NWORTH Annual Report 2017-2018

North Wales Organisation for Randomised Trials in Health & Social Care (NWORTH)

2017-18 Annual Report

CONTENTS

Foreword 3 Lay Summary

4

Who We Are

6

NWORTH Organogram

7

Work Packages

8

Cross-cutting Themes

10

Key Achievements

13

Case Studies

14

Looking Ahead

16

Conclusions 18

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FOREWORD The North Wales Organisation for Randomised Trials in Health and Social Care, (NWORTH), is funded by Health and Care Research Wales.

This report provides an overview of our work and activity in the final year (2017-2018) of a threeyear grant period (2015-2108).

It highlights the range of projects with which we are engaged and the different types of evaluative methods that we use. It also shows

confident that this work package will continue to flourish. We now have 42 linguistically validated Welsh language health measures available on micym.org NWORTH has maintained its strong links with the School of Health

During 2017-18, NWORTH has been awarded eight new studies with a total grant value of over £5.5 million. Across the three-year grant period (to May 2018), we have submitted 64 grant applications and 24 of these have been awarded. This means that our success rate over the three-year period has been consistently above the national average for grants in applied health research (35.9% compared to 19%). our increasing strength in trials of complex interventions and pragmatic trials.

In Year Three, as well as being successful in renewing its core funding from Health and Care Research Wales for a further two years, (2018-20), NWORTH was successful in renewing its full United Kingdom Clinical Research Collaboration (UKCRC) registration for another five years.

We were sorry to say goodbye to Gwerfyl Roberts, Director of LLAIS upon her retirement in December 2017. Gwerfyl received a Lifetime Contribution award at the ‘More than Just Words’ showcase to celebrate her work to improve the quality of bilingual health care provision. We have now welcomed Beryl Cooledge to the team as the new Director of LLAIS and are

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Sciences, which allows for interdisciplinary research, particularly around implementation science.

In addition, the Unit has increased its reach and now has a number of new collaborators, whilst also attracting repeat business with our existing links.

Our Core Operations Group continues to improve the quality of the studies on our portfolio and enables us to have an agile and timely response to any arising issues. We have spent considerable time developing ‘Panopto’ presentations to populate the NWORTH website with an overview about each functional area: Trial Management, Statistics, Quality Assurance and Information Systems.

This enables potential collaborators to learn about the wide ranging and tailored input we can provide for their studies.

Year Three has seen progress in the methodological developments at the Unit. We are part of a research team that won a Medical Research Council grant to examine the impact of Studies Within a Trial (the PROMETHEUS study). We have also been actively engaged with a research team from the University of Manchester to promote Patient Centred Trials (the PACT study). We continue our interest in the use of implementation frameworks in trials of complex interventions. We were asked to give a presentation on knowledge mobilization for the Council of European Chief Dental Officers and a further poster was presented at the Society of Clinical Trials in May 2018.

This report provides a snapshot of our work and achievements over 2017-18. It also provides a summary of our future plans for 2018-20, where we hope to build on our success to date. This success is a testament to the dedication and hard work of the entire NWORTH team who are instrumental in the delivery of our research portfolio.

Professor Paul Brocklehurst Director of NWORTH

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LAY SUMMARY Who are we and what do we do?

NWORTH is a Clinical Trials Unit that specialises in the design and delivery of clinical trials and other studies. We are fully accredited by the UK Clinical Research Collaboration (UKCRC), which means that we have met a range of criteria that demonstrate our capability to co-ordinate clinical trials to the highest quality standards.

NWORTH’s mission is to improve the health and well-being of the people of Wales and beyond by carrying out research in health and social care.

Our research evaluates the effectiveness of interventions in real-life health and social care practice. This provides valuable information for those planning and commissioning health and social care services and ensures their decisions are based on the latest research regarding what works best and for who.

We also aim to improve the design of clinical research by looking at improvements that can be made at the planning and delivery stages of research studies.

We consist of a multi-disciplinary and multi-functional team with a wide range of experience and expertise in healthcare research and clinical studies.

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This includes: Statisticians: experts in the design, data management and analysis of studies. Our Statisticians work with health professionals, clinicians and those leading the research, to advise on the design of the research study. This includes the calculation of how many participants are required and how the results should be best analysed. When a trial is finished, the Statistician also helps to write the final report of the study.

IT and Data Capture: these are experts in the design of information systems and databases that manage all the data collected from participants in our studies.

