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Healthcare Research and Development

16th May 2007

With a number of new developments planned to the way healthcare research is carried out, we provide an overview of how things are shaping up.

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How is healthcare research and development currently organised?

Broadly speaking, there two main organisations which oversee and support healthcare research and development (R&D):

National Institute for Health Research (NIHR) was the body created in April 2006 by the Department of Health to provide the support and infrastructure to the NHS to deliver the Department’s five year research and development strategy, Best Research for Best Healthcare. It oversees R&D efforts in social care as well as NHS healthcare. The NIHR reports to the Department of Health.

Medical Research Council (MRC) describes its mission as being to “support research across the biomedical spectrum, from fundamental lab-based science to clinical trials, and in all major disease areas?. It therefore has a broader clinical research remit than the NIHR beyond the NHS and social care. The MRC is a non-departmental body that reports to government through the DTI.

What is being proposed for the future organisation of healthcare R&D?

The Cooksey report was published in December 2006, proposing better co-ordination of healthcare R&D efforts. The government has accepted, and is now taking forward, its recommendations which include establishing:

• A new, single, ring-fenced fund for healthcare research.

• A new ‘light touch’ Office for Strategic Coordination of Health Research (OSCHR) which will oversee health research strategy and make sure MRC and NIHR activities are well co-ordinated. The OSCHR will be established by 2009.

• A joint health research funding board between the MRC and NIHR.

• The NIHR as a real, rather than virtual, institution in the next few years.

The Cooksey report looked at the option of a full merger of the MRC and NIHR, but decided that this would lead to too much attention to internal re-organisation that would better be spent on developing research activities in partnership between the two bodies. Both the MRC and NIHR have welcomed the report’s recommendations.

The Cooksey report also emphasised the need for the focus in healthcare research to shift towards ‘translational research’. This will make sure that scientific breakthroughs quickly work through to developments that impact patient care in practice. Though this has been broadly welcomed, there are some concerns amongst academics that this shift may disadvantage ‘pure’ medical research in favour of service improvement research.

There are reports that at the new single research fund, once established, will receive £300m less from the Treasury than all the existing funds counted together.

New biomedical research centres

One of the first practical steps taken by the Department of Health following the Cooksey review has been to announce 11 new biomedical research centres for England. These have the aim of getting research ‘out of universities and into hospitals’. The 11 centres have been selected because of the close working relationship a university and a hospital trust enjoy and can use to aid more translational research. The government hopes that the new research centres will ensure the UK stays at the top of the international biomedical research league table. Patricia Hewitt sees them as a vital part of “producing a world class health research system?.

The new centres include Guys and St Thomas partnered with Kings College London, the Oxford Radcliffe partnered with Oxford University, and the Royal Marsden partnered with the Institute of Cancer Research. There are others in Liverpool, Newcastle, and Cambridge. Seven of the eleven centres are in London.

Five of the eleven centres will be ‘comprehensive’, working across a range of research topics, whilst six will be ‘specialist’ working in one specific area. Research topics being covered by the centres include:

• Cancer

• Heart disease

• Asthma

• Blindness

• Children

• Older people

• HIV

• Mental health

• Nutrition, diet and lifestyle, including obesity

The new centres, launched in April 2007, will receive a share of £50m in Year One, and then a share of £100m for each of the four years after that, making a total government invest in these centres of £450m over the next five years. The process for selecting the centres was extremely competitive. The government plans to support unsuccessful candidates in developing their research credentials over the next five years prior to the next funding competition round in 2012. In this way it hopes to continue to drive excellence in research through the whole research establishment, not just in the eleven successful centres.

A complete list of the new centres and their subject areas can be found in the Department of Health’s press release at:

http://www.gnn.gov.uk/environment/fullDetail.asp?ReleaseID=249162&NewsAreaID=2&NavigatedFromDepartment=False

The new research centres fall under the banner of the NIHR, but have been launched just as the MRC has itself announced an investment of £15.5m into the creation of six new ‘translational medicine’ centres which have the aim of translating scientific research into clinical practice. A number of the MRC centres include the same organisations as the ones making up the eleven new NIHR biomedical centres, such as Kings College, Imperial College, and Oxford and Cambridge Universities. The MRC’s centres will focus on topics including:

• Transplant medicine

• Obesity

• Neuromuscular disease

• Genomics and global health

• Causal analysis of translational epidemiology

• Outbreak analysis

The co-incidence of these two developments from the NIHR and MRC goes to underline the need for the two organisations to work more closely together in the future to make sure that what healthcare research funds are available are best used.

NHS research networks

Apart from special developments in research such as the new biomedical research centres, the NIHR has established a system of research networks across the country to ensure research effort within the NHS at least is well co-ordinated. The aim of these networks is to:

• Increase the number of practicing clinicians and other health professionals, and patients, who participate in clinical research and clinical studies.

• Better integrate health and social care research.

The research networks are organised as follows:

Topic specific national research networks for cancer, stroke, mental health, diabetes, children, and dementia and neuro-degenerative diseases.

Primary care national research network announced early in 2007 with an investment of £2m.

Comprehensive research network which ensures the full range of health and social care research is covered nationally to supplement the work being undertaken by the topic specific and primary care national networks.

All three of these types of national network are supported by strings of local research networks in the particular subject area – topic specific, primary care, or comprehensive. Overseeing all of this is the clinical network co-ordinating centre for England which links into the wider UK network known as the UK Clinical Research Collaborative.

Latest news

  • The UK's first academic health science centre could be created later this year if the merger of the Hammersmith and St Mary's Hospital Trusts with Imperial College go ahead. The new organisation, combining research with frontline healthcare, is similar to the model adopted by many leading US hospitals. Consultation on the proposal is due to close in August.
  • A Department of Health press release announcing the launch of the eleven new biomedical research centres has confirmed that the first to start (Hammersmith/St Mary's and Imperial College) will focus on research into the safety, quality, resilience and reliability of technology used by the NHS, and the role of NHS managers and staff and more effective use of information technology in enhancing patient safety.
  • The NIHR has announced a programme of 29 research projects with a focus on priorities that carry a 'significant disease burden' for the NHS, including stroke, mental health and diabetes. These Programme Grants for Applied Reseach will be worth £75m per year once fully underway (www.gnn.gov.uk/environment/fullDetail.asp?ReleaseID=277505&NewsAreaID=2&NavigatedFromDepartment=False)

For more information on NHS R&D go to:

http://www.nihr.ac.uk/programmes_biomedical_research_centres.aspx

http://www.ukcrn.org.uk/index.html

http://www.dh.gov.uk/en/Policyandguidance/Researchanddevelopment/Researchanddevelopmentstrategy/DH_4127109

http://www.hm-treasury.gov.uk/pre_budget_report/prebud_pbr06/other_docs/prebud_pbr06_odcooksey.cfm

http://www.mrc.ac.uk/NewsViewsAndEvents/News/MRC003562

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