ‘entirety’ of thetranslational medicine spectrum but willfocus on areas of expertise within it.

• Embedding evidence-based innovations inclinical services and optimise strategies foruptake of innovation into clinical practicebased on the Greater Manchester CLAHRCapproach to cardiovascular disease

• Developing local NHS capacity to plan andimplement evidence-based changes to carepathways for patients, through close working

and knowledge transfer between Universityresearchers and NHS providers andcommissioners. This will be achieved in part byembedding “knowledge transfer agents”whose remit is to identify and implement aresearch evidence base in PCTs via the CLAHRCprogramme. This work will be assessed viaexternal evaluation by research commissionedthrough the NIHR Service Delivery andOrganisation programme. Knowledge transferactivity will also be the responsibility of theMAHSC academic section leads

• Rationalising provision of services by partnerTrusts building on existing successful templates.Examples of these are: Stroke Services, acomprehensive arrangement for provision ofacute stroke services between Salford, Southand Bury; Neurosciences, a hub and spokeprovision with the hub at Salford; andRadiotherapy Services with the hub at Christie.

• Development of interactive simulation modelsto assist commissioners in assessing the likelyimpacts that changing care pathways andservices will have on NHS costs and patientoutcome

• Increasing capacity to plan and implementevidence-based changes to service delivery.Sustaining innovation through PCTcommissioning.

1.4 Working with PCTs

We will engender a research ethos in generalpractice, with a cultural change, so that, ratherthan being unusual, GPs across GreaterManchester see it as their normal activity toengage in research and have effective supportfor doing so. This is key to the long-termtranslational mission.


Goal OneImprove the health and wellbeing of the population through thedevelopment and application of innovative healthcare and research

In order to deliver quality healthcare, based on researchand innovation, MAHSC must improve the speed andbreadth of translation of research to patient benefit. Thisactivity will focus on improving the interfaces at the twotranslational gaps identified in the Critical Path for UKHealth Research (A review of UK health researchfunding. Sir David Cooksey 2006)

Five year

• At least one new birth-cohort studyattracted to Manchester

• All Greater Manchester PCTsparticipating in Clinical Trials

• Number of patents participating inclinical trials trebled

Ten year

• More than 10 demonstrable healthadvances delivered and implemented inroutine practice in Greater Manchester

Key Performance Indicators

MAHSC is Innovating and TranslatingResearch into Practice

We have powerful exemplars of partnershipworking on which to develop the MAHSCvision:

The Manchester Cancer Research Centre(MCRC) is a research partnership betweenthe University, Christie and Cancer ResearchUK (CRUK) and links with other MAHSCpartners. It has been instrumental in shapingshared research strategies and our city-widebiomedical imaging strategy, developingtissue banking across all partners, buildingon the University’s strategic alliance withAstraZeneca, attaining a new CRUK-fundedDrug Development Centre and developingan integrated scientific-clinical trainingprogramme.

The Wellcome Trust Clinical Research Facilitywas established by the partners in 2000. Ithas supported nearly 300 research studiesand safely completed 90,000 patient visits –more than any other such facility.

Manchester Integrating Medicine andInnovative Technology (MIMIT) is the firstinternational affiliate of the Center forIntegration of Medicine and InnovativeTechnology in Boston (CIMIT). MIMITspecifically identifies unmet clinical need todrive the rapid development of new devices,diagnostics and healthcare treatments.

The Greater Manchester CLAHRC carries outhigh quality applied research into healthservice delivery and ensures that knowledgegained from this research is implemented toimprove services in partner Trusts

Manchester pioneered developments in themanagement of research infrastructure andintegrated research governance in the UK egthe Research Passport to enable researchstaff to work across partner institutions, andresearch monitoring and assessment tools allof which have been adopted nationally bythe DH and MRC.

Central hosts the NHS National TechnologyAdoption Centre which works with NHSTrusts to embed innovative technologies inreal-time NHS environments. The Centre'steam will then work with a range oforganisations to promote the uptake oftechnologies which have been successfullyembedded as standard of care in theseTechnology Implementation Projects.

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Figure 1: MAHSC Academic Sections

Figure 2: First and Second Translational Gaps (Cooksey Review 2006)

BasicResearch

PrototypeDiscovery& Design

PreclinicalDevelopment

EarlyClinicalTrials

LateClinicalTrials

NHS R&D NHS HTA NHS SDO NHS CfH NHSMRC

NICEMHRA

HealthTechnologyAssesment

HealthServicesResearch

KnowledgeManagement

HealthcareDelivery

Critical Path within UK health research

First Gap in Translation Second Gap in Translation

Infastructureand technology

Evaluation Implementationand health of

the public

Education and training

Cancer

Cardiovasular

Human development

Inflammation and repair

Mental health

Clinical

Enabling

DNA banks

Tissue banks

-omics

Imaging e-Health

Health services

Primary care

Quality of life

Health inequalities

PostgraduateIntegratedacademictrainingprogramme

HIECinterface

CLRN interfaceBiostatisticsBio-healthinformatics and epidemiology

Healtheconomics

2.1 MAHSC will develop and deliver aninternal communications programme toensure staff members are familiar with,and can communicate to others, keyactivities and achievements to the widerworld.

2.2 The breadth and power of research at theUniversity, ranked equal 3rd in UK onResearch Power RAE 2008, is a majorstrength of the partnership and its abilityto disseminate research and innovationthrough publications, conferences andwider networking.

2.3 The NIHR Research Networks are keystakeholders for MAHSC. Disseminationto the public is a focus for the TopicSpecific Local Research Networks (LRNs)which aim to involve more patients (andtheir families) in high quality clinical trials.MAHSC partners are also active in thePrimary Care LRN. Members of the LRNsare also involved in the National ClinicalStudies Groups which work in partnershipwith Patients’ Groups to lead the researchagenda.

2.4 MAHSC will work closely with theStrategic Health Authority, NHSNorthwest. It is the largest geographicallyand second largest in population amongEngland's ten SHAs. It comprises 64 NHSorganisations and is one of only twoSHAs with an R&D department. MAHSCsections are already aligned with some ofthe most pressing health and healthcarechallenges facing the region’s population.

2.5 MAHSC will link to the NHS Evidence(part of the National Institute for Healthand Clinical Excellence, NICE) and the DHNational Innovation Centre through theNW Innovation Hub (Trustech), which ishosted by Central. MAHSC is also amember of the SHA Innovation Group.

