Richard combines a busy vascular and endovascular practice in Gloucestershire (UK) with research work at the Clinical Trial Service Unit (CTSU).

His academic interests centre around the design, conduct and analyses of large randomised trials and include the use of lipid-lowering and anti-thrombotic therapy to reduce vascular risk (HPS, SEARCH, HPS 2-THRIVE, HPS 3-REVEAL Collaborator). He coordinates the long-term follow-up of HPS and SEARCH, using data linkage to electronic health records.

He is also Co-PI of ACST-2, a large international randomised trial comparing carotid endarterectomy versus carotid artery stenting in asymptomatic carotid artery disease. This trial aims to randomise 3600 patients during the 2010s, yielding uniquely reliable evidence about the short term hazards and long-term durability of stenting and surgery for stroke prevention.