Annual Review 2023: Transforming Health and Care

Our expertise across health and care has the fundamental aim of transforming lives

Our expertise across health and care has the fundamental aim of transforming lives. Our worldleading research is addressing today’s most pressing healthcare and psychological challenges, unlocking innovative new treatments for conditions including cancer, dementia, Parkinson’s disease, and all manner of mental health issues. At the same time, our commitment to research-informed teaching and real-world learning means our students are acquiring both the personal and professional skills they will rely on in their future careers.

Celebrating our contribution to community dental care

The University’s work to combine firstrate dental training with outstanding community care was acknowledged at the Times Higher Education Awards 2023.

The pioneering work of the Peninsula Dental School and the Peninsula Dental Social Enterprise (PDSE) won the Outstanding Contribution to the Local Community category at the awards ceremony in Liverpool. It is recognition of the efforts of more than 100 staff and 400 students working and studying with the Plymouth Dental School, and in communities and clinics run by PDSE across Devon and Cornwall. Over the past year, they saw almost 5,600 patients in the course of 28,000 appointments. 418 dental and dental therapy students were able to deliver crucial primary care to many of the more vulnerable members of society, including those experiencing homelessness and other forms of social exclusion. This activity marked a significant rise both in the number of patients seen, and appointments delivered, at the Dental Education Facilities in Plymouth, Exeter and Truro.

To have our work recognised at a national level is further evidence that our approach is delivering positive change across our community. It is the result of an amazing team effort that continues to benefit our students and staff, and the people of Devon and Cornwall.

Professor Ewen McColl
Head of Peninsula Dental School

Joining forces to deliver pharmacy degree

The University is working with the University of Bath to address the urgent need for more pharmacists, nationally and in south-west England. From September 2024, Bath’s MPharm (Hons) Pharmacy course will also be delivered in Plymouth.

The collaboration will give students more opportunities to study pharmacy and increase the number of pharmacy graduates in the South West, significantly contributing to healthcare within the region. The partnership brings together the University of Bath’s longstanding expertise in pharmacy education and research with the University of Plymouth’s excellence in providing health and social care education. It will be delivered in close collaboration with NHS England and many local stakeholders. The move comes at an exciting time for the profession, as changes to pharmacy education will allow all pharmacists to prescribe on registration from 2026, increasing the diversity of roles within the career.

Plymouth is already home to more than 4,500 health and social care students. Adding the pharmacy degree to the options available in Plymouth means we now offer an even broader suite of pathways into careers that will make a tremendously positive difference to the health and wellbeing of people in our region and beyond.

Professor John Curnow
Deputy Vice Chancellor, Education and Student Experience

Using targeted ultrasound to change brain functions

Research by neuroscientists at the University found the targeted use of ultrasound technology can bring about significant changes in brain function that could pave the way towards the treatment of conditions such as depression, addiction or anxiety.

The study explored the impacts of an emerging technique called transcranial ultrasound stimulation (TUS). Writing in Nature Communications, the researchers said a study involving 24 healthy adults showed that TUS can induce significant changes in GABA (gamma-aminobutyric acid) concentration within the brain’s posterior cingulate cortex in the hour following ultrasound treatment. As such, they believe it represents an important first step in the generation of clinical applications that could use ultrasound to treat mental health disorders.

We already know that specific regions of the brain (and some of their connections) are dysfunctional in certain conditions but other regions can work perfectly well. This study provides us with the genuine potential to think about using ultrasound for more targeted interventions in people with a range of mental health conditions.

Professor Elsa Fouragnan
Associate Professor of Neuroscience

Neuroscience research - computer screen showing brain scans

Neuroscience research - researcher placing equipment on participants head

Uncovering the genetic mutations that cause neurodegenerative disease

Scientists have discovered an additional potential cause of the genetic mutations that result in rare conditions such as Huntington’s disease (HD).