2.6 MAHSC has hosted a national networkingevent of the AHSCs to sharedevelopments, compare effectiveness andbest practice and to form a major forcefor ‘selling’ the health and wealth agendaon behalf of UK plc. This activity willcontinue with our AJHSC colleagues aswe go forward.

2.7 MAHSC is a member of the AmericanAssociation of Academic Health Centersand will also participate in the EuropeanAcademic Medical Centres Group. Wewill develop our relationship with theUniversity of Pittsburgh Medical Centre,and consider potential mechanisms tobenchmark our effectiveness and sharebest practice. MAHSC has an agreementto partner with the integrated AcademicMedical Centre in Nijmegen, Netherlands.

2.8 As with delivery, working with keymultipliers in the research and innovationlandscape is integral to dissemination ofour work locally, nationally andinternationally, to both industry and otherstakeholders eg Department of Health,Department of Business, Innovation andSkills, NWDA Bionow Cluster, KnowledgeTransfer Networks (KTNs), TechnologyStrategy Board (TSB), the Trade Bodiesincluding the Association of the BritishPharmaceutical Industry (ABPI), theAssociation of the British HealthcareIndustries (ABHI), the BioindustryAssociation (BIA) and Medilink, inaddition to UKTI.

Goal TwoDisseminate innovation in technology and care nationally and internationally


The challenge for MAHSC in its communication anddissemination work is to build and embed a newstrong and compelling brand. This will be foundedupon a joint vision and shared set of values whichdoes not diminish but adds to the brand value of itsindividual partner organisations.

Examples of MAHSC Partners’ ResearchDirecting National Health Policy

Manchester research has had a direct impacton health policy and practice, as evidencedby the following examples:

Newborn hearing screening protocolsdeveloped by the audiology and deafnessunit.

Development of new strategies to reducerisk for suicide from the NationalConfidential Inquiry into Suicide andHomicide by People with Mental Illness.

New methods for measuring quality of carein general practice, an evaluation of theNHS expert and patient programme.

Dental screening protocols for schoolswere developed by the University's oralhealth unit.

Professor Alex Molassiotis, theUniversity’s School of Nursing, Midwiferyand Social Work, received a DistinguishedAchievement Award (2009) from theUniversity for his work in the development ofclinical antiemetic guidelines which arecurrently international practice standards. Hiswork on home delivery of chemotherapy haslead to important changes in practice bothlocally and nationally.

Promotion of the uptake of falls preventionadvice and coordination of ProFaNE(Prevention of Falls Network Europe)

Influence on NICE guidelines in dentistry,mental health, head injury, stroke, psoriasisand rheumatic disease.

MAHSC Partner Service Innovations

Computerised Pathology Sharing System(Salford Royal) – a computer programmeto enable secure downloading of pathologyresults for renal patients from one site toanother enabling reduction in GPappointments and waiting times, reductionin duplication of tests, improved decisionmaking for patient and professional and alsoa reduction in pathology staff time.

Post-ITU Rehabilitation Programme(Central) – a Physiotherapist led, out-patient programme of physical exercise andeducation sessions for ITU survivors whichincreases functional independence anddecreasing dependence on relatives/carersas well reducing GP visits and cost onongoing care.

Professor Chris Griffiths developed the"hub-and-spoke" model of dermatologyservices for Greater Manchester, instigatedthe North West Regional DermatologyTraining Scheme and introduced themultidisciplinary Manchester PsoriasisService (run from Salford), which wasawarded Hospital Doctor DermatologyTeam of the Year Award 2002.

Salford (along with other colleagues inGreater Manchester PCTs) has piloted theMet Offices’ Healthy Outlook® forecastservice. This provides automatic alert callsfor people with Chronic ObstructivePulmonary Disease (COPD) when weatherconditions increase their risk of illness andsignificantly increases hospital admissions.Although a full analysis of this innovativeservice is not yet complete but early figuressuggest that the service decreased hospitaladmissions in those GP practices that tookpart by up to 33%.

Trustech, the NW NHS Innovation Hub,based at Central, actively supports thedevelopment of service innovations in theNHS.

www.mahsc.ac.uk 09

Five year

• Uptake of at least five MAHSCgenerated policy, protocol or projectactivities at national level

Ten year

• Uptake of at least three MAHSCgenerated policy, protocol or projectactivities at international level


3.2 Manchester provides high qualityeducation at undergraduate,postgraduate and specialty training levelsacross nearly every healthcare relateddiscipline; MAHSC will further developthese programmes, including lifelonglearning elements. The focus will be ontargeting them to its Clinical AcademicSections thereby generating greatersynergy and momentum in both theproduction of research and in its uptake.

3.3 Education will be a key vehicle forinnovation. MAHSC’s education strategywill be delivered in partnership with, andas part of, the proposed HealthInnovation and Education Cluster (HIEC)to promote the implementation ofclinical/service innovations targeted tolocal population needs.

3.4 Inter-professional and inter-disciplinaryeducation programmes will be activelyencouraged, where not already in place,to underpin future behaviours in bothtranslational research and service delivery– integrated academic training.

3.5 The importance of research andinnovation in NHS management will beunderpinned through close working withthe Manchester Business School andthrough partnership with the Institute ofHealth Sciences and the GreaterManchester CLAHRC

3.6 MAHSC, with its comprehensive resourcesfor the education and on-site training ofhealthcare scientists, provides animportant vehicle for the implementationof the DH “Modernising ScientificCareers” agenda across the full range ofhealthcare scientist disciplines. Thisapproach is also suitable for providingeducational opportunities for thebiopharmaceutical sector.

3.7 MAHSC provides an ideal environment fordeveloping the postgraduate programmesalready available. This will be achieved byimproving links to its Clinical AcademicSections and integrating the trainingprovided across the University and itspartner NHS Trusts, thereby building acadre of young clinician and healthcarescientists that will sustain and renew ourresearch into the future

3.8 MAHSC partners will promote andsupport postgraduate degrees deliveredby the University with a strong researchcomponent eg MRes, MD and PhD andencourage flexible entry points forclinicians and life scientists

3.9 Research will become an integral part ofTrust core business with a real expectationthat every member of staff will either beactively leading research, engaged inresearch or supporting research. Bench-marked metrics such as publications andcitations, research income, membershipof national bodies such as MRC, andenrolment of patients into clinical trials,will be key performance indicators for allsenior clinical staff.

