Society is battling with an explosion of health conditions that need long-term management. These chronic conditions occur at all ages: UK children have some of the world's highest levels of both asthma and type 1 diabetes and, with a third of the UK's school children leaving primary education obese, there are huge concerns over type 2 diabetes at all ages; in any year, working age men and women in the UK have a 12% chance of a diagnosed mental health issue such as anxiety, depression and post-natal depression; conditions including dementia, Parkinson's disease and frailty are rapidly increasing in later years.
Low-cost, connected, digital technologies are increasingly seen as vital to the understanding, prevention, diagnosis and management of these conditions for months and years in the community. These digital technologies, such as smartphone apps, wearables, blood sugar monitors - and a near future of Internet of Things (IoT) devices such as smart home systems (e.g. Echo), smart meters and connected appliances - offer an unprecedented opportunity to monitor a patient's condition within their community. With the data processed by artificial intelligence they will deliver decision support to health and care professionals; predict or detect a patient's symptoms worsening; support independent living; deliver behavioural and even pharmaceutical interventions; and allow the efficacy of treatments to be monitored.
This cannot be business as usual for doctoral education since a digital health technology is likely to require a highly multidisciplinary understanding of technologies spanning software engineering, microelectronics, data communication, signal processing, machine learning and visualisation. Achieving actual patient benefit requires user-centred/driven design, a broad understanding of health and care, psychology, physiology, ethics, regulation, health economics and the design of clinical trials.
To meet the challenge and seize the opportunity, the UK needs to nurture leadership that will span this hugely multidisciplinary space - combining technological depth with broad appreciation of the health landscape; empathy with the patient's needs with an eye to business models that underpin adoption; ambition to accelerate innovation with a principled commitment to ethics, inclusivity, regulation, data security and privacy.
The opportunity and the challenge for this Centre for Doctoral Training (CDT) in Digital Health and Care is to be bigger than the sum of its parts; to physically co-locate a cohort of students from Engineering & Computer Sciences and Health & Life Sciences; to bridge the disciplinary gaps, work with key external partners, foster better understandings and activate peer-to-peer learning within the cohort itself. Bristol is the perfect place to train future leaders at this disciplinary interface, building on £30M of digital health research at the University since 2013.
Our proposed CDT will develop team-players with the skills to work effectively with experts from other disciplines, with patients and with the public. In a space where issues of trust, privacy, transparency, accountability and inclusion are absolutely fundamental, the CDT will not only embrace Responsible Innovation but influence and lead best practice nationally and internationally.
The CDT will build on a variety of established relationships; with small and medium sized businesses, technology companies, big pharmaceutical companies, charities, universities, one of the UK's largest public science centres (WeTheCurious), Bristol City Council, and with the public. This CDT is therefore envisaged as a multidisciplinary community of students and academics that will create exciting research projects and will build networks of individuals across academia, industry and the NHS at all levels. It will sow the seeds of future collaborative research and of commercialisation activities.
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