They work with researchers to design, develop, programme, test and maintain the best systems for collecting data. They undertake rigorous procedures to test these systems to ensure that they are fit for purpose and collect all the information required for the study. They also design the systems that randomize and allocate participants to different treatment groups in clinical trials.

Quality Assurance: ensure all the legal requirements for running clinical trials are adhered to and monitor each of our studies to ensure they meet these requirements and that they are delivered to the highest possible standards. They conduct audits and monitor activity to ensure that all research is being carried out according to the study protocol.

Quality Assurance is essential to ensure that the data and results of clinical trials are credible and accurate. It also ensures that the rights, safety, well-being and confidentiality of participants in clinical trials is protected.

Trial Managers: these are experts in the project management and co-ordination of studies and ensure that each study runs according to plan and delivers what it has set out to achieve. They are key members of the trial team and ensure that all research sites recruit to ‘time and to target’. They are responsible for the day-to-day paperwork, reports, and data management for studies.

What do we want to achieve?

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Excel as a clinical trials unit undertaking randomised controlled trials and other studies to the highest quality standards.

Develop new partnerships and collaborations with researchers by linking with local NHS organisations and the wider Health and Care Research Wales infrastructure.

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Increase research activity in areas identified as being important to the people of Wales and beyond.

Provide a Research Design and Conduct Service to encourage and support staff working in Health and Social Care research to develop research proposals.

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Maintain the quality of new trials and studies undertaken at the Unit by ensuring all new studies are costed appropriately and delivered to ‘time and target’ and to budget.

Through LLAIS, facilitate trial participation through the medium of Welsh in order to ensure that people in Wales can participate in research in the language of their choice.

Develop methodological expertise in the design of research, which is recognised both nationally and internationally.

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WHO WE ARE

Core Operational Group Team Members (L-R): Alison Jenkins, Paul Brocklehurst, Ian Woodrow, Jean Ryan, Zoe Hoare.

NWORTH consists of a multidisciplinary team, which is divided into four main functions: Information Technology, Trial Management, Statistics, and Quality Assurance.

The Unit’s Core Operations Group (COG), meets weekly to oversee all studies being undertaken

by NWORTH. They also review incoming collaboration requests to determine whether potential studies are of a high enough quality to be adopted onto our portfolio and ensure

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the Unit has the capacity to deliver, within the timeframes and budgets allowed. Our COG consists of the Unit’s Director, Manager and four leads from each functional group.

COG’s role is crucial in terms of ensuring the Unit’s projects are run according to the appropriate regulatory and governance requirements.

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Data Manager: Greg Flynn (0.5fte)

Trial Development RPSO: Dr Karolina Rusiak (1.0fte)

Trial Delivery Facilitator, Research: Sion Griffiths (0.5fte)

Trials IT Specialist: Lexi Bastable (1.0fte) Trials IT Facilitator, Research: Lisa Jones (1.0fte)

Trial Statisticians (incl RDCS Lead & Support): Dr. Andrew Brand (1.0fte) Dr Nia Goulden (1.0fte) Rachel Evans (1.0fte)

Data Entry Clerk: Iwan Jones (1.0fte)

Trial Delivery Facilitator, Research: Sion Griffiths (0.5fte)

QA Officer: Dr Kirstie Pye (0.8fte)

IS Manager: Ian Woodrow (0.8fte)

Principal Statistician: Dr. Zoe Hoare (1.0fte)

Lecturer in Health Improvement & Implementation Dr. Lorelie Jones (1.0fte)

LLAIS RO: Dr. Llinos Spencer (0.2fte) Social Care RO: Dr. Gill Toms (0.2fte)

Trial Manager: Chris Woods (0.6fte)

Senior Trial Manager: Alison Jenkins (1.0fte)

CTU Manager: Jean Ryan (0.8fte)

Director: Professor Paul Brocklehurst (1.0fte)

NWORTH ORGANOGRAM

Key:

Trials Delivery Facilitator, Research: Greg Flynn (0.5fte)

Mixed Funding

Project Funding

H&CRW Core Funding

Bangor University Institutional Funding

Administrator: Karen Law (0.8fte)

Senior leadership input (All within Bangor University): University Lead, Prof.Jo Rycroft-Malone Strategic School Lead, Prof Chris Burton Social Care Lead, Prof Martina Feilzer Welsh Language Lead, Beryl Cooledge Implementation Lead, Dr Lynne Williams Qualitative Lead, Dr Sion Williams

WORK PACKAGES: Seven Work-Packages (WPs) make up our work plan for the duration of the current grant (2015-2020) WP1: Portfolio Development

NWORTH has maintained its success rate (from outline to decision to fund) at over 30%. This is an incredible achievement over a sustained period. Out of a total of 64 applications submitted over the three-year period, 24 were awarded, representing £14.4M in total grant capture and £11.9M for National Institute of Health Research projects (the largest applied research funder). Our current portfolio total grant value is £9.5M, (representing 15 active studies); with another £5M currently in submission (six studies).

