Improving outcomes, minimising re-admissions, prioritising hospital resources and expanding home or community-based management are major objectives of the NHS. Patient care needs to be considered for the entire recovery process of patients and potential impact on life-long health and wellbeing. The future of surgery is therefore moving towards precision intervention, increasingly driven by focus on quality-of-life after surgery, as well as the need for taking a systems approach towards surgery. The aim of the proposed network is to establish a forum for surgical innovation with seamless integration of engineering research, clinical translation and industrial development by aligning EPSRC healthcare technologies with NIHR Healthcare Technology Co-operatives (HTCs) to accelerate the development and clinical adoption of new surgical and assistive devices that can improve the treatment, functional restoration, rehabilitation and quality-of-life for patients. The network is supported by NIHR HTCs, KTN, and a number of academic, NHS, industrial and healthcare stakeholders. The research and clinical bases to be covered by the proposed Technology Network include the following three areas: 1) Sensing for improved peri-operative care - which is a determining factor for mitigating against post-operative complications; 2) Smart surgical devices - for surgery with increased consistency and accuracy, streamlining intraoperative surgical decision making and circumventing potential post-operative complications and revisions; 3) Assistive devices and robots - to facilitate remote monitoring and managed rehabilitation in community or home care settings. The three areas share common engineering research challenges but need to be pursued under different clinical context. The planned activities of the network include 1) Network Events: Symposia and Focused Workshops; 2) Strategic Roadmap events and User Forums; 3) Support for Interdisciplinary Mobility and Industrial Secondment; 4) Proof-of-Concept Projects and Design Competitions; 5) Exhibitions and Patient/Public Engagement; and 6) Online Engagement, Web Forum and Social Media; and 7) Health Policy and High Level Engagement. The benefits for those involved in the proposed network include partnership with extensive industrial and clinical connections already established by the partnering HTCs, host institutions, clinically aligned research and development pathways addressing the future of surgery, engagement of healthcare stakeholders and policy makers, access to research expertise and young talents in this highly interdisciplinary area, early end-user involvement, and tapping into design expertise, access to user group feedback, deliver rapid results through HTCs' clinical network, match evidence to needs of NICE, strong commercial engagement.

Advances in surgery have made a significant impact on the management of major acute diseases, prolonging life and continuously extending survival rates. Earlier diagnosis, improved efficiency and delivery of therapeutic measures combined with advances in surgical techniques have all contributed to improved prognosis. Many terminal illnesses have now been transformed into clinically manageable, chronic lifelong conditions. Increased longevity and survival after major illness has resulted in many surgical patients being more likely to have co-morbidities; the future of surgery is therefore moving towards precision intervention, increasingly driven by focus on quality-of-life after surgery, as well as the need for taking a systems approach towards surgery. The aim of the proposed network is to establish a forum for surgical innovation with seamless integration of engineering research, clinical translation and industrial development by aligning EPSRC healthcare technologies with NIHR Healthcare Technology Co-operatives (HTCs) to accelerate the development and clinical adoption of new surgical and assistive devices that can improve the treatment, functional restoration, rehabilitation and quality-of-life for patients. The network is supported by two NIHR HTCs - the Enteric HTC led by Barts Health NHS Trust and the Trauma Management HTC by University Hospitals of Birmingham NHS Foundation Trust. The proposed network will also be supported by Health KTN and a number of academic, NHS, industrial and healthcare stakeholders. The research and clinical bases to be covered by the proposed Technology Network will include the following three areas: 1) Sensing for improved peri-operative care - which is a determining factor for mitigating against post-operative complications; 2) Smart surgical devices - for surgery with increased consistency and accuracy, streamlining intraoperative surgical decision making and circumventing potential post-operative complications and revisions; 3) Assistive devices and robots - to facilitate remote monitoring and managed rehabilitation in community or home care settings. The three areas share common engineering research challenges but need to be pursued under different clinical context. The planned activities of the network include 1) Network Events: Symposia and Focused Workshops; 2) Strategic Roadmap events and User Forums; 3) Support for Interdisciplinary Mobility and Industrial Secondment; 4) Proof-of-Concept Projects and Design Competitions; 5) Exhibitions and Patient/Public Engagement; and 6) Online Engagement, Web Forum and Social Media; and 7) Health Policy and High Level Engagement. The benefits for those involved in the proposed network include partnership with extensive industrial and clinical connections already established by the partnering HTCs, host institutions, clinically aligned research and development pathways addressing the future of surgery, engagement of healthcare stakeholders and policy makers, access to research expertise and young talents in this highly interdisciplinary area, early end-user involvement, and tapping into design expertise, access to user group feedback, deliver rapid results through HTCs' clinical network, match evidence to needs of NICE, strong commercial engagement.