The neurodegenerative diseases, which also include most spinocerebellar ataxias (SCAs), are known to be caused by an expansion in the CAG (cytosine-adenine-guanine) repeats within a gene, which in turn leads to an expanded polyglutamine (polyQ) tract in a protein. Previously, it had been thought the damage in these genetic diseases was caused solely by increased protein aggregate toxicity. However, a new study published in Nature Chemical Biology has found that an additional source – ribonucleic acid (RNA) – can generate levels of toxicity that cause damage to the brain in these diseases.

Conditions such as Huntington’s disease currently have few treatments and no known cure. If we are to make the significant steps needed to directly benefit patients and their families, we need to fully understand the nature of the conditions we are dealing with.

Professor Shouqing Luo
Professor of Neurobiology

Shedding new light on the challenges of killing superbugs

One of the primary chlorine disinfectants currently being used to clean hospital scrubs and surfaces does not kill off the most common cause of antibiotic-associated sickness in healthcare settings globally, according to a new study.

Research by the University showed spores of Clostridioides difficile, commonly known as C. diff, are completely unaffected despite being treated with high concentrations of bleach used in many hospitals. In fact, the chlorine chemicals are no more effective at damaging the spores when used as a surface disinfectant than using water with no additives.

Writing in the journal Microbiology, the study’s authors say susceptible people working and being treated in clinical settings might be unknowingly placed at risk of contracting the superbug. As a result, and with biocide overuse fuelling rises in antimicrobial resistance (AMR) worldwide, they have called for urgent research to find alternative strategies to disinfect C. diff spores to break the chain of transmission in clinical environments.

Far from demonstrating that our clinical environments are clean and safe for staff and patients, this study highlights the ability of C. diff spores to tolerate disinfection at in-use and recommended active chlorine concentrations. It shows we need disinfectants and guidelines that are fit for purpose and that work in line with bacterial evolution.

Dr Tina Joshi
Associate Professor of Molecular Microbiology

Scientist swabbing a culture on a petri dish

Pinpointing the causes and treatments of autoimmune diseases

Scientists have developed a potentially transformative new technique that could aid in the discovery and development of new therapeutics for globally prevalent autoimmune diseases.

Conditions such as lupus, rheumatoid arthritis and inflammatory bowel disease (IBD) – as well as failures within transplanted cells – are all caused by altered cytokine secretion of immune cells within the human body. To find treatments for such diseases, experts need to identify the genetic regulators of the secretion so they can explore the most effective ways of inhibiting them. An international team of researchers, led by the University, detailed a method of doing so in a study published in Nature Biomedical Engineering. They demonstrated the method is accurate in sorting hundreds of millions of CRISPR-edited cells based on their secretion patterns, and in identifying the genetic regulators of cytokine secretion in an autoimmune condition. In addition, the method takes into account the detailed profiles of approved treatments to establish whether therapies already in existence can be reapplied in new ways.

This is an incredibly novel approach that can potentially deliver huge benefits. It gives us the ability to sort a large number of cells based on their secretion patterns and identify therapeutic targets that could be applied to help those with conditions for which there are currently few therapeutic options.

Dr Mahmoud Labib
Lecturer in the Peninsula Medical School

Highlighting the challenges of enabling smokers to quit

Promoting physical activity and other behavioural support can help people wanting to reduce their smoking to quit in the short term.

However, after nine months, physical activity delivers no noticeable benefits – compared with offering no additional support – in the rates of people stopping smoking, according to the findings of a major national study led by the University. The Trial of physical Activity and Reduction of Smoking (TARS) study took place across four cities – Plymouth, Nottingham, Oxford and London.

Its aim was to provide a definitive answer as to whether future NHS services should be adapted to provide additional support to smokers not ready to quit but who do wish to reduce their smoking. The study showed that engaging with the motivational support had some short-term benefits; however, just 2% of those receiving the support had abstained from smoking for between three and nine months. In addition, while after three months people receiving the additional support took part in 81 minutes more physical activity each week than those receiving no support, researchers found no evidence of sustained differences in physical activity at nine months.

Generally, the smokers in our study were enthusiastic about the support they received, but they were unable to maintain increases in physical activity, and smoking reduction did not lead to more smokers giving up completely. Helping smokers to move from wanting to reduce to quitting completely is far more challenging than other less rigorous studies had suggested.

