Dr Nathan Bray

Senior Lecturer

ALPHAcademy Lead (Preventative Health) (College of Medicine & Health)

n.bray@bangor.ac.uk

0000-0001-7646-5435

Dr Nathan Bray

View Dr Nathan Bray’s profile on the Bangor Research Portal

Dr Nathan Bray is a Senior Lecturer in Preventative Health, Lecturer in Healthcare Improvement and leads Bangor University’s Academy for Health Equity, Prevention and Wellbeing (AHEPW). He has an MSc in Public Health and Health Promotion and a PhD in Health Economics. His research focuses on public health and disability, in particular the application of methods of economic evaluation to disability and assistive technology. In 2016 Nathan was awarded a post-doctoral fellowship by Health and Care Research Wales to develop a new preference-based instrument for measuring the quality of life of people who use wheelchairs and other mobility aids. Dr Bray has received research funding from a range of organisations including the National Institute for Health Research, the European Commission’s Horizon 2020 programme, Health and Care Research Wales and NHS England. As lead applicant and co-applicant Dr Bray has contributed to over £7.5million worth of grant capture. From 2015 to 2018 Dr Bray chaired the International Society of Wheelchair Professionals’ comparative effectiveness research committee, and was an Associate Editor for the British Journal of Dermatology from 2017 to 2021. Nathan is currently a member of the Health and Care Research Wales Social Care PhD Studentship Committee and College Lead for Sustainability.

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n.bray@bangor.ac.uk

@drnathanbray

+447792670053

  • PhD: Health Economics
    Bangor University, 2015
  • MSc: Public Health and Health Promotion
    Bangor University, 2013
  • BSc: Psychology
    University of Liverpool, 2007

I am willing to supervise a PhD

2024

2023

2022

2021

2020

2019

2018

2017

2016

2015

2014

2013

2022

  • Co-applicant

    Leading economic evaluation

    1 Feb 2022 – 30 Sep 2024

    Activity: Other (Contributor)

2017

  • CHESS: Investigating the clinical and cost-effectiveness of targeting everyday family routines to improve self-care in children with neurodisability

    01/02/2024 – 15/02/2028 (Active)

  • An exploration of the opportunities to provide health promotion to the population of Wales within the NHS 111 Wales service

    01/10/2023 – 15/10/2027 (Active)

  • UK Valuation EQ-5D-5L

    01/09/2022 – 16/09/2024 (Finished)

  • LOad Monitoring and Alert System (LOMAS) to prevent diabetic foot ulceration

    01/01/2021 – 31/03/2024 (Finished)

  • Cost-effectiveness of earlier provision of powered wheelchair interventions for children with mobility limitations

    01/04/2018 – 01/08/2022 (Finished)

    Description

    EMPoWER is an NIHR HTA funded evidence synthesis project examining the cost-effectiveness of earlier provision of powered wheelchair interventions for children with mobility limitations. The project is being led by Bangor University, in collaboration with Newcastle University. The aim of the EMPoWER project is to estimate the costs and benefits of providing very young disabled children (under 5 years) with powered mobility aids, such as mini wheelchairs and ride-on-cars. During the conduct of this evidence synthesis project, we will combine the results of existing research and produce an economic model to predict how cost-effective it is to provide powered mobility aids from a very early age.

    More than 70,000 children in the UK use special equipment, such as wheelchairs, to help them move around. There are many different reasons why children may have issues with their mobility, and for some children powered or electric mobility aids (such as powered wheelchairs) may be the only way to move around on their own. Helping children under the age of 5 to move around on their own can have long-lasting benefits, including physical and mental development, increased independence and more participation in everyday life. These benefits can also have positive impacts on the physical and mental health of children’s parents, and may reduce later health, social care and education costs. What is currently unknown is whether providing powered mobility aids for very young children provides more benefits than waiting until after the child is aged 5. The NHS is the largest UK provider of powered mobility aids for children, but there is often variation in what different NHS services provide, particularly for children under the age of 5. At the moment there is no national guidance to help NHS services decide the best age to start providing powered mobility aids for children, or what costs and the benefits to consider.

    As part of the EMPoWER project, we will gather all existing research and evidence about the costs and benefits of powered mobility aids for children. We will look at the quality of the evidence and combine all relevant information to get a better understanding of the extra costs and benefits of providing powered mobility aids (and related training and support) at a very early age, rather than waiting until after a child turns 5. Using this information we will develop an economic model, which will allow us to estimate whether the extra benefits of early powered mobility outweigh the additional costs.

    If you would like find out more about this project, please contact chief investigator Dr Nathan Bray: n.bray@bangor.ac.uk / 07792670053

    Links:

  • Mobility and Quality of Life: Improving methods of economic evaluation

    01/09/2016 – 08/08/2024 (Finished)

    Description

    In the UK over 11 million people live with an impairment, disability or limiting chronic illness; approximately 6% of children, 16% of working age adults and 45% of the elderly are classified as disabled. Mobility impairments are one of the most common causes of disability, and many disabled people require mobility aids, such as wheelchairs, to move around independently. The NHS is the largest supplier of mobility-aids in the UK, however more evidence is needed to understand which mobility-aids are the most cost-effective means of improving the mobility and quality of life of people with mobility impairments.

    In the NHS resources for healthcare are limited, therefore evidence is needed to guide decisions about resource allocation. The National Institute for Health and Care Excellence (NICE) provides independent guidance to the NHS based on evidence of cost-effectiveness. Cost-effectiveness analysis is used to calculate the additional cost of achieving an outcome, such as increased quality of life. For cost-effectiveness analysis NICE recommends an outcome measurement known as the quality-adjusted life year (QALY). A QALY is calculated by multiplying the amount of time spent in a given health state by the associated quality of life of that health state. Health states are assigned utilities which are values representing a person’s preference for that health state. QALYs are universal because both quantity and quality of life are measured; therefore they can be used and compared across lots of different conditions and treatments. This helps the NHS to make efficient decisions about the use of resources.

    Health-related quality of life (questionnaires are designed to measure the impact that health has on quality of life and the positive or negative impacts of a medical treatment. These questionnaires are often preference-based, which means they can be used to calculate QALYs. Because these questionnaire tools are so generic they are sometimes not sensitive to disease or condition specific changes to health or quality of life. For instance, the EQ-5D (a widely used health-related quality of life outcome measure) asks people to rate their mobility using 1 of 5 options, none of which account for mobility other than walking, for instance using a mobility-aid. At present there are no mobility-related quality of life questionnaires which can be used to calculate QALYs.

    The aim of this project is to develop a questionnaire tool to specifically measure quality of life related to mobility. This will help researchers and medical professionals to understand how mobility-aids improve the quality of life of people with mobility impairments. This project will involve interviewing people with mobility impairments about how mobility affects quality of life, then developing a questionnaire based on their responses. In order to create a scoring system, we will then ask a large of number of people to state their preferences for all of the different health states identified in the new questionnaire. Throughout the project we will test the questionnaire to make sure that it is valid and reliable.

    If you would like find out more about this project, please contact chief investigator Dr Nathan Bray: n.bray@bangor.ac.uk / 07792670053

    Links: