The Manchester Academic Health Science Centre (MAHSC) is proud to continue its series of inaugural lectures, honouring the outstanding contributions of our honorary clinical chairs. These lectures celebrate leaders in clinical service, research, and education, who have profoundly impacted healthcare through their dedication, expertise, and partnership with the NHS.

This edition of the series was an exciting event featuring two highly respected professionals: Professor Daniel Horner and Professor Martin Smith, Consultants in Emergency Medicine at Northern Care Alliance (NCA). They were introduced by Professor Paul Dark, Vice Dean of the Faculty of Biology, Medicine, and Health at the University of Manchester, who emphasised the importance of celebrating clinical leadership and excellence within the university and its NHS partners

Professor Martin Smith delivered a compelling lecture titled “Accidental Academic,” in which he reflected on his unconventional path in medicine, filled with unexpected turns and profound learning experiences. He recounted his beginnings in Stockport and his early desire to become a veterinarian, a dream thwarted by an allergy to horses. This led him to pursue medicine at the University of Edinburgh, which laid the foundation for his illustrious career.

One of the key takeaways from Professor Smith’s lecture was how serendipity and adaptability shaped his career. He initially trained in general practice during a time of significant social and healthcare challenges in the 1980s. However, a pivotal year spent in New Zealand marked his transition to acute and emergency care. It was there that he encountered new medical techniques and witnessed the importance of interdisciplinary teamwork, which sparked his interest in emergency medicine.

Leadership and Innovation in Trauma Care

A significant part of Professor Smith’s career has been his work in trauma care. Appointed as a consultant at Salford Royal in 2003, he played a crucial role in reshaping how paediatric emergency services were delivered and contributed to the development of short-stay paediatric units. His leadership extended into the national trauma care landscape, where he helped shape major trauma networks in the UK.

A profound part of his lecture was his account of the Manchester Arena bombing in 2017. Professor Smith shared insights into the trauma network’s response plan, which had been developed in collaboration with colleagues over several months. Though the plan had not been fully tested or signed off, it was put into action on the night of the attack. This pre-emptive work, which focused on the strategic dispersal of casualties across multiple hospitals, has since become a model for managing mass casualty incidents across the UK.

Reflections on Mentorship and Academic Growth

Throughout his lecture, Professor Smith expressed his gratitude for the mentorship and guidance he received throughout his career. He credited many colleagues, both in the UK and abroad, for shaping his approach to clinical leadership and research. He emphasised the importance of learning from experienced professionals and urged early-career clinicians to seek out mentors and remain open to new ideas and innovations.

When asked for advice for early-career researchers and clinical fellows, Professor Smith’s message was clear: “Find people who know what they’re doing, and stay close to them.” He underscored the value of collaboration across disciplines and encouraged the next generation to immerse themselves in opportunities for growth and leadership.

Looking Ahead: A Vision for the Future

In the concluding part of his lecture, Professor Smith turned his attention to the future. He highlighted the recent launch of a centre dedicated to Emergency Care and Trauma sciences research in Salford (CENECT Centre for Emergency Care and Trauma Sciences – Research & Innovation) which is poised to drive innovation, foster research engagement and ultimately improve patient outcomes. His work, alongside colleagues such as Professor Dan Horner, Professor Fiona Lecky and Professor Paul Dark, continues to focus on improving emergency care systems through collaboration, research, and advanced training.

Professor Martin Smith’s journey from an aspiring vet to a leading figure in emergency medicine—is a testament to the power of resilience, adaptability, and lifelong learning. His leadership in trauma care, commitment to mentorship, and dedication to academic excellence have left an indelible mark on the field of emergency medicine.

The Catalyst for Research Engagement
Reflecting on his early days in emergency medicine, Professor Horner was fortunate to be surrounded by outstanding role models, particularly clinical academics such as Professor Kevin Mackway-Jones, Professor Fiona Lecky and Professor Simon Carley. These individuals seamlessly integrated academic knowledge into clinical practice, demonstrating the direct impact of research translation on patient care. They inspired him to consider academia as a fundamental component of being a clinician.
Professor Horner highlighted that over the past decade, multiple studies have shown a strong correlation between research activity and improved clinical outcomes. A notable example is a 2015 study analysing over two million emergency admissions within the NHS. Even after adjusting for variables like access to critical care services and staffing levels, the findings indicated that institutions highly active in research had lower patient mortality rates. This evidence reinforces the value of embedding research within clinical practice.