Professor Adrian Taylor
Professor in Health Services Research

Helping people with respiratory health conditions to find their voice

Physiotherapists from the University are working with a Devon-based charity to explore how singing can improve breathing and overall wellbeing.

The Singing for Wellness project, run by Wren Music, has received funding from the National Lottery Community Fund to run sessions for the next three years. It follows a successful NHS-funded pilot in Torbay before the pandemic, with the new sessions taking place in East Devon, West Devon and Torbay. Singing can be of particular benefit to people with respiratory conditions and those suffering the effects of long COVID, but many in this vulnerable group are anxious about attending group events and remain socially isolated. The Singing for Wellness sessions aim to overcome some of those barriers.

We are constantly looking for techniques that can help patients to manage a respiratory condition, and singing has been shown to have a number of benefits. It will be fascinating to explore that through this project, and to see how the sessions they are running are having positive impacts for people and their families.

Mrs Kath Donohue
Lecturer in Physiotherapy

Exploring the signs of dental patients’ anxiety

Experts in dentistry and filmmaking are working in tandem to find ways to support patients who suffer from extreme anxiety when visiting the dentist. The University was awarded funding by the MPS Foundation to assess and then develop ways to manage dental anxiety.

They are also looking to establish a novel approach to detecting subtle signs or ‘tells’ of anxiety in the dental clinic by building a partnership between patients, clinicians, filmmakers, ethnographers, researchers and the public. The AngST project builds on a decade of work by researchers from the University’s Transtechnology Research Group and colleagues at the Torbay and South Devon NHS Foundation Trust. It will see a pilot study conducted using video recordings of dental treatment, which will be used to analyse patients’ emotional experiences during dental visits. The ultimate aim of the project will be to encourage all the parties to respond in a way that helps to reduce anxiety, and thereby improve the provision and take-up of dental care and the wellbeing of dentists.

For many people, just the thought of going to the dentist evokes all manner of anxieties that they choose to avoid. That can lead to dental issues going unmanaged, so it is essential for us to find better ways of managing people’s anxieties, and give clinicians and patients themselves the tools to manage them.

Professor Mona Nasser
Director Plymouth Institute of Health and Care Research (PIHR)

Exploring whether online arts and culture can enhance young people’s mental health

Young people across Cornwall are helping to create an online museum and explore whether it can improve their mental health, as part of a groundbreaking project. The £2.6 million five-year ORIGIN project, funded by the National Institute for Health and Care Research (NIHR), is a collaboration between NHS trusts and universities, working in partnership with museums and charities.

It will see diverse communities of young people aged 16 to 24 co-designing an online arts and culture intervention aimed at reducing anxiety and depression. Its effectiveness will then be tested in a trial of nearly 1,500 young people, including LGBTQ+ and autistic young people, ethnic minorities and those who live in some of the most deprived areas of the UK. The ORIGIN project involves the University, Cornwall Museums Partnership, Cornwall Partnership NHS Foundation Trust, Cornwall-based Making Waves, the Dreadnought Centre, Speak Up Cornwall, and Imagineear.

By engaging young autistic people as research partners, we will ensure their opinion is heard regardless of their preferred method of communication. Also, by listening to parents, teachers, allied professionals and other family members, we can identify the ways in which existing online interventions are currently delivered and received, and how we can improve their impact through empathy, kindness, care, respect and compassion.

Professor Rohit Shankar
Professor of Neuropsychiatry

Brain illustration showing neuron connections

Assessing changes to midwifery models of care in England

Researchers have launched the largest study to date in the world of a model that aims to improve the quality and safety of midwifery care. Midwifery Continuity of Carer (MCoC) is a major policy initiative in NHS England, aimed at ensuring a woman’s care before, during and after birth is led by the same midwife, or a small team of midwives.

This represents a significant shift in usual approaches to care, which often meant that women saw different midwives through pregnancy, labour and early motherhood. This could lead to gaps in care that resulted in poorer outcomes and experiences for women and their babies.

