As a national leader in HSR, HSRU promotes collaboration with research leaders from across Scotland, UK and internationally.

This collaborative approach has led to many directly measurable impacts and achievements. 

We are delighted that, together with the Health Economics Research Unit (HERU), we received the Queen’s Anniversary Prize for our sustained excellence in health services research over the last 40 years.

For further examples of our recent impact and achievements please see the links below.

Queens Anniversary Prize Award

We are delighted that, together with the Health Economics Research Unit (HERU), we received the Queen’s Anniversary Prize for our sustained excellence in health services research over the last 40 years.

It is the UK’s most prestigious form of national recognition open to a UK academic or vocational institution.

We received the award for pioneering the combination of clinical and economic research to assess which medical treatments are effective for use in the NHS and worldwide. Our researchers have conducted more than 1000 studies, involving 46,000 participants from 1,500 places worldwide.

The work has changed clinical practice, policy, legislation and academic methods; directly impacting on the lives of millions of people around the world.

For further information click here

   

Guiding the Introduction of Surgical Robots

Around 2010-2012, there was substantial uncertainty across the UK about the place of surgical robots in the routine treatment of prostate cancer given their large capital costs (each robot costs around £1.5m). Although surgical robots appeared to offer improved patient outcomes and subsequent quality of life, and change the way that surgery is delivered, the balance of potential harms and benefits was unknown.  Neither was it clear whether the benefits outweighed the costs.http://www.urology.uci.edu/prostate/Images/robot_5.jpg

HSRU undertook a novel health economic assessment that showed the large cost of the robot would only be offset if it was used at high volumes; at least 100–150 procedures per year. With this knowledge, the Scottish Government invested £1 million in 2015 towards the purchase of a robot in Aberdeen, followed by a further £2 million later that year for another 2 robots for the east and west of Scotland, on the proviso that recommended level of 100-150 procedures per year was maintained.

The first robotic prostatectomy in Scotland was undertaken in Aberdeen in August 2015 and the service is now fully operational. The National Institute of Health & Clinical Excellence in England recommended in 2014, on the basis of our findings, that commissioners of urology services should only consider providing robotic surgery for localised prostate cancer in centres able to perform at least 150 procedures per year.  There are now approximately 60 surgical robots in the UK, of which approximately 40 provide radical prostatectomy services across the country, directly benefiting up to 5000 patients per year who undergo radical prostatectomy.

Ramsay C, Pickard R, Robertson C, Close A, Vale L, Armstrong N, Barocas DA, Eden CG, Fraser C, Gurung T, Jenkinson D, Jia X, Lam TB, Mowatt G, Neal DE, Robinson MC, Royle J, Rushton SP, Sharma P, Shirley MDF, Soomro N. Systematic review and economic modelling of the relative clinical benefit and cost-effectiveness of laparoscopic surgery and robotic surgery for removal of the prostate in men with localised prostate cancer. Health Technol Assess 2012;16(41):1-313.

Reducing Antibiotic Prescribing Across Scotland

Dentists are responsible for prescribing 10% of all antibiotics dispensed in UK community pharmacies. Despite clear clinical guidance, dentists often prescribe antibiotics inappropriately in the absence of clinical need.  We sought to address this issue directly using our internationally renowned expertise in cluster randomised trials and implementation research methodologies.      We undertook the world’s first national cluster randomised trial of  different audit and feedback interventions to improve antibiotic prescribing practice, involving all 795 dental practices in Scotland. 

Our interventions produced a 7% reduction in annual antibiotic prescribing compared to usual practice- resulting in over 20,000 fewer antibiotic prescriptions across Scotland annually since 2014. 

The trial was:

  • methodologically innovative as it was the first trial of audit and feedback to use a partial factorial design to understand the mechanisms that drove the reductions in prescribing.
  • highly efficient, costing less than £30K because it used only routinely collected data.

Elouafkaoui, P, Young, L, Newlands, R, Duncan, EM, Elders, A, Clarkson, JE,Ramsay, CR. An audit and feedback intervention for reducing antibiotic prescribing in general dental practice: The RAPiD cluster randomised controlled trial. PLoS Med 2016;13(8):e1002115. doi:10.1371/journal. pmed.15.

Influencing the Introduction of New Trauma Services Across Scotland

In 2013, the Scottish Government committed to developing a trauma system – a clinical network of trauma centres, supported by emergency medical services – in order to reduce death and disability from major trauma. The key issue for Scotland, given its geography, is how such a system should be configured.  

The GEOS study involved a year-long prospective data collection, by the Scottish Ambulance Service, of where trauma incidents occurred, and what level of care (major trauma centre, trauma unit, or local emergency hospital) patients required. This information was then used to conduct a mathematical modelling of all theoretically possible trauma system configurations. More than 80,000 patients were included, around 7,000 of whom were triaged to major trauma centre care. The results of the GEOS study were fed directly into the National Planning Forum's formal deliberations on how Scotland’s trauma system should be taken forward.

Jansen JO, Campbell M, on behalf of the GEOS Investigators. The GEOS study: Designing a geospatially optimised trauma system for Scotland. The Surgeon 2014;12(2):61-63.

Informing Clinical Guidelines

Research publications relating to HSRU projects have successfully contributed to inform national and international guidelines. Among others, 26 NICE Clinical Guidelines (affecting over 200,000 patients in Scotland), 2 SIGN Guidelines and 16 International Guidelines (e.g., European Association of Urology Guidelines, International Incontinence Society Guidelines, Canadian Urology Association Guidelines, Cancer Care Ontario Guidelines).

An example is the diagnostic assessment on Point-of-care coagulometers for the self-monitoring of the coagulation status in people receiving long-term vitamin K antagonist therapy was reviewed by the Scottish Health Technologies Group to inform the Health Improvement Scotland, Evidence Note 57.