WP2: Oversight of Ongoing Studies

Our Core Operations Group, (COG) works with our collaborating Chief Investigators and Principal Investigators to ensure that adequate resources and infrastructure are in place to deliver planned research studies to time and budget. The COG meets once a week to ensure that all research is conducted according to the study protocol and is appropriately monitored and audited. All of our work is underpinned by our Quality Manual and a suite of 30 Standard Operating Procedures (SOPs).

During 2017-18, nine of our SOPs were updated and 24 internal audits were carried out. We were sorry to say goodbye to Debbie Skelhorn, our Quality Assurance Manager, who retired in July 2017.

Debbie had been instrumental in establishing NWORTH’s Quality Manual and Quality Policy. It is largely due to her efforts that NWORTH has excelled at offering 8

seamless processes, which embed quality and add value to all of our collaborations. Debbie has been succeeded in the role of Quality Lead by Dr Kirstie Pye who brings the same commitment to our quality goals.

WP3: Building Collaborations 2017-18 has been a busy period with many collaboration requests coming from previous collaborators who wanted to work with us again.

During 2017-18 we reviewed 19 collaboration requests with 13 (68%) proceeding to work-up or submission. Our active portfolio consists of a range of collaborators from both Wales (41%) and across the UK (59%).

We have also strengthened links to key policy-makers, including the Chief Dental Officers for Wales and Northern Ireland, the Deputy Chief Medical Officer for Wales, Consultants from Public Health England and gerodontologists across Europe.

We are striving to work closer with Betsi Cadwaladr University Health Board, (BCUHB), and are exploring a joint research strategy to strengthen the research infrastructure in North Wales.

NWORTH is also working closely with the School of Social Care and will be directly linked to the implementation of the Social Care Strategy for Wales, working with Professor Fiona Verity. As lead for the Research Design and Conduct Service for social care, we are taking steps to improve the support for social care researchers wishing to undertake research across Wales.

In the years to come, we hope to build significantly on our strong relationship with the School.

We have spent considerable time reviewing our website to appeal to potential new collaborators and to highlight our unique selling points. Testimonials from previous collaborators have been added to the website to underline their positive experiences of working with NWORTH. They have highlighted the key strengths of the Unit: flexibility, agility, a tailored personal approach and a high grant success rate.

WP4: Methodological Development

NWORTH were one of the Trials Units chosen by Professor Pete Bower’s team to contribute to the Patient Centred Trials (PACT) study.

The Director is also a co-applicant on a MRC funded study to look at Studies Within A Trial (PROMETHEUS).

The Director was also part of a Senior research team at Bangor (including the Pro Vice Chancellor for Research and the Head of the School of Health Sciences), who undertook a work stream for a European Union Coordination and Support Action (Horizon SC1HCO-06–2016), on behalf of the Welsh Government. ‘TO-REACH’ (https://to-reach.eu) explored how research evidence can support health care services and systems to become more resilient, effective, equitable, accessible and sustainable.

We have also published three papers over the last year to highlight the importance of considering the implementation of research evidence as studies are designed and planned.

We will shortly be investing in a Lecturer in Health Improvement & Implementation who will drive a key methodological work stream that will address the

Our Statistics team are progressing with on-going work in developing our randomisation methodology and are drafting publications on this work. The Statistics team also prepared a podcast for inclusion in a module in the new Masters of Research programme.

Our IT Team is in the process of considering further improvements to the approach for specifying, documenting and testing MACRO electronic data capture builds.

Recent studies have been used to evaluate approaches and further refinements are being considered in order to simplify our processes and move towards a prototype driven approach.

WP5: Trial Unit Development

We appointed five new members of staff at NWORTH during 2017-18 and all have completed their inductions and job-specific training.

In addition, a range of additional internal and external training has been offered to all our staff. Our Principal Statistician has designed and led an innovative multifunctional training progamme for all staff across the Unit, which has been received very positively and has provided an original forum for cross learning and debate.

