Consultant Physician (Northumbria Healthcare NHS Foundation Trust) and Honorary Professor of Ageing and International Health (Newcastle University)

Background

Introduction

I am a Consultant Physician, Honorary Professor of Ageing and International Health, with an interest in healthcare of the elderly, at North Tyneside General Hospital where I was appointed a consultant in 1995. I have a special interest in Parkinson’s Disease (PD) and I am the Clinical lead for Northumbria PD Service. I am Director of R&D for the Trust and I am closely involved both locally and nationally with the DeDRoN Research Network.

My main research interest in the UK is Parkinson’s disease. In Sub-Saharan Africa (SSA), specifically Tanzania, I have a research interest in stroke and Parkinson’s disease. Non-communicable diseases are

Background

My MD thesis was on the risk factors, and outcome, for stroke in the Gambia, West Africa and I have also published the largest ever prevalence study of stroke in Sub-Saharan Africa, from Tanzania as well as the largest mortality (by verbal
autopsy) stroke study in SSA, also from Tanzania. In Tanzania we have just completed the first ever community-based stroke incidence study in SSA and we are presently preparing the results for writing up. We have also just conducted the first Parkinson’s disease prevalence study in SSA (also in Tanzania).

Research

RW’s research interests in PD in the UK include epidemiology, psychiatric symptoms, palliative care, respiratory symptoms and exercise. He was on the PD NICE Guidelines Development Group (published July 2017) and is on NICE PD Quality Standard Advisory Committee. For Dementia and Neurodegenerative Disease Research Network (DeNDRoN) he is the north east lead for PD research and on the national Portfolio Development Group and National Speciality Group.

 

He has been involved in research in SSA since 1989 and has published extensively (over 170 peer-reviewed articles). He has previously received research funding from Parkinson’s UK for epidemiological research on PD, including long term outcomes, in Tanzania. This funding supported the only published robust PD specific prevalence study in SSA and investigation of cueing as a treatment for drug-naive patients (with LR).^5,10

 

RW led the Wellcome Trust funded Tanzanian Stroke Incidence Project (TSIP) which is still the only fully community-based stroke incidence study from SSA and led to a seminal paper in Lancet Neurology.¹⁷ A subsequent publication in Lancet Global Health demonstrated for the first time that HIV independent of medication side effects was a risk factor for stroke.¹⁸ The study has led to 14 publications and is widely cited. It demonstrated some of the highest age-adjusted stroke incidence rates in the world.

His other interests in non-communicable diseases in SSA include epilepsy, hypertension, atrial fibrillation, dementia and frailty. The dementia research is currently funded by Grand Challenges Canada (IDEA study) and NIHR (DePEC study).We are now developing an app for screening for dementia and cognitive impairment which we plan to trial in 2018. As chief investigator, he also has MRC Confidence in Concept funding of £50,000 for a randomised controlled trial to look at beetroot and folate as treatment for hypertension in Tanzania.

 

In 2009 he set up the SSA interest group (ATF since 2012) within the MDS which he Chaired until June 2017, and remains on the committee. He is Associate International Director (AID) for SSA for the Royal College of Physicians (RCP) in London (since September 2016) and he has numerous contacts throughout SSA with research active clinicians with an interest in PD. He is part of the RCP faculty for the East African Development Bank (EADB) funded East African Neurology Training Programme which commenced in 2016.

Area of expertise

• Parkinson's disease (UK)
• Non-communicable disease in Sub-Saharan Africa

Qualifications

2002 MD, University of Newcastle
2001 Cert Med Ed, University of Newcastle
2000 FRCP, Edinburgh
1999 FRCP, London
1991 FRACP, New Zealand
1989 DTM&H, Liverpool
1985 MRCP, UK
1982 MB BS, Newcastle

Previous Positions

Oct 2002 - Aug 2009 Consultant Physician and Honorary Clinical Senior Lecturer, North Tyneside General HospitalJun Jun 1995 - Oct 2002 Consultant Physician with an interest in health care of the elderly
Nov 1994 - Jun 1995 Research Fellow attached to the Adult Morbidity and Mortality Project, Moshi, Kilimanjaro region, Tanzania
Oct 1991 - Nov 1994 Northern Regional Senior Registrar rotation in general medicine/geriatrics
May 1991 - Sep 1991 Registration/First Assistnat in Neurology, Royal Victoria Infirmary, Newcastle upon Tyne
Feb 1990 - Apr 1991 Senior Registrar in Medicine, Royal Victoria Infirmary, Banjul, The Gambia, Overseas Development Administration (ODA)

