Personal profile

Overview

I am Professor of Stroke Medicine and an Honorary Consultant in Stroke Medicine at the Comprehensive Stroke Centre at Salford Royal Foundation Trust. My research interests include translational studies of immunomodulation after acute ischaemic stroke and subarachnoid haemorrhage, studies in stroke rehabilitation and implementation studies in stroke. I was Clinical Lead for the NICE Acute Stroke and TIA Guideline (2006-8) and contributed to the 2016 National Clinical Guideline for Stroke. Until 2013 I was Clinical Lead for Stroke in Greater Manchester and led the Manchester stroke service redesign from 2007. I am Associate Director of the Royal College of Physicians Stroke programme with responsibility for the National Stroke Audit, SSNAP.  I am Vice Chair (Medical) and  Trustee of the Stroke Association and Chair of its Research Awards Panel.

Biography

I graduated from the University of Cambridge in 1978 with a first in Medical Sciences, and from the University of London (London Hospital Medical College) in 1981. I trained in General Medicine and Neurology in London (St Bartholomew's Hospital and St Mary's). From 1986-90 I was a Research Fellow at the MRC Cyclotron Unit, London and National Hospital Queen Square, where I studied the relationship between clinical features and PET scan appearances in various forms of degenerative dementia. As a Senior Registrar in Geriatric and General Medicine in London I became interested in stroke, and after completing clinical training in Manchester in  1995,  I was  appointed Consultant in Stroke Medicine in Salford. I was the first designated Stroke Physician in Manchester, and set up a nationally leading stroke service singlehandedly. In 1999, I was awarded my first research grant in collaboration with Professor Nancy Rothwell and was appointed Senior Lecturer in the University of Manchester in 2006. I am Clinical Lead to the Greater Manchester Clinical Stroke Network and have led a nationally leading redesign of stroke services. I was Clinical Advisor to the NICE guideline on Acute Stroke and TIA 2006-8, and lead the National Stroke Audit (SINAP) at the RCP. I was  RGL to the Clinical Neurosciences Group 2006-2009; Clinical Neurosciences Clinical Governance Lead 2004-2007;  and  Clinical Lead, NW Stroke Research Network (2006-13). This was the leading Stroke LRN for recruitment into RCTs and has brought clinicians from across the NW into research.  I undertake  translational research with Professor Nancy Rothwell, Professor Stuart Allan, Professor Andrew King, Professor Craig Smith, Dr Adrian Parry-Jones, Mr Hiren Patel and others   in neuroinflammation in stroke and subarachnoid haemorrhage. I am involved in studies of cognition following stroke, led by Professor Audrey Bowen, and studies of motor control and balance (Professor Sarah Tyson). I was   lead for the Stroke Implementation Programme of the first GM CLAHRC (2008-13) and led on the development of the Greater Manchester Stroke Assessment Tool (GM-SAT) which is now in clinical use across many parts of the NHS. I support the Stroke Programme in GM CLAHRC 2 which is delivering a new version of the GM-SAT for care home use and a carer support study. I am recognised nationally and regionally as an expert in clinical stroke management and lead an exciting and productive research programme. I have also been very involved in the delivery of stroke services within SRFT to a high standard, improving delivery of acute services including  thrombolysis and interventional procedures to patients from across GM. This service redesign has been the subject of an influential NIHR study on service redesign in the NHS. 

Research interests

My main research interest is in the modulation of the inflammatory response following stroke. This work has led on from the ground breaking work of Professors Nancy Rothwell and Stuart Allan and their teams over many years, and has now been translated into clinical trials with the help from many colleagues but particularly the Stroke Research team at Salford Royal Foundation Trust. A phase 3 study of IL-1Ra in subarachnoid haemorrhage will be ready to start in 2017, and a phase 2 study of IL-1Ra in acute ischaemic stroke has just completed with results due early 2017. Other research interests include how services are organised (NIHR HS&DR study); how stroke needs are assessed in the community (GM CLAHRC studies), and longer term rehabilitation needs of people with stroke. My academic colleagues continue to develop this research programme, with Professor Craig Smith leading on pneumonia prevention and infection following stroke, Dr Adrian Parry-Jones leading on a ground breaking programme of research in ICH, Professor Audrey Bowen leading a programme on cognition and language after stroke, and Professor Sarah Tyson leading on studies of balance and gait after stroke. 

Teaching

I teach year 2 undergraduates as part of their neuroscience programme, and am academic advisor to year 4 and 5 clinical students. I am a Communication Skills Tutor, teaching on year 4 Breaking Bad News and year 5 pre Foundationer Communication Skills days. I am lead for the neurosciences Integrated Academic Training programme. 

