UKCRC Registered CTU Network
Annual Director’s Meeting - 5 th January 2012
Dr David Cox
Deputy Director - Research Finance & Programmes, DH

NHS Reforms and Research Update
1. Government commitment to research in the NHS
2. Setting the context for the NHS – current position
3. The Health & Social Care Bill 2011
4. Research and Growth

NHS Reforms and Research Update
1. Government commitment to research in the NHS
2. Setting the context for the NHS – current position
3. The Health & Social Care Bill 2011
4. Research and Growth

Research and the NHS:
Government Commitment
Andrew Lansley
27 February 2010

Research and the NHS:
Government Commitment
Earl Howe
30 July 2010

Research and the NHS:
NHS White Paper
"The Government is committed to the promotion and conduct of research as a core NHS role ". (para 3.16)
"Research is vital in providing the new knowledge needed to improve health outcomes and reduce inequalities ". (para 3.16)
"The Government will cut the bureaucracy involved in medical research.". (para 5.8)

NHS Reforms and Research Update
1. Government commitment to research in the NHS
2. Setting the context for the NHS – current position
3. The Health & Social Care Bill 2011
4. Research and Growth

Research and the NHS:
NHS Constitution
Principles that guide the NHS
“NHS commitment to the promotion and conduct of research to improve the current and future health and care of the population.”

Research and the NHS:
NHS Operating Framework
“The promotion and conduct of research continues to be a core
NHS function and continued commitment to research is vital if we are to address future challenges. Further action is needed to embed a culture that encourages and values research throughout the NHS”. (para 2.4)

Research and the NHS:
NHS Outcomes Framework
“continued research and the use of research evidence in the design and delivery of services at a local level will be vital.” (para 1.9)

NHS Reforms and Research Update
1. Government commitment to research in the NHS
2. Setting the context for the NHS – current position
3. The Health & Social Care Bill 2011
4. Research & Growth

Research and the NHS:
Health and Social Care Bill 2011
Duties
A duty to promote research on matters relevant to the health service on:
• Secretary of State for Health
• NHS Commissioning Board
• Clinical Commissioning Groups
• Monitor
A duty to promote the use of research evidence by the health service on:
• Secretary of State for Health
• NHS Commissioning Board
• Clinical Commissioning Groups
Powers
A power to support the conduct of research, including financial support for:
• Secretary of State for Health
• NHS Commissioning Board
• Clinical Commissioning Groups
• Monitor
• Local Authorities (in relation to the health service)

Research and the NHS:
Health and Social Care Bill 2011
SoS NHSCB CCGs Monitor LAs
DUTIES to promote research to promote the use of research
POWERS to support the conduct of research
P P P P
P P P
P P P P P

Research and the NHS:
NHS Culture
“We will therefore ensure that a culture of research and innovation is embedded in the arrangements for the new NHS
Commissioning Board and Public
Health England.”

Research and the NHS:
NHS Commissioning
“In particular, we will make sure that the systems and processes for commissioning used by the
NHS Commissioning Board and clinical commissioning groups ensure that research is promoted, supported and funded by the NHS .”

Research and the NHS:
NHS Commissioning
“We will also make sure that clinical commissioning groups and the NHS Commissioning
Board ensure that treatment costs for patients who are taking part in research funded by
Government and Research
Charity partner organisations are funded through normal arrangements for commissioning patient care.”

Research and the NHS:
NHS Commissioning Board
Functions
• Promoting “a culture which promotes research and innovation”
Relationships
• The Board must work in partnership with the Health Research Authority
Structures
• Commissioning Development will cover “the development of commissioning tools and commissioning guidance ensuring that patient care is commissioned so as to support the conduct of research in the NHS”

Research and the NHS:
Clinical Commissioning Groups
“ And to achieve the best outcomes for patients, CCGs will need to recognise the vital roles innovation and the promotion and support of research have to play .”
David Nicholson
NHS Chief Executive

Research and the NHS:
Clinical Commissioning Groups
Authorisation
“ CCG will need to demonstrate how it will exercise important functions, such as the need to promote research .”
“Systems and processes are in place to promote patients’ recruitment to and participation in research ”
“Systems and processes that ensure
…CCG… has regard to the need to promote research including funding the treatment costs of patients taking part in research .”

