UKCRC Registered CTU NetworkAnnual Director’s Meeting - 5th January 2012

NHS Reforms and Research Update

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

“An NHS which sees research and innovation as central to being the best healthcare.”

Andrew Lansley27 February 2010

Research and the NHS: Government Commitment

“The Government is committed to a future in which research continues as a core function of the NHS.”

Earl Howe30 July 2010

Research and the NHS: Government Commitment

"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)

Research and the NHS: NHS White Paper

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

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 Constitution

“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 Operating 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)

Research and the NHS: NHS Outcomes Framework

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

DutiesA 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

PowersA 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

Research and the NHS: Health and Social Care Bill 2011

SoS NHSCB CCGs Monitor LAs

DUTIES

to promote research P P P Pto promote the use of research P P PPOWERS

to support the conduct of research P P P P P

“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 Culture

“In particular, we will make sure that the systems and processes for commissioning used by the NHS Commissioning Boardand clinical commissioning groups ensure that research is promoted, supported andfunded 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

• Promoting “a culture which promotes research and innovation”

Research and the NHS: NHS Commissioning Board

Functions

• The Board must work in partnership with the Health Research Authority

Relationships

• 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”

Structures

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 NicholsonNHS Chief Executive

“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.”

Authorisation

Research and the NHS: Clinical Commissioning Groups

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

• 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: Chancellor’s Autumn Statement

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.

Research and Growth: Strategy for UK Life Sciences

December 2011

BIS & DH NHS CE Prime Minister

Strategy for UK Life Sciences

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

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

Strategy for UK Life Sciences

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

… 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 Academia

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 Patients and Patient Data

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.

NHS Chief Executive’s Report: Key role of Leadership

Prime Minister’s Prospectus

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 Patients

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.

Prime Minister’s Prospectus: Key role of NHS performance