All staff have undertaken GDPR training and an assessment of Unit policies and procedures in relation to GDPR has been completed.

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WP6: Research Design & Conduct Service

Although we continue to promote this service and have undertaken a range of promotional activities to market the support available during 2017-18, the response and uptake of the service in North and Mid-Wales remains low.

However, we continue to work towards building stronger links with both Betsi Cadwaladr and Powys Health Boards in order to maximise the uptake of the RDCS and the support that is available.

This is important because an analysis of RDCS requests received since August 2016 indicates that only 14% of requests for RDCS support meet the eligibility criteria detailed in the RDCS Charter.

The RDCS Twitter account was re-activated and an article promoting the RDCS was published in the Betsi Cadwaladr University Health Board (BCUHB) R&D Newsletter.

During 2017-18, we responded to 19 enquiries from NHS and Social Care Professionals and attended 15 events across North and Mid Wales.

WP7: LLAIS

The Director of LLAIS, Gwerfyl Wyn Roberts, retired from Bangor University on 31st December 2017.

We are very grateful for all her work in developing and promoting Welsh language strategies at Bangor University’s School of Health Sciences over the past 26 years. We have subsequently appointed Ms Beryl Cooledge as the new LLAIS Director (who is the new Director for Bilingualism at the School).

Excellent progress has been made with this work package with the award of two new projects during 2017-18 (ADTRAC and Aneurin Bevan University Health Board

Stroke Project). The Welsh translation and linguistic validation of health measures in 2017-8 has included the following: • QOLLTI-F • Family MSAS-GDI • PROMIS-10 • smRq • PHQ-Young Person • GAD-Young Person • Warwick-Edinburgh Mental Well-being Scale 42 names are now on the RHOI LLAIS database of Welsh speaking lay members. Details of all measures are available at www.micym.org Dr Llinos Spencer, representing LLAIS, has continued to contribute fully to the all-Wales RDCS service and has attended and presented at a number of events to highlight the availability of Welsh Health Measures and promote language awareness to researchers across Wales.

WORK PACKAGES

recommendations from the ‘TOREACH’ project and explore how we can utilise implementation frameworks in the design of trials of complex interventions in health and care services.

In October 2017, Gwerfyl Roberts was presented with a Welsh Government Lifetime Achievement award for her contribution to leadership on Welsh language services in healthcare.

Gwerfyl Roberts receiving Welsh Government Lifetime Achievement Award for contribution to leadership on Welsh language services in healthcare. October 2017.

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CROSS-CUTTING THEMES: Public Involvement

CROSS-CUTTING THEMES

In total, NWORTH has offered 178 public involvement opportunities during the period 2015-2018.

Dr Llinos Haf Spencer has been invited onto to the School of Health Sciences’ Patient and Public Involvement (PPI)/ Citizen Science working group and will support Professor Paul Brocklehurst as he leads the PPI work stream at NWORTH and within the School of Health Sciences with Dr Lynne Williams.

Llinos has been working with Barbara Moore and Rebecca Burns within Health and Care Research Wales and aims to undertake a review of all PPI activity at the Unit and produce a PPI strategy.

NWORTH is organizing a PPI event entitled “Dweud Eich Dweud! / Have Your Say” which will celebrate health and care research in Wales and launch our new PPI hub.

PPI has been embedded into all NWORTH applications during this period.

Social Care:

NWORTH takes the strategic lead for social care as part of the AllWales RDCS. Dr. Gill Toms was appointed this year as our lead for this work package. She links seamlessly with the RDCS, NWORTH and the Wales School for Social Care Research (WSSCR), to ensure joined up approaches.

Through this role, we have fed into the consultation on the All-Wales Social Care Research Strategy and have highlighted the role of the RDCS and its remit in supporting Social Care researchers. Professor Paul Brocklehurst will be invited to attend a task and finish working group on the implementation of the social care research strategy.

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NWORTH is working with the WSSCR to provide documentation, (both internal and external), to capture the flow of the research process for social care practitioners and what support is available at the different stages.

A training needs analysis for social care practitioners has also been completed. Work has begun on a compilation of reference guides for RDCS teams on research methods commonly used in social care. We have also updated our RDCS web pages and documentation to ensure that Social Care professionals are properly included in all offers and that content is streamlined with WSSCR signposting.

Commercial Partners:

Two studies on the portfolio during this period have been industry funded. B-ADENOMA (BowelScope: Accuracy of Detection using ENdocuff Optimisation of Mucosal Abnormalities) is currently in write-up and is being led by Professor Colin Rees, from South Tyneside NHS Foundation Trust.