3.10 We will use workforce development plansto support redesign of care pathways andservices, including training programmesfor practitioners. This will improve NHSresponsiveness to the needs of individualpatients.

Goal ThreeEducate effectively in all aspects of healthcare, healthcare management,and biomedicine in support of workforce development.


MAHSC recognizes that excellence in educationincluding continuing professional development is vitalnot only for healthcare professionals, managers andscientists, but also as a vehicle to accelerate translationof research into practice.

MAHSC partners are committed toEducation and Workforce Developmentthrough Lifelong Learning

Undergraduate health-professionaleducation - 6000 students taught under aunified management team, includingmedicine, dentistry, nursing, pharmacy, andclinical psychology. A further 1500 studentsstudy life sciences.

Manchester “Walport” NIHR IntegratedAcademic Training Programme - largestportfolio of academic specialists in trainingin England, comprising 84 Academic ClinicalFellows and 50 Clinical Lecturerscommended by the Royal College ofPhysicians.

Multi-disciplinary, taught postgraduateprogrammes - provided for over 1300healthcare professionals across all disciplineseg University Centre for PharmacyPostgraduate Education which providescontinuing education to over 37,000 NHScommunity, hospital and specialistpharmacists and technicians.

The University has launched a new distancelearning MRes in Health and Social Care forprofessionals seeking a research career orrequiring research training and distance

Manchester Business School delivers severalMasters programmes supporting integrationof leadership and translation of research intopractice: MSc Healthcare Management,Master of Public Administration and theProgramme for NHS Management Scheme,in collaboration with the University ofBirmingham, designed to create the futureNHS leaders.

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Five year

• Twenty pan MAHSC Fellowshipsestablished relating to the ClinicalAcademic Sections

• 1150 graduate clinicians in medicine,dentistry, pharmacy, and nursing delivered viathe University and NHS partners per annum

Ten year

• More than 1,000 research-enabledhealthcare workers trained and qualifiedwith post registration qualifications egcertificates, diplomas, MScs, MBAs, MDsand PhDs


4.1 The Quality agenda is at the heart of careprovided by NHS Trusts in the North West.The region was one of the first to have100% sign-up of acute trusts to thenational Patient Safety First campaign.This and region-wide initiatives such asAdvancing Quality NW (hosted by Salfordas part of its leading role in QualityImprovement for NHS Northwest) and theNW Improvement Alliance demonstratethat MAHSC partners and other NW NHSTrusts can work together towardscommon goals and lead initiatives whichcan be adopted nationally. Quality is alsointegral to research, innovation,improvement and implementationprogrammes, such as CLARHC, and toMAHSC partners’ R&D strategies, directedat improving clinical care.

4.2 MAHSC will be uniquely positioned tofocus on clinical pathway re-design aspart of the pipeline for translationalresearch. Key skills and competencies inimprovement methodology will beprovided to clinicians and staff via apartnership between MAHSC and TheNorth West Quality Observatory /Advancing Quality Alliance (AQuA).AQuA will provide the infrastructure toorganise the delivery of system-wideimprovements focussed on ambitious andchallenging goals.

4.3 MAHSC partners already have establishedrelationships with National andInternational Improvement organisationsincluding the NHS Institute for Innovationand Improvement (NIII), the HealthFoundation, the Institute for HealthcareImprovement and Premier Inc. in the USwho are an Expert Partner in developingmetrics and systems to deliver AdvancingQuality.

4.4 Engagement of the wider community, ourcitizens of the future, our patients andhealthcare professionals is essential whenconsidering large scale research initiatives.Public engagement encompasses manydifferent dimensions including decision-making, stimulating dialogue,understanding thinking, and informationsharing. We will harness existing MAHSCassets and build on the track record ofMAHSC partners in and wider publicengagement as follows.

4.5 Public and patient involvement (PPI) willbe delivered through the partner PPIteams, which have well developednetworks engaged in a mission toimprove the quality and responsiveness ofhealthcare and patient and publicinvolvement with it, in alignment withINVOLVE. We shall also utilise the activecharitable and volunteer arms of theMAHSC partners, which offer a valuableopportunity to explore the attitudes ofpatients and communities to serviceprovision and research.

4.6 MAHSC will work with primary andsecondary care providers to develop theconcept of ‘citizen scientist’ where apopulation of patients understand theneed to, and are motivated to take part inclinical research, primarily through theacademic enabling sections.

4.7 The Centre for Genetics in Healthcare(Nowgen) based on the central site, has anational reputation for publicengagement work. It currently delivers awide-ranging programme of public eventsincluding exhibitions, surveys, debates aswell as Wellcome Trust commissionedworkshops for school students. MAHSCwill also work with the ManchesterHEFCE Beacon for Public Engagementwhich is committed to accessing hard-to-reach groups, such as people with poorhealth and poor education.

4.8 MAHSC will also exploit its strong linkswith a range of organisations in the cityand North West region to develop anintegrated approach with the NHS,academic, commercial and innovationsectors. Such organisations include, forexample, Local Research Networkconsumer groups; the North West PatientInvolvement Regional Advisory Group;Local Involvement Networks (LINks), theManchester Black Health Agency andManchester Knowledge Capital. MAHSCwill also link with Media City and with theBBC in Salford to develop opportunitiesfor enhanced dissemination.

Goal FourLead on quality of care and public involvement


Improving the quality of patient care is core to the MAHSCNHS partners’ mission as is the wellbeing of the widerpopulation. This is underpinned by our recognition that the“active involvement of the public in the research processleads to research that is more relevant to people and ismore likely to be used” (NIHR INVOLVE programme).

A track record in Public Involvement and Quality Improvement programmes

Central’s PPI team together with YouthForum established best practice guidance fortransitional care addressing the importantand topical issue facing young people withlong term conditions as they move frompaediatric to adult care services

Nowgen has developed a high profile in localpublic engagement, notably exhibitionsFaces of Manchester and Our Kid atManchester Science Festivals 2007 & 2008, avibrant schools’ programme and laboratoryworkshops for students and teachers.Further work has included measuringoutcomes in genetics services for patientbenefit and patient preferences inpharmacogenetic testing and a survey ofattitudes to pharmacogenetics and accessingviews of hard to reach groups, especiallyethnic minority groups.

