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The NHS at 70

Leeds General Infirmary

This month, the nation has been sending its birthday wishes to the NHS. Over the last 70 years, it has brought most of us into the world and been at our side during illness and injury. But the monumental achievements of the NHS are due, in part, to the unique partnership it has had with another public institution, the Universities.

In less than four weeks, Saadiyah Khan will begin work at St James’ University Hospital in Leeds as a newly-qualified junior doctor.

With a great sense of pride, she will be taking the first steps on a professional ladder that one day will enable her to specialise in emergency medicine.

“My first rotation will be general surgery, which I’ve been told is one of the more challenging rotations,” she said.

“I expect a fast-paced routine and to deal with a high volume of patients. Night shifts and long days are guaranteed.

“However I have been tutored well by the University of Leeds over a lengthy six year period, and I feel ready to join the NHS workforce.”

Saadiyah’s transition from medical student to doctor is a tremendous personal achievement. But it is also symbolic of the deep synergy that exists between the university sector and the NHS. According to the latest workforce statistics, the NHS employs in excess of 1.2 million people, many of them will have graduated with degrees that allow them to practice in their specific field.

NHS principles such as care, compassion and professionalism underpin the way staff are expected to treat patients. Those ideals are instilled early on in degree programmes and they sit alongside the University of Leeds’ values of integrity, inclusiveness and academic excellence. Universities help define the public persona of the NHS.

The Faculty of Medicine and Health at the University of Leeds teaches around 4,500 students each year, the equivalent to a small university in itself. And it does not stop with the training of the next generation of healthcare professionals, the University is involved in research that improves NHS practices.

Professor Mark Kearney, Deputy Dean of the School of Medicine and Health, said: “The NHS and university researchers up and down the country have played a crucial role in improving the health of the nation. Diseases that were once certain killers can now be prevented or managed outside of hospital. The survival rates for many cancers have improved significantly.

“The progress seen in healthcare over the last 70 years has resulted from the hard work and dedication of NHS staff. But underpinning that is the close collaboration that has existed with the university sector.

“Not only do we play an important role in developing the academic and professional skills needed by people at all levels in the NHS, we are close partners in undertaking the research and innovation that has fuelled the revolution in healthcare.”

University researchers collaborate closely with clinical colleagues in the NHS. At Leeds, many staff hold dual appointments, working at the Leeds General Infirmary, St James’ Hospital, or Chapel Allerton Hospital, and at the University. The aim is to have a seamless connection between research and practice, so patients see the benefits more quickly.

A shared history

The idea of a healthcare professional being both a clinician and someone involved in research and innovation is not new. In fact, it predates the existence of the NHS and the University.

In 1824, Thomas Pridgin Teale was elected surgeon to the Leeds Public Dispensary. He was something of a celebrity scientist. Aged just 22, he acquired fame as the first provincial surgeon to tie the subclavian artery, one of the major blood vessels going into the arm.

In an era when surgeons started their careers as apprentices, he campaigned for a more formalised approach to training and was one of the founders of a medical school in Leeds. That happened in 1831, with the school laying the foundations for what would become the University of Leeds.

Giving the Leeds Medical School’s inaugural lecture, he argued that doctors must be prepared to continually update their knowledge, a principle that is as true today as it was almost 150 years ago.

From the outset, Teale saw the link between research, and the application of research to patient care. The creation of the NHS in 1948, accelerated that process, and extended it to other healthcare professionals.

Research pioneers

From the early days of the NHS, Leeds began to establish itself as a research centre.

Surgeon Leslie Pyrah grew up in Leeds and was a medical student at the University. After graduating, he went on to work at St James’ Hospital, focussing on renal disease.

In 1956 he was appointed Professor of Urological Surgery at the University and became the director of the Medical Research Council unit in Leeds.

That same year, with the help of fellow surgeon Frank Parsons, he set up the first renal haemodialysis unit in a UK hospital, at the Leeds General Infirmary. Frank Parsons had been to the US and had seen a dialysis unit at work there and brought the idea back to the UK.

The University library’s Special Collections holds the scientific reports, papers and letters written by Professor Pyrah and Frank Parsons. The library also holds photographs that were taken in the Department of Urology in the earl years of the NHS and show the kidney dialysis machine used at the LGI.

Four years after establishing the dialysis unit, Professor Pyrah successfully convinced the Wellcome Foundation and other benefactors that they should fund a four-storey research building at Leeds General Infirmary.

In more recent years, the drive to answer the tricky and seemingly intractable questions at the heart of some disease has attracted ‘cross-cutting’ research, where experts from different backgrounds come together to bear down on a problem. There has been progress in dealing with some of the bigger health challenges:

Myeloma?—?research in collaboration with Myeloma UK which has refined the treatment of a bone marrow cancer called multiple myeloma. The treatment involves high-dose chemotherapy and a transplant using the patient’s own bone marrow or blood. The treatment is now widely used across the world and the latest statistics show patients alive one year after diagnosis has increased from 35 percent to 70 percent.

Bowel cancer?—?The University led a trial into the use of minimally-invasive surgery to treat bowel cancer. It showed that cancerous tissue could be removed effectively without the patient having to undergo open surgery which is more painful and results in a longer stay in hospital.

Musculoskeletal disease?—?research has pioneered the early diagnosis and treatment of rheumatoid arthritis, a disease that affects 600,000 people in the UK. Studies at the University show that early identification of the disease and aggressive treatment can reduce pain and reduce disability. The research has changed management of the disease.

Cardiovascular disease?—?30 years ago, patients who had a heart attack faced a bleak future when it came to long-term survival. Research at the University showed that the early use of drugs known as angiotensin-converting enzyme inhibitors improved survival and quality of life for patients. The results have influenced treatment of heart attacks worldwide.

Professor Kearney said: “The University of Leeds and the NHS have not only worked on the fundamental questions at the heart of biomedical research but we have evaluated new drugs, developed medical technology and pioneered clinical techniques.

“The journey continues as we work on tackling the big issues facing the modern NHS: obesity, diabetes, heart disease, cancer and wound care. Our partnership places us at the vanguard of research: for example, we are using the power of computers to find patterns that exists in large health datasets: statistics that might provide clues as to groups who are susceptible to certain disease and why some groups may experience less disease.

“We’re looking at personalised medicine, where research comes together to allow healthcare professionals to tailor a highly specific course of treatment to tackle illness?—?or perhaps to halt it before it starts.

“As an educational institution, we make sure all our students are equipped to take forward the philosophy that Thomas Teale expounded almost 150 years ago that medicine and healthcare research does not standstill, and as health professionals they must embrace new knowledge to improve the lives and wellbeing of patients.”

When Saadiyah Khan begins her first round of ward visits at St James’ Hospital, she will do so safe in the knowledge that thanks to the partnership between the University of Leeds and her hospital, the treatments and advice given to patients is based on years of careful research and a continual desire to provide the best treatment based on strong evidence-based foundations.