Professor Julian Bion OBE MBBS MRCP FRCP FRCA MD FFICM

Professor Julian Bion

Birmingham Medical School
Professor of Intensive Care Medicine

Contact details

Address
Anaesthesia & Critical Care
Institute of Clinical Sciences
University of Birmingham
Edgbaston
Birmingham
B15 2TT
UK

Julian Bion is the Professor of Intensive Care Medicine at the University of Birmingham (UoB).  He was consultant in intensive care medicine at University Hospitals Birmingham (UHB) from 1987 until 2017 undertaking full duties including nights and weekends.  He continues to support UHB in the role of Freedom To Speak Up Guardian for the Trust.  At UoB he chairs the Clinical Trials Oversight Committee, responsible for the governance of all clinical research at the University.

He led the NIHR-funded High-intensity Specialist Led Acute Care (HiSLAC) project from 2014-2020 which has identified the likely causes of the ‘weekend effect’, the phenomenon of higher mortality rates associated with admission to hospital at weekends.  He has also led the NIHR-funded Patient Experience and Reflective Learning (PEARL) project which has developed a framework and toolkit for reflective learning in healthcare. 

He was President of the European Society of Intensive Care Medicine (2004-2006), and Foundation Dean of the UK Faculty of Intensive Care Medicine (2010-13), establishing primary speciality status for intensive care medicine in 2011.  He was awarded the BUPA Medical Foundation Doctor of the Year Award in 1986; has received the Shubin Weil International Award for Excellence 2004 (Society Critical Care Medicine USA), four Honorary Life Memberships; the European Society of Intensive Care Medicine Medal 2012: the Intensive Care Society’s President’s Award (2014), the Gold Medal of the Royal College of Anaesthetists (2017), the Lifetime Achievement Award of the Intensive Care Society (2017), the Gold Medal of the UK Faculty of Intensive Care Medicine (2018) and was appointed to the Order of the British Empire (OBE) in the Queen’s Birthday Honours (2018).

Qualifications

  • ECFMG (London), July 1975
  • MBBS (London), Dec 1975
  • MRCP (UK), Oct 1979
  • FFARCS (FRCA), July 1982
  • MD (London), 1991
  • FRCP (UK) by election, 1996
  • ALS Instructor status, Oct 8th 2009-Oct 8th 2013 & renewed
  • FFICM by election, 2011

Biography

Patient-focussed clinical care:

Since 2010, Professor Bion worked in the new Intensive Care Unit (ICU) at the new Queen Elizabeth Hospital Birmingham, with 100 bed spaces and 4000 admissions a year - making it the largest single intensive care unit in Europe - providing care to a wide range of critically ill patients, and offering a fully integrated service with colleagues from the Royal Centre for Defence Medicine to our injured soldiers.   

Professor Bion set up a patient and family ‘Pathfinder’ group to provide advice and feedback on quality of care across the critical care service. This has helped make important improvements to service provision and clinical behaviours, and the members are now advising and collaborating on a number of research projects. 

In 2001 he obtained a grant in excess of £1M to establish an observational database in 1996 for all 27 intensive care units in the West Midlands Region, employing more than 30 data clerks and a project manager. The project is now an integral part of the national ICNARC case mix programme, providing essential performance feedback to all ICUs.

In 2012-13 he co-led (with Dr Chris Roseveare) the Academy of Medical Royal Colleges project to develop professional standards for consultant-led care. For the first time this mandated daily consultant review of all hospitalised patients, and stimulated the development of NHS England.

He is currently leading a 5-year national research collaboration (the HiSLAC project) on services delivery and organisation of services for acute and emergency patients.

Academic Research:

  • Professor Bion has two major grants from the NIHR’s Health Service and Delivery Research (HS&DR) Programme. 
    • High-intensity Speciality Led Acute Care (HiSLAC), £2.4M over 5 years (2014-19) evaluating the utility of various aspects of 7-day services [www.hislac.org]. 
    • He is also leading the PEARL project (Patient Experience and Reflective Learning) funded (£0.7M) by the HSDR programme for three years (2017-19).
  • He established a framework for multidisciplinary multinational research, the European Critical Care Research Network, through the European Society of Intensive Care Medicine. This is now participating in global critical care trials.
  • He conceived, initiated and led a world-wide European Community Leonardo Programme-funded international competency-based training programme for intensive care in Europe (CoBaTrICE).  Completed successfully in October 2006, fifteen (45%) of European countries have adopted the CoBaTrICE model, and a further 12 are considering or planning to follow suit, with translations into eight national languages.  The programme can be viewed at www.cobatrice.org/
  • Lead investigator in a collaborative group studying the genetics of sepsis (GenOSept), awarded a grant of Eur 2.1M by the FP6 programme (2006-2014).
  • Senior Clinical Lead for the Department of Health funded NPSA’s ‘Matching Michigan’ project to minimise blood stream infections linked to the use of central venous catheters (2009-2011). 
  • November 2007 – 2010: Deputy Director of the new UoB/UHB Research Academy to promote translational research between the University and the NHS in Birmingham.
  • January 2009 – 2012: Co-Director (non-cancer) for Research & Development for the University Hospital Birmingham NHSFT
  • Appointed as the first Critical Care Speciality Group lead for the Birmingham & Black Country CLRN (local arm of the National Institute for Health Research), 2008-2010.
  • Published widely on intensive care and related topics, including original articles, reviews, editorials, book chapters and one textbook.