My collaborations

 

Professor Dame Nancy Rothwell

Professor Stuart Allan

Dr Catherine Lawrence

Dr Emmanuel Pinteaux

Dr Herve Boutin

Professor  Andrew King

Mr Hiren Patel

Dr Adrian Parry-Jones

Mrs Sharon Hulme

Professor Craig Smith

Professor  Audrey Bowen

Professor Sarah Tyson

Professor Andy Vail

Professor Ruth Boaden

Professor Matt Lambon-Ralph

 

 

 

 

 

 

 

 

 

 

Memberships of committees and professional bodies

  • Member of the Scientific Committee, The Stroke Association (2006-2010)
  • Member of the Scientific Committee, British Association of Stroke Physicians 2000-2003; 2004-2007
  • Member of the British Association of Stroke Physicians
  • Member of the Executive Committee, British Association of Stroke Physicians 2009-12
  • Member IDSMC: STASH study
  • Member, IDSMC, NIHR funded DARS study
  • Clinical Lead, SSNAP (RCP) and Associate Director, Stroke Programme, Royal College of Physicians 2008-date
  • Clinical Lead, GM Clinical Stroke Network 2007-13
  • Chair, Scientific Committee,  Stroke Association, 2012-
  • Trustee, Stroke Association 2012-
  • Vice Chair (Medical) Stroke Association 2014-date

Methodological knowledge

As lead for a translational programme of stroke research I have expertise in the design and conduct of difficult clinical trials in vulnerable groups, together with observational studies of inflammatory markers in plasma and CSF. I am aware of many of the pitfalls and difficulties of biomarker studies particularly inflammatory biomarkers. I have expertise in the design of imaging (MR and PET) studies in cerebrovascular disease, and in the basic science underlying the translational aspects of my work.

 I have experience in the adoption, design and conduct of a wide variety of RCTs and other well designed studies in stroke and subarachnoid haemorrhage. I have expertise in patient and public involvement through the clinical and research networks, and am frequently asked to talk to public groups about both research and clinical practice.

I have extensive clinical expertise in acute stroke and stroke rehabilitation, with a very active clinical practice including 24/7 cover for acute interventions, and I am nationally recognised as an expert in stroke care. I wrote the NICE Acute Stroke and TIA guideline in 2008, and I am lead for SSNAP, the national stroke audit. I have expertise in stroke rehabilitation studies, particularly dysphagia studies, as well as a specific interest in post stroke pain. I have expertise in implementation research and I am familiar with the role of qulaitative research in rehabilitation studies. 

 

Qualifications

  • BA (Hons) 1st Class University of Cambridge 1978
  • MB. BS (Hons) University of London 1981
  • MA (Cantab) 1982
  • MD (University of London) 1991
  • FRCP (London) 2000

Social responsibility

I was involved in Science Stroke Art 2014 (www.sciencestrokeart.co.uk, #SSA14), a unique partnership between the University of Manchester and the Stroke association, together with a number of cultural organisations across the NW. This ran throughout May 2014 and included talks, theatre, story-telling, science and art demonstrations to capture people's imaginations and challenge misconceptions about stroke. This project developed into "Stories of the Self Through Science and Art" (2015-16). 

I am a Trustee of the Stroke Association and its Medical Vice Chair. I chair my local transition town group and help organise a community garden, a project to restore a peat bog and other community activities related to raising awareness of climate change and sustainability.

 

Expertise related to UN Sustainable Development Goals

In 2015, UN member states agreed to 17 global Sustainable Development Goals (SDGs) to end poverty, protect the planet and ensure prosperity for all. This person’s work contributes towards the following SDG(s):

  • SDG 2 - Zero Hunger
  • SDG 3 - Good Health and Well-being
  • SDG 4 - Quality Education
  • SDG 11 - Sustainable Cities and Communities
  • SDG 12 - Responsible Consumption and Production
  • SDG 13 - Climate Action
  • SDG 16 - Peace, Justice and Strong Institutions
  • SDG 17 - Partnerships for the Goals

External positions

Medical Vice Chair, The Stroke Association

31 Aug 2014 → …

Areas of expertise

  • RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
  • stroke
  • subarachnoid haemorrhage

Research Beacons, Institutes and Platforms

  • Digital Futures
  • Christabel Pankhurst Institute

Keywords

  • stroke; inflammation; immunology; pneumonia; oral hygiene; dysphagia

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