Current Research Projects
OxCERPC is proud to showcase current research projects being undertaken by OxCERPC staff, members of the Oxford Palliative Care Department, and Colleagues associated with the Oxford Palliative Care Department. If you are involved in any research and would like it to be included, please email [email protected]
This page is reviewed biannually (last reviewed 02.05.2025).
Dr Victoria Bradley, Consultant Palliative Medicine and Clinical Lead of the Department of Palliative Care, Oxford
Transition from paediatric to adult palliative care services in Oxfordshire
Together with the team at Helen and Douglas House the department is actively exploring how to best provide palliative care to patients who are reaching their eighteenth birthday and moving from paediatric to adult services. This work involves quality improvement work focused on the service design as well as qualitative research to explore staff, patient and family experience and expectations. Current research threads include exploring after death and bereavement care.
Poster: Jones, J., Carey, M., Nohavicka, L. and Bradley, V., 2025. 187 How to help young people transition from paediatric to adult palliative care services in Oxfordshire: our experiences and lessons learned. BMJ Supportive & Palliative Care, 15(Suppl 2), pp.A79-A79.
Prion Diseases
The team at Oxford have convened and co-lead a national group of specialists from Neurology, Palliative Care, General Practice, Psychiatry and Psychology as well as patient advocates to try to develop practical guidelines for the care of patients dying from this rare but devastating group of diseases. This has involved a large literature review to explore the existing evidence, and then development of a Delphi style group to co-produce guidelines. The guidelines are currently being written.
Papers:
Hogg, R., Centola, J., Durley, K., Chin, C.A., Quibell, R., Spriggs, H., Carey, M., Bajorek, T., Miller, M., Bradley, V. and Pal, S., 2024. Prion disease: clinical pathway development for the terminally ill. BMJ Supportive & Palliative Care, 14(e1), pp.e326-e327.
Hogg, R., Centola, J., McDermott, E.A., Mastaglio, F., Grundy, A., Awe, T., Carey, M., Miller, M., Chin, C.A., Quibell, R. and Bajorek, T., 2024. Prion diseases motor and neuropsychiatric symptom cluster pharmacotherapy: structured scoping review. BMJ Supportive & Palliative Care, 14(e3), pp.e2397-e2410.
Recognising that patients with metastatic bone disease currently receive a fragmented and poorly coordinated service, the team in Oxford has created a novel, world-first holistic service, reviewing patients virtually on a weekly basis. The Palliative Care team leads a multidisciplinary team comprising Oncologists, Surgeons, Anaesthetists, Radiologists, Psychiatrists, Nurses, and Physiotherapists. The service is designed to improve equitable access and deliver well-evidenced care for these patients.
Posters:
The UK Acute Oncology conference 2024, Birmingham, 27 September 2024.
OXMINT a new pathway for managing metastatic bone disease. Early outcomes and future directions.
Georgios Zilidis 1,2, Nicolas Beresford-Cleary 1,2, Clare Jacobs 1,3, Gerard Mawhinney 1,2,9, Jeremy James Reynolds 1,2, Yaron Berkowitz 1,4, James Teh 1,4, Raj Chari 1,4, Ather Siddiqi 1,5, Martin Gillies 1,6, Tim Mccormick 1,7, Emma Kenney-Herbert 1,3, Ami Sabharwal 1,2, Hayley Jones 1,3, Mariam Latif 1,7, Tomasz Bajorek 1,8, Victoria Bradley 1,10
1 OxMINT, Oxford Metastatic Intervention, Oxford University Hospitals NHS Foundation Trust
2 Oxford Spinal Surgery Unit, Oxford University Hospitals NHS Foundation Trust
3 Department of Clinical Oncology, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust.
4 Department of Musculoskeletal Radiology, Oxford University Hospitals NHS Foundation Trust
5 Sarcoma Service, Oxford University Hospitals NHS Foundation Trust
6 Department of Neurosurgery, Oxford University Hospitals NHS Foundation Trust
7 Department of Anaesthesia, Oxford University Hospitals NHS Foundation Trust
8 Department of Psychiatry, Oxford University Hospitals NHS Foundation Trust
9 Nuffield Department of Clinical Neurosciences, University of Oxford
10 Department of Palliative Medicine, Oxford University Hospitals NHS Foundation Trust
There should be a poster from AOS (September 24), PCC (March 25), Lille (April 25), Rotterdam (April 25), and then 5 from Rio (May 25) – George please can you give the citations for each please to Aisce?