The Centre for Doctoral Training in Tissue Engineering and Regenerative Medicine will provide postgraduate research and training for 75 students, who will be able to research, develop and deliver regenerative therapies and devices, which can repair or replace diseased tissues and restore normal tissue function. By using novel scaffolds in conjunction with the patient`s own (autologous) cells, effective acellular regenerative therapies for tissue repair can be developed at a lower cost, reduced time and reduced risk, compared to alternative and more complex cell therapy approaches. Acellular therapies have the additional advantage as being regulated as a class three medical device, which reduces the cost and time of development and clinical evaluation. Acellular technologies, whether they be synthetic or biological, are of considerable interest to industry as commercial medical products and for NHS Blood and Transplant as enhanced bioprocesses for human transplant tissues. There are an increasing number of small to medium size companies in this emerging sector and in addition larger medical technology companies see opportunities for enhancing their medical product range and address unmet clinical needs through the development of regenerative devices. The UK Life Sciences Industry Strategy and the UK Strategy for Regenerative Medicine have identified this an opportunity to support wealth and health, and the government has recently identified Regenerative Medicine as one of UK`s Great Technologies. In one recent example, we have already demonstrated that this emergent technology be translated successfully into regenerative interventions, through acellular human tissue scaffolds for heart valve repair and chronic wound treatment, and be commercialised as demonstrated by our University spin out Tissue Regenix who have developed acellular scaffold from animal tissue, which has been commercialised as a dCEL scaffold for blood vessel repair. The concept can potentially be applied to the repair of all functional tissues in the body. The government has recognised that innovation and translation of technology across "the innovation valley of death" (Commons Science and Technology Select Committee March 2013), is challenging and needs additional investment in innovation. In addition, we have identified with our partners in industry and Health Service, a gap in high level skills and capability of postgraduates in this area, who have appropriate multidisciplinary training to address the challenges in applied research, innovation, evaluation, manufacturing, and translation of regenerative therapies and devices. This emerging sector needs a new type of multidisciplinary engineer with research and training in applied physical sciences and life sciences, advanced engineering methods and techniques, supported by training in innovation, regulation, health economics and business, and with research experience in the field of regenerative therapies and devices. CDT TERM will create an enhanced multidisciplinary research training environment, by bringing together academics, industry and healthcare professionals in a unique research and innovation eco system, to train and develop the medical and biological engineers for the future, in the emerging field of regenerative therapies and devices. The CDT TERM will be supported by our existing multidisciplinary research and innovation activities and assets, which includes over 150 multidisciplinary postgraduate and postdoctoral researchers, external research funding in excess of £60M and new facilities and laboratories. With our partners in industry and the health service we will train and develop the next generation of medical and biological engineers, who will be at the frontier in the UK in innovation and translation of regenerative therapies and devices, driving economic growth and delivering benefits to health and patients

The proposal seeks funds to renew and refresh the Centre for Doctoral Training in Formulation Engineering based in Chemical Engineering at Birmingham. The Centre was first funded by EPSRC in 2001, and was renewed in 2008. In 2011, on its 10th anniversary, the Centre received one of the Diamond Jubilee Queen's Anniversary Prizes, for 'new technologies and leadership in formulation engineering in support of UK manufacturing'. The scheme is an Engineeering Doctoral Centre; students are embedded in their sponsoring company and carry out industry-focused research. Formulation Engineering is the study of the manufacture of products that are structured at the micro-scale, and whose properties depend on this structure. In this it differs from conventional chemical engineering. Examples include foods, home and personal care products, catalysts, ceramics and agrichemicals. In all of these material formulation and microstructure control the physical and chemical properties that are essential to its function. The structure determines how molecules are delivered or perceived - for example, in foods delivery is of flavour molecules to the mouth and nose, and of nutritional benefit to the GI tract, whilst in home and personal care delivery is to skin or to clothes to be cleaned, and in catalysis it is delivery of molecules to and from the active site. Different industry sectors are thus underpinned by the same engineering science. We have built partnerships with a series of companies each of whom is world-class in its own field, such as P&G, Kraft/Mondelez, Unilever, Johnson Matthey, Imerys, Pepsico and Rolls Royce, each of which has written letters of support that confirm the value of the programme and that they will continue to support the EngD. Research Engineers work within their sponsoring companies and return to the University for training courses that develop the concepts of formulation engineering as well as teaching personal and management skills; a three day conference is held every year at which staff from the different companies interact and hear presentations on all of the projects. Outputs from the Centre have been published in high-impact journals and conferences, IP agreements are in place with each sponsoring company to ensure both commercial confidentiality and that key aspects of the work are published. Currently there are 50 ongoing projects, and of the Centre's graduates, all are employed and more than 85% have found employment in formulation companies. EPSRC funds are requested to support 8 projects/year for 5 years, together with the salary of the Deputy Director who works to link the University, the sponsors and the researchers and is critical to ensure that the projects run efficiently and the cohorts interact well. Two projects/year will be funded by the University (which will also support a lecturer, total >£1 million over the life of the programme) and through other sources such as the 1851 Exhibition fund, which is currently funding 3 projects. EPSRC funding will leverage at least £3 million of direct industry contributions and £8 million of in-kind support, as noted in the supporting letters. EPSRC funding of £4,155,480 will enable a programme with total costs of more than £17 million to operate, an EPSRC contribution of 24% to the whole programme.

Regenerative devices (scaffolds, biomaterials and interventions) which can repair and regenerate tissues using the patients` own cells, can be translated into successful clinical products and deliver patient benefit at much lower cost and risk and in shorter timescales then other regenerative therapies such as culture expanded cell therapies or molecular (drug) therapies. It is estimated that the global market for regenerative devices will grow to £50bn by 2020 and this offers a real opportunity to grow a £1bn per year industry in the UK in this field. The UK has genuine research strengths in the areas of biomaterials and tissue engineering, musculoskeletal mechanics (prioritised by EPSRC) and regenerative medicine. Regenerative medicine is one of the eight great technologies prioritised across the Research Councils. Research discoveries, new knowledge, outputs and outcomes are often not ready for uptake by industry to take forward through product development to the market and patient benefit. New technologies need to be advanced and de-risked. The clinical needs, potential products and markets need to be defined in order to make them attractive for investment, product development and clinical trials by industry. In the Medical Technologies Innovation and Knowledge Centre (MTIKC) Phase 1, working with industry and clinical partners, we have developed a professional innovation team and a unique innovation and translation process, creating a multidisciplinary research and innovation ecosystem. We have successfully identified research outcomes and new knowledge and created, advanced and translated technology across the innovation valley of death, enabling successful investment (over £100m) by industry and the private sector in new product development. Some products have already progressed to clinical trials and commercialisation and are realising patient benefits. We have established a continuous innovation pipeline of over fifty proofs of concept technology projects. Over the next five years in MTIKC Phase 2, we will address unmet clinical needs and market opportunities in wound repair, cardiovascular repair, musculoskeletal tissue repair, maxillofacial reconstruction, dental reconstruction and general surgery and diversify our research supply chain to over ten other Universities. We will support 150 collaborative projects with industry and initiate forty new industry inspired and academically led proof of concept projects, which are predicted to lead to a further £100m investment by the private sector in subsequent product development. This will enable a sustainable research and product development pipeline to be established in the UK which will support a £1bn / year industry in regenerative devices beyond 2020.