NHS Reforms and Research Update
1. Government commitment to research in the NHS
2. Setting the context for the NHS – current position
3. The Health & Social Care Bill 2011
4. Research and Growth

Research and Growth:
Chancellor’s Autumn Statement
• Establish Health Research Authority
• NIHR funding conditional on 70 day benchmark for trial start-up
• More information about clinical trials to enable greater public involvement
• Build consensus on using e-health record data
• More information on clinical research to promote collaboration
• Establish Translational Research
Partnerships

Research and Growth:
Strategy for UK Life Sciences
We have the strengths, but we recognise that too often we have failed to capitalise on them.
This is an ambitious strategy to change that and to finally join up life sciences in the UK:
• to open up universities and business to more collaboration;
• to invest in the best British ideas at an early stage;
• to tear down the regulatory barriers you face;
• and crucially, to open up the NHS to new innovations and new clinical trials .
December 2011

Strategy for UK Life Sciences
BIS & DH NHS CE Prime Minister

Strategy for UK Life Sciences

Strategy for UK Life Sciences
1. Building a life sciences ecosystem
2. Attracting, developing and rewarding the best talent
3. Overcoming barriers and creating incentives for the promotion of health care innovation

Strategy for UK Life Sciences
Extending Patient Choice
• Clinical Practice Research Datalink - new secure data service
• Centres in e-health - MRC with NIHR and other funders
• Clinical Research Zone - NIHR Clinical Research Network in partnership with The Guardian
• Smartphone App - UK Clinical Trials Gateway
• Enhanced website - UK Clinical Trials Gateway
• National NIHR Bioresource and associated Bioinformatics
• NHS Constitution - consult on amending NHS Constitution so there is a default assumption (with ability to opt out):
 for data collected as part of NHS care to be used for approved research, with appropriate protection for patient confidentiality;
 that patients are content to be approached about research studies for which they may be eligible, to enable them to decide whether they want a discussion about consenting to be involved.

Strategy for UK Life Sciences
Overcoming Barriers and Creating Incentives
• NIHR incentives for efficiency in research initiation and delivery
 publish clinical trial information against benchmarks
 funding to NHS providers conditional on meeting a 70 day benchmark to recruit first patients for trials
• Health Research Authority - to combine and streamline approvals for health research

NHS Chief Executive’s Report

NHS Chief Executive’s Report
Our ambition must be for an
NHS defined by its commitment to innovation , demonstrated both in its support for research and its success in the rapid adoption and diffusion of the best, transformative, most innovative ideas, products, services and clinical practice.

NHS Chief Executive’s Report:
Key role of Academia
… we shall support these Centres
[AHSCs] and build on their models of accelerating adoption and diffusion by designating a number of
Academic Health Science
Networks (AHSNs) across the country.
The NHS Chief Executive and the
Chief Medical Officer will work with the NHS and industry to designate these networks with the first to go live during 2012/13.

NHS Chief Executive’s Report:
Key role of Academia
The AHSNs will present a unique opportunity to align education , clinical research , informatics , innovation , and healthcare delivery.
Their goal will be to improve patient and population health outcomes by translating research into practice and developing and implementing integrated health care services.

NHS Chief Executive’s Report:
Key role of Patients and Patient Data
Patient data can provide great insight for health research, which in turn improves the quality of diagnosis, treatments and other interventions.
It is a key goal of the NHS for every willing patient to be a research patient , enabling them to access novel treatments earlier.
The greater the number of patients involved in research, the wider the public benefit.
The NHS could and should do more to explain to patients the benefits … of their agreement to participate in clinical trials and approved research.

NHS Chief Executive’s Report:
Key role of Leadership
Every NHS Board should explicitly invest time, resource and effort in innovation.
We will require the Chief Executive of every NHS commissioning organisation, including the NHS
Commissioning Board, to take personal responsibility to ensure that arrangements are in place to champion research , innovation and adoption, and that the adoption and spread of proven innovation is central to their commissioning plans.

Prime Minister’s Prospectus

Prime Minister’s Prospectus:
Key role of Patients
To increase the number of patients who can benefit from being involved in trials the NIHR have also developed a free Smart Phone App .
It provides a practical and innovative way for patients to access information about clinical trials, via the UK Clinical Trials Gateway .

Prime Minister’s Prospectus:
Key role of NHS performance
In addition, to make sure that our clinical trials performance is transparent the NIHR has teamed up with the Guardian newspaper to launch The Clinical
Research Zone .

Prime Minister’s Prospectus:
Key role of NHS performance
This hub publishes data on the participation of individual NHS Trusts in clinical trials and the number of patients recruited.
Information will be presented as both a “heat map” of activity and a national league table.