July 5th marks the 72nd birthday of the NHS. The birth of the NHS was the first time, anywhere in the world, that health care was provided completely free (at the point of use) to everyone. It was revolutionary. In 1948 the NHS employed 11,700 doctors; it now employs ~150,000. This partly reflects how demand has increased, but also how quickly medicine has advanced. The reason for these advances is scientific research. 

The commitment to innovation and research is enshrined in the NHS Constitution. The NHS Constitution is a ‘deal’ between citizens and our government about what we can expect from the NHS.

The UK has a long tradition of medical innovation and has made many significant contributions to medical science. This has resulted in groundbreaking advances in patient care. 

Here’s a brief timeline of some of the major advances developed in the UK:

• 1940’s – the development of Penicillin 
• 1950’s-  the link between smoking and lung cancer
• 1960’s – the development of the first variable rate pacemaker 
• 1970’s – the discovery of DNA sequencing 
• 1980’s – the invention of MRI and some of the world’s first robotic surgery 

And even more recently, significant advances in T-cell therapy for cancer treatments, gene silencing therapies to target the genetic cause of Huntingdon’s disease, gene therapy trials for children without an immune system and stem cell treatment for macular degeneration are just some examples. What a staggering achievement every one of those milestones is. It is impossible to think of modern medicine without these discoveries. 

Research enables greater decision making at scale

Research tells us which treatments we should give, but importantly which we should not give. In the 1940s an antibiotic drug called Patulin was thought initially, based on a few small studies, to be effective in treating the common cold. However, a large clinical trial demonstrated that the drug was not effective and so was not prescribed to treat colds. Imagine how much worse the challenge of antimicrobial resistance would be if we hadn’t learned that antibiotics were not effective to treat common colds! 

We know that antimicrobial resistance is a grave threat to our health. Scientists in Liverpool are helping to discover and develop new antibiotics that can treat multidrug-resistant bacteria and fungi. Some of these antibiotics work in completely new ways which means that we can’t develop resistance to them. These new drugs are thought to be ‘game-changing’. 

Liverpool is collaborating across the system to deliver exciting research studies 

As well as telling us which treatments we should give, research tells us how we can give it safely and effectively. For example, researchers from Birmingham found that treating patients over 75 who had an irregular heartbeat, with a blood-thinning medicine called Warfarin, reduced strokes, bleeds or blood clots by half compared to those who just took aspirin. 

The problem with warfarin is that it can be difficult to find the right dose for an individual and this was done by ‘trial and error’ by attending hospital clinics between 6 and 8 times.  If the dose is incorrect it can increase the risk of bleeding or blood clot. So, researchers in Liverpool pioneered personalised medicine dosing, which means that an individual’s genes determine the correct dose for them. This insight created a much safer way to dose the medicine to patients at scale.

Research continues to save lives, especially during COVID-19

COVID-19 has proven how significant a role research plays in the NHS and the nation’s health. We need to find out how to treat those who become ill with the virus, we need to understand why some are unaffected by it. We need to understand how the virus affects the health of those who have had it in the medium and longer term, so that we can reduce any impact as much as we can. We need to develop a vaccine, understand how effective the vaccine is and for whom.

Throughout the COVID-19 pandemic, research has remained a key priority for all NHS organisations and Universities in Liverpool. We have worked collaboratively to recruit over 3,000 patients into COVID research studies and are already planning to deliver vaccine research studies to tens of thousands of people across the city. 

The NHS is a vital institution in the UK, it achieves amazing things every day. Though, we can always improve, and research has a key role in helping the NHS to become even more effective. Research is the way that we can find answers for patients about how to cure or treat their illness. To find out what research studies are available locally please visit: www.bepartofresearch.nihr.ac.uk.