Written Evidence Submitted by Aerospace Medicine and Physiology Research Group, Centre for Human and Applied Physiological Sciences, King's College London






Human spaceflight (HSF) should be an integral part of the new UK space strategy. HSF provides a powerful vehicle for science, exploration, innovation and inspiration. It can help us to build back better and to help deliver on our great potential as a nation for generations to come. The innovative research and technology development for HSF will have profound benefit for all of us on Earth as well as enabling us to push the boundaries of human exploration of space.


The discovery of new knowledge or exploration of new places enriches us all, forging a path to a future for humanity off the Earth whilst also teaching us about our own planet and how we can take better care of it for the benefit of all. There is growing excitement for a human return to the Moon, that will lead to permanent Lunar bases with potential to become like our eighth continent, all the while laying the foundations and testing the technology that will enable human exploration of Mars.


On a different level HSF is also seeing growing relevance in the context of shifting international geo-political landscape with developments like the United States Space Force, a resurgent Russia and growing Chinese HSF capability. These developments are driving and shaping the direction of much of the competition or cooperation in the utilisation of space. The UK needs to be an active player in this if we wish to continue our global influence through the rest of this century. From an economic perspective, HSF is also starting to deliver on its potential as a commercial market, which the UK can capitalise on. The key first step to unlock this potential is to ensure that HSF is included in the new UK space strategy.


Why we need to embed human spaceflight in UK space strategy


We stand on the verge of unprecedented international activity in HSF from growing commercialisation of space to rejuvenated international collaborative efforts to return humans to the Moon and lay the foundations for the first human exploration of Mars. The UK should play an active part through the European Space Agency (ESA) or directly through NASA to ensure we have UK astronauts as part of these programmes. This is to inspire the UK and next generation but also to gain access to the associated research drives for life and health sciences and to help achieve broader UK national priorities. 


The potential of HSF in this context range from helping to deliver the UK R&D roadmap, address Industrial Grand Challenges like healthy ageing, potential for international engagement and capability development  aligned to the Integrated Review, or by supporting the growing space industry around the UK it can help deliver the levelling up agenda.


Indeed, we have already started to see commercial benefits and opportunity to exploit UK strengths in robotics, telecommunications and small satellites with award of contracts to UK companies in support of HSF. These include the Surrey Satellite Technology Limited led group, including Goonhilly Earth Station, that was awarded ESA contracts in support of human and robotic exploration of the Moon.[1] This is an example of economic returns to UK companies working in satellite and communications that traditionally may have been seen as competition to HSF rather than complimentary in nature. There are also plans for an innovative series of UK robotic missions to the Moon, that will help to explore and lay foundations for future human Lunar habitation and life support options, demonstrating another example of human and robotic exploration working together.[2]


These examples show that UK investment and involvement in HSF can bring innovation, inspiration and commercial opportunities for UK companies. Prioritisation now will help to position the UK as a leading HSF nation in the 2030s and beyond, positioning the UK to capitalise on emerging and yet to be realised commercial HSF markets over the coming decades.


What lessons can be learned from the successes and failures of previous space strategies for the UK


One lesson from the past would be to avoid pitching investment in HSF against robotic space exploration or against space science as has often historically been the case. This has contributed to the recurrent opposition to UK involvement in HSF at the highest levels of UK Government or their scientific advisors. A valuable review if these issues is provided by Richard Farrimond in his book for the British Interplanetary Society “Britain and human space flight” (2013).


Impact and future potential


With UK investment in HSF through ESA over the past decade we have seen the great value that can be gained from having a British astronaut like Tim Peake. In our field, this is evidenced by growth in Space Life and Health science research; captured in the recent “Why Space? The opportunity for Health and Life Science Innovation” paper by UK Space Life and Biomedical Sciences association.[3]


At the broader societal level the teams at ESA, UK Space Agency (UKSA) and UK Space Education Office (ESERO-UK) have engaged the public and captured the nations imagination, with the outreach programme for Tim Peake’s Principia mission reaching over 2 million school students.[4] This was achieved with a single UK astronaut and a single mission. There is so much more potential here with continued and enhanced investment in HSF programmes. Imagine the impact of a true Moon shot of a British astronaut going to the Moon as part of the collaborative international Artemis programme that will return humans to the Moon in the next decade. As part of the ESA exploration programme, or direct through NASA, the UK could be part of this. 


Further investment to build on the success and impact of Tim Peake’s mission could be harnessed to inspire STEM careers, to help address the broader societal skills gap as well as within the growing UK space industry, and to develop our HSF capability.


King’s College London at the academic heart of aviation and space medicine in the UK


King’s College London (KCL) is a world leading educational and research institute, one of the UK’s flagship Universities and, as demonstrated by its broad activities in the fight against Covid-19, a dynamic force at the cutting edge of life and health science research and practice in the UK and internationally. The Aerospace Medicine and Physiology Research Group, located within the Centre for Human and Applied Physiological Sciences at KCL, provides a niche area of expertise that works with and provides support across the UK military, industry and to Government.[5] We are working to support multiple strands of activity in support of Team Tempest work on future fast-jet aircraft to help drive forward UK military aviation capability. With suitable ambition for UK HSF and capability development over the coming decades as part of an emboldened UK Space Strategy, KCL could provide the same human centred test and development contribution to support the domestic and export potential these developments would offer.