Paper – we have one in submission at present that I will update once accepted
Global Spine Congress 28-31 May 2025
Please check the Global Spine Congress 2025 website for updates.
https://www.globalspinecongress.org/index.php/abstracts/abstract-results
1/5
Accepted at the Global Spine Congress (May 28-31, 2025, Rio de Janeiro, Brazil) for an oral presentation that Dr Bradley will deliver.
Abstract PDF (Global Spine Congress 2025 1/5)
The OxMINT pathway. A novel service for the rapid referral assessment and treatment of metastatic spinal patients in Oxford. The design and implementation of the patient pathway and the multidisciplinary team meeting and comparison with other international models.
Georgios Zilidis, Clare Jacobs, Gerard Mawhinney, Jeremy Reynolds, Yaron Berkowitz, Emma Kenney-Herbert, Ather Siddiqi, James Teh, Basavaraj Chari, Martin Gillies, Tim McCormick, Ami Sabharwal, Stana Bojanic, Hayley Jones, Alex Anderson, Claire Worrall, Niamh Louwman, Harriet Dent, Mariam Latif, Tomasz Bajorek, Victoria Bradley, Nicolas Beresford-Cleary.
2/5
Accepted at the Global Spine Congress (May 28-31, 2025, Rio de Janeiro, Brazil)
Abstract PDF (Global Spine Congress 2025 2/5)
Early data from the OxMINT project a novel multidisciplinary service model for managing metastatic bone disease.
Georgios Zilidis, Clare Jacobs, Gerard Mawhinney, Jeremy Reynolds, Yaron Berkowitz, Emma
Kenney-Herbert, Ather Siddiqi, James Teh, Basavaraj Chari, Martin Gillies, Tim McCormick, Ami
Sabharwal, Stana Bojanic, Hayley Jones, Alex Anderson, Claire Worrall, Niamh Louwman,
Harriet Dent, Mariam Latif, Tomasz Bajorek, Victoria Bradley, Nicolas Beresford-Cleary.
3/5
Accepted at the Global Spine Congress (May 28-31, 2025, Rio de Janeiro, Brazil)
Abstract PDF (Global Spine Congress 2025 3/5)
The OxMINT Effect; Understanding how good clinical decisions are made in novel clinical teams, an ethnographic study.
Ellana Slade, Georgios Zilidis, Clare Jacobs, Gerard Mawhinney, Jeremy Reynolds, Yaron Berkowitz, Emma
Kenney-Herbert, Ather Siddiqi, James Teh, Basavaraj Chari, Martin Gillies, Tim McCormick, Ami
Sabharwal, Stana Bojanic, Hayley Jones, Alex Anderson, Claire Worrall, Niamh Louwman,
Harriet Dent, Mariam Latif, Tomasz Bajorek, Mehrunisha Suleman, Victoria Bradley, Nicolas
Beresford-Cleary.
4/5
Accepted at the Global Spine Congress (May 28-31, 2025, Rio de Janeiro, Brazil)
Abstract PDF (Global Spine Congress 2025 4/5)
The OxMINT score. A novel scoring system to guide clinicians on the choice of intervention between best supportive care, spinal surgery, interventional radiological procedures and anaesthetic interventions in metastatic spinal disease developed using AI systems.