Memberships

Member of British Geriatrics Society
Fellow of The Royal Australasian College of Physicians
Fellow of the Royal Society of Tropical Medicine and Hygiene
Member of African Gerontological Society
Vice president of Newcastle branch of the Parkinson’s Disease Society
Vice president of Hexham branch of the Parkinson’s Disease Society
Fellow of The Royal College of Physicians, London
Fellow of The Royal College of Physicians, Edinburgh
African Neurology Interest Group (Association of British Neurologists) – Member since its inauguration in January 2003
Fellow of the Graduate School, University of Newcastle upon Tyne

Representative on the British Geriatrics Society Parkinson’s Disease Special Interest Group, with a remit for research (October 2002).
Board member of local charity, “Action for Disability” (1996 - present).
Board member of local charity, “Development Direct” (2001 - present).
Member of the British Geriatrics Society Academic and Research Committee (February 2004 - present) – BGS meetings poster assessor and session chair.

Representative on the British Geriatrics Society Parkinson’s Disease Special Interest Group, with a remit for research (October 2002)
Board member of local charity, “Action for Disability” (1996 - present)
Board member of local charity, “Development Direct” (2001 - present)
Member of the British Geriatrics Society Academic and Research Committee (February 2004 - present) – BGS meetings poster assessor and session chair

Research

Research Interests

I am the head of the Northumbria Parkinson’s Disease (PD) Service, which was mentioned three times in the National Service Framework for Chronic Conditions Good Practice Guide in 2005 and was a finalist in the Health Service Journal Awards in the Patient Access Category, also in 2005. My main research interests in Parkinson’s disease are primarily clinical involving epidemiology, palliative care, pain, service use, sexual dysfunction and falls, and presently autonomic dysfunction and its relation to urinary dysfunction as well as cause-specific mortality of PD.

In Sub-Saharan Africa (SSA) I have published on the outcome, prevalence, and mortality from stroke and was principle investigator on a recently completed stroke incidence study in Tanzania which is the first community-based stroke incidence study in SSA. Also in Tanzania we have just carried out the first Parkinson’s disease prevalence study in SSA, and are presently investigating the impact of treatment in the individuals identified.

Other Expertise

I am the director of R&D for Northumbria Healthcare NHS Foundation Trust and I am also the Clinical Lead for a higher educational link between Northumbria Healthcare NHS Foundation Trust and Kilimanjaro Christian Medical Centre (KCMC), Moshi, Northern Tanzania.

Current Work

We are currently looking at autonomic dysfunction in PD, and the relationship of this to bladder dysfunction. We are also looking at cause – specific mortality in PD and place of death.

In Tanzania we have just completed, and commenced writing up, the Tanzanian Stroke Incidence Project. We have just completed the first Parkinson’s disease prevalence study and are presently investigating drug intervention in the cohort of individuals identified.

Future Research

I am hoping to continue recruitment for the Tanzanian Stroke Incidence Project and find further funding to maintain this. We are keen to investigate genetic aspects in relation to both the Parkinson’s disease and stroke work in Tanzania, and have DNA stored with respect to this. We are keen to specifically investigate cognitive impairment and dementia following stoke in Tanzania and are collaborating with Professor Raj Kallaria in relation to this. I hope in the future to be successful in applying for a programme grant to continue research in Tanzania focusing on neurological disability and the impact of interventions such as physiotherapy.

Research Roles

I am the principal investigator on the Tanzanian Stoke Incidence Project and on the Parkinson Disease Prevalence Study and the Director of R&D for Northumbria Healthcare NHS Foundation Trust.

Postgraduate Supervision

I have already successfully supervised three MDs with a fourth about to submit, and a fifth due to submit in 2008.

Esteem Indicators

In April 2006 I was awarded a national bronze award.
I am a reviewer for prestigious journals such as Lancet Neurology, Stroke and Movement Disorders.

