Translational Health Sciences

Professor Kabir Sheikh discusses how social trends shape health systems in low- and middle-income countries, focusing on the complex mix of public-private, traditional-modern, and digital-nondigital axes. Health systems are social systems, and are shaped by broader trends such as urbanisation, commercialisation, the information revolution, and the post-pandemic social reordering. Against that backdrop, the configuration of health systems in low- and middle-income countries (LMICs) is often deeply heterogeneous or “mixed” across different intersecting axes, for instance: public-private, professional-lay, traditional-modern, and digital-nondigital. These dynamic and contested intersections influence health system performance and equity, and also create unique policy challenges and opportunities. Professor Sheikh will outline key inferences from his body of research on the governance of mixed health systems in LMICs, and reflect on the changing character of health systems, and implications for the future of the field of health policy and systems research (HPSR). Professor Kabir Sheikh is a field leader in health policy and systems research (HPSR) with over 20 years’ experience of research in diverse settings across Asia and Africa. His interests lie in the domain of equity-oriented, contextually relevant health policy and systems research (HPSR) that generate insights and solutions for health systems problems, using social science approaches (policy and implementation analysis).

Mr Khaled Dawas shares his recent experiences of working in Gaza as a surgeon providing emergency care. In this episode, Mr Khaled Dawas reflects on the targeting of health facilities and health workers during the conflict, the implications for medical education in Palestine and the role of global health students and practitioners world-wide. The main lecture is delivered by Mr Dawas and will also feature perspectives of other health workers who have experiences of working in Gaza, including Dr Brenda Kelly (women's health doctor) and Dr Jane Crawley (paediatric doctor). Mr Khaled Dawas is a consultant surgeon and associate professor at University College London Hospitals. He chairs the board of the medical education charity, Al Quds Foundation for Medical Schools in Palestine. He has been to Gaza twice with emergency medical teams since December 2023. Dr Brenda Kelly is a consultant obstetrician who has also been to Gaza and is part of the Gaza Medical Teaching Group. Dr Jane Crawley is a paediatrician who has worked in global child health for the past 30 years. As a member of the Oxford Gaza Group of clinicians, she has visited Gaza several times over the past 8 years in order to teach medical students and young doctors. This talk is part of the Translational Science and Global Health course on the Translational Health Sciences programme.

Professor Nick Watts explores net zero in the context of health care. Working at the intersection of politics, policy, industry, healthcare and academia, Professor Nick Watts will reflect on his time as Chief Sustainability Officer of the NHS, on the Lancet Commission on Sustainable Health Care, and his current role at the National University of Singapore. He will explore what net zero means in the context of health care, the influence of national (and transnational) politics, industry, and other stakeholder interests on advancing towards net zero across different geographical settings and unpack what works and what doesn't. He will critically reflect on the role of innovation in reaching net zero and on what is needed to bring about change and to translate solutions into practice within the boundaries of what is politically, financially and technologically possible. Professor Watts is the Director of the Centre for Sustainable Medicine, leading NUS's efforts to accelerate the transition to net zero and resilient healthcare systems, across the world. Prior to NUS, he worked as the Chief Sustainability Officer for the NHS in the UK, where he spearheaded their efforts to efforts to deliver low-carbon healthcare, leading the Greener NHS team with a budget of almost S$1 billion. He is a medical doctor, a Fellow of the Royal College of Physicians' Faculty of Public Health, and has worked as the Executive Director of the Lancet Countdown, and as the founder of the Global Climate and Health Alliance and the UK Health Alliance on Climate Change. This talk is part of the Sustainable Health Care course on the Translational Health Sciences programme.

This talk by Dr Gemma Hughes is intended to show how problems, such as loneliness, can be understood and researched in multiple ways. By outlining the methodology of the research programme Virtual Presence, and explaining the qualitative methods used to study the adoption of telepresence technologies designed to prevent loneliness, Dr Hughes will argue for the importance of interpretive approaches in health research. Dr Hughes is a social scientist concerned with the intersections between organisational practices, health and social care policy and people's experiences. She has a professional background in the UK public sector, which informs her interest in tackling 'real world' problems of how to best organise care. Dr Hughes completed her DPhil at the University of Oxford in 2019 under the supervision of Professors Sara Shaw and Trish Greenhalgh, after which she worked as a researcher in the IRIHS group until 2023 when she joined the University of Leicester School of Business as Associate Professor in Healthcare Management.

Guest lecturer Dr Nick Fahy is a research group director for health and wellbeing at RAND Europe, where he oversees research in such areas as health systems and healthcare innovation, and the behavioural and social determinants of health and wellbeing. Innovation is the central challenge facing health systems. The constant expansion in our ability to improve health has brought us benefits of length and quality of life that would have been unimaginable a hundred years ago. But this also creates challenges for our health systems. This lecture will explore three challenges in particular. First, what do we get? How well do our systems for generating innovations meet the health needs that we want to see addressed? Second, how do we make the best use of the innovations that we have; through understanding the value they bring, and making best use of them in practice? And third, how do we pay for this challenge - and how long will we keep being able to? Our guest lecturer is Dr Nick Fahy, research group director for health and wellbeing at RAND Europe, where he oversees research in such areas as health systems and healthcare innovation, workplace wellbeing, and the behavioural and social determinants of health and wellbeing. Nick Fahy joined RAND Europe from the University of Oxford, where he was a senior researcher in the Nuffield Department of Primary Care Health Sciences and a research fellow at Green Templeton College. As a researcher and consultant in health policy and systems, he looked at how health systems work; lessons learned by comparing health systems across countries; and how to bring about constructive change in health systems. Alongside his Oxford role, Nick was also an expert advisor on innovation and implementation for the European Observatory on Health Systems and Policies, working with policymakers across Europe to support evidence-informed policy-making. This built on wide-ranging experience in international health policy, including over a decade in the European Commission, most recently as head of the health information unit. Nick Fahy has a D.Phil. from the University of Oxford in evidence-based healthcare, specifically examining psychological theory and its role in the model of diffusion of innovations in healthcare. He is also a Chartered Psychologist and continues to contribute to research and teaching at the University of Oxford and more widely.

