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Academic Directorate of Specialised Medicine: Rheumatology

Key Contacts

Name Role
Josh Wright
Clinical Director
James Maxwell
james.maxwell@sth.nhs.uk
Research Lead
Dr Tim Tait
Clinical Lead
Operations Director
Kath Knight
Deputy Operations Director
Julie Senior
julie.senior@sth.nhs.uk
Deputy Group Finance Manager
Mark Palmer
Directorate Accountant
Directorate Research Coordinator
Gaurika Kapoor
gaurika.kapoor@sth.nhs.uk
Clinical Research Office Coordinator
(Industry-Sponsored Studies)

 

Rheumatology Research

(Research Lead on Specialised Medicine Executive – Dr James Maxwell)

The department of Rheumatology comprises 8.5 WTE NHS Consultant Rheumatologists with clinical and research interests which include Early Inflammatory Arthritis, Connective Tissue Disease and Vasculitis, Adolescent Rheumatology, Spondyloarthropathy and Sports and Exercise Medicine. Around 9,000 patients receive care from the department on an ongoing basis, with 1400 receiving biological medications. The clinical team also includes 5.5 FT specialist nurses, including a 0.5 FT Research Nurse, and 3 clinical specialist registrars. The department is currently going through an extensive re-organisation which will result in full integration within a single point of access musculoskeletal service which will include orthopaedics, the chronic pain service and community physiotherapy.

Clinicians within the department are active in a variety of research fields, recruiting patients to a significant number of NIHR portfolio and industry supported studies, and in this regard are supported by the research nursing and administrative team within the CRF. In support of this the department has developed a coding system for all outpatient attendances which allows improved identification of patients for specific research studies. We have strengthened the links between the clinical and research nursing teams with the introduction of monthly research meetings since January 2014 within which we review all studies currently open for recruitment, and those we are considering taking on. As a consequence of the large number of patients treated with biological medications, we have successfully negotiated a savings share agreement with our commissioners across the region which will allow a proportion of the income saved when patients enter funded biologic research studies, to be reinvested in the research nursing infrastructure.

Following the relocation of Professor Wilson to Dublin in 2013, the research focus within the department has been in recruiting patients to a number of NIHR and Industry supported clinical studies. The department is supported by the trust Clinical Research Facility, and has recently been successful in attracting additional research capability funding, together with further funding as a consequence of a savings share agreement with our commissioners to support the expansion our nursing infrastructure.  The department remains a EULAR Centre of Excellence in Rheumatology.

Theme 1 Rheumatoid Arthritis and Early Inflammatory Arthritis

Research Leads: Dr J Maxwell / Dr M Akil

The department is currently recruiting to a number of NIHR and Industry supported studies including treatment strategy trials with biologic and conventional disease modifying medications. Additional work continues in investigating predictors of outcomes in patients treated with biologic medications in established local and national cohorts. With increased nursing support, we are looking to increase the number of studies available to patients and to establish effective research collaboration with primary care.

Theme 2: Connective Tissue Diseases

Research Leads: Dr M Akil / Dr R Kilding

Large cohorts of patients with Systemic Lupus Erythematosus (SLE), Systemic Sclerosis, Primary Sjogren’s and Systemic Vasculitis. The specialty has been involved in several national collaborative studies and drug trials funded from the Medical Research Council (MRC), ARUK and Industry. Collaborative work will continue on biomarkers and plans to expand work in biological therapy. A clinical database has been established to support this work.

Theme 3: Physical Activity Medicine & Employee Wellbeing

Research Lead: Dr S Till

Sheffield is one of the 3 foundation partners for the National Centre for Sport & Exercise Medicine, an Olympic legacy initiative that seeks to co-locate clinical care, education & research in dedicated community facilities with the remit of promoting the health benefits of physical activity.

It is anticipated that the National Centre, through its academic programs and delivery arm, MoveMore, will build on existing physical activity research programs across a number of academic & clinical departments and facilitate new avenues of research by virtue of the unique facilities that comprise the National Centre in Sheffield.

The value of enhancing employee wellbeing is already prioritised by the private commercial sector and has been highlighted in several recent policy documents relating to the public sector and healthcare sector in particular. A tripartite agreement between STHFT, the University of Sheffield and the Health & Safety Laboratory was launched in 2005 as the Centre for Workplace Health (CWH). Dr Till is currently employed on a part-time basis as a joint appointment across rheumatology and the CWH. This relationship, in addition to Dr Till’s roles as clinical lead for the National Centre & Reader in Exercise Medicine at Sheffield Hallam University (SHU) is leading to a portfolio of research proposals focusing on aspects of employee wellbeing, the promotion of physical activity within the workplace and the related area of sedentary behaviour. This work is currently being partly funded by the AHSN.

Sheffield Olympic Legacy Park, a joint venture between STHFT, SHU, Sheffield City Council and private stakeholders has recently announced its’ proposal to create community, education and academic facilities on the old Don Valley stadium site. Modelled on the success of the Advanced Manufacturing Research Centre, the centre piece will be the Advanced Research Wellbeing Centre (ARWC). The AWRC will aim to facilitate the design, research, evaluation and implementation of products linking the medical, physical activity, leisure & sports sectors. The overlap between education & health/physical activity is a priority and the Park will house Sheffield’s 2nd University Technical College and a secondary school. To ensure the academic potential of this opportunity is fully realised a proposal is being explored to create an academic centre dedicated to physical activity research in children and young people.

Theme 4: Adolescent and Transition Rheumatology

Research Lead: Dr R Tattersall

The field of adolescent (patients aged 10-19 years) and young adult (aged 20-25) (AYA) rheumatology research is a burgeoning one. Structural constraints in the NHS (where children are seen in paediatrics and adults are seen in adult medicine) mean that adolescent research is often overlooked. Sheffield is unique outside of London in having a seamless adolescent service across the childrens and adult trusts in which research is strongly embedded. Sheffield have led in opening juvenile idiopathic observational and registry studies in both services so that young people transition both their clinical care and research enrollment together. We also enrol AYA in appropriate JIA studies even though they are technically in adult care and also recruit to studies in juvenile connective tissue disease. There is a strong collaborative approach with multicentre prospective portfolio studies in both qualitative and quantitative science in adolescence and transition open to recruitment in the department. Rachel Tattersall is also the Chair of the Barbara Ansell National Network for adolescent rheumatology (BANNAR), an ARUK funded initiative to promote adolescent research.

Theme 5: Spondyloarthropathy

Research Lead: Dr L Dunkley

A large specialist clinic of patients with Ankylosing Spondylitis and Non-radiographic Axial Spondyloarthritis has been established within the department, which we hope will allow us to increase recruitment to portfolio and commercial studies, and provide access to a greater range of therapeutic options for patients in this cohort.