Institute for Health and Human Development

Approach

Strategic Partnerships

UNIVERSITY OF EAST LONDON PARTNERS WITH NEWHAM UNIVERSITY HOSPITAL NHS TRUST TO IMPROVE HEALTH IN LOCAL COMMUNITIES

The University of East London (UEL) and Newham University Hospital NHS Trust (NUHT) have jointly funded a new post of Professor of Community and Family Health in order to strengthen research into how local issues impact on the health and healthcare of families and communities within Newham.

This partnership is in keeping with NHS Newham’s remit to:

• look at the relationship between health, poverty, ethnicity and environment;
• research how multi-agency interventions which act on the wider determinants of health can be used to deliver health gain; and
• use existing and new evidence to provide investment advice in the regeneration and planning context.

It is hoped that the inspiration of the 2012 Olympics, for which Newham is the host borough, will underpin the research and ensure sustainability. Given the close proximity of NUHT to two of UEL campuses at Stratford and Docklands, the partnership is seen as an ideal opportunity to facilitate academic cooperation and interchange between the two organisations, with the research and learning resulting from this work providing a rich source of material for multidisciplinary teaching.

Angela Harden was appointed as the new Professor of Community and Family Health in October 2008. Her vision for the post is three-fold:

• to develop a thriving programme of high quality research linked to reducing inequalities and promoting health and well-being in Newham, focusing in particular on the health of women, children and young people;
• to establish strong relationships with local stakeholders, including the public, for the generation and implementation of relevant research around key priorities; and
• to build sustainable research capacity for the creation of a reliable evidence base which has local relevance and international significance.

Working closely with colleagues in UEL, NUHT and relevant external partners, Angela’s key research themes include:

• equality in access to appropriate health care;
• the promotion of health and well-being and chronic disease prevention;
• the wider determinants of health;
• public and patient perspectives and experience;
• randomised trials of complex interventions; and
• the synthesis and translation of existing knowledge into policy and practice.

Some of her key responsibilities include:

• Developing and leading a research group in Community and Family Health within the Institute for Health and Human Development (IHHD) / School of Health and Bioscience and Newham University Hospital NHS Trust and supporting education and research training in this field.
• Developing a sustainable research network with other individuals, universities, NHS Trusts and partner organisations.
• Securing funding for a programme of research jointly between the Trust and UEL.
• Bringing coherence to, and enhance the profile of, research activities related to family and community health across UEL and NUHT

PARTNER PROFILE

The Newham Locality

Population

Newham is a place of exceptional complexity with high levels of socioeconomic variation, deprivation and ethnic and cultural diversity. Black Asian and minority ethnic groups comprise over 60% of the local population of over 243,000. It has the third fastest growing population in England with 40% of the community being 0-24 years old and the largest population of under 1’s in the UK. This makes it a borough of youth and opportunity.

Regeneration and the London 2012 Games

Current projections for Newham are that we will see a further 85,000 new residents as a result of the regeneration in homes and employment made possible by the Thames Gateway. Economic regeneration is being further stimulated by developments such as the City airport and the building of ExCel - London’s new Exhibition Centre with new central government investment in large infrastructure projects such as the Jubilee line and the European high speed train terminal at Stratford in the north of the borough.

It is anticipated that the Olympic and Paralympic Games in 2012 will generate extensive additional opportunities for this part of East London. The 500-acre Olympic Park will be based in Lower Lea Valley which forms the boundary between the boroughs of Newham, Waltham forest, Hackney and Tower Hamlets. Two thirds of the park and the majority of the facilities including the athletes’ village, the main stadium, swimming pools, media centre and warm-up tracks, will be in Newham. Eighteen of the 26 events will take place within 20 minutes walking distance of Stratford station. The Park will also have the Olympic Village proving accommodation for every competitor and official with 80% within 20 minutes of their event venues. This will form the legacy at the heart of one of Europe’s largest urban regeneration projects after the Games.

Health Status and Outcomes

There is a high prevalence of long term illnesses such as diabetes and coronary heart disease in Newham; rates are three to four times the national average. People in Newham experience high levels of morbidity and mortality. Type 2 diabetes in children is a growing problem. The borough has the highest rate of TB in the country and there are new and complex challenges for sexual health, in particular, HIV in families. As the population is young the Borough has one of the highest birth rates in the country. Working to meet challenges has led to a wealth of local knowledge and experience in developing and delivering culturally-sensitive health services. There are close working partnerships between various stakeholders and a number of clinical, research and management networks exist between the trusts, Council, academic institutions and the voluntary sector. Despite continual efforts, health outcomes remain poor owing to a number of factors including delayed access to care, socio-economic deprivation, structural barriers to making healthy lifestyle choices, poor health education and maternal and childhood malnutrition.

Newham University Hospital NHS Trust

Newham Healthcare NHS Trust was formed in April 1993 (renamed in July 2004 to Newham University Hospital NHS Trust) and presently manages Newham General Hospital and some outpatient facilities based at the Shrewsbury Road clinic, Appleby Centre and the Centre, Manor Park. Newham General Hospital is situated in the middle of the Borough. The Trust provides secondary care health services to the population served by the London Borough of Newham, although there are small flows of patients to and from surrounding health districts. The Trust has close relationships with St Bartholomew’s Hospital, the Royal London Hospital (Whitechapel), Homerton University Hospital, Whipps Cross University Hospital and King George’s Hospital (Ilford).