In his new book, 'For the Common Good: Philosophical Foundations of Research Ethics' (Oxford University Press), Prof Alex John London argues that there is a moral imperative to carry out research with human subjects... ... and that this imperative is grounded, in part, in the relationship between the information that research produces and the purposes of a just social order. In this talk, Prof London will explore (1) why research ethics has been resistant to recognising such a moral imperative, (2) how orthodox research ethics eviscerates the role of justice in research oversight and (3) how the egalitarian research imperative is grounded in considerations of justice and how this reframing of research ethics should reshape the future of the field. Alex John London is the Clara L. West Professor of Ethics and Philosophy and Director of the Center for Ethics and Policy at Carnegie Mellon University. His book, For the Common Good: Philosophical Foundations of Research Ethics is a free and open access title from Oxford University Press. He is the author of over 100 papers or book chapters that have appeared in venues such as Mind, The Philosopher’s Imprint, Science, JAMA, The Lancet as well as numerous other journals and collections.

Until a vaccine can prevent COVID-19, protective behaviours (such as social distancing, handwashing, cleaning/disinfecting) must be used to limit the spread. Germ Defence is a digital behavioural intervention developed using mixed-methods person-based research to help people improve their home hygiene and curb the spread of COVID-19. The Germ Defence project is collaboratively conducted between the universities of Bath, Bristol, Southampton and Public Health England. There are several aspects to the Germ Defence project: co-design and adaptation, evaluation, and implementation. In this talk, Ben Ainsworth will outline the evidence and theory that underpin Germ Defence, and the person-based research that was used to develop it during the swine-flu pandemic. He will then discuss the rapid UKRI-funded adaptation for the COVID-19 pandemic, conducted using novel co-participatory development methods. Finally, Ben Ainsworth will critically discuss the evaluation and implementation methods, and the challenges of doing so during a rapidly changing digital context. Dr Ben Ainsworth is an Associate Professor in Health Psychology at the University of Bath, and study lead of Germ Defence. His research is focused on using experimental methods to understand behaviour in chronic respiratory disease, and the degree to which non-pharmacological and digital interventions can modify these behaviours.

This talk will introduce and explore, the global mechanisms and initiatives that align process, strategy and methodology for Health Technology Assessment (HTA). It will introduce and explain the methods behind stakeholder involvement in HTA, with a particular focus on patient involvement. It will explore the benefits and challenges posed by increasing innovation complexity, and explore how new methods and forms of evidence are being used to reduce barriers to patient access and health system financial constraints. Neil Bertelsen is an independent consultant with over 25 years of experience bringing the patient voice to health care decision-makers and communicating the science of health care to patients in a way that truly informs their own personal health choices. Neil is passionate about bringing the patient experience and perspectives to decision-makers including industry and health technology assessment bodies. Neil works directly with the patient advocacy community, the industry, and authorities such as HTA agencies to facilitate collaborations and co-creation of approaches to improve access to healthcare and better provision of care. As a facilitator of meetings and advisory boards, Neil has global experience working with multiple stakeholders on demanding issues that require a coordinated response. This talk was held as part of the Economics and Regulation in Translational Science module which is part of the MSc in Translational Health Sciences.

'Homebound' students are unable to attend school for health-related reasons. To lessen their predicament, schools have begun experimenting with 'telepresence robots' for remote participation. Based on an interview study of stakeholders of the robot 'AV1' in Norway, I find that most users are highly positive about the robot's prospects for reconnecting them with their friends in school. However, I also find that school workers can be highly sceptical towards the robot, with some even refusing its use in their classroom. This raises the question of why someone might object to a technology for homebound children. In addressing this, I highlight the value of qualitative methods for unearthing multiple perspectives on innovations, and how failure to attend to these perspectives can entail a series of complications for those working to implement, scale-up and spread an innovation. Lars Johannessen is a sociologist with research on professions, culture and micro interaction. He has done several ethnographic studies of health and social care, including a PhD on the relationship between discretion and standardization in the decision making of healthcare professionals. Johannessen has extensive experience with qualitative methods and analysis, and he is one of the authors behind the book "How to use theory: Useful tools in qualitative analysis". Johannessen is now working on a study of AV1 - a robot for children with long-term illness, which is meant to be the child's eyes, ears and voice in the classroom. Situated in cultural sociology and science and technology studies, the project explores the development, marketing, implementation and effects of the robot. This talk was held as part of the Introduction and Research Methods for Translational Science module which is part of the MSc in Translational Health Sciences.