60 seconds with...Dr Dave Brealey


What led you to work as an Intensive Care & Emergency Medicine doctor? 

I started life training to be a general hospital physician, I loved it. I particularly enjoyed looking after the sicker patient and found I could do things to help. However, at some point these patients always seemed to be whisked off to the Intensive Care Unit and their care managed by a different team. The more I talked to these teams the more fascinated I was by their approach. They based their decisions on an understanding of physiology and biochemistry and used monitoring to adjust these decisions, it seemed so logical. This 'logic' turned many of my strongly held beliefs on their head and I was at last able to question everything. I moved over to anaesthesia and intensive care and never looked back. I am now fortunate enough to work with a great team who similarly ask a lot of questions and spend a lot of effort looking for the answers.

What are the biggest challenges facing healthcare today?

Rising expectation coupled with the need to curtail expenditure continues to challenge all sectors of healthcare. There are many new technologies out there that can help us evolve with these challenges, but healthcare is generally a slow adopter of these ideas. We need to be more agile, to recognise and adopt helpful technologies, to be willing to take a chance and seize on ideas that could positively disrupt the current ways of working.

How can using data through wearable technology transform healthcare?

This will be an iterative process, initially nurses, doctors; patients will need to learn to 'trust' the data, to see it helps them and makes a difference. Once this is achieved it will be possible to deploy far more exciting ideas that may allow us pre-symptomatic detection and more accurate predictions. The ability to link this acute care episode to longer term outcomes will inform all of us in ways we have previously been unable to imagine

How can applying the principles of engineering & design bring better care to patients?

Most medical research is carried out in a very set and linear pattern. Once the project starts it often does not change until completed, even if issues are identified. It is almost like we lay siege to the problem. The design principles allows for a much more fluid approach being able to change and adapt to user requirements and feedback. It is iterative and so allows for a product that may look very different from the original concept, this is vital if we are going to get the buy-in of our patients, nurses and doctors. The device has to work for them!

How does your experience as an Emergency Doctor inform your role on the Nightingale project?

I have been a doctor for 24 years and many things have changed over that time. However one of the things that we all find frustrating is our repeated inability to detect clinical deterioration in a rapid, reliable way so as to bring the appropriate help at the right time. In many ways it should be easy, but working within Nightingale has shown that this problem is truly global and absolutely not just a problem to the UK's NHS. To me, this suggests the problem is deeper than just a funding, system, nationality or education problem and we need a disruptive approach to finally grapple with this problem

What’s the best piece of advice you’ve been given?

Become a dentist.

If you weren’t a doctor, what would you be doing?

I always wanted to fly helicopters.

What is your ideal Sunday?

Riding a horse up a mountain, snowboarding down to pick up a windsurfer on the beach to sail across to a good family meal (most of which is quite difficult whilst living in London).