The Studying Implementation of Midwifery Continuity of Carer (SIMCA) project, led by the University, is exploring where implementation of MCoC is going well and where its implementation is creating challenges. It also involves partners across the UK – including Cardiff University, the University of Birmingham, Imperial College London, Imperial College Healthcare NHS Trust, leading pregnancy charity Tommy’s and The Mosaic Community Trust.

Midwives invariably deliver firstrate care for women and their babies. However, several reports into safety failures in England and internationally have demonstrated where that isn’t always the case. Better understanding of how implementation of MCoC works best and what factors influence implementation is imperative, and by the end of this study we plan to deliver that.

Professor Aled Jones
Head of School of Nursing and Midwifery

Examining the impacts on humans of space flight

Researchers from the University are taking part in a major international project using cave systems in the Azores to explore the impact of space missions on the human body.

The Caving Analog Mission: Ocean, Earth, Space (CAMões) project is bringing together a team of experts to develop and implement research programmes that will be critical for improving conditions on future space flights. For a week in November 2023, seven members of the team lived and worked inside a cave on Terceira Island, a lava tube cave which they believe will enable them to recreate conditions to be found on the moon.

The project has been developed by the Institute for Systems and Computer Engineering, Technology and Science (INESC TEC) in Portugal. The work involves researchers from the School of Health Professions, School of Psychology, Peninsula Dental School, and the School of Geography, Earth and Environmental Sciences.

This is a fascinating way to investigate human adaptability in environments mimicking extraterrestrial conditions. We’re exploring aspects like vision, cognition, oral health and environmental empathy in a location that offers an ideal research context due to its geological features and facilities. That makes it a suitable stand-in for lunar and Martian missions, with any findings therefore relevant to long-duration space flights.

Dr Daniela Oehring
Associate Professor in Optometry

Supporting doctors of the future thanks to £1.1 million donation

A game-changing legacy will support University students into medical careers for generations to come. The new bursary will benefit around a quarter of the University’s aspiring doctors, as they progress from a foundation year to the first year of their degree.

As part of a drive to open up access to careers in medicine, the fund is targeting undergraduates from underrepresented and disadvantaged backgrounds. The £1,158,644 bequest from Jean Johnston is in memory of her late son James, who studied at Plymouth in the 1980s. The University already awards a bursary of £1,000 to students who undertake a foundation year of study as preparation for five years of study on its Bachelor of Medicine and Bachelor of Surgery course. The funding can be the difference between students being able to join the course or not, and the new James Johnston Bursary Fund will see each cohort of students who progress from the foundation year to their degree in medicine awarded a further £500.

We are passionate about making the medical profession more accessible and diverse. The fact we are able to offer bursaries and other financial support on a rolling basis has a huge impact on our efforts in encouraging students who might not normally consider a career in medicine because of their background or personal situations.

Professor Laura Bowater MBE
Head of Peninsula Medical School

Young female doctor checking on a patient

Enrolling 10,000 participants to life-saving trial

A clinical trial which researchers hope could lead to improved survival rates among intensive care patients has achieved a significant milestone. Running at almost 100 UK intensive care units (ICUs), the UK-ROX trial has signed up its 10,000th participant.

Each year, around 184,000 patients are admitted to NHS ICUs and over 30% require help with their breathing using a ventilator (breathing machine). Giving oxygen through the ventilator is an essential part of this treatment; however, the most effective concentration of oxygen that should be administered is still not known as both too much, and too little, may cause harm. The UK-ROX trial, funded by the National Institute for Health and Care Research, is testing whether giving a lower concentration of oxygen than usual to people on ventilators may be beneficial. If this is shown to reduce mortality rates compared to the current standard care, the study will recommend immediately changing clinical practice in ICUs throughout the NHS.

In the past we assumed people needed more oxygen than usual when unwell, thinking oxygen couldn’t be harmful. We now know that giving too much oxygen to patients might cause harm. Given how many patients we treat with oxygen on ICUs every day in the UK, any adjustments that might be delivered from the study have the potential to save thousands of lives.

Professor Daniel Martin
Professor of Perioperative and Intensive Care Medicine