Aviation and space medicine specialty and associated training[6]


Space medicine is a key enabler of HSF and is a fundamental consideration in any planning of crewed space operations. Through strategic vision and foresight, the Royal College of Physicians Specialty Advisory Committee for Aviation and Space Medicine (ASM) worked to establish this as a specialty in the UK, with General Medical Council recognition in 2016.[7] Currently this is the only formally recognised training route in Europe to become a Consultant medical specialist in aviation and space medicine. This provides great support to UK industry, operators and regulators and provides another area of opportunity for the UK to harness for international engagement or to contribute to collaborative international HSF endeavours. Research in support of HSF can also be of wider benefit to terrestrial patients in the National Health Service.


Human spaceflight as a driver of innovation


The cross-sector and inter-disciplinary nature of research in HSF fields bring different eco-systems together. This provides a powerful opportunity for cross pollination of ideas that can spark innovation. This is exampled by future space habitat research such as that exhibited at the Design Museum Moving to Mars exhibition[8], or by the diverse team supporting the EthnoISS social and medical anthropology study of culture on board the International Space Station[9] or the bringing together of diverse disciplines in support of plans for the first UK space analogue mission in 2022.[10] These activities all also offer potential benefit to terrestrial life from smart homes for the future through to understanding of terrestrial societies and advancing healthcare in remote areas.


Future developments in hypersonic, stratospheric and sub-orbital vehicles offer different challenges to traditional aviation flight profiles and systems. UK industry will need ASM support to develop these vehicles and associated protection systems, which would provide novel UK military operational capability and associated export potential.


Research to support UK Civil Aviation Authority[11]


Very few people have ever flown on suborbital flights, which will soon be available to members of the public. Suborbital flight profiles entail novel physiological challenges, going in a matter of minutes from high G acceleration to microgravity and then back to high G. The forecast population that will initially be taking suborbital flights is very different from traditional astronaut or test pilot populations that are carefully selected and highly trained. Suborbital space travel is ultimately expected to revolutionise global transportation. For example, the Swiss investment bank UBS (total assets ~ $1 trillion) recently notified investors to expect very fast suborbital space travel to be ‘cannibalising’ long-haul air routes within the next decade (e.g. London–New York in 30 minutes), while the US investment bank Morgan Stanley (total assets also ~ $1 trillion) recently forecast $800 billion in annual sales for suborbital point-to-point travel by 2040.


Dr Thomas Smith is Head of Aerospace Medicine Research at KCL and leads an international research collaboration exploring the physiology and medicine of commercial suborbital spaceflight. A grant from the UKSA enabled experiments to advance UK technology and provided novel data regarding the effects of high G on the lungs. Led by KCL, this work was conducted in collaboration with the University of Oxford, QinetiQ, the Royal Air Force Centre of Aviation Medicine and RWTH Aachen University. The respiratory effects identified in this research could become clinically important in suborbital passengers who are particularly susceptible either due to advanced age or conditions such as obesity or smoking-related lung disease. At least initially, there is expected to be a tendency towards older age groups among suborbital passengers, and such comorbidities are likely to be relatively common. We believe it is important to include training and familiarisation experience for individuals taking these flight profiles and to try and gain data about spaceflight participant experience and physiological effects from real world suborbital flights as they start to increase flight numbers.


This work is required to inform the UK Civil Aviation Authority (CAA) approach to regulation of future HSF from the UK. It is important for training and protection of passengers that we have a better understanding of the physiological and medical challenges posed by these flight profiles. Further studies are required to address these issues that require funding, which would be aided by inclusion of these aspects of HSF in the UK space strategy.


Healthy ageing[12]


The human body is profoundly affected by the microgravity environment with adaption occurring in numerous physiological systems. The adaptations observed in astronauts during spaceflight has drawn parallels with those that are typically associated with ageing where reductions in bone and muscular strength and the associated reductions in mobility are common hallmarks of ageing. This has led to the microgravity environment being considered an analogue of ageing, or more accurately disuse/inactivity, which is an area of significant research interest within our group, the Ageing Research at Kings (ARK) consortium and more broadly in the UK and internationally.


Research of this nature has implications not only for astronauts but also could be beneficial for older individuals. The adaptations that occur in microgravity and bed-rest studies (or similar) mimic the deconditioning that accompanies ageing but in a significantly accelerated manner. As such they can be used as a model to study age-associated frailty or loss of intrinsic functional capacity, but also disuse-associated reductions in metabolic health that accompany inactivity which can lead to conditions such as Type 2 diabetes. These are major areas of interest terrestrially due to our ageing population and the rise in activity-related diseases. These have significant impact on the health and wellbeing of individuals, health-care systems as well as socio-economically. Research on the impacts of (simulated) microgravity thus has direct benefit not only for astronauts but also for populations on earth.





