Oxford University Hospitals NHS Foundation Trust – Beyond Hospital Beds
Oxford University Hospitals NHS Foundation Trust is playing a vital role in providing research, training, and a picture of the future of healthcare.
Oxford University Hospitals NHS Foundation Trust is one of the leading academic medical centres in the UK. Structured as an NHS Foundation Trust and partnered with the University of Oxford the Trust focuses on teaching, research, and clinical care. The Trust carries out clinical training in its hospitals for students studying medicine for their undergraduate or postgraduate degree, as well as training nurses and other medical professionals.
“We have a lot of teaching and research activity, while also serving patients,” explains Dr Bruno Holthof, CEO of Oxford University Hospitals NHS Foundation Trust. “We gather clinical data, imaging data, pathology data, and whole-genome sequencing data. Our research aims to change the way we practice medicine in the future. We provide local services to Oxfordshire patients, and highly specialised services that we provide to the whole of England and sometimes Scotland, Wales and beyond.”
The Front Line Against Covid
Whether or not you are familiar with the Trust’s work, you might have some of it in your body right now.
“We’ve been instrumental in the development of the Oxford AstraZeneca vaccine, the most used vaccine today, especially in low- and middle-income countries,” Holthof points out. “Based on our models it has saved more than a million lives to date.”
The Covid pandemic was an unprecedented event, but it also showcased everything that Oxford University Hospitals NHS Foundation Trust does best.
“The Covid pandemic has illustrated how Oxford has delivered, fighting a specific disease, but we apply the same model to fight other diseases,” Holthof explains. “Covid-19 was a new disease, not a lot was known about the virus. So, we’ve done work around the diagnosis and treatment of the disease. The sequencing of RNA or DNA is not that difficult, it’s about the analyses. We have developed specific analytical tools that will now be distributed globally. These tools allow for faster and better diagnoses. We’ve collected data from other NHS trusts, randomising them to different treatments arms, letting us identify which drugs are working against Covid-19, and which are not. We have positive results in both of these camps.”
As well as establishing vaccines and treatments that are effective against the disease, it has been equally important to establish which ones do not help at all.
“We also demonstrated that drugs were not effective and therefore should not be used- hydroxychloroquine is the most high-profile example,” Holthof says. “We demonstrated it was not effective and made no difference in treating the disease.”
While this has certainly been a flagship effort, it is also emblematic of how Oxford University Hospitals NHS Foundation Trust is responding to countless other diseases. Innovations in genomics, imaging, artificial intelligence and medical or surgical interventions will, for example, also improve the outcome of patients with cancer.
While Covid remains a present and pertinent issue, as lockdowns and restrictions have eased the Trust is also turning its efforts towards patients that have received less attention due to the pandemic.
“The challenges are similar across the world. Covid-19 has created a backlog of patients that weren’t treated or diagnosed,” Holthof explains. “The NHS has a larger backlog than other countries because we had more limited capacity to start with. So, we’re increasing the productivity of how we diagnose and treat patients. We are, for example, improving the scheduling of our operating theatres to operate more patients per theatre session. And we need more staff to provide more diagnostic and treatment capacity.”
The Trust benefits from its location in Oxford, at the heart of a vibrant network of commercial and academic activity.
“Oxford has a vibrant life sciences campus with three types of organisations that work well together. These include the University of Oxford, the health system- we are increasingly not a hospital but a health system and the private companies,” explains Holthof. “We have a very active ecosystem of private companies working with the University and the Trust on innovating in healthcare and transforming that into benefits for patients.”
Sometimes those innovations will be spun off into private businesses, allowing the ideas to be shared on a wider scale.
“One example is Vaccitech, a company that worked with AstraZeneca, who developed, manufactured and distributed the Oxford vaccine worldwide,” Holthof says.
Oxford University Hospitals NHS Foundation Trust works with a wide range of businesses, from the same-day delivery firm, CitySprint, to Oracle, a partner that provides a genomic analytics platform in the cloud. The Trust also has a partnership with Oxford Nanopore, which aims to commercialise gene sequencing. But it all comes back to working with the patients that the Trust is built to serve.
“We have developed partnerships with companies that work with us to innovate and bring that innovation to patients,” Holthof says. “We allow our partners to have carefully controlled access to the de-identified data we collect around patients to test their innovations. We will also take a share in companies’ profits in exchange for supporting innovators to accelerate the adoption of their innovations.”
Healthcare at Home
And Holthof has a good idea of what some of those benefits might look like. When we talk to him about the future, it is a future where healthcare looks very different to what we see now.
“Most people still ask how many hospital beds you have,” he says. “But I say beds are not a relevant measure. Ask how many interventions we do, how many operating theatres and diagnostic scanners we have.”
Holthof has seen lots of new technology coming through and believes there are still many innovation opportunities to diagnose patients earlier, so they can be treated earlier with less invasive methods.
“Taking out advanced cancer may take five-to-six hours, if you diagnose early, it is shorter. So, you can do more of these operations in a day and the chances of taking out the whole cancer are a lot better,” Holthof explains. “We are applying targeted screening for patients with higher risk for lung cancer even if these individuals don’t have symptoms. We detect a lot of cancers early in the high smoking population and can treat them a lot earlier.”
This, Holthof believes, is where the entire health service is heading.
“We have seen the future during the pandemic,” he insists. “There will be earlier diagnosis using genomic data, imaging data, and biomarker data, which can all be done outside of the hospital. Many will be receiving their diagnostic kit at the home and mail the sample to a lab as they did with Covid swaps. With home diagnostics, you don’t need to come to the hospital. There will be community diagnostic centres for imaging or endoscopies that you can’t do at home. If needed, the patient will come to the hospital for intervention and many patients will go home in the evening.”
It is a bold vision, but one that this Trust is helping to make a reality.