Georgios Zilidis, Clare Jacobs, Gerard Mawhinney, Jeremy Reynolds, Yaron Berkowitz, Emma
Kenney-Herbert, Ather Siddiqi, James Teh, Basavaraj Chari, Martin Gillies, Tim McCormick, Ami
Sabharwal, Stana Bojanic, Hayley Jones, Alex Anderson, Claire Worrall, Niamh Louwman,
Harriet Dent, Mariam Latif, Tomasz Bajorek, Victoria Bradley, Nicolas Beresford-Cleary
5/5
Accepted at the Global Spine Congress (May 28-31, 2025, Rio de Janeiro, Brazil)
Abstract PDF (Global Spine Congress 2025 5/5)
The OxMINT metastatic spine tumour checklist.
Georgios Zilidis, Clare Jacobs, Gerard Mawhinney, Jeremy Reynolds, Yaron Berkowitz, Emma
Kenney-Herbert, Ather Siddiqi, James Teh, Basavaraj Chari, Martin Gillies, Tim McCormick, Ami
Sabharwal, Stana Bojanic, Hayley Jones, Alex Anderson, Claire Worrall, Niamh Louwman,
Harriet Dent, Mariam Latif, Tomasz Bajorek, Victoria Bradley, Nicolas Beresford-Cleary
Professor Bee Wee CBE, Fellow and Tutor in Clinical Medicine, Associate Professor of Palliative Care, Consultant Palliative Medicine, Oxford
Optimising the Virtual Hospice: NIHR Programme Development Grant
In this 14 month project, we will undertake a number of work packages to prepare for a more comprehensive study on how to optimise virtual hospices: identifying a diverse set of partner sites using different approaches to delivering virtual hospices, building relationships and research capacity, and optimising the methodology for an economic evaluation including agreeing a set of outcome measures for this. This is a collaborative project between Oxford University Hospitals NHS Trust and the Department of Primary Care Health Sciences and Nuffield Department of Medicine Experimental Medicine Division, Oxford.
Thara Chandran, Research Administrator
This project offers an historical narrative of the RIPEL initiative, exploring how the service evolved through stakeholder insight, adaptive leadership, and real-time problem-solving. It highlights the human, relational, and ethical dimensions of delivering integrated palliative care in a complex system.
Dr Victoria Hedges, Consultant Palliative Medicine, Oxford
Dr Audrey Le Bihan, Specialist Registrar in Clinical Oncology, Oxford
Dr Hedges and Dr Le Bihan are currently contributing to several ongoing projects related to opioid-induced neurotoxicity. Learn more about each project by using the tabs below.
Published Abstract: Opioid prescribing and opioid-induced neurotoxicity in the palliative care setting: a single-centre observational study.
Opioid-induced neurotoxicity in the palliative care population: a rapid review of the current evidence.
The Delphi study of palliative care doctors’ understanding and management of OIN is currently underway, with involvement from Dr Jac Jones.
Dr Hedges has conducted local reviews (unpublished) of opioid reduction as main management of OIN and of low-dose opioid management at end of life.
An Luu, PhD student at NDM’s Oxford University Clinical Research Unit (OUCRU)
Exploring end of life care in the context of infectious diseases in Vietnam: A social science study using multiple methods.
Understanding the ethical and socio-cultural aspects of hospital discharge at the end of life.
Dr Mary Miller – Consultant in Palliative Medicine, Sobell House, Honorary Senior Clinical Lecturer in Palliative Medicine, University of Oxford, Director OxCERPC (Oxford Centre for education and research in palliative care) and Clinical Lead for NACEL
Sarah T Pendlebury, Dimitrios Gratsias, Mary Miller
Predicting 90-day mortality for targeting proactive palliative care in older hospital patients: validation of the CRiSTAL score and a streamlined e-CRiSTAL score
The CRiSTAL score reliably identified those at high short-term risk of death but required manual collection by trained researchers in OUH. In contrast, the e-CRiSTAL score performed similarly using only routinely collected EPR data and could help target proactive palliative care in hospital.
The manuscript is in the final stages of preparation for publication.
Mary Miller, Maria Schelin
To routinely measure quality of care within palliative care – two national systems of benchmarking.