Fostering a Culture of Curiosity
Professor Horner discussed how many may find getting into research challenging, but the key lies in nurturing curiosity. Research activity surrounds clinicians, often ignited by simple questions that arise in daily practice. Why was a specific medication chosen? What guided the decision-making process behind a particular procedure?
Professor Horner believes that encouraging open discussions and appreciative inquiry among all levels of staff can break down hierarchical barriers and foster a culture where questioning and learning are paramount. This initial curiosity can transform clinical inquiries into academic outputs. For example, best evidence topic reports—structured literature reviews that originated at Manchester Foundation Trust—offer a platform to report these questions and share findings across the emergency care community.

From Curiosity to Academic Outputs
Once clinicians engage in critical appraisal, it is natural for them to further develop academic interests and skills. Structured reviews can lead to journal updates, narrative manuscripts, guideline articles and a developing sense that completing your own research is possible. Professor Horner delved into primary research during his emergency medicine registrar training. He took a two-year hiatus from the programme to pursue an MD at The University of Manchester, focusing on the management of calf vein thrombosis. He was supported to deliver a randomised control feasibility trial which allowed him to witness firsthand the positive impact that well-structured research can have on clinical practice. He expressed how seeing his work cited in systematic reviews and subsequently influencing clinical guidelines is one of the most gratifying experiences a researcher can experience in their career.

Balancing Research with Clinical Responsibilities
Professor Horner detailed how completing an MD while managing registrar responsibilities, preparing for specialty exams, and starting a family can be daunting. Many clinicians find it difficult to balance these competing demands and maintain an active research agenda.
He described how finding funding opportunities, even for a portion of time as a junior consultant, can allow clinicians to continue engaging in research. Professor Horner maintained an interest in thrombosis care and started to focus on areas of clinical equipoise, such as the prevention of thrombosis in patients immobilised with lower limb injuries. Despite facing challenges this process allowed him to develop his expertise in a specific research area and led to international collaborations and further awards to support his research time. These efforts have now culminated in a recent NIHR award to deliver a large pragmatic randomised controlled trial, which Professor Horner is leading as chief investigator.

Collaboration and Clinical Impact
His collaboration with the University of Sheffield and the Royal College of Emergency Medicine led to the development of consensus recommendations on thrombosis management. By synthesising existing evidence and engaging with other specialities, Professor Horner and his colleagues generated a buzz around this critical topic, receiving invitations to publish in various journals. These collaborations not only helped enhance his credibility but also paved the way for more significant research opportunities.
By leading the thrombosis committee at his institution, Professor Horner was able to translate his academic findings rapidly into clinical practice. Working alongside colleagues from haematology, orthopaedics, and pharmacology, they established a comprehensive resource for their VTE service, complete with evidence-based guidelines accessible to all healthcare professionals. Their efforts have garnered national recognition, underscoring the importance of aligning clinical practice with robust evidence.

Mentorship and Community Building
Lastly, the importance of mentorship and capacity building in academic emergency medicine cannot be overstated. Professor Horner recognises the value of having role models and academic leaders who inspire and support the next generation of emergency medicine clinicians. They emphasise the necessity of creating a community that nurtures academic interests and fosters collaboration among colleagues.

Through initiatives like CENECT, Professors Horner and Smith aim to establish a sustainable framework for research engagement that supports clinicians in their pursuit of research opportunities. By curating diverse pathways for involvement in research—from being curious on the shop floor, to participating in clinical trials, to leading projects—clinicians can find their niche and contribute meaningfully to advancing the field.

As the landscape of emergency medicine continues to evolve, it’s imperative to recognise the profound impact that research can have on patient care. The journey of becoming a clinical academic may seem overwhelming, but by fostering curiosity, encouraging open discussions, and collaborating across specialties, a culture that embraces research as a core component of clinical practice can be cultivated.

With the right support and dedication, every clinician can contribute to advancing the field and improving patient outcomes. As they move forward, it is essential to make research an integral part of everyday practice, ensuring that the pursuit of knowledge continues to enhance the quality of care provided to patients.