Modernising the UK's health and social care system is a priority for government and for the country as a whole. To do this, wide ranging organisational and funding reforms are being put in place. An unprecedented investment to renew the built and technical infrastructure for delivering care is also underway: new hospitals and primary care centres are being built, information and communication technology is being upgraded and new technologies for diagnosing and treating disease are being introduced. If world-class infrastructure is to be delivered, this investment must achieve its full potential. The aim of HaCIRIC is to establish a new research centre to help accomplish this. HaCIRIC's focus is on the built and technical infrastructure for health and social care, and the interaction between infrastructure specification and the way patients are treated. Improving the way this is planned, delivered and managed is at the core of HaCIRIC's activity. What are the challenges? The health and social care system is one of the most complex and rapidly changing organisational and technical environments in any sector of the economy. Many stakeholders are involved in delivering care, funding mechanisms are convoluted, and patterns of demand and use are changing, as are government health policies. All this places new pressures on the underlying infrastructure. These are compounded by two problems. First, there is an historic legacy of out-dated buildings and cultures within the care system. Second, the life cycles of the various elements of the infrastructure / buildings, medical and information technology / are mismatched. Each involves complex supply chains, multiple users with their own needs and differing institutional and funding arrangements. All these have to be reconciled. For example, the current PFI programme for new hospitals involves supply contracts for thirty years or more, but incorporates technologies which have five year life cycles to help deliver diagnostics and therapies which are undergoing rapid evolutionary change. Modernising the health and social care infrastructure will therefore require innovative approaches. HaCIRIC will help develop the tools and processes which will embed 'innovation as normal business' amongst those responsible for delivering the investment in infrastructure. Its research programme has been developed in partnership with all the key stakeholders from the care system, including the Department of Health, the NHS, the Department of Trade and Industry and the supply industries. Seven research themes have been identified:- Managing innovation in a context of technological change- Procurement for innovation- Innovative design and construction- Care delivery practices- Delivering improved performance through operations management- Knowledge management in complex systems - Design and evaluation of integrated systems HaCIRIC is a collaboration between existing research centres at Imperial College London and the Universities of Loughborough, Reading and Salford. Additional partners from other universities, industry and the care system will be involved in specific research projects. Together this represents a resource valued at more than 11m, of which 7.0m consists of EPSRC support, 2.9m is from the four existing research centres, 500,000 is from the Department of Trade and Industry and 720,000 is from industrial partners. HaCIRIC will therefore represent a substantial resource and a unique capability in skills and knowledge to find solutions to the key healthcare infrastructure problems of the 21st century.

The Innovative Construction Research Centre (ICRC) is dedicated to socio-technical systems research within the built environment, with particular emphasis on through-life performance in support of the client's business operations. Our vision is for a research centre that not only supports the competitiveness of the architectural, engineering, construction and facilities management sectors, but also supports societal needs for built infrastructure and the broader competitiveness of the UK economy. The domain of enquiry lies at the crucial interface between human and technical systems, thereby requiring an inter-disciplinary approach that combines engineering research methods with those derived from the social sciences. The ICRC's research portfolio is organised into six themes: (1) Integration of design, construction and facilities management. Concerns the through-life management of socio-technical systems within the built environment. Topics of consideration include: integrated logistic support, design for reliability and systems integration for building services. Of particular concern is the way that firms within the supply chain are integrated to provide solutions that add value to the client's business. (2) Knowledge management and organisational learning. Addresses the means of supporting knowledge flows across extended supply chains and the extent to which procurement systems learn across projects. Of particular importance is the design of learning mechanisms that extend across organisational boundaries. Also investigates the degree to which the construction sector can learn from other sectors, i.e. aerospace, automotive, retail, defence. (3) Human resource management and the culture of the industry. The construction sector is too often characterised by regressive approaches to human resource management (HRM) with little emphasis on developmental to support innovation. Of particular importance is the concept of 'high commitment management' that has emerged as a central component in the quest to link people management to business performance. Any attempt to improve HRM practices in the construction sector must also recognise cultural barriers to the implementation of new ways of working.(4) Innovative procurement. Includes legal, economic and organisational aspects of procurement systems. The last twenty years has seen a plethora of new procurement methods seeking to encourage different behaviours and allocations of risk. Many such initiatives experienced significant reality gaps between technological intent and resultant behaviours. Of particular importance in the current context is the notion of performance-based contracting which seeks to reward parties on the basis of building performance.(5) Innovation in through-life service provision. Most innovation in facilities management (FM) is concerned with service provision rather than the design and construction of the built asset. The inclusion of FM-service provision reflects the ICRC's strategic focus on through-life issues. The shift towards service provision is reflected in practice through procurement approaches such as PFI/PPP. But the issue has a wider significance as construction contractors increasingly embrace service philosophy. (6) Competitiveness, productivity and performance. Focuses on techniques for performance improvement, coupled with a broader emphasis on competitiveness and profitability within the marketplace. Techniques for performance improvement include: process mapping, benchmarking, value management, risk management and life-cycle costing. Also seeks to assess the competitiveness of the construction sector in comparison to other countries, and to achieve a broader understanding of the economic context within which firms operate.

