REAL Health

In 2018, we awarded £2.2m to establish the Research Enabled Learning (REAL) Health programme at Queen Mary University of London. Its key aim is to use a ‘learning health system’ approach, using primary care data to address and improve key health inequalities facing the people of East London. 

The programme is led by Professor John Robson and Professor Carol Dezateux of the Clinical Effectiveness Group at Queen Mary’s Wolfson Institute of Population Health. 

About REAL Health

Using anonymised health data, the REAL Health programme aims to address clinical and public health issues in three core areas: 

Child health

In East London, one in four children leaves primary school very overweight, while 20% aren’t protected against measles, mumps and rubella (MMR) by their second birthday. The team have been using innovative data driven methods to understand key factors that influence children’s health in East London, such as obesity, immunisation uptake and levels of overcrowding within homes. 

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Respiratory health

Between 2023 and 2024, emergency hospital admissions for asthma in adults increased by 17% in England. The team aimed to improve asthma management by identifying those at higher risk of hospital admission using data to better predict the risk of an asthma attack. Patients identified as high risk can then be flagged for ‘asthma risk review’ appointments to recommend changes and improvements in medication.  

Cardiovascular health 

Cardiovascular disease remains one of the leading preventable causes of premature death and disability. However, gaps remain between the best possible treatment and what is delivered. The team developed software tools that help clinicians use data from patient records to find people who aren’t getting the treatment they need and prescribe medications accordingly. 

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The impact of this funding

Key findings from the three core areas of the REAL Health programme over the past five years include: 

Child health

• Children living in the most deprived areas of North East London are three times more likely to have severe tooth decay, requiring hospital extraction.  
• Girls with obesity are 1.7 times more likely to visit the GP for musculoskeletal problems than those with a healthy weight. 
• Children in the most deprived areas and those from Black and mixed ethnic backgrounds were less likely to be immunised by 18 months. By developing an actionable software tool as part of a GP quality improvement childhood immunisation programme in east London, the percentage of children who received their first MMR dose on time increased by 4.1%. This is equivalent to an additional 1,100 children per year being protected.  
• The team is now sharing results with local and national NHS decision-makers, advocating for achievable targets and financial support for GP practices to continue driving improvement and protecting all children. 

Respiratory health 

• Excess prescription and use of quick-relief ‘short-acting beta-agonist’ (SABA) inhalers is associated with poor asthma control and increasing risk of severe attacks and hospital admissions. SABA overprescribing was found in more than >25% of the asthma population in East London, with a 10-fold variation in overprescribing rates among practices and a strong association with repeat dispensing (whereby prescriptions are issued automatically).  
• The team developed a learning health system built on electronic prescription data from primary care. They provided GP practices with tools, including prescribing alerts, to help identify and manage high-risk patients. This has had a big impact on respiratory health. The tools have helped reduce overuse of SABA inhalers by half. 

Cardiovascular health

• Research findings have shown that supporting those with high blood pressure and cardiovascular disease in getting timely and appropriate treatment could prevent heart attacks and strokes and reduce hospital costs. This has demonstrated that medication optimisation tools such as those developed by the research team can help save lives. 
•  Using these software tools with support of the Clinical Effectiveness Group and Barts Health pharmacy, the North East London region has achieved: the best levels of lifesaving treatment with statins in England, the best blood pressure control rates in England and among the best levels of anticoagulants for people with atrial fibrillation.

The REAL Health programme’s findings have demonstrated the power of data to provide actionable insights that identify and improve key areas of health inequalities as part of a learning health system.  

This approach provides a practical example of how the Neighbourhood Health Service described in the 2025 NHS 10-Year Health Plan – grounded in real clinical workflows – is actually doable now.

How this helps our community

On the vaccination programme, one staff member from a GP practice in City and Hackney said: “The tool makes managing what can be a complex area easy to understand. I use it weekly to call those that are due that week. This was not happening prior to the tool, and it has proven to be successful in ensuring that children get the right vaccines at the right time.”