Research prize could save patients from trauma of amputation

Posted on in Awards, Hospitals, Research, Staff, The trust

Confident: Dr Simon Ashwell and Emma Scott

Confident: Dr Simon Ashwell and Emma Scott

A specialist in diabetic foot disease at The James Cook University Hospital has been awarded £30,000 research funding – which could prevent patients from having to go through the trauma of amputation.

Dr Simon Ashwell and podiatry colleague Emma Scott took the coveted prize at South Tees Hospitals NHS Foundation Trust’s Dragons’ Lair 2016 event, run by the Research and Development team.

The competition, which took place for the second year running at the South Tees Institute for Learning Research and Innovation (LRI), attracted scores of entries from staff across the trust, which were whittled down to four impressive pitches.

Dragons - they're not so scary after all!

Dragons – they’re not so scary after all!

And this week, the four shortlisted researchers put themselves in the line of fire of a fierce panel of dragons, led by trust Chairman Deborah Jenkins.

Dr David Chadwick impressed the dragons with a research idea around improving the diagnosis of blood borne diseases such as HIV and Hepatitis B and Hepatitis C.

He was looking for funds to develop software that could assist diagnosis, assist with evaluating testing procedures and to develop improved screening processes.

Dr David Chadwick, cool in dragons' line of fire

Dr David Chadwick, cool in dragons’ line of fire

Dr Helen Chitty, higher specialist trainee in neonatal medicine and neonatal nurse consultant Dr Lynne Paterson’s research proposal looked at the use of deferred consent in neonatal emergency research studies.

And Dr David Austin, consultant cardiologist, was hoping to win the funds for his research on “cardiotoxicity” caused by cancer treatments and how it could be prevented.

All received praise for their innovative ideas and were encouraged to develop them further.

Dr Helen Chitty and Dr Lynne Paterson

Dr Helen Chitty and Dr Lynne Paterson

But the dragons deemed Dr Simon Ashwell and podiatrist Emma Scott’s proposal,  to reduce foot attacks and possibly amputation in diabetic, kidney failure patients on dialysis, worthy of the funds on the night.

Dr Ashwell, a consultant endocrinologist within the Diabetes Care Centre at The James Cook University Hospital, said: “The event has been fantastic and we’re delighted to have won the prize against such strong competition.

Tough questions for Dr David Austin

Tough questions for Dr David Austin

“It’s clear that all the ideas presented tonight are worth pursuing and could produce positive long term benefits for patients and the NHS.”

The winning pair’s research proposal builds on existing studies which have shown people with diabetes and kidney failure who require dialysis have a higher risk of suffering foot ulcers and leg amputation.

While this risk is well recognised Dr Ashwell says there is an “absence of published evidence on how to address the problem”.

“Multidisciplinary diabetes foot care teams have been shown to reduce admissions to hospital, length of hospital stay and leg amputation in people with diabetes,” he said.

“We have had a multi-disciplinary diabetes foot care team at James Cook since 1995 and leg amputation rates have fallen by 86% from 1995 to 2010. We now aim to do the same for people with diabetes on dialysis.”

Dr Ashwell says his work has demonstrated this group of patients fail to access the diabetes foot clinic or community podiatry services, as they already require dialysis three times per week, which sees them in hospital for several hours at a time.

This is in addition to many other hospital appointments they have to attend.

Deborah Jenkins and Jo Cresswell present £30,000 prize.

Deborah Jenkins and Jo Cresswell present £30,000 prize.

As a result of this “medical burden,” Dr Ashwell says these patients “too often” forget about their feet, particularly as they are often numb due to nerve damage.

This results in failure to protect themselves from diabetic foot disease or get it treated when it develops – which can have devastating consequences.

However, thanks to the funding, a 12 month pilot project will now run, which will see Emma attend the dialysis unit three times per week to examine the feet of all patients with diabetes.

She will assess their risk of foot ulceration to help prevent this developing in the first place, as well as identifying and treating active diabetes-related foot problems, in partnership with the existing diabetes foot multidisciplinary team.

It is hoped such patient-centred care will reduce leg amputation, hospital admission, length of stay and artery surgery in these patients, compared to the current process of patients being required to attend separate foot clinic appointments.

Dr Ashwell said: “Now we’ve won the funding we plan firstly to obtain a little additional funding to support the statistical and health economic evaluation of our intervention.

“Then we plan to start the project which will run for 12 months. After this we plan to analyse and publish the results. We see this as a pilot study and following its completion we plan to apply for NIHR funding to perform a larger, randomised, controlled trial using the same intervention across the North East.”