REF Impact Case Studies

How we are working with rough sleepers and people who use drugs to eliminate hepatitis C virus

According to data from the homeless charity Shelter (2021), Brighton and Hove has one of the highest rates of homelessness in the UK, after London and Luton. Homelessness exposes individuals to many vulnerabilities such as poor health, unemployment and depression. In addition, alcohol and drug dependence can be very high amongst rough sleepers, thus increasing their exposure to infectious diseases such as hepatitis C virus (HCV) and HIV. 

Over the past decade, Professor Sumita Verma (view her profile here) and her team have reached out to these hard-to-reach, high-risk, populations to provide HCV treatment. HCV affects the liver and can lead to serious liver disease if left untreated. 

A unique aspect of this research is that the team chose to work in the community setting unlike the traditional hospital- based care. They used a ‘one-stop’ care model that included screening of people who use drugs and homeless individuals at the Brighton Pavilion, one of the largest addiction centres. A community-based nurse offered treatment and a painless liver scan to assess for liver scarring. Addiction teams, peer mentors and social workers joined in to ensure effective care and delivery of service. The work gradually expanded into Arch Healthcare, the only surgery in Brighton and Hove, providing specialised healthcare to people experiencing homelessness or using hostel services.  

The response to this community-based HCV service has been overwhelmingly positive. Patients really valued the personal, flexible, engaging, and non-judgemental approach, far more than going through hurdles to access care in hospitals. Cure rates have been comparable to hospital- based treatment. Deaths from hepatitis C virus related liver disease almost halved in Brighton, though other factors also contributed to this. This work also had a significant positive impact on the individual’s quality of life and understanding of their disease and their ability to access treatment. As a result, once the HCV was  treated, many were able to address other issues in their lives such as their drug or alcohol use. 

This research has changed the way patients, GPs, nurses, social workers perceive people who use drugs and rough sleepers and their associated health issues. The new HCV care model developed by Professor Verma and team has been rolled out in other UK centres, which shows the breadth and impact of their work. Their research-led interventions are playing a vital role in achieving the national goal of eliminating HCV by 2025; adoption of some of these interventions has enabled two of the largest HCV centres to achieve NHS England HCV elimination targets. Furthermore, Professor Verma has secured further funding from a leading international pharmaceutical company, Gilead Sciences to develop similar care models throughout East and West Sussex. 

This study has shone a light on some of the health inequalities that exist in marginalised communities in the UK. The work of Professor Verma and team and translated into a positive treatment and care experience in the lives of those enduring drug use, homelessness, poverty and ill health.

Delayed umbilical cord clamping: a ray of hope for improved survival and better health outcomes for premature babies

Premature birth is one of the leading causes of death in babies and children up to the age of five. Early clamping of the umbilical cord, a traditionally standard practice, has been associated with neonatal complications, particularly in premature babies.

Research led by Professor Heike Rabe (view her profile here) on delayed cord clamping (DCC) has contributed to improved outcomes and health benefits, including reduced risk of premature deaths and increased survival rates among infants. A delay in clamping of at least 30 seconds and up to 3 minutes can enhance redistribution of placental blood in the baby, stabilise blood pressure, reduce brain haemorrhage and lower rates of anaemia. It can also contribute to better overall care outcomes for complex premature births.

This impactful research on DCC has been instrumental in shaping wider public health strategies to improve both infant and maternal health. It has directly influenced and informed 17 national and international clinical guidelines, including the WHO Care of the Newborn Infant and NICE Preterm Labour and Birth guidelines. Consequently, there has been a shift in understanding, acceptance and practice of DCC in preterm births in the EU, Canada and USA. 

An important feature emerging from this research is the development of British Association of Perinatal Medicine Optimal Cord Management Toolkit. It has been implemented in maternity and neonatal units across NHS England, which has contributed to the frequency of DCC rising from 30 to 85 per cent in preterm births in one year in West and South West England. See more here.  

A unique feature of this research is that it has contributed to translating scientific evidence into teaching sessions for health care practitioners. The midwifery team and junior medical staff within the NHS attend DCC sessions as part of their induction and mandatory study days. Furthermore, this research is being publicly acknowledged, shaping conversations on awareness of among consumer organisations, professional bodies, guideline developers and policy makers. 

Professor Rabe’s work has strengthened the evidence base supporting the routine adoption of DCC. This is seemingly minor change in clinical practice is giving premature infants the best opportunity to thrive during the crucial first few weeks of life.

Emerging Impact

Engaging with patients and the public about new genomic medicine technologies through creative methods

Genomic medicine is an emerging medical discipline that involves using genomic information about an individual as part of their clinical care. Professor Bobbie Farsides and Dr Rich Gorman have been working with patient groups and families affected by rare disease to explore how the promissory discourses surrounding these medical technologies are (re)shaping the social worlds and lived experiences of patients and their families. Their aim has been to use arts-based narratives, co-produced with participants, as a means of creating accessible resources that develop opportunities for public engagement about the lived experience of rare disease, as well as supporting the development of ethically prepared healthcare professionals. The arts-health methods mobilised have provided valuable data. They have also been highly popular with stakeholder groups wishing to encourage public discussions, and Bobbie and Rich’s research has been exhibited at events such as The Festival of Genomics & Biodata, as well as featured on the radio, prompting greater public understanding and dialogue about the arrival of these novel technologies into the clinic.

