A busy NHS pathology lab in Newcastle will double as a training and research hub, physically embedding university scientists alongside clinical staff to speed up the development of new diagnostic tests. Many diseases—including liver disease, inflammatory bowel conditions, and childhood cancers—are not uniform. Patients who appear similar can respond very differently to the same treatment. Stratified medicine tailors therapy to the individual, but this requires reliable diagnostic tests that work in routine hospital labs. The problem is that the specialists who validate these tests—cellular pathologists—have been squeezed by service pressures and lack time to keep up with molecular techniques or do research. The Newcastle Proximity Laboratory aims to close that gap. By placing research activity directly inside a working NHS pathology department, and by funding short-term pilot projects (two to four per year, for one to two years), the lab will generate the real-world evidence needed to push new tests toward clinical use. It will also train laboratory staff through distance-learning courses up to Master’s level, and offer bursaries to attract undergraduates into the field. If successful, the model could accelerate the adoption of stratified medicine across the NHS, reducing unnecessary side effects and conserving expensive therapies.
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The introduction of new scientific methods has shown that many diseases are much more heterogeneous than originally believed and that differences between cases can have a marked influence on the way that patients respond favourably to treatment. This has led to the concept of "stratified" medicine in which treatment is adjusted to meet the needs of individual patients. This approach ensures that treatment is only given to patients who are likely to respond and has both clinical and economic benefits, as unnecessary toxicity will be avoided and expensive new therapies are conserved. The introduction of stratified medicine requires the development of diagnostic techniques which can be used in clinical practice. In order for a new test to be adopted it has to be validated using "real-life" samples and adapted so that it can be used reliably in routine clinical laboratories. For many tests this requires input from experts in Cellular Pathology. However, in recent years, due largely to service pressures, many clinical and non-clinical specialists in this discipline have been unable to dedicate time to maintaining their knowledge in Molecular Pathology or to undertake research themselves. Our bid responds to the three areas for need identified by the MRC in order to ensure that the development of new diagnostic tests keeps pace with the demands of stratified medicine; restoration of the proximity between clinical and research activity; development of a clear path between discovery science and clinical application and addressing the training needs of laboratory staff. PROXIMITY We will establish a "Proximity Laboratory" in a busy NHS service department, which is adjacent to the University Medical Faculty, involving both University and clinical staff. Three satellite laboratories will be established in the Medical School and the Transplant Institute (Freeman Hospital), to provide a well-equipped training and research environment close to the discovery laboratories. PATH Initial projects undertaken in the Proximity Laboratory will build on current expertise in treatment stratification in the fields of liver, inflammatory bowel and mitochondrial disease and childhood cancer. An advisory panel will be established to assist research teams in the development of new diagnostic approaches and 2-4 projects per year will be selected for support to generate pilot data to underpin applications for validation by funding programmes such as those operated by the NIHR or MRC. Funding by the Proximity Laboratory will generally be for 1-2 years and monitored to prevent stagnation. Links with the Newcastle Diagnostic Evaluation Co-operative (DEC) will assist with the adoption of promising new diagnostic approaches by commercial partners, thereby helping to ensure the maximum impact on clinical practice. In addition to the support given to biomedical projects the Proximity Laboratory will also promote research activity in the fields of biomedical engineering and computing science. Biomedical engineering projects will focus on the need to improve methods for handling small samples in response to a trend towards the use of minimally invasive biopsy techniques and will involve collaboration with groups based in our established nanotechnology laboratory (NanoLAB) and Diagnostic and Therapeutic Technologies Group. Collaborations will also be established with computer scientists in the Interdisciplinary Computing and Complex BioSystems (ICOS) research group in Newcastle University in order to develop new ways to present complex datasets in a way accessible for clinical application. PEOPLE Training in Molecular Pathology will be offered through a range of distance learning opportunities, up to the level of a Master's degree. In addition undergraduates will be encouraged to enter the speciality by offering bursaries for intercalated degrees. This approach will both increase capacity and help to augment the skills of existing staff
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