The Christie charity is the second largest inthe country (after Great Ormond Street inLondon), with 2,000 active fundraisers and20,000 supporters. The majority of these arepatients or former patients and their familiesand friends. Much of the £13 million raisedby the charity every year is for cancerresearch, an area many of the fundraisersand donors feel passionate aboutsupporting.

South’s First Friday initiative operates wheresenior trust managers and executives visit aselection of patients on our wards to hearfirst hand of their experiences of using ourservices. This takes place on the First Fridayof every month and all resultant feedback iscollated by the Patient Liaison Team. ThePatient Liaison Team in turn feed aggregateddata back to the relevant services anddivisions.

CLAHRC, established in late 2008 to carryout research and implement researchfindings, is focused on vascular conditions(stroke, diabetes, kidney diseases and heartdisease), has already initiated the:

• scoping of a telephone support service toassist patients with a range of long termconditions including diabetes via PCTs

• first Breakthrough collaborative in kidneydisease in Primary Care in England withresults from the first cycle of improvementavailable in 2010. Engagement of staff fromall 10 Greater Manchester PCTs inimplementation projects, including 20 GPpractices from 4 different PCTs.

• IMPACT software tool to assist publichealth simulations and epidemiology studies

www.mahsc.ac.uk 13

Five year

• 1,000 members of the public signed upas ‘Citizen Scientists’

• Leadership/significant involvement with10-20 national health quality initiatives

• Schools workshops related to theMAHSC themes for 500/1000 schoolstudents per year


5.1 MAHSC will provide greater accessibilityfor enquiry via a virtual ‘one stop shop’. Itwill establish a more efficient interface forindustry as a result of harmonisedprocesses, protocols and contracts. Theinitial focus will be on clinical trial supportin coordination with the GreaterManchester CLRN

5.2 MAHSC will orchestrate its commercialpartnership activities through theoperations team and most importantly,via an ‘extended team’ for businessdevelopment. This will include those withthe member organisation remit forbusiness development and industrialliaison and the individuals charged withbusiness development (where they exist)in the MAHSC assets. MAHSC will,however, be mindful of commercialactivities that are better focused atindividual member level and will ensurethat there is no interference with memberprogrammes for charitable giving.

5.3 MAHSC will develop its interactions withContract Research Organisations (CROs)to develop partnerships that willcomplement NHS trials capability andexpertise to mutual benefit eg sharedfacilities, on-site facility development andtraining programmes

5.4 MAHSC partners have developed amutually productive interface withindustry through commercialisationorganisations. In particular, The Universityof Manchester Intellectual Property(UMIP) Company Ltd and University ofManchester Incubator Company (UMIC)Ltd have a considerable track record incommercialisation as well as state-of-the-art facilities for incubation in thebiomedical sector. In addition, Trustech(NW NHS Innovation Hub hosted atCentral) represents all the MAHSCpartners (as well as all the other researchactive NHS Trusts in the region) for NHScommercialisation activity includingservices. UMIP Ltd and Trustech (actingfor the University and NHS respectively)have already adopted a harmonised andincentivised approach to organisationaland regulatory issues, including IPmanagement, which is governed by aformal memorandum of understanding.MAHSC will work closely with theseorganisations to offer support to industry.

5.6 MAHSC will seek funding to support pilotprogrammes and industrial networkdevelopment in MIMIT. MIMIT is alreadyworking across the membership toidentify unmet clinical need relating todevices and diagnostics to developprototypes in collaboration with industry.

5.7 Beyond MIMIT, MAHSC has a particularability to coordinate discovery to marketsupport for the medical device anddiagnostics industries via its technologytransfer partners (Trustech, UMIP) andassociated funds - the £35M UMIPpremier fund invests in healthcareopportunities where there is a direct orstrategic link to the University. TheManchester location enables furtherlinkage with the regional cluster (Bionow)and medtech business support (MedilinkNW) organisations as well as the nationaltechnology evaluation authorities (NICE)and adoption organisation (NTAC).

Goal FivePartner more widely and more beneficially with thecommercial sector


MAHSC will build on existing industry partnershipsand the strategic alliance agreements with globalpharmaceutical and healthcare companies that arealready in place. For the first time, such partnershipshave the potential to extend across the full scope ofMAHSC translational activity from basic science toclinical service.

AstraZeneca - Manchester CancerResearch Centre (MCRC) Alliance: A model for industry partnership

In 2006 Cancer Research Technology andThe University of Manchester agreementwith AstraZeneca to establish clinicalpharmacology biomarker research anddiscovery collaboration.

Clinical pharmacology research fellowshipsjointly funded by Cancer Research UK andAstraZeneca. Within the three-yearfellowship programs, clinical research fellowsreceive training in translational research andPhase I clinical trials from academic, clinical,and industry perspectives at the PatersonInstitute for Cancer Research, the ChristieHospital, and AstraZeneca.

This collaboration focuses on theinvestigation of blood-borne biomarkers.The alliance has enabled the creation of anew regional biobank. Five hospital Trustsacross Manchester have biobank techniciansdedicated to collecting tissue, blood andurine samples from patients undergoingsurgery where cancer is suspected. Thetissues are stored in the MCRC biobank as aresource for research use.

In 2008 AstraZeneca announced a newpartnership with the National CancerCentre Singapore (NCCS) and the NationalUniversity Hospital (NUH) in Singapore todevelop anti-cancer compounds. Thepartnership also includes a TrainingProgramme placement with the MCRC.