Teaching

  • 1st year: Basic Life Support training programme for all health care students (MBChB, GEC, Physiotherapy, Dentistry)
  • 3rd year: Medical Student Acute Medicine and resuscitation training programme coordinator
  • 4th year: Critical Care component of the ARICM module
  • 5th year: Immediate Life Support course coordinator

Research

  • As President of the European Society of Intensive Care Medicine (2004-2006) I was instrumental in establishing the European Critical Care Research Network, through the European Society of Intensive Care Medicine.
  • I initiated and lead a world-wide European Community Leonardo Programme-funded international competency-based training programme for intensive care in Europe (CoBaTrICE). Completed successfully in October 2006, we are now implementing this programme worldwide, and will be developing a social sciences research programme to evaluate its impact on medical education and patient care. The programme can be viewed at www.cobatrice.org/ .
  • I am a member of the WHO's sepsis group within the Integrated Management of Acute Illness programme, developing best practice guidance for resource-limited environments.
  • I was a member of the Executive Committee of the Surviving Sepsis Campaign (2003-9) developing best practice guidance in the management of patients with severe sepsis and septic shock.
  • I am one the lead investigators in a collaborative group studying the genetics of sepsis (GenOSept) which has been awarded a grant of Eur 2.1M by the FP6 programme (2004-8)
  • I am the senior clinical lead for the DoH-funded NPSA's ‘Matching Michigan' project to minimise blood stream infections linked to the use of central venous catheters.
  • I am collaborating in a range of clinical projects focussed on improving the management of patients with sepsis, and acutely ill patients in general, to enhance reliable delivery of best practice care.

Other activities

  • University Hospital Birmingham NHSFT Co-Director of R&D (non-cancer)
  • Birmingham Clinical Research Academy Deputy Director
  • Birmingham & Black Country UK-CLRN Speciality Group lead for Critical Care
  • Royal College of Anaesthetists Council member and Chair, Professional Standards Committee
  • Foundation Dean of the UK Faculty of Intensive Care Medicine

Publications

Recent publications

Book

Bion, J, Aldridge, C, Beet, C, Boyal, A, Chen, YF, Clancy, M, Girling, A, Hofer, T, Lord, J, Mannion, R, Rees, P, Roseveare, C, Rowan, L, Rudge, G, Sun, J & Lilford, R 2021, Increasing specialist intensity at weekends to improve outcomes for patients undergoing emergency hospital admission: the HiSLAC two-phase mixed-methods study.

Article

CATALYST investigators, Fisher, B, Veenith, T, Slade, D, Gaskell, C, Rowland, M, Whitehouse, T, Scriven, J, Parekh, D, Balasubramaniam, M, Cooke, G, Morley, N, Gabriel, Z, Wise, M, Porter, J, McShane, H, Ho, L-P, Newsome, P, Rowe, A, Sharpe, R, Thickett, D, Bion, J, Gates, S, Richards, D, Kearns, P & Mussai, F 2022, 'Namilumab or infliximab compared with standard of care in hospitalised patients with COVID-19 (CATALYST): a randomised, multicentre, multi-arm, multistage, open-label, adaptive, phase 2, proof-of-concept trial', The Lancet Respiratory Medicine. https://doi.org/10.1016/S2213-2600(21)00460-4, https://doi.org/10.1016/s2213-2600(21)00460-4

Sutton, E, Bion, J, Mannion, R, Willars, J, Shaw, E & Tarrant, C 2021, 'A qualitative study of organisational response to national quality standards for 7-day services in English hospitals', BMC Health Services Research, vol. 21, no. 1, 205. https://doi.org/10.1186/s12913-021-06213-w

Veenith, T, Fisher, BA, Slade, D, Rowe, A, Sharpe, R, Thickett, DR, Whitehouse, T, Rowland, M, Scriven, J, Parekh, D, Bowden, SJ, Savage, JS, Richards, D, Bion, J, Kearns, P, Gates, S & CATALYST Trial Investigators 2021, 'CATALYST trial protocol: a multicentre, open-label, phase II, multiarm trial for an early and accelerated evaluation of the potential treatments for COVID-19 in hospitalised adults', BMJ open, vol. 11, no. 11, e050202. https://doi.org/10.1136/bmjopen-2021-050202

Watson, SI, Lilford, RJ, Sun, J & Bion, J 2021, 'Estimating the effect of health service delivery interventions on patient length of stay: a Bayesian survival analysis approach', Journal of the Royal Statistical Society Series C (Applied Statistics). https://doi.org/10.1111/rssc.12501