The area served by the Trust lies immediately east of the London Borough of Tower Hamlets which is served by the Barts and London Trust (BLT). There are close working links with Bart’s and The London School of Medicine and Dentistry, Queen Mary University of London.

Trust Strategic Vision - to develop the 'Health Village'

The Trust aims to create a 'Health Village' at Newham which will serve as an open, welcoming environment for local residents to utilise health care services relevant to their needs in a culturally appropriate way while addressing relevant social factors.

There is significant investment in education with access to employment for staff and local people, using a skills escalator approach. Underpinning the health village concept is also the principle of partnership with patients, promoting good citizenship and ownership to local health services. To achieve this vision, the Trust developed a 10-year capital programme with the local PCT and North East London Strategic Health Authority, culminating in the agreement of a Strategic Development Plan (SDP) which represents significant capital investment on the site of the Newham General Hospital. This provides a strategic framework for the development of facilities for the Trust between 2000 –2010 and has been used to guide the Trust’s on-going capital investment.

There is great emphasis on partnerships with Primary Care, Mental Health Trust, neighbouring Acute Trusts, Social Services and particularly, with the London Borough of Newham, colleagues in Housing, Education and Employment. The Newham Local Strategic Partnership and Local Action Partnership Board help to create joint action plans where health issues are addressed across all of the agencies involved. The Trust also contributes to local regeneration projects.

A critical part of Newham’s vision for the future involves modernising services within a centralised facility, where planned changes to clinical services will enable the Trust to improve performance in-line with the targets set in the NHS Plan and changes proposed by the Healthcare for London document.

Women's & Family (WFH) Centre

The Trust is currently preparing a business case to redevelop a part of the site as a new Women’s and Family Health Centre. This presents the opportunity to redesign maternity services to provide real choices for local women around their care throughout pregnancy and delivery. The number of births is projected to continue to increase over the next decade, and the intention is to strengthen the local provision for maternity and neonatal care. The Centre will include the first adolescent unit within a redeveloped children’s service, and a dedicated women’s sexual health service

Research & Development at NUHT

The Trust was awarded University Hospital status in July 2004 in recognition of the significant amount of research and medical education that is undertaken here.

Research activity

R & D remains central to the core trust strategy and aims to address the health needs of the local population. Research activity is therefore focussed on clinical areas like infectious and communicable disease (TB, HIV), long terms conditions (diabetes, coronary artery disease, chronic airway disease, stroke) and maternal and childhood health (pre-eclampsia, foetal growth restriction, pre-maturity and gestational diabetes). Funding is received from a number of grant giving organisations including the Department of Health and its associate research bodies, MRC, Kings Fund and Charities. The trust also receives a budget from the Department of Health to support ongoing activity. In addition, staff conduct commercial trials funded by the pharmaceutical industry, which bring in much needed income.

Research Networks

The Trust is actively involved in and leads on funded projects for collaborative networks, which in accordance with NHS R & D requirements include NHS acute and primary care trusts, academic groups and voluntary agencies and charities. These include:

• Stroke Network: The Stroke department currently based in the state of art St. Andrews Wing participates in three National Studies into acute stroke management and is currently in the process of setting up two commercial studies which will be of benefit to the local population. As Newham has one of the highest rates of stroke in London, this is a research area encouraged by the Trust. This is also an area of on-going research collaboration with UEL.
• Diabetes Network: The Diabetes Unit is a principal partner of the local Diabetes Research Network led by BLT and has been a key player since its inception. Two prestigious funded studies (one by the NHS SDO programme and the other by the EU) led by Newham, have been adopted by the Network which provides additional research nurse support. The Department also contributes to the growing number of national multi-centre trials supported by the Network.
• North East Cancer Research Network: The Trust is a recruitment centre for a number of multi-centre cancer trials, including breast cancer, colo-rectal, lung cancer and haematology trials.
• Comprehensive Research Networks: This is a newly established DH research network that will incorporate the other areas of research at Newham including:
• Cardiology – The department has just led and completed a large National Study evaluating the first locally led open access chest pain clinic, the findings of which are expected to significantly influence National Strategy. The department also contributes to a large number of National commercial and non-commercial studies.
• Women’s and Family Health: This is a significant area of research to the Trust which is currently conducting an EU funded ‘Fish Oils in pregnancy study’ adopted by the Diabetes network (discussed above). The department has supervised and supported a number of research registrars and Fellows over the years.
• Sexual Health: The Trust is an important site for sexual health research with six ongoing studies and two studies due to start shortly. In addition, the sexual health department was recently awarded the King’s Funds’ first ever grant for HIV research. The research targets male partners of pregnant women for HIV screening to improve the screening rates in the population.
• Chest medicine: Research activity has focussed around TB which is a serious health issue for Newham. A recent study looking at the role of Vitamin D in TB prevention has attracted national interest. The Trust also participates in multi-site studies in chronic airway disease and asthma

Exploitation of Intellectual Property (IP)

NUHT is a member of the NHS innovations Ltd (NHSIL), set up by the government to facilitate IP exploitation within the NHS. Over the last two years, a number of suitable intellectual properties have been identified and patented. Two health education books developed by staff have recently been published by Virgin Books, one of which was short listed for a National Innovations award.

The Research & Development Office

The local R&D office supports the development of research projects, manages research governance and supports staff with training in research skills. A number of awareness raising events are held including an annual research forum. The appointee to this post will be a member of the trust R & D committee.

The strong Bilingual Health Advocacy department at NUHT is also a key asset for investigators working with the local population, and the R & D office has links with Patient and Public Involvement groups.

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© 2010