Comprehensive Clinical Trial SupportInfrastructure

MAHSC has a close working relationshipwith the NIHR Greater ManchesterComprehensive Local Research Network(GMCLRN) hosted at South

The following topic specific regional andlocal NIHR research networks are also hostedwithin MAHSC partners: Dementias andNeurodegenerative Diseases (DeNDRoN) atMental Health; Cancer (NCRN) at South;Diabetes (DORN) at Salford Royal; Medicinesfor Children (MCRN) at Central, MentalHealth (MHRN) at Mental Health and;Stroke (SRN) at Salford Royal

The national topic specific Mental HealthResearch Network (MHRN) CoordinatingCentre is managed by the University inpartnership with the Institute of Psychiatry,King’s College, London

MAHSC Partners offer in-patient clinicaltrials facilities ranging across Phases I-IVfor general disease areas and specialistfacilities for cancer, paediatrics, respiratory,cardiovascular and diabetes including twoNIHR registered Clinical Trials Units atChristie (Derek Crowther Unit – Cancer) and South (Medical Evaluation Unit –Respiratory)

There are also ambulatory clinical trialsfacilities covering diabetes, renal,dermatology, neuroscience, stroke, GI,Rheumatology and Community LIFT Centres

The Wellcome Trust Clinical ResearchFacility, located on the Central site, is oneof the leading centres of its kind in thecountry. It has now extended to provide anin-patient paediatric facility.

The ActNOW database hosted at centralprovides a comprehensive list of more than1000 registered investigators, Trusts in thenorthwest region and affiliated NIHRresearch networks to aid communicationand support efficient site selection forindustry, alongside GMCLRN.

MAHSC partners work closely with ClinicalResearch Organisations, for example, theManchester base of US- owned ICON hasphase I facilities on the Central site.

www.mahsc.ac.uk 15

Five year

• 50 SME businesses assisted via theMAHSC portal

• Five new products/proceduresdeveloped via the MIMIT programme

• Most rapid set-up time (first in patient)for commercial trials in UK

• 95% of sites within MAHSC recruit to orabove target

• Establishment of MAHSC-IndustryExchange programme in clinical research

Ten year

• Trebled commercial partnerships withthe biomedical industry


6.1 MAHSC will support inward investmentactivity not only in overtly bio/healthrelated areas but also in linked sectors egdigital media and Media City at Salford.To achieve this MAHSC will work closelywith the city-region inward investmentagency, MIDAS, the regional developmentagency, NWDA, and its inward investmentagency, North of England (a joint venturewith other northern UK regionaldevelopment agencies) and UKTI, via itsoperations team.

6.2 The MAHSC Federation partner sitesstretch geographically from the west ofGreater Manchester (Salford, Salford PCT)through the centre (University, MentalHealth, Central, Christie) to the south(South) adjacent to ManchesterInternational Airport. The ManchesterCorridor developments and the AirportCity Industrial Zone will both be foci forcommercial property developmentsaligned to health.

6.3 MAHSC and its member organisationswill contribute to economic developmentthrough spin out companies andcommercialisation programmes forintellectual property. The University ofManchester, in particular, has a strongtrack record of commercialisation andspin out activity through its companiesUMIP and UMIC. Trustech, the NWInnovation Hub, based at Central, hasdeveloped a strong reputation in thecommercialisation of device and serviceproducts based on IP from within theNHS.

6.4 Within MAHSC is the stated aim to seethe “introduction of a cultural change inuptake of innovation across theorganisation”. Not only do we want tosee staff within MAHSC embraceinnovation to advance the quality ofservice delivery but, also, we want toencourage them to develop their ownability to innovate which may in turn leadto commercial activity. Pioneering work inthis area has been led by Trustech;MAHSC will further support this activity.

6.5 By improving public health throughresearch and innovative practice, MAHSCwill indirectly improve the economythrough the health and the wellnessagenda. The Northwest region has a veryhigh proportion of its population (9%) onincapacity benefit. New approaches toself help, treatment and care of chronicconditions will potentially enable many ofthese individuals to take up work andbecome active members of the economy.

6.6 A key MAHSC asset in this area of activityis the Brooks World Poverty Institute, amultidisciplinary centre of excellenceresearching poverty, poverty reductionand inequality in both developed anddeveloping countries. The importance ofhealth and health inequalities are a focusfor MAHSC.

Goal SixContribute significantly to innovation, enterprise and economicdevelopment in the city region and the North West of England


MAHSC will act as a beacon for inward investment inthe city region while success in harnessing theinnovation capability of the 35,000 strong workforcewill lead not only to patient benefit but also to wealthcreation opportunities.

Intellectual Property, Incubation and Commercialisation

The partnership makes over 200 inventiondisclosures per year, one of the highestactivity rates in the UK, and has the 2ndhighest number of start up companies.

£48M has been invested in bioincubatorfacilities – the Manchester BiotechnologyIncubator, the first of its kind in Europeopened in 1999, and the adjacent CoreTechnology Facility established five yearslater. To date the incubator facilities haveresulted in £74M sales in tenant companiesand the creation of 1,000 jobs.

Renovo, which floated on the London StockExchange in 2006 at £150M, and NeutecPharma, sold to Novartis for over £300M in2005, are just two examples of our successin translating basic research intodevelopment for patient benefit.

The UMIP Premier Fund is the largestsingle investment fund (£32M) in an HEI inthe UK; this is used to support spin-outcompanies and commercialisation includinghealthcare

www.mahsc.ac.uk 17

Ten year

• Direct delivery and/or support ofinward investment in excess of £100Minto the regional economy


7.1 MAHSC can only succeed with the bestresearchers, the best innovators, the bestmanagers and the best clinicalpractitioners in an environment that issupportive and attractive to theseindividuals. MAHSC will inform theappointments of all senior researchersand senior executives in its memberorganisations to ensure not only thehighest quality of appointees but also areal commitment to the principles ofresearch, innovation and quality in NHSmanagement.

7.2 MAHSC will implement a staffing andappointments policy for members. Thiswill provide strategic direction for theappointment and development ofresearch staff via a coordinated appraisalprocess based on common metrics.Academic Section Leads will provideleadership in the identification anddevelopment of key research staff andMAHSC will inform the appointment ofsenior staff.

7.3 The Education and Training AcademicSection Lead will coordinate workforcedevelopment needs identified across theother academic sections. Throughongoing investment in physicalinfrastructure, training and networks,MAHSC will provide research leaders withthe best facilities, equipment and supportstaff to undertake their work.

7.4 MAHSC proposed and is actively engagedin a national network of AHSCs to shareinitiatives and compare effectiveness. Thisnetwork may offer the potential to reviewa UK wide strategy for appointments inareas of speciality in each AHSC that arenot directly competitive.

7.5 Through MAHSC’s international links withAHSCs, other Centres of Excellence andcolleagues overseas we will encouragestaff exchanges and focus on thedevelopment on the ‘stars of the future’.