B-ADENOMA has been funded

by ARC Medical Design Limited who developed the Endocuff VisionTM to improve adenoma detection rates in colonoscopies.

The ADENOMA and B-ADENOMA studies were recognised at the prestigious Medilink Northern Powerhouse Healthcare Business Awards, held on 7 March 2018 at The Lowry Hotel in Salford.

South Tyneside NHS Foundation Trust’s industry partnership with ARC Medical, supported

by NWORTH, was awarded the Acute Sector award. The judges called it an exciting partnership that was commercialising product innovation. The team also won the ‘across categories’ competition and went through

to the national Medilink UK Healthcare Business awards held in Coventry on 25th April.

The second industry-funded study, (completed during this period), is the Harness Gravidarum (HG) Trial, (Management of Pelvic Girdle Pain in Pregnancy using Harness Gravidarum: A Randomised Controlled Trial comparing current treatment with a new device), being led by Dr Kalpana Upadhyay from BCUHB. The latter was jointly funded by BCUHB and HGR Limited, (suppliers of the pelvic girdle) and has now progressed to a full trial funding application which is currently at the second stage for ‘Research for Patient and Public Benefit’ funding.

NWORTH has offered 178 public involvement opportunities during the period 2015-2018

NWORTH takes the strategic lead for social care as part of the All-Wales RDCS.

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KEY ACHIEVEMENTS We have improved on all of our key metrics in 2017-18 and our cumulative performance for 2015-2018 is detailed below:

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64

£14.4M

(35 to NIHR NETSCC schemes)

of grants being funded between 2015-2018

grants awarded

(35.9% success rate)

£ £3.3M

£11.9M NETSCC

accruing to Wales

KEY ACHIEVEMENTS

grant applications submitted,

74 articles published in

income awarded

peer-reviewed journals,

(average impact factor = 3.144)

Our return on investment £5M

to Wales is 201.33%, £2,214,603; annualised

return on investment over

three years: 44.4%)...

178 public

involvement

opportunities

offered nworth-ctu.bangor.ac.uk

currently in submission

£250k commercial income generated

all within the Unit are green Key Performance Metrics

developed inductively

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CASE STUDY Adenoma & B-Adenoma Studies

CASE STUDY - Adenoma & B-Adenoma Studies

NWORTH collaborated on the ADENOMA study, led by Professor Colin Rees, (South Tyneside NHS Foundation Trust) from inception to completion.

This led onto a further collaboration on the B-ADENOMA study with the same research team. Both studies investigated the Endocuff Vision device, which has been designed to give an optimal view of the entire colon - an essential element of early detection for bowel cancer.

Bowel cancer remains the second largest cause of cancer-related mortality in the UK, and the fourth most common cancer in England with 34,000 people diagnosed each year. Low adenoma detection rates (ADR) are linked to increased post colonoscopy colorectal cancer rates and reduced cancer survival.

Devices to enhance mucosal visualisation such as Endocuff Vision (EV) have been argued to improve ADR. To evaluate this, the ADENOMA study was a multicentre randomised controlled trial that compared ADR between EV-assisted colonoscopy (EAC) and standard colonoscopy (SC).

This study demonstrated that the Endocuff Vision device increased ADR in bowel cancer screening patients and should be used to improve colonoscopic detection.

For every 1,000 people screened for cancer, it is estimated that an additional six cases could be avoided thanks to early detection through the use of this device.

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The research resulted in the award of an Innovation and Technology Payment (ITP) for 2018/19 from NHS England. The aim of the ITP is to help deliver the conditions and cultural change necessary for proven innovations to be adopted faster and more systematically through the NHS, and to deliver examples into practice for demonstrable patient and population benefit.

Endocuff Vision is one of only four innovations funded by NHS England for 2018/19 following a competitive process.

Simon Stevens, Chief Executive of NHS England, said:

“From the very beginning the NHS has been at the forefront of driving innovation, as we celebrate the NHS’s 70th birthday the NHS continues to champion innovation. These technologies will improve patient safety and potentially reduce the need for invasive and expensive tests.”

Professor Colin Rees, Chief Investigator for the ADENOMA and B-ADENOMA studies and Consultant Gastroenterologist at South Tyneside NHS Foundation Trust commented:

“NWORTH are an excellent clinical trials unit providing responsive, supportive running of clinical trials. I find them a pleasure to work with.”