The aim of this paper is to provide guidance for countries/regions/healthcare providers that wish to start or develop palliative care benchmarking. We will describe the two current national approaches, Swedish Palliative Registry of Care and National Audit of Care at the End of Life, specifying and comparing advantages and disadvantages of both approaches.
The manuscript is with co-authors for comment, prior to finalising the paper for publication.
Mary Miller, Tim Harrison, Siobhan Barrie, Anton Pick
Prolonged disorders of consciousness: Practice described by palliative and rehabilitation physicians
Presented as a poster at Palliative Care Congress 2025. Paper in preparation for publication.
Prion disease – think VB will have covered this – wrote a chapter n care at the end of life.
The manuscript is with co-authors for comment, prior to finalising the paper for publication.
William Reilly, Medical Student, University of Oxford
The Rapid Intervention for Palliative and End of Life care project (RIPEL) at Oxford University Hospitals NHS Foundation Trust (OUH) is designed to provide ‘enhanced palliative care and support for adults with advanced life-limiting illness’, including a hospital rapid response (HRR) which facilitates the rapid discharge and continuing support for patients who are dying and have expressed a wish to go home.
Data were extracted from the electronic patient records (EPR) of 1008 inpatients who died in OUH in April 2023, July 2023, October 2023, and January 2024, and anonymised where necessary. Patient records flagged as potential missed opportunities for HRR referral were revisited for in-depth journey-mapping, and univariate statistical analysis was used to evaluate equity of referral.
Only 5 patients were identified as potential missed opportunities from their clinical notes, and there are no consistent factors among these patients such as ward or demographic characteristics which differ from the HRR-referred patients – so no particular areas for improved HRR access were identified from this group. However, the statistical analysis identified several areas where learning around RIPEL services and improved referral may be beneficial, for example with regards to older patients and patients in intensive care or stroke wards; though the extent to which differential referral is based on differential clinical needs (as opposed to systematic bias) is difficult to quantify. Overall, these results provide reassurance that few clear opportunities for better care have been missed; but more explicit conversations and documentation around preferred place of death would likely reveal more opportunities for better care for people at the end of life.
Dr Joanne Skinner, Clinical Fellow Palliative Medicine, Specialty Registrar Renal Medicine, Oxford University Hospitals NHS Foundation Trust
I am undertaking a qualitative research project studying what patients would like to know about dialysis withdrawal.
I have conducted 6 semi-structured interviews with patients on haemodialysis, known to the renal supportive care team. Interviews were transcribed and underwent thematic analysis by 3 independent reviewers. The main themes identified were that patients want more information, they want to know timelines for their illness and they want to know what symptoms they would experience if they chose to withdraw from dialysis. Patients also discussed who they would consult for further information and who they would involve in decision making.
Whilst not specifically related to the research question, all patients discussed their experience on dialysis and how dialysis resulted in exhaustion, pain as well as the limitations it posed on their life.
I will create a poster which I plan to present at both the Palliative Care Congress 2026 and the UK Kidney Association Week in 2026.
Dr Joanne Skinner, Clinical Fellow Palliative Medicine, Specialty Registrar Renal Medicine, Oxford University Hospitals NHS Foundation Trust
I am undertaking a qualitative research project studying what patients would like to know about dialysis withdrawal.
I have conducted 6 semi-structured interviews with patients on haemodialysis, known to the renal supportive care team. Interviews were transcribed and underwent thematic analysis by 3 independent reviewers. The main themes identified were that patients want more information, they want to know timelines for their illness and they want to know what symptoms they would experience if they chose to withdraw from dialysis. Patients also discussed who they would consult for further information and who they would involve in decision making.
Whilst not specifically related to the research question, all patients discussed their experience on dialysis and how dialysis resulted in exhaustion, pain as well as the limitations it posed on their life.
I will create a poster which I plan to present at both the Palliative Care Congress 2026 and the UK Kidney Association Week in 2026.