Goal SevenAttract the best national and international health researchers and healthcare workers


Only by being the best, can we attract the best.MAHSC will offer an environment for research andinnovation that is amongst the best in the world.

Recognition and Awards for Excellence

The University has 23 Nobel Prize winnersamongst its current and former staff andstudents. Laureates in life sciences andbiomedicine include Archibald V Hill, LinusPauling and Michael Smith.

Professor Joseph E Stiglitz is the CurrentDirector of the Brooks World PovertyInstitute and a recipient of the Nobel Prize inEconomics (2001)). Professor Sir JohnSulston FRS, winner of the 2002 Nobel Prizein Physiology or Medicine, is Chair of theInstitute of Science, Ethics and Innovation(iSEI) at The University of Manchester.Professor Ashley Woodcock OBE(respiratory medicine) contributed to theIntergovernmental Panel for Climate Change(IPCC) which was awarded the 2007 NobelPrize for Peace jointly with the former UnitedStates Vice President Al Gore.

More than 20 academic from MAHSCpartners are members of the Academy ofMedical Sciences and many of these andothers undertake leading national roles inthe NHS.

www.mahsc.ac.uk 19

Five year

• Research PA allocation outputsincreased by 5% per annum acrossMAHSC members

• Research PA allocation aligned toacademic sections increased by 10%across MAHSC members

Ten year

• More than 100 new seniornational/international health researchersemployed in MAHSC partners


• MAHSC has selected a federated rather thanan integrated AHSC model as this best suitsthe combination of multiple NHS organisationsserving Manchester’s population.

• MAHSC is enabled by a not-for-profit,Company Limited by Guarantee (CLG). TheBoard of Governors, chaired by Sir DavidHenshaw (also Chairman of the North WestSHA), includes the Chief Executives of theNHS Trusts, the President of The University,the Director of MAHSC and three non-executive members. .

• The CLG Board sets strategic direction,approves annual plans and budgets, agreespriorities for major bids/investments,appoints and appraises the Director,monitors performance against strategy, andensures proper accountability. It thereforeprovides the mechanism to integrate,intellectually and operationally, the researchand innovation potential of the partners.

• The Director and Chief Operating Officerwill be supported on a day-to-day basis bythe Executive Management Team (EMT)comprising the Deputy Director, Board levelmembers of each of the NHS partners alongwith the Associate Dean for Research in theUniversity’s Faculty of Medical and HumanSciences, the nine academic section leads,with the Deputy Dean for Clinical Affairs,Faculty of Medical & Human Sciences, inattendance. The EMT will input to businessplanning and project proposals as well asactively championing MAHSC activitieswithin their own organisations.

• The Chief Operating Officer and operationsteam will develop and support fundingproposals for the benefit of the MAHSCpartnership as appropriate.

• MAHSC will provide a coordinated approachto research and innovation for healthcareimprovement around a series of nineacademic sections. These comprise: fiveclinical academic sections that relate to thepopulation challenges and partner expertise(cancer, cardiovascular, humandevelopment, repair and inflammation,mental health); three cross cutting enablingacademic sections (infrastructure andtechnology, evaluation, implementation andhealth of the public) and an education andtraining academic section.

• Each Academic Section will have anindividual Lead, reporting to the MAHSCDirector. S/He will lead the strategy for theindividual clinical, enabling or educationalsection in coordination with other sectionleads, to oversee the interface betweenbasic research, clinical research, patient careand health. For certain sections the Leadwill automatically be the same individualwho heads up a key asset. For example, theMCRC Clinical Director will also be theClinical Academic Section Lead for Cancer.

• The academic section leads will work closelyacross all partners and the MAHSC assets toset the internal benchmark for MAHSC andensure that the full breadth of translationalactivity is understood and enabled.

Harmonisation

• In order to improve both pan-member workingand accessibility to external stakeholders,MAHSC will coordinate and facilitate theharmonisation of processes and protocolsacross the partners wherever relevant.

• The MAHSC partners have already pioneereddevelopments in the management ofresearch infrastructure and integratedresearch governance for the UK eg theResearch Passport which enables researchstaff to work across partner institutions. Thisvaluable experience is a major boost toMAHSC’s ability to take further stepstowards comprehensive harmonisation.

• The harmonisation process will build on bestpractice amongst the partners with individualpartners identified as a lead/local benchmarkfor each work programme. Initially this willfocus on four operational areas: researchoperations (contracts and protocols); staffingand appointments (including KeyPerformance Indicators and appraisals);research funding (identification andoptimisation); business development andindustrial relations (access and coordination)

• Ongoing improvement to practice andprotocols will be managed through theMAHSC operational ‘extended teams’comprising representatives of all themembers with additional experts drawnfrom the members as appropriate.

• The MAHSC NHS partners are pioneering“Advancing Quality” - a Northwest SHAinitiative unique to the UK. The programmewill incentivise improvement in the quality ofcare provided to patients by measuringthree quality indicators: clinical outcomes;patient reported outcome measures andpatient experience. MAHSC will also deliverknowledge transfer amongst NHS partners,thereby ensuring that all Trusts reach thequality standards of the best and furtherimprove clinical excellence.

Building Blocks Governance, Management and Organisation


Effective organisation and management across the interfacebetween research and clinical care: a federated approach withharmonisation of processes based on best practice

Five year

• CLG becomes a self sustaining operation

• MAHSC operational principlesembedded in member organisations

• Adoption of standard clinical researchcontract across members

• Adoption of common clinical researchcosting template across members


Board of Governors

Director

Executive Management TeamDeputy DirectorChief Operating OfficerUniversity Associate Dean for Research Six Trust Medical/other DirectorsFive Clinical Academic Sections LeadThree Enabling Academic Section LeadEducation & Training Academic Section Lead

Chief OperatingOfficer

Operations Team

MAHSC Partners: Networks & Extended Teams AcrossUniversity, Acute, Specialist And Primary Care Trusts

www.mahsc.ac.uk 21

MAHSC Management Structure

• Greater Manchester’s local population has rates of infant mortality, cardiac disease,mental health disorders and cancer thatexceed the national average. Based on thisknowledge and the research, innovation and delivery capabilities of the MAHSCmembers, five clinical academic sectionshave been identified: Cancer;Cardiovascular; Human Development;Inflammation & Repair and; MentalHealth.