Funding

NIHR - Global Health Research Group on estimating the prevalence, quality of life, economic and societal impact of arthritis in Tanzania: A mixed-methods study - Glasgow University.  CI Emma McIntosh, Co-I Emma Laurie, Ian McInnes, Joe Halliday, Richard Walker, Sarah Cleaveland, Stefan Siebert - April 2018 - March 2021 - £2million

NIHR - Global Health Research on Dementia Prevention and Enhanced Care (DePEC), Professor Louise Robinson PI, RW CI.  August 2017 - July 2020 - £2million

NIHR - Confidence in Concept on effects of dietary nitrate and folate supplementation on blood pressure in hypertensive Tanzanians: A feasibility trial.  CI RW, CoI Mario Siervo, Blossom Stephan, Louise Robinson, Stella-Maria Paddick.  June 2017 - May 2019 - £50,000

MRCGACD Mental Health Call - Cognitive stimulation therapy for dementia: International implementation in Brazil, India and Tanzania (CST - International). CI Aimee Spector, CoI RW - October 2017 - September 2020

Grand Challenges Canada - Identification and treatment for people with dementia in SSA. PI Adesola Ogunniyi, CoI RW, Declare Mushi, Catherine Dotchin.  July 2012 - Canadian $816,749.  Extension given for 2 years April 2017 - March 2019 - Canadian $200,000

Dunhill Medical Trust - Randomised controlled clinical trial comparing transcutaneous tibial nerve stimulation to sham stimulation for bladder symptoms in Parkinson's disease. CI Professor Doreen McClurg, CoI RW.  December 2017 - £298,190

Wellcome - Stroke incidence study for the Hai district and Dar-es-Salaam, Tanzania.
R W = Principal investigator. January 2003 - December 2005 - £337,040

Wellcome - Masters Research Training Fellowship for Mr Gregory Kabadi. 2004 – 2006: MSc course in Health Sciences at the University of Newcastle upon Tyne, research project entitled “Economics of Stroke Incidence and Prevention”.  - £37.639

Wellcome - Masters Research Training Fellowship Grant entitled “Perceptions and treatment seeking for stroke in urban and rural Tanzania” – awarded May 2005 - £52,158. Upgraded to PhD fellowship funding – June 2006

Wellcome - An analysis of sexual and relationship dysfunction in people with Parkinson’s disease and their partners. June 2002 – May 2003 - £17,000

Parkinson’s Disease Society - The prevalence of Parkinson’s disease in the Hai district of northern Tanzania. March 2005 - £58,000

Teaching

Undergraduate Teaching

Stage I students – I have been involved with teaching stage I students for those attending North Tyneside for initial clinical exposure.
Stage II students - I have taught on the clinical skills (later Foundations of Clinical Practice) course for the Stage II students since commencing at North Tyneside in 1995. One of my main involvements has been with respect to the organization of the neurology week. I have supervised Stage II MBBS student literature review projects. I have been involved in the development and delivery of the Chronic Illness, Disability and Rehabilitation module and the Infectious Diseases module in Northumbria.
Stage III - I am the organiser of stage III student option projects based in the department of health care of the elderly at North Tyneside.
Stage IV (final year students) – I am involved with the Preparing for Practice course and also with the final year rotations.

Postgraduate Teaching

Junior House Officers - I have given lectures as part of the JHO compulsory teaching course.
Senior House Officers - I have given lectures as part of the SHO and Foundation teaching programme.
MRCP - I continue to help with MRCP Part I and II, and also PACES, teaching for both individuals and groups and have also been an “Examiner” in the PACES teaching examinations.
RITA assessor for foundation 1/2 doctors.
I was appointed senior lecturer (teaching) at Northumbria Healthcare NHS Trust (October 2002). This was part of the process of building up teaching capacity within Northumbria Healthcare NHS Trust with the medical student expansion and the increased teaching role that Northumbria has taken on. I have a ½ time commitment to teaching which includes specific commitments to the Chronic Illness Disability and Rehabilitation and also infectious diseases modules, the curricular for which I have helped develop. I am the Northumbria base-unit coordinator for Student Selected Components. I obtained my Certificate in Medical Education at Newcastle in 2001.