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The University of Southampton
Medicine

Dr Ian Williamson MB, ChB, MD, FRCS(Ed), FRCGP

Visiting Fellow

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Dr Ian Williamson is a Visiting Fellow within Medicine at the University of Southampton.

Dr Williamson retired from his position as Associate Professor in September 2015, he is now a Visiting Fellow within the School of Primary Care, Population Sciences and Medical Education. He is a graduate of Edinburgh University and did his fellowship in general surgery whilst completing surgical rotations in Liverpool. He subsequently moved to Manchester where he was a registrar in ENT. He completed his GP training in 1987 and in addition to his academic duties is also currently a practicing GP at Highfield Health University practice.

He is involved in the tasks of researching the evidence for evidence based medicine on a number of levels. Firstly as a clinical trialist involved in leading a number of primary care/ENT type studies for common problems. Particularly for acute and chronic ear problems in children but also for acute conditions in adults such as acute sinusitis and other respiratory disorders. He is member of several groups working to improve and apply rational prescribing of antibiotics in primary care. He works as GP editor in the Cochrane collaboration on ENT disorders, BMJ Clinical Evidence, SCHIN, Drugs and Therapeutics and NICE. He is an active RCGP college member and teacher.

Qualifications

MB ChB Medicine University of Edinburgh 1975
FRCS General Surgery Royal College of Surgeons of Edinburgh 1979
MRCGP UK The Royal College of General Practitioners 1987
MD The Aetiology of Bell’s Palsy University of Edinburgh 1990
FRCGP UK The Royal College of General Practitioners 2006

Appointments held

Associate Professor: University of Southampton 2014-2015

Senior Lecturer in Primary Care: University of Southampton 2000-2014

Lecturer in Primary Care: University of Southampton 1987-2000

SHO in Obstetrics and Gynaecology: Tameside District General Hospital 1986

Academic Trainee: Rusholme at University of Manchester 1985-6

Previous clinical rotations in ENT in Manchester, General Surgery in Liverpool.(post fellowship post Chester Royal Infirmary 1979-81) Previous full time academic post: Anatomy Demonstrator Liverpool University 1976.

Research interests

Otitis Media management in primary care

This is a clinically fascinating topic area that ranges from genetics and biomedical risk factors, to behavioural aspects of illness presentation and treatment. Impact on the child, their family and society is considerable not least in costs. In many ways it also embodies what is quintessential about a GP consultation.

It is clear that whilst most cases are self limiting much more could and should be done to improve matters for the many hundreds of thousands of affected families, and to improve NHS cost effectiveness. Database studies and epidemiology have identified risk factors. Work with the MRC Otitis Media group has helped highlight the importance of a new measurable quality of life aspect that should prove very useful in selecting cases for referral and help active monitoring. A recently completed large study on topical steroids showed these did not help recovery in glue ear but this is being followed through with further studies of different interventions. Hopefully “upstream” in the natural history of otitis media it will be easier to treat and prevent some of the disease processes progressing, and this is a major aim.

Rational prescribing of antibiotics in respiratory infections in primary care

Antibiotic resistance is a global problem and has encouraged a rise in international links around this problem area in primary care networks. This is because high antibiotic use in Spain for example can via air travel and human carriers, transmit resistant bacterial infections to places with low use such as Iceland. Most antibiotics, 80%, are prescribed in the community and 80% of these are for respiratory disorders. The rational basis for this amount of prescribing is now under the microscope.

A study on acute sinusitis done with the help of mostly Wessex GPs showed no benefit of antibiotics using the best available diagnostic criteria for general practice (i.e. likely to be true cases of bacterial sinusitis). Previously over 90% of cases were prescribed antibiotics. It is deemed likely that this over prescribing has not as yet reduced very much because of cultural expectations and the power of anecdote. We are now therefore aiming to develop the work a step further by looking for “substitute treatments” e.g. nasal irrigation with saline and through international collaborations in Europe and America. The principle of treatment substitution is likely to be more effective than finding a treatment doesn’t work. Nonetheless negative findings are important and progressive both to the scientific community and the larger one when the goal is an earnest seeking after scientific truth.

Wessex has a first rate GP network which has enabled scientific proposals to be tested in the practice laboratory, and the findings trusted. It is also exciting that the community laboratory is increasingly a good place for theory development in relation to causation, treatment and technology development.

Department(s)

Primary Care, Population Sciences and Medical Education

Research project(s)

PRIMIT

A primary care trial of a website based infection control intervention to modify influenza-like illness and respiratory infection transmission.

Post graduate supervision

Current

Zoe Crosby PhD
Nmaemeka Okpala MSc

Faculty of Medicine

School of Medicine Ethics Committee
B Med Sci Working Group ( PCPS representative)
Guest lecture seminars

National and International

External examiner-Oxford Rhodes scholar 2010, Cardiff University PhD 2011.
RCGP Wessex Faculty academic GP member
Cochrane ENT group –GP editor.
NICE guidelines respiratory problems eg recurrent sore throat, grommets etc.
BMJ clinical evidence- Otitis Media with Effusion.
UK Otitis Media Groups- MRC, Oxford, and GSK OM symposia.
Active (founder) member of a European General Practice Research Infection Network
Occasional conference organiser
Advisor Deafness Research UK
Reviewer for BMJ,MJA,JAMA,RCGP,FP etc.

BM4 facilitator- graduate groups

BMedSci. Organiser for Primary Care projects about 15 fourth year student projects annually. Supervisor and support.

Marker student assignments etc.

Associate Professor Williamson (co-author) and Research Fellow Jane Vennik have been involved in a study for children with a common middle-ear problem. A simple procedure with a nasal balloon can reduce the impact of hearing loss and avoid unnecessary and ineffective use of antibiotics. Continue reading here. Media coverage can also be found here and here. (July 2015)

Dr Ian Williamson
Primary Medical Care Aldermoor Health Centre Aldermoor Close Southampton SO16 5ST
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