Improving healthcare experiences for neurodivergent people

Neurodivergent people face barriers to accessing healthcare. Despite this, in the case of autistic people, we know that life expectancy is reduced and that they live with more co-occurring health conditions. Neurodivergent doctors may be an important piece of the puzzle in improving the healthcare system for the wider neurodivergent community. Over the last decade, research led by Dr Sebastian Shaw at BSMS along with other researchers has been extensively exploring the experiences of neurodivergent people in relation to healthcare – both those of medical students / doctors and those of people accessing healthcare. A key part of this strategy has been centring neurodivergent people within the research, impacting the research and subsequent clinical priorities from the inside. Recently, this work has culminated in the creation of the ‘Autistic SPACE’ framework – guidance for providing real-world adjustments for autistic people in health settings. This framework has now been incorporated into the Royal College of Psychiatrists’ National Autism Training Programme for Psychiatrists (Foundation Course). It has also been incorporated into clinical practice guidelines for GPs through the Scottish National Autism Implementation Team. The Royal College of Speech & Language Therapists have also recently incorporated it as a key resource for providing reasonable adjustments in clinical settings.

Paradigm changes for trials and treatment in ALS 

Amyotrophic Lateral Sclerosis (ALS; also known as Motor Neurone disease, MND) is a fatal neurodegenerative condition for which there is no effective treatment. The MIROCALS (Modifying Immune responses and Outcomes in Amyotrophic Lateral Sclerosis) study co-led by Professor Nigel Leigh (Chief Investigator) represents a major European effort – funded through the EU H2020 programme in partnership with the Motor Neurone Disease Association and other charities- to find an effective treatment to improve survival and quality of life. In a large randomised placebo-controlled trial designed and coordinated by the University Hospital of Nimes in France and BSMS, the MIROCALS study has shown that a low dose of interleukin-2 (IL2) significantly prolongs survival after 18 months treatment. Furthermore, for the first time in ALS trials the study systematically included molecular and cellular biomarkers in blood and cerebrospinal fluid to better understand variations in response to treatment, representing progress towards ‘personalised medicine’ in this devastating disorder. The Consortium coordinators are currently preparing the scientific report for publication and the full study dossier required for regulatory submissions.

Emerging Innovations in Infection Prevention: Shaping the Future of Global Health

Healthcare-associated infections (HCAIs) and antimicrobial resistance (AMR) present persistent global challenges, causing substantial morbidity, mortality, and economic burden. While traditional approaches focus on controlling infections after they occur, they often fail to address the root causes proactively. Novel technologies, such as whole-genome sequencing (WGS) and artificial intelligence (AI) prediction tools, offer transformative potential by enabling healthcare systems to shift from reactive to preventative infection control, improving patient outcomes, reducing antimicrobial use, and safeguarding the future of global health.

Dr James Price and his research group have made significant contributions to advancing infection prevention and control (IPC) by integrating research, clinical practice, and public engagement. During the COVID-19 pandemic, he developed a real-time surveillance system for hospital-onset infections, which reduced cases by 90% in his Trust and influenced national NHS and WHO guidelines. As a principal investigator within the COVID-19 Genomics UK (COG-UK) Consortium, he demonstrated the value of WGS in informing IPC strategies, shaping international pandemic recovery plans.

Beyond COVID-19 he has pioneered predictive analytics and surveillance frameworks to address AMR and HCAIs, including research challenging existing MRSA prevention hypotheses. His contributions to international guidelines for managing multidrug-resistant organisms have been adopted globally as gold standards, directly impacting patient safety and healthcare efficiency.

His commitment to public engagement has further amplified the impact of his work. Collaborating with internationally recognised bio-artists, Dr Price has co-created exhibitions exploring AMR, reaching over 2.2 million people across the UK, USA, India, and China. These exhibitions have successfully increased public understanding of AMR, with post-event analyses demonstrating enhanced awareness of antimicrobial stewardship and its importance in healthcare sustainability.

Dr Price’s contributions have been recognised through numerous accolades, including the ACCIA National Clinical Impact Award and the European Society for Clinical Microbiology and Infectious Diseases Young Investigator Award. He has secured over £7 million in research funding, authored 90 peer-reviewed publications, and serves as an advisor to national and international health organisations.

Dr Price envisions establishing an internationally recognised academic centre for translational infection research. This centre will focus on:

1. Integrating WGS, AI, and predictive analytics into routine clinical practice to pre-emptively combat HCAIs and AMR.
2. Developing scalable solutions to align healthcare decarbonisation with robust IPC measures.
3. Collaborating with global stakeholders to enhance preparedness and resilience against emerging infectious threats.

In the short term, Dr Price aims to expand WGS and AI-driven IPC tools and foster interdisciplinary partnerships to address healthcare sustainability challenges. Long-term, his goal is to reshape IPC research and clinical practice, reducing the global burden of HCAIs and AMR while creating a safer, more sustainable healthcare system.

Dr Price’s work exemplifies how innovation in research, clinical practice, and public engagement can transform IPC, leaving a lasting impact on healthcare systems worldwide.