• MAHSC will provide an overarching strategicplan for the clinical academic sections aimedat research investment from all tenManchester PCTs, focused on a smallnumber of areas with measurable outcomessuch as coronary artery disease, lifestylecancers, long-term conditions, diabetes andobesity.

• MAHSC will support key projects andproposals within partners in line with thestrategic direction of MAHSC, for example,application for BRC status as appropriate.

• MAHSC will also work closely with theStrategic Health Authority, NHS Northwest,to ensure alignment between MAHSC’sstrategy and the regional strategy “HealthierHorizons for the North West”.

Clinical ThemesClear focus on the clinical themes in which we have real capacity to make adifference: leading capabilities combined with strong communication and crossworking across the translational medicine spectrum


Five year

• Delivery of at least three research-basedinnovations for health improvement ineach of the clinical academic sections


Clinical AcademicSection

MAHSC Partner/Asset Support

Areas of expertise

Cancer Christie Manchester Cancer Research Centre(MCRC)Christie CTU (Derek Crowther Unit)

• Lung, breast & haematology cancers• Radiation research• Biomarker development

Cardiovascular Central/SalfordCollaboration for Leadership in AppliedHealth Research and Care (GreaterManchester CLAHRC)Diabetes LRN (DORN)

• Diabetes• Stroke• Arrhythmias

HumanDevelopment

Royal Manchester Children’s Hospital & St Mary’s Hospital (Central) Biomedical Research Centre (BRC)NowgenNational Genetics Reference Laboratory Medicines in Children LRN

• Pregnancy• Genetics

Repair andInflammation

South/SalfordNIHR Translational Research Facility &Medicines Evaluation Unit (RespiratoryMedicine) and the NationalAspergillosis CentreUK Centre for Regenerative Medicine(UKCRM)Northwest Embryonic Stem Cell Centre(NWESCC);Wellcome Trust Centre for Cell-MatrixResearch

• Airway inflammation (asthma, COPD)• Inflammatory skin disease• Genetics of arthritis

Mental Health Manchester Mental Health MCRN National Coordinating Centre MCRN and DeNDRoN LRNsCentre for Suicide Prevention

• Neurodegenerative disease (fronto-temporal lobe dementia) & memory clinics • Management of psychosis and bipolar disorders• Suicide and self harm prevention• Liaison psychiatry (psychological aspects of physical disorders)

• MAHSC will build on the support structurealready contained within its assets andwhich already offer significant capability andcapacity to support the clinical academicsections.

• MAHSC has identified three enablingacademic sections: Infrastructure &Technology; Evaluation and;Implementation & Health of the Public.The Enabling Academic Sections Leads willwork in coordination with the ClinicalAcademic Sections Leads and will also spanactivity in basic research, clinical research,patient care and health.

• The Infrastructure & TechnologyAcademic Section coordinates and invests inrepositories (genomics, DNA, protein, tissue,images, and clinical phenotype), drives thedevelopment and use of imaging acrossmodalities, leads the development of e-health.

• Although specifically noted underInfrastructure & Technology, the coordinatede-health strategy for MAHSC, implementedby all partner Trusts, and backed bymethodological development and evaluationwithin the University, will be organised withNorth West e-Health (NWeH), led by theUniversity and Salford. NWeH will provideadvanced data management and statisticaltools on top of anonymised health recordsto the population of Greater Manchesterand will also be harmonised with all“Connecting for Health” developments.

• Data from the MAHSC integrated clinicalsystems can be combined with other datawithin the local NHS, such as mortality rates,area-based deprivation scores etc via NWeHfor the development of better NHS servicesto the local community. It will also providemajor opportunities for the biohealthindustry in support of discovery and productdevelopment as well as post-marketingmonitoring and assessment. The Farsite tool,for example, will be developed tofacilitate/optimise the running of clinicaltrials.

• The Evaluation Academic Section isresponsible for coordination and design ofclinical trials across the partners and derivesfrom our existing strengths in statisticalmethodology and in the Greater ManchesterCLRN. This section will include biostatistics,informatics, epidemiology, and healtheconomics and create an integrated singleportal of entry for clinical trials includinggovernance, management, and streamliningof operational arrangements and trainingalso supported by the MAHSC operationalteam.

• Linked to the Evaluation Academic Section,the NIHR Research Networks are keystakeholders and allies for MAHSC in boththe delivery of translational medicine andalso the dissemination of best practice.MAHSC will build on what is already asubstantial capacity and capability in clinicaltrial delivery through the networks aspreviously described. The GreaterManchester CLRN is second nationally inrecruitment of patients to clinical trials andits Local Priority Groups are co-terminuswith our Clinical Academic Sections.

• The Implementation & Health of thePublic Academic Section is based on ourstrengths in health services research, and inprimary care. This section will beresponsible for assessing changes in qualityof patient care, health inequalities andpublic health by metrics and internationalbenchmarking.

Education and Training

• The Education and Training AcademicSection Lead will coordinate workforcedevelopment needs identified across theother academic sections as well as coreundergraduate and post graduateprogrammes.

• The importance of research to the deliveryof the quality agenda and openness to theuptake of innovation will underpin alltraining and recruitment activity.

Enabling InfrastructureStrong investment in enabling infrastructure and training: pan MAHSCresource and alignment with national programmes supported by fullytrained staff

Five year

• Delivery of a MAHSC Clinical Trials Unit(CTU) (building on the Christie CTU) andrecruitment of 25 academic staffsupporting clinical trials (statistics, healtheconomics, clinical pharmacology)

• Delivery of e-enabled populationdatabase of ≥ 2.5M

• Delivery of a co-ordinated bio-repositoryacross MAHSC members

• Established dedicated clinical trialstraining for nurses and other trialsupport staff


www.mahsc.ac.uk 23

Academic Section MAHSC Partner/Asset Support Areas of expertise

Enabling

Infrastructure andTechnology

Manchester Interdisciplinary Biocentre (MIB)Biomedical Imaging Institute (BII)Northwest e-Health (NWeH)

• DNA banks• Tissue banks• -omics• Imaging• e-Health

Evaluation Fully aligned to NIHR GMCLRNManchester Institute of Science Ethics and Innovation (iSEI)

Clinical Trials Support Infrastructure (see box - Goal Five)