This project is to develop a rapid and inexpensive screening device that predicts how a patient will respond to leukaemia chemotherapy within hours. The test will initially be used for Acute Myeloid Leukaemia (AML), a potentially fatal cancer in which white blood cells multiply rapidly and unchecked in the bone marrow and blood. AML patients are usually treated with the anticancer agent cytarabine (Ara-C) in different doses or combined with other agents including Fludarabine, to increase the effectiveness of Ara-C. Up to 40% of patients do not respond to first course of chemotherapy treatment; lack of response is only seen after weeks when a patient may have suffered severe side effects. The nature of AML means it is vital to treat it as soon as possible; a delay of weeks can have severe consequences. This project will develop a quick and simple multi-drug test device based on blood or bone marrow samples BEFORE the start of treatment, to show response to COMBINED drugs used for treatment. The results of the multi-drug test will ensure that a patient receives the right combination of chemotherapy drugs, in the correct dose, to meet their needs and so prevent any delay in effective treatment. The test device will be particularly useful to patients whose leukaemic cells are sensitive to low doses of chemotherapy, allowing them to be treated with minimum drug doses, with less side effects. For elderly patients, where AML incidence and mortality rates are increasing, and where other health conditions may rule out aggressive chemotherapy, this screening test could be particularly timely. We have previously devised, published and patented details of a rapid test to measure response of AML patient blood or bone marrow samples, within 8 hours, to the SINGLE drug Ara-C. The test uses a bioluminescent bacterial biosensor that has been genetically modified to give increased light output in response to the active form of Ara-C within leukaemic cells; it gives an accurate measure of drug uptake and conversion to the active drug form. We have used our biosensor test on 71 patient samples and shown good agreement with a standard laboratory cytotoxicity test and a test efficiency of 83% when compared with 53 known patient outcomes. The single drug test will be extended to include other commonly used chemotherapeutics and the amount of patient cells per test reaction will be minimised, so that multiple drugs can be tested on a small clinical sample, vital for bone marrow testing, where sample volume is limited. Preliminary studies indicate that our device predicts the effectiveness of combined Ara-C/fludarabine chemotherapy. The test device will be extended to include other relevant drug combinations to exploit its full usefulness for AML treatment. The main aims of this project are to find the optimum conditions for a multi-drug test device that will predict how a patient responds to clinically relevant doses of combined drug chemotherapy, within 12 hours, using minimal number of patient cells. Also to validate the test device by retrospective testing of 500 clinical samples to correlate biosensor assay results with patient outcomes. This will produce a test device with a simple protocol suitable for routine laboratory use, which will be brought to 'regulatory approval' stage. The main application of our test device is in AML, to rapidly predict effectiveness of combined drug chemotherapy BEFORE treatment begins. Benefits include determining the most suitable treatment for an individual patient. Those with cytarabine resistant cells can be given effective combined chemotherapy that will enhance survival outcomes; patients with responsive cancer cells can be effectively treated with lower drug dose, reducing acute and long-term side effects including severe infection, infertility, secondary cancer, whilst enhancing quality of life and saving costs of hospitalisation.