My interests include clinical research in chronic obstructive pulmonary disease (COPD) and respiratory aspects of motor neurone disease.

COPD exacerbation is the 2nd commonest reason for hospitalisation. NICE guidelines endorse hospital at home and early (supported) discharge services in this condition, recommend that selection should be informed by risk of death but acknowledge the (previous) lack of a robust prognostic score. I led development of the DECAF prognostic score to risk stratify such patients, with multicentre validation, in 2,645 patients consecutively admitted to participating sites. DECAF is simple to apply at the bedside, offers excellent discrimination for in-hospital death and outperforms other tools sometimes used in this setting. Routine use to inform care is endorsed by: UK COPD Audit Report and BTS COPD Specialist Advisory Group 2015 and an independent Thorax Editorial 2016. I conceived and supervised a RCT of hospital at home selected by low risk DECAF score (RfPB funded); up to 50% of admitted patients are eligible thus the potential clinical and cost benefits are large. Based on this research, I won a NIHR Clinical Research Impact of the year award 2016.