• Single portal of entry for clinical trials• Biostatistics• Bio-health informatics and epidemiology• Health economics

Implementation andHealth of the Public

Fully aligned with the Institute of Health Sciences (HIS)

Collaboration for Leadership in Applied HealthResearch and Care (Greater Manchester CLAHRC)National Primary Care Research and Development Centre (NPCRD)

NIHR School for Primary Care ResearchManchester Integrating Medicine and Innovative Technology (MIMIT)

Salford PCT

• Health services• Primary care• Quality of life• Health inequalities

Education and Training

Education and Training Fully aligned to Health Innovation and EducationCluster (HIEC) Trust Education CentresThe UHSM Education Academy (South)

• Postgraduate training• Integrated academic training programme• Cross professional teaching• CPD


Figure 3: MAHSC Infrastructure AssetsWellcome Trust Centre for Cell Matrix ResearchCentre of Excellence in BiopharmaceuticalsManchester Interdisciplinary Biocentre (MIB)Manchester Institute of Science Ethics and InnovationManchester M-Health Innovation CentreBrooks World Poverty InstituteBiomedical Imaging InstituteUMIC Biotechnology Incubator and Core Technology FacilityUniversity of Manchester Interllectual PropertyCompany (UMIP)

MAHSC Partners

The University of Manchester; Central Manchester UniversityHospitals NHS Foundation Trust; Manchester Mental Health & Social Care Trust; NHS Salford (Salford Primary Care Trust);Salford Royal NHS Founation Trust; The Christie FoundationTrust and University Hospital of South Manchester NHSFoundation Trust.

Cancer ResearchCentre UK

The University of Manchester

Engineering and Physical Sciences

Humanities

Life Sciences

Medical and HumanSciences

GM CLRN

Greater Manchester

Acute, Specialist Trustand PCTs

NW CLRNs

Merseyside & Cheshire

Lancashire & Cumbria

CityCouncils

DH

SHANHS

Northwest

Charities

MRC/

Other RCs

OLS/BIS

NWDA

(Bionow)

NorthwestEmbryonic

Stem Cell Centre(NWESCC)

UK Centre for Regenerative

Medicine (UKCRM)

RespiratoryTranslational

Research Facility(RTRF)

Northwest Institute forBiohealth

Informatics (NIBHI)

Northwest e-Health(NWeH)

Biomedical Research Centre

(BRC)

ManchesterIntegratingMedicine

and InnovativeTechnology

(MIMIT)

Wolfson Molecular Imaging

Centre (WMIC)

Greater Manchester PCT

Institute of Health Sciences(IHS)

Collaboration for Leadershipin Applied Health Research

and Care (CLAHRC)

Manchester CancerResearch Centre WT Clinical

Research Facility

Trustech

Wellcome Trust

Northwest NHSTrusts

MAHSC

www.mahsc.ac.uk 25

Glossary of Abbreviations and Acronyms

ABHIAssociation of the British Healthcare Industries

ABPIAssociation of the British PharmaceuticalIndustry

AQuANorthwest Advancing Quality Alliance

BIABioindustry Association

BIIBiomedical Imaging Institute

BionowNW Biomedical Cluster Group (NWDA)

BISDepartment of Business, Innovation and Skills (UK)

BRCManchester Biomedical Research Centre

CentralCentral Manchester University Hospitals NHSFoundation Trust

ChristieThe Christie NHS Foundation Trust

CLAHRCGreater Manchester Collaboration forLeadership in Applied Health Research and Care

CfHConnecting for Health, National NHS IT programme

CLRNComprehensive Local Research Network (NIHR)

CTFUMIC Core Technology Facility

DHDepartment of Health (UK Government)

FCOForeign & Commonwealth Office (UK Government)

GMGreater Manchester

HIECHealth Innovation and Education Clusters (UK)

HTAHealth Technology Assessment programme(NIHR)

IHSGreater Manchester Institute of Health Sciences

iSEIManchester Institute of Science Ethics and Innovation

KTNsBIS-funded Knowledge Transfer Networks eg Health Tech & Medicines

LRNLocal Research Network (NIHR)

MCRCManchester Cancer Research Centre

Mental HealthManchester Mental Health and Social CareNHS Trust

MEUMedical Evaluations Unit associated with North West Lung Research Centre

MHRA Medicines and Healthcare products Regulatory Agency (UK)

M2HIC Manchester M-Health Innovation Centre

MIBManchester Interdisciplinary Biocentre

MIMITManchester Integrating Medicine and Innovative Technology

NHSNational Health Service (UK)

NIBHINorthwest Institute for Biohealth Informatics

NICENational Institute for Health and Clinical Excellence (UK)

NIHR National Institute for Health Research (UK)

NTACNational Technology Centre (UK)

NWDANorthwest Development Agency

NWeHNorthwest e-Health

NWESCCNorthwest Embryonic Stem Cell Centre

OLSOffice of Life Sciences (BIS/DH)

PCT Primary Care Trust

ReGroupGreater Manchester Primary Care ResearchGovernance Partnership

RTRF Respiratory Translational Research Facility,North West Lung Research Centre

Salford PCTNHS Salford (Salford Primary Care NHS Trust)

SalfordSalford Royal NHS Foundation Trust

SHAStrategic Health Authority (NHS Northwest)

SouthUniversity Hospital of South Manchester NHSFoundation Trust

SDOService Delivery and Organisation programme(NIHR)

TrustechNW NHS Innovation Hub

TSBTechnology Strategy Board (UK)

TRNTopic Specific Research Network (NIHR)

UKCRMUK Centre for Regenerative Medicine

UKTIUK Trade and Investment (BIS/FCO UK Government)

UMICUniversity of Manchester Incubator Company

UMIPUniversity of Manchester Intellectual Property Company

UniversityThe University of Manchester

WMICWolfson Molecular Imaging Centre

WTCMRWellcome Trust Centre for Cell-MatrixResearch

WTCRFWellcome Trust Clinical Research Facility

Manchester Academic Health Science Centre (MAHSC)

Simon BuildingBrunswick StreetManchesterM13 9PL

[email protected]

November 2009

J2561 11.09

MAHSC Strategy J2561

Documents

christie nhs foundation

manchester mentalhealth

nhs trust partners toformalise

medical research

academichealth science

research andinnovation

research hasbecome

social care trust