Lall, R, Mistry, D, Skilton, E, Boota, N, Regan, S, Bion, J, Gates, S, Gordon, AC, Lord, J, McAuley, DF, Perkins, G, Singer, M, Young, D & Whitehouse, T 2021, 'Study into the reversal of septic shock with landiolol (beta blockade): STRESS-L Study protocol for a randomised trial', BMJ open, vol. 11, no. 2, e043194. https://doi.org/10.1136/bmjopen-2020-043194

Bion, J, Brookes, O, Brown, C, Tarrant, C, Archer, J, Buckley, D, Buckley, LM, Clement, I, Evison, F, Gao Smith, F, Gibbins, C, Hayton, E-J, Jones, J, Lilford, R, Mullhi, R, Packer, G, Perkins, G, Shelton, J, Snelson, C, Sullivan, P, Vlaev, I, Wolstenholme, D & Wright, S 2020, 'A framework and toolkit of interventions to enhance reflective learning among health-care professionals: the PEARL mixed-methods study', Health Services and Delivery Research, vol. 8, no. 32, pp. 1-110. https://doi.org/10.3310/hsdr08320

Bion, J, Aldridge, C, Girling, A, Rudge, G, Sun, J, Tarrant, C, Sutton, L, Willars, J, Beet, C, Boyal, A, Rees, P, Roseveare, C, Temple, M, Watson, S, Chen, Y, Clancy, M, Rowan, L, Lord, J, Mannion, R, Hofer, T & Lilford, R 2020, 'Changes in weekend and weekday care quality of emergency medical admissions to 20 hospitals in England during implementation of the seven day services national health policy.', BMJ Quality & Safety.

Foster, M, Taylor, A, Bishop, J, Gilligan, L, Bion, J, Lord, J & Arlt, W 2020, 'Mapping the steroid response to major trauma from injury to recovery: a prospective cohort study', Journal of Clinical Endocrinology and Metabolism, vol. 105, no. 3, dgz302. https://doi.org/10.1210/clinem/dgz302

Infection in Critical Care Quality Improvement Oversight Group & Bion, J 2020, 'Surveillance of bloodstream infections in intensive care units in England, May 2016–April 2017: epidemiology and ecology', The Journal of hospital infection, vol. 106, no. 1, pp. 1-9. https://doi.org/10.1016/j.jhin.2020.05.010

Mergental, H, Laing, RW, Kirkham, AJ, Perera, MTPR, Boteon, YL, Attard, J, Barton, D, Curbishley, S, Wilkhu, M, Neil, DAH, Hübscher, SG, Muiesan, P, Isaac, JR, Roberts, KJ, Abradelo, M, Schlegel, A, Ferguson, J, Cilliers, H, Bion, J, Adams, DH, Morris, C, Friend, PJ, Yap, C, Afford, SC & Mirza, DF 2020, 'Transplantation of discarded livers following viability testing with normothermic machine perfusion', Nature Communications, vol. 11, no. 1, 2939. https://doi.org/10.1038/s41467-020-16251-3

Editorial

Bion, J & Alderman, JE 2022, 'Peer review of quality of care: methods and metrics', BMJ Quality & Safety. https://doi.org/10.1136/bmjqs-2022-014985

Preprint

Veenith, T, Fisher, BA, Slade, D, Rowe, A, Sharpe, R, Thickett, DR, Whitehouse, T, Rowland, M, Scriven, J, Parekh, D, Bowden, SJ, Savage, JS, Richards, D, Bion, J, Kearns, P & Gates, S 2021 'CATALYST trial protocol: a multicentre, open-label, phase II, multi-arm trial for an early and accelerated evaluation of the potential treatments for COVID-19 in hospitalised adults' medRxiv, pp. 1-15. https://doi.org/10.1101/2021.02.10.21251478

Fisher, BA, Veenith, T, Slade, D, Gaskell, C, Rowland, M, Whitehouse, T, Scriven, J, Parekh, D, Balasubramaniam, MS, Cooke, G, Morley, N, Gabriel, Z, Wise, MP, Porter, J, McShane, H, Ho, L-P, Newsome, PN, Rowe, A, Sharpe, R, Thickett, DR, Bion, J, Gates, S, Richards, D & Kearns, P 2021 'Namilumab or infliximab compared to standard of care in hospitalised patients with COVID-19 (CATALYST): a phase 2 randomised adaptive trial' medRxiv, pp. 1-26. https://doi.org/10.1101/2021.06.02.21258204

Review article

Quinn, L, Veenith, T, Bion, J, Hemming, K, Whitehouse, T & Lilford, R 2022, 'Bayesian analysis of a systematic review of early versus late tracheostomy in ICU patients', British Journal of Anaesthesia, vol. 129, no. 5, pp. 693-702. https://doi.org/10.1016/j.bja.2022.08.012

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