CASE STUDY Alleviating anxiety in patients prior to MRI

CASE STUDY - Alleviating anxiety in patients prior to MRI

NWORTH collaborated on the above study led by Jenna Tugwell-Allsup, Research Radiographer, BCUHB.

Patients undergoing magnetic resonance imaging (MRI) often experience anxiety prior to and during scanning. The aim of this study was to explore two simple, cost-effective and easily implemented interventions to reduce anxiety before MRI scanning. Patients were randomised to receive either a video demonstration or a telephone conversation with a radiographer versus routine intervention.

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This study demonstrated that both of these types of interventions could significantly reduce preMRI anxiety, although the video performed slightly better than the phone call intervention. Importantly, the standard appointment letter that is routinely issued within the NHS did not contain enough information for most patients, which makes a strong case for a change in current practice.

This study was shortlisted for an NHS Wales award in 2017 in the Promoting Clinical Research and Application to Practice category.

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LOOKING AHEAD The new Trial Development Research Support Officer is completing her induction period and will be working with Jean Ryan, Zoë Hoare and Paul Brocklehurst to develop the strategy for new business. This will include:

LOOKING AHEAD

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Infographics and visual aids Using infographic and other visual aids to summarise and market NWORTH’s current performance in pragmatic trials and trials of complex interventions to existing and new Chief Investigators (CIs).

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Target areas already at capacity

Direct Data Entry Investigate the use of direct data entry and other methods to improve the efficiency of trial conduct.

Build on our current success

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Build on our current success and growing portfolio so that there is increased progression from feasibility and pilot studies to full definitive trials.

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Target CIs and PIs in areas where other Trials Units are at capacity.

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2

Utilise NWORTH’s geographic position Utilise NWORTH’s unique geographic position to explore grants promoting the Welsh language, Welsh culture and rural health.

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Build on our Patient and Public Involvement Build on our Patient and Public Involvement activities to deliver new patient driven opportunities and Citizen Science projects.

Academics and Clinicians Increase the number of trials led or supported by academics and clinicians with links to the School of Health Sciences and the College of Human Sciences.

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Build on ‘To-REACH’ outputs Build on the outputs of the ‘To-REACH’ to take forward a methodological programme on the use of implementation science in trials.

Social Media Output

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Increase the level of social media outputs after each trial highlighting our accomplishments and achievements using end of study ‘exit’ interviews.

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Link with key trialists Link with key trialists across the United Kingdom to promote the use of Studies Within a Trial.

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CI & PI Positive Relationships

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Continue to build on the positive relationships with current CIs and Principal Investigators (PIs) to attract new grant income with the same teams and colleagues of these teams.

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Invest in staff Further invest in staff to promote academic and methodological outputs.

Target CIs & PIs across England Target CIs and PIs across England using the information from the Open Data Platform across Wales and England in areas of traditional strength of NWORTH.

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Support practice -based research networks

Support the development of practicebased research networks in North Wales to promote a vibrant research infrastructure, clinician-led projects and opportunities to test implementation projects.

LOOKING AHEAD

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CONCLUSIONS NWORTH has made significant steps forward in the first three years of our grant from Health and Care Research Wales.

CONCLUSIONS

We have submitted a high number of grant applications to the largest funders of health research in the United Kingdom (UK) and our success rate is almost double the national average.

What is even more impressive is that this success rate has been sustained over the three-year period of our grant from the Welsh Government. To attract two pounds into Wales for every pound invested and to have an annualised Return on Investment of approximately 45% (over the three years) is extremely positive. This is a reflection of the knowledge, skills, attitude and commitment of the whole team at the Unit.

We continue to maintain good links with research teams across the UK and have also been successful in attracting new researchers to the Unit. We have extended the breadth and depth of the clinical areas that we engage with, whilst maintaining our traditional strengths in dementia, cancer and now oral health. Our involvement in industry-funded studies has been nationally recognised.

We have an opportunity of further developing our methodological interest in areas that improve the design and conduct of trials and promote the use of evidence in health and care services.

We see the next year as a period where we will grow further as a trials Unit and maintain the steep trajectory that we have set for ourselves.

Professor Paul Brocklehurst Director of NWORTH Clinical Trials Unit

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NWORTH CTU Bangor University Y Wern, Normal Site, Holyhead Road, Bangor, Gwynedd, LL57 2PZ 01248 388095 karen.law@bangor.ac.uk

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