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Saving and Improving lives: The Future of UK Clinical Research Delivery sets a clear ambition for research across the UK, but what does it mean for NHS patients and health professionals?
When the NHS was established in 1948, its focus was treating infectious disease such as tuberculosis, treating chronic diseases caused by poor nutrition, and treating injuries. At that time less was known about what we now call long term conditions such as diabetes, certain lung conditions or cardiac disease. Much has changed since then. We’ve built a deeper evidence base, developed better treatments and care and, as living/working conditions have also improved, people are leading longer lives. Research helped to make all this possible.
Research is beneficial to people and patients, with breakthroughs enabling earlier diagnosis, more effective treatments, prevention of ill health, better outcomes and faster returns to everyday life.
Research is beneficial to healthcare professionals who are able to develop imaginative solutions for real NHS problems, improving care and increasing job satisfaction.
Research is also beneficial to the NHS systems – we know that hospitals that are more ‘research active’ have lower mortality rates than those that are not. This effect is not limited to research participants.
COVID-19 has put research in the spotlight. The Recovery Trial, for example has to date found two drugs, Dexamethasone and tocilizumab that are beneficial and help people recover, but equally importantly the trial has shown us the treatments which do not have any impact on recovery, including antibiotics. While COVID-19 research will continue, the vision now sets the ambition for research related to all health conditions.
Research is a very broad term and it plays an important role in most advancements – to me research is simply “finding out something new”. The Future of UK Clinical Research Delivery focuses on clinical research, which is research to look at the safety and effectiveness of medicines, devices, technologies or diagnostics. This includes testing new products, testing existing products for their effectiveness for new indications, or comparing different treatments to see which works best in certain circumstances.
It is critical at this time to focus the vision on the delivery of clinical research, while noting that health research carried out in the NHS is broader still. It encompasses observational discovery science, looking at patterns in diseases (epidemiology), and research to identify gene mutations that cause particular cancers or rare diseases. It includes research into NHS services and care pathways, leading to improvements in the way those services are set up and run, impacting quality, efficiency and cost effectiveness of services, and of course improving the experience of people using those services. Research provides the most reliable data to put evidence-based practice into action.
Research is not limited to big teaching hospitals with links to universities, in the NHS all hospitals are involved in research to some degree. I would love to see more research done across the country, for it to be part of all health and care staffs roles and focussed in areas where there is most need, increasing the diversity of people who get involved in research. This twin ambition of embedding clinical research in the NHS and involving more people from more diverse communities, is central to the vision set out in Future of UK Clinical Research Delivery.
COVID-19 has highlighted that when front line nurses, doctors and other health professionals work with research teams to embed research in care and treatment pathways, we can give more people an opportunity to get involved in research. And faster recruitment means speedier results, leading to improvements in outcomes and experiences for people using health services.
The vision acknowledges we must therefore have a well-supported research workforce which offers exciting careers opportunities for all, supporting healthcare professionals to develop research skills relevant to their clinical roles. My message to all staff is this, you don’t need to be employed as a researcher to get involved in research. Understanding what research is, what’s happening and being able to talk to colleagues about research is important. I would love to see all healthcare professionals across teams being proactive and seeking out opportunities for the patients under their care to be involved in research, giving all patients the opportunity to learn about and get involved in research if they want.
NHS England and NHS Improvement will play a key role embedding research in care and treatment. We will support regional teams to develop plans to take a system wide approach to research. We will support making research more efficient, a central theme of the vision. Already we are working on streamlining the way commercial research is costed and we will work closely with partners to support the final strand of the vision, to ensure the UK has a world leading data-enabled clinical research environment.
Research changes lives, saves lives and improves outcomes. The public because of COVID-19 research are now more aware of health research than ever before and more people have got involved in research during the pandemic, with over 1 million people taking part in COVID-19 research. Research is also taking place across the full range of health conditions and with healthy volunteers, so if you are interested in taking part in research you can find more information at bepartofresearch.nihr.ac.uk/
The vision sets the ambition, the direction of travel and as Deputy Director of Research at NHS England and NHS Improvement, I am excited to be working with colleagues across our organisation to explore our contribution and with others across the sector to deliver the vision of improving health through research.