Professor Jonathan Valabhji recently joined MDR as a Clinical Chair in Medicine and will be based at the Chelsea and Westminster Hospital. We caught up with him to find out about his background, research and interests.
Introduce yourself – who are you and what do you do?
My name is Jonathan Valabhji, Clinical Chair in Medicine at Imperial College London, and Honorary Consultant Diabetologist at Chelsea & Westminster Hospital NHS Foundation Trust. I am a researcher and clinician, and over the last decade have also been a national clinical leader and policy-maker.
Where were you working before you joined MDR?
I was the National Clinical Director for Diabetes and Obesity, NHS England, 2013-2023, a Consultant Physician, Diabetologist and Endocrinologist, Imperial College Healthcare NHS Trust, 2002-2023 and was Professor of Practice (Diabetes), Imperial College London, 2018-2023. My current major research interests involve the application of real-world data to support population health and health improvement, through the implementation and quality assurance of specific interventions, and through healthcare delivery at English population level. I have developed expertise over the last decade in national health system leadership, policy development, and health system implementation within England; my research interests and outputs reflect the corresponding work streams that I have developed across England as National Clinical Director over this time, focusing on lifestyle interventions, clinical care, technological support for diabetes self-management, multimorbidity, and the impact of diabetes and obesity on COVID-19-related outcomes.
What first inspired your interest in diabetes?
As a Junior Doctor, I spent three years at SHO level, rotating through most of the medical specialities, which allowed me to decide which speciality I enjoyed the most. I loved the holistic nature of diabetes and general medicine, which informed my subsequent career choice. I consider myself very fortunate: as a diabetologist and physician, it is all about the one-to-one, doctor-patient relationship; but superimposed on that, and informed by my decade as National Clinical Director for Diabetes and Obesity, I have also been able to look at things through a population health lens to inform my research direction. When I qualified in 1990, the prevalence of type 2 diabetes in the adult population of England hovered at around 2%; it is now in the region of 7-8%, so diabetes now has a major impact on the nation’s health.
What is the most interesting piece of research you are currently working on?
During the early days of the COVID-19 pandemic, I led a collaboration of researchers from Cambridge, Leicester, and Glasgow Universities that applied linked national datasets, including the National Diabetes Audit, a fully comprehensive register of all with a coded diagnosis of diabetes in England, to demonstrate the risk of COVID-19-related mortality in people with diabetes, by type, for the first time internationally. Applying the same national datasets that include around 60 million individuals (all individuals registered with a GP in England), and include data on 35 different long-term conditions, I am now leading research that investigates the sequence of acquisition of long-term conditions in those with multiple long-term conditions (MLTC) / multimorbidity, and the impact of nationally available lifestyle interventions, such as the NHS Diabetes Prevention Programme, on the prevention of, the sequence of acquisition of, and the healthcare utilization and costs of, long term conditions and MLTC in England.
Do you have any collaborative opportunities in your research?
The MLTC work would benefit hugely from broader collaboration with those interested in the field, as well as with generalist and specialist (particularly from other specialities) researchers and clinicians from across Imperial College.
What has been the proudest achievement of your career so far?
In 2014 I successfully made the case for (within NHS England and to UK Government Treasury), and led subsequent implementation of, the NHS Diabetes Prevention Programme, including digital modes of delivery, with over 1.3 million people with pre-diabetes now referred in, and published evidence demonstrating reduced Type 2 diabetes incidence in programme participants and at English population level associated with programme implementation.
What do you find to be the most challenging aspect of your work?
Managing the stakeholder, including political, interface associated with the implementation of interventions at scale nationally.
What do you consider to be the key challenges in healthcare and medicine that we need to overcome in the next 20 years?
Increased population longevity (a great success of public health and healthcare over recent decades) means that many more people are living for longer with morbidity/MLTC, which poses major challenges around future NHS workforce capacity and healthcare delivery, and will necessitate a shift back from specialist-orientated healthcare delivery to generalist-orientated healthcare delivery.
What is the best piece of advice you would give to students and early career researchers who aspire to have a successful career in research and/or academia?
For clinicians who aspire to have a successful career in research/academia, clinical practice is a great means by which we can personally identify research needs and identify what matters most to our patients (and indeed to populations), in order to generate our research ideas.
And finally, if you could time travel, when/where would you go?
Surely we all want to know what the future holds? I would love to have a fleeting glimpse of London 100 years from now!