Education and outreach[13]


At KCL we have been at the academic heart of aerospace medicine in the UK for over two decades. We are the only place in Europe to provide Postgraduate Diploma and Masters course in Aerospace Medicine, providing a valuable component of UK capability to support the aerospace industry and future operations. With regular attendance from international militaries and diverse nations this provides an example of the potential for HSF to offer opportunities for international and defence engagement through the associated specialist support roles like space medicine. We also have close research and teaching links with ESA, which provide key contributions to these courses.


Within the Centre for Human & Applied Physiological Sciences at KCL, the Keeble research group offers a unique opportunity for undergraduates to develop experiments for launch to the International Space Station (ISS). The experiments the students develop cover a range of research disciplines ranging from protein activity studies to applied physiology on small organisms such as Daphnia or earthworms. With future Mars missions a decade or more away, the bioscientists who will be facing the biological challenges of this feat, are the undergraduates of today. Thus, by exposing undergraduate students to the challenges and rewards of developing experiments for spaceflight this group acts to empower the young scientists who will be central to the UK’s long-term ambitions in space. This helps to ensure that the UK educational sector can offer the calibre of scientists required to meet the bioscientific challenges that further Lunar and Martian exploration will bring.


Behind the experiments developed within this group is the International Space School Educational Trust (ISSET), of which Dr Keeble is the Chief Scientist. This Trust provides educational experiences (the Mission Discovery programme) for students aged 14-18 to produce ideas for scientific experiments for launch to the ISS. The students are supported by a range of NASA astronauts and engineers alongside university scientists. This scheme has so far produced over 30 experiments, launched aboard 8 separate commercial resupply missions.




The UK space strategy should identify human spaceflight as a priority, along with associated space health and life science research, and embed these as a key part of UK space strategy. This strategic vision then needs to be supported by associated policy and direction for UKSA and the UK CAA to empower them and the HSF community in the UK to help deliver it. A vital part of this will be further investment in the ESA HSF and associated space health and life science programmes at the next ESA Ministerial Council meeting in November 2022.


The UK should consider establishing a centralised UK space health and life science centre of excellence. This could be within the UKSA or established as a virtual institute drawing in expertise from current centres of ASM excellence like the RAF Centre of Aviation Medicine, CAA medical department, industry and academic centres. This would help bring together space medical experts in the UK to develop a roadmap to prioritise research, facilities, funding streams, coordinate training and focus on building on our strengths in Space Health and Life Sciences. Additionally, it could be supported through opening up of UKRI funding streams to more explicitly support research in this area both for terrestrial benefit and, critically, in direct support of HSF.


These recommendations could also be complemented through exploration of other opportunities for UK companies and scientists to support NASA directly in HSF programmes or other national HSF opportunities that could arise. Underpinning these developments should be the continuing good work of UKSA and the CAA to provide a regulatory and operating framework in the UK that supports and enables suborbital HSF from the UK. This includes creation off a permissive environment for development of associated infrastructure such as those being proposed by Spaceflight Academy at Spaceport Wales or Blue Abyss at Spaceport Cornwall.


(June 2021)

[1] Accessed 23 Jun 2021. https://spacenews.com/esa-awards-study-contracts-for-lunar-communications-and-navigation-systems/

[2] Accessed 23 Jun 2021. https://spacebit.com

[3] Accessed 23 Jun 2021. http://www.ukspacelabs.co.uk/documents/space-life-science-paper.pdf

[4] Accessed 23 Jun 2021. https://www.gov.uk/government/news/on-third-anniversary-of-tim-peakes-space-mission-report-reveals-over-2-million-inspired-by-education-campaign

[5] DeJohn (2021).Aerospace Medicine at King’s College London. Aerospace Medicine and Human Performance: 92(1); 2-3. DOI: https://doi.org/10.3357/AMHP.921PP.2021

[6] Section adapted from Hodkinson and Velho (2021). Space Medicine in the UK. In: Why Space: The opportunity for Health and Life Science Innovation. UK Space LABS Association.

[7] Accessed 23 Jun 2021. https://www.jrcptb.org.uk/aviation-and-space-medicine

[8] Accessed 23 Jun 2021. https://designmuseum.org/exhibitions/moving-to-mars

[9] Accessed 23 Jun 21. https://ethnoiss.space

[10] Accessed 23 Jun 21. https://www.ucl.ac.uk/risk-disaster-reduction/space-health-risks-research-group

[11] Section adapted from Smith (2021). Medical Aspects of Commercial Spaceflight. In: Why Space: The opportunity for Health and Life Science Innovation. UK Space LABS Association.

[12] Section adapted from Pollock and Harridge (2021). Spaceflight and its application to muscle ageing. In: Why Space: The opportunity for Health and Life Science Innovation. UK Space LABS Association.

[13] Section adapted from Mollan, Gaffen and Keeble (2021). Educational opportunities for bioscience students in experiment development for International Space Station science payloads. In: Why Space: The opportunity for Health and Life Science Innovation. UK Space LABS Association.