Following the NIHR Imperial BRC funding announcement, BRC Director, Professor Mark Thursz, spoke about the application and the centre's future impact.

The National Insitute for Health and Care Research (NIHR) has awarded Imperial College Healthcare NHS Trust and Imperial College London over £95 million of funding to continue joint research, developing and improving treatments, diagnostics and medical technology through the NHS-hosted NIHR Imperial BRC. 

The BRC provides the infrastructure – human and technological – to conduct early-stage experimental medicine within our Academic Health Science Centre. The BRC aims to harness the scientific power of the College’s Faculties of Medicine, Engineering and Natural Sciences, and provide proof of principle of new breakthroughs within the clinical setting.

Benjie Coleman spoke with Professor Mark Thursz, Director of the NIHR Imperial BRC, about the renewal application, BRC successes, and upcoming plans for its research themes.

How can the new BRC funding benefit Imperial researchers?

MT: The BRC is effectively an infrastructure grant and that is how it's seen by NIHR. This means it's supporting lots of facilities within College and Trust, which ensure that we can deliver our world-leading research.

We have, for instance, the Imperial BRC Genomics Facility, the Clinical Phenotyping Centre, a Flow Cytometry Core Facility (FACS), the Circulating Biomarker Lab and the IC Clinical Imaging Facility (ICCIF). And in addition to those laboratory-based facilities, we also have bioinformaticians and research delivery staff.

And then, perhaps most importantly on the digital health side, we have created a trusted research environment, Imperial Clinical Analytics, Research and Evaluation (iCare), which houses primary and secondary care electronic health record data from the 2.4 million people that live in north west London.

How do researchers from across Imperial’s faculties go about accessing BRC infrastructure, funding and support?

MT: The infrastructure is available for everyone within the AHSC research community - Imperial College London, The Institute of Cancer Research (ICR), Imperial College Healthcare NHS Trust, The Royal Marsden NHS Foundation Trust and Chelsea and Westminster Hospital NHS Foundation Trust - to use, and those facilities are advertised through the BRC website. 

Access to funding opportunities will be predominantly through the themes, with each having a management committee co-chaired by the theme leads, to examine proposals. They will also be inviting principal investigators from their areas of research—mostly college and Trust employees—as well as patient partners, to apply to access funding. So, I recommend anyone who has an interest in a particular theme or working with the BRC and faculties, to visit the BRC website and contact the relevant theme lead. 

Can researchers outside of the Faculty of Medicine benefit from the BRC?

MT: Yes, they can. A key selling point of our application was that one of the four connecting threads, which runs across all our themes, is the concept of convergence science. This is where you are trying to solve medical problems by not just bringing together people with clinical academic expertise, but also people with expertise in life sciences, engineering, computing, and other non-medical specialities. The best example of this is the biomedical engineering theme, which will be jointly run between the Faculty of Engineering and the Faculty of Medicine.

What was the application process like and who was involved?

MT: The application process was extended over an 18-month period and was conducted in three stages. Stage one involved developing the themes, finding the key researchers who would be involved in those themes and creating an outline of the work they would be doing. In the background at that stage, the NIHR was looking at our publication and grant metrics.

Stage two was a much, much bigger process! It involved laying out our plans for each theme, the researchers who would support these and their level of expertise, detailed costings, and examples of successful previous BRC activities. We had to also make sure that these theme plans were aligned to four common threads that will run across our themes - early diagnosis, precision medicine, digital health and convergence science.

Finally, stage three was the face-to-face interview that was conducted in April. All in all, the application document was well over 250 pages and involved many hours of hard work and dedication from lots of people.

In terms of those involved, I would first like to highlight PERC - The Patient Experience Research Centre - and our patient and public partners. One of the key ingredients behind our successful application was the 1400 or so patients and members of the public who contributed to developing our research strategy. PERC, along with our theme leads, coordinated really fruitful meetings with these people, where our strategy was developed. This was absolutely crucial to our success.

We also had a central team writing the application. Des Walsh, Shona Blair, Chrystalla Orphanides, Phil Bennett and Paul Craven were absolutely essential to the writing, drafting and organising of all our theme leads. And then, of course, the theme leads had quite a lot of work to do themselves. For this cycle’s application, we have a whole new set of theme leads, two leads for each of the 14 themes.

Can you give some examples of previous BRC research successes?

MT: This will be our fourth successful BRC application, with each cycle lasting five years, and of course, our previous research successes played a key role in securing this cycle’s funding. These include:

• Coming out of the cardiovascular research theme, the instantaneous wave-free ratio (iFR) is now used globally to evaluate coronary artery stenosis. 
• gripAble™ was launched as an Imperial College spin-out company with the aim to make training of arm and hand function more accessible in the physical rehabilitation of patients. 
• The REACT studies were real-time surveillance platforms for COVID-19, which were set up very quickly, with the support of BRC, during the pandemic. 
• And a huge amount of background work in the field of cancer research, which has received ongoing support from the BRC, has led to developments like CDK 7 inhibitors for breast cancer.

All of these projects involved invaluable collaboration with our NHS partners, and really highlights the benefits of researchers working with clinicians and patients.

What ambitions do you have for this funding cycle of the BRC, and are there any areas of research you are particularly excited about?

MT: As I mentioned earlier, I am excited about the collaborative work we are doing with the Faculty of Engineering around biomedical engineering. I also think there will be a lot of exciting work in the field of digital health. We really have put that front and centre of our strategy. Not only will we have the trusted research environment to facilitate research, but we will also be developing, a 'sand pit' to develop and evaluate a new artificial intelligence, so deep learning and machine learning technologies, which will be important for evaluating our own digital tools and also for working with commercial partners to test their technology.

In the area of infectious disease, I think we are already leading the way in terms of human challenge studies, but I expect to see these expand with new infectious challenges. Another area, that may be related to some extent to our convergence science approach, is the development of novel sensors for monitoring. For example, transcutaneous, superficially worn sensors with microneedles. We already have these to monitor blood glucose, and there has been recently published work on monitoring antibiotics. I expect this area to grow, with new sensors coming through looking at various different hormones and metabolites. I think it is going to be quite exciting. 

What research theme will make up this cycle's BRC work and how do they differ from previous cycles? 

MT: Previously, we had eight themes and four infrastructure or cross-thematic sub-themes that were bundled into what we called ITMAT, the (Institute of Translational Medicine & Therapeutics). The new application rules didn't allow for cross-cutting themes, which is one reason why we now have 14 themes.

Of the new themes, we now have molecular phenotyping, which includes genomics and the Phenome Centre for metabonomics. We are excited to have a new respiratory theme, as clearly there's a huge proportion of the country's clinical academics in respiratory medicine based at Imperial. As mentioned before, biomedical engineering is one of our new themes.

And I'm really delighted, we have a pregnancy and prematurity theme. That's an area that Professor Phil Bennett has built up over a number of years and is really very strong. And he'll be working with Professor Nenna Modi, who is a Consultant in Neonatal Medicine at Chelsea and Westminster NHS Foundation Trust. This is a very good example of the sector-wide research strategy we took in this application. We are not just focused on Imperial and Imperial College Healthcare NHS Trust, we will also be working with a number of external partners.

Which external partners will be working with Imperial BRC on its research?

MT: We were aware that the Government’s levelling up agenda and were encouraged to address that through our BRC application. So, we will be working with two external partners outside of north-west London, the first being the University of Cumbria, with whom the College is already developing plans for a new graduate-entry medical school in Carlisle. This BRC success will allow us to also develop collaborative research capacity in Cumbria, working particularly with nurses, midwives and allied health professionals. Our second partner is the Liverpool University Hospitals, and we will be working in a few areas there, including digestive diseases, and particularly alcohol-related liver disease.

How will the BRC funding support research development and training?

MT: Looking to the future, an important research agenda is the training of future clinical academics. We have a very successful Clinical Academic Training Office which manages the seamless transition, particularly for medical practitioners, between clinical training and research training.

Their remit is going to expand substantially, with additional funding to help provide training for nurses, midwives and allied health professionals. And in addition, we will continue to support the Chain Florey scheme, which we will co-funded with the Medical Research Council (MRC), through the MRC London Institute of Medical Science (LMS).

How should researchers acknowledge the NIHR BRC and its support?

MT: The BRC as an infrastructure grant, it's not supposed to fund the projects themselves, and it's very important in terms of renewals and in terms of our annual reporting that the publication outputs that acknowledge where the funding comes from.

Because the BRC provides so much infrastructure at Imperial, sometimes researchers forget that that is supported by the BRC. And without it, they wouldn't have access to a genome centre or a phenome centre, even though their research may not be BRC funded.

All research staff who carry out any patient/healthy volunteer clinical and/or experimental medicine research within either Imperial College or Imperial College Healthcare NHS Trust should acknowledge NIHR funding.

In addition to directly (co-)funding projects and staff, the BRC supports essential clinical research infrastructure at Imperial, including technology platforms (e.g. imaging, genomics, cell sorting), tissue banking, key NHS support services (pharmacy, labs, radiology), research nurses, administrators, clinical trials infrastructure and governance support. Therefore, if your research is translational or clinical in any way, it is supported – either directly or indirectly – by the BRC and you must acknowledge this in all your peer-reviewed publications. Sample wording for each type of BRC funding can be found on the BRC website. 

Finally, I'd like to thank all those who have been involved with research through the BRC, and I look forward to all the exciting work planned to make further translational research impact over the next five years.