Usher Institute

Usher Institute REF 2021 impact case studies

A summary of our key impact case studies from the Usher Insitute as submitted to REF 2021

The Usher Institute brings together key applied and translational research and innovation within the Edinburgh Medical School, College of Medicine and Veterinary Medicine – and as such was well placed to offer several impact case studies as part of The University of Edinburgh’s REF 2021 submission.

It’s been really heartening to have had so many outstanding impact case studies from across the Usher Institute included in our very successful REF 2021 submission. Although these represent only a small fraction of our ongoing efforts to translate our research findings into societal impact, they do illustrate the range of ways our research is leading to public benefit. My sincere thanks and congratulations to everyone who has been involved in activities that have led to, and will continue to lead to, real-world impact from across the Institute

Professor Aziz SheikhDirector, Usher Institute

We are privileged to be home to a wide variety of excellent on-going work across the Institute – in our Centres for Global Health, Medical Informatics, Population Health Sciences and Biomedicine, Self and Society. These example case studies, submitted to REF 2021, give a small insight to the broad range of our transformative work.

PrEP - Ingrid Young, Nicola Boydell


PrEP is a newly repurposed pharmaceutical that prevents HIV. Understanding inequalities in experiences of accessing HIV services, especially for women and Black African populations in the UK, has helped to shape the implementation of PrEP, with wide health benefits.

Evidence-based PrEP literacy tools have been adopted by NHS Scotland and are widely used by community organisations across the UK in developing ‘HIV literacy’.

PrEP and Women in Scotland Roundtable: A Community Report - on the Centre for Biomedicine, Self and Society website

(Unit of Assessment 20: Social Work and Social Policy)

Full published case study

Securing equitable policy and practice for HIV pre-exposure prophylaxis (PrEP) in the UK 

Digital Health Leadership - Kathrin Cresswell

doctor using a laptop

National evaluations of health IT systems highlighted a critical shortage of digital skills within the NHS workforce and contributed to a marked change of direction in England’s digital health strategy.

The NHS Digital Academy (NHSDA), the world’s first national digital health leadership training programme, now allows clinicians and managers from UK NHS hospitals to earn a postgraduate Diploma in Digital Health Leadership.

NHS Digital Academy website

(Unit of Assessment 20: Social Work and Social Policy)

Full published case study:

Identifying and addressing the challenges of NHS IT policy and practice

SPICT - Kirsty Boyd, Scott Murray, Bruce Mason

comforting hands

An extensive programme of studies in early palliative care, provided evidence that suffering and financial problems due to ill-health are preventable from earlier in the illness journey.

This led to the development and evaluation of the clinical Supportive and Palliative Care Indicators Tool (SPICT). SPICT indicators and guidance are now used around the world to drive effective identification of needs and planning of palliative care.

SPICT website

Primary Palliative Care Research Group website

(Unit of Assessment 1: Clinical Medicine)

Full published case study:

Delivery of early integrated palliative care for all patients with advanced illnesses: the development, validation, translation and international adoption of a research-based tool (SPICT)

Childhood Pneumonia - Harish Nair, Harry Campbell, Igor Rudan, Evropi Theodoratou

x-ray of lungs

Global child pneumonia mortality in 2013 was 1,200,000 per year; down from 2,100,000 in 2000, but still unacceptably high. More than 90% of these deaths occur in children living in low-and-middle-income countries.

Epidemiological modelling informed international priority-setting to scale up vaccination, resulting in 1,000,000 fewer child pneumonia deaths and raising the priority to develop an effective RSV vaccine.

Evropi Theodoratou - A Model of Health - Edinburgh Impact website

NIHR Global Health Research Unit on Respiratory Health - RESPIRE

(Unit of Assessment 1: Clinical Medicine)

Full published case study:

Accurate estimates of pneumonia disease burden guide child immunisation policy, practice and global investment to reduce child pneumonia mortality

Integrated Palliative Care - Liz Grant, Scott Murray, Mhoira Leng

tree in african sunset

Integrated Palliative Care is an important health service intervention, but one that is absent in many low-and-middle income countries (LMICs) due to lack of training, limited evidence of need and fear of morphine use as an effective analgesic for severe end-of-life care.

Research has shown that palliative care can be delivered effectively in LMICs to alleviate patients’ and family suffering while simultaneously strengthening weak health systems - leading to widespread availability of care and pain relief.

Primary Palliative Care Research Group website - theme 'all nations'

Global Health Academy website - PallCHASE

(Unit of Assessment 1: Clinical Medicine)

Full published case study:

Integration of palliative care into health systems in Sub-Saharan Africa leads to widespread availability of care and pain relief 

EQUIST - Igor Rudan, Harry Campbell, Evropi Theodoratou

mother and baby

A framework to guide effective and equitable investment in health interventions, to reduce maternal and child mortality and morbidity in low-and-middle-income countries.

At lesat ten countries have used EQUIST to develop their investment cases and directly influence national health policies. In Angola alone, this contributed to a $400 million increase in the health and education budget.

EQUIST website - UNICEF - 'Equitable strategies. Save Lives'

EQUIST in action - online learning materials from RESPIRE

(Unit of Assessment 1: Clinical Medicine)

Full published case study:

Implementation of EQUIST, a framework to guide effective and equitable investment in health interventions, to reduce maternal and child mortality and morbidity in low-and-middle-income countries

Delirium Assessment Tool - Alasdair MacLullich, Susan Shenkin, Zoë Tieges, Atul Anand, Christopher Weir, Julia Boyd

person in intensive care

To address the highly significant problem of under-diagnosis of delirium in the acute hospital setting an interdisciplinary team designed and validated a new clinical test for delirium detection in routine practice called the 4 ‘A’s Test (4AT).

The 4AT is now recommended in 11 national and 14 international guidelines/care pathways, and is now the most-used clinical tool for delirium assessment in 80% of NHS acute hospital trusts in the UK.

The 4AT - rapid clinical test for delirium

(Unit of Assessment 4: Psychology, Psychiatry and Neuroscience)

Full published case study:

Design and use of a rapid assessment tool that improves detection of delirium benefits patients and health services