Delivering research for all: expectations and aspirations for the NHS in England

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Delivering research for all is a new project supported by the RCP that is calling for every clinician working in the NHS to become research active.

 

Professor Marcel Levi, chief executive of University College London Hospitals, voices his support for RCP’s call for clinicians to have protected time to conduct research.

Every clinician working in the NHS should be supported to become research active. High-quality research in the NHS is everyone’s responsibility and a core part of clinical care. Read our statement of how a research-active health service can be achieved.

The Royal College of Physicians sees research in its broadest sense, from quality improvement to epidemiology and clinical trials, as crucial to patient care. Research is a key part of the NHS England constitution and the benefits research can bring are broad.[1] Research-active trusts have improved outcomes for patients and the Care Quality Commission (CQC) has now included clinical research activity within its remit for trust inspections.[2] Many doctors both regard research as an important part of their job and find it a very positive experience. However, clinicians are challenged by the lack of protected time for patient-facing research.[3]

High-quality research in the NHS is everyone’s responsibility and a core part of clinical care. It is important that every clinician working in the NHS is research active, whether this is identifying opportunities for new research, recruiting patients, supporting colleagues or leading trials themselves. Facilitation of research in trusts should be part of core activity and seen as a key indicator of improving patient care. Trusts should increase their research activity and doctors should be supported to pursue research activity as far as they wish to.[3] This will mean more patients than ever can have the opportunity to be involved with or benefit from clinical research.

The UK is one of the best places in the world for investment in clinical research. This means investment into the NHS and National Institute for Health Research (NIHR) activity can generate revenue for trusts with further employment opportunities for the wider economy.[4]

Trusts should:

  • ensure that research activity is integral to the work of the organisation and its staff and overseen at board meetings
  • ensure there is a direct link between research and development (R&D) departments and the board
  • use job planning to protect time for clinical research, including within the direct clinical care programmed activities
  • provide opportunities to showcase research, including to patients and the public, or connect local researchers
  • ensure R&D departments are equipped to provide leadership, support and advice on research processes as well as resources so that time doing research is well spent
  • ensure transparency for funding and resource allocation
  • facilitate the translation of research into practice across the NHS.[3]

Doctors should:

  • be proactive in seeking opportunities for their patients to be involved in research
  • be able to easily access available information about current research activity
  • seek development opportunities to equip themselves with research skills
  • support colleagues and their multidisciplinary teams to be research active
  • identify opportunities for improvement in care through research in their daily activity.[3]

Patients should:

  • be encouraged and feel able to ask their doctor and their care team about opportunities to be involved in research
  • feel able to access tools and networks to learn about the benefits, opportunities, participation and involvement in research
  • feel able to make informed choices about participating in research.

Health research facilitators* should:

  • ensure that there is a transparent business case for the value of their research to the trust
  • support trusts to enhance their capacity and capability in research
  • ensure there is support for research skill development[3]
  • ensure that funding opportunities reflect identified priorities for improvement of care and outcomes
  • ensure there is opportunity for collaboration across all areas of clinical care between academia, industry and the NHS that will involve patients.

*including NIHR, CQC, GMC, royal colleges, Health Research Authority, funders, universities

References

[1] NHS England. The NHS Constitution for England. NHS, 2015. www.gov.uk/government/publications/the-nhs-constitution-for-england
[2] Based on clinical trial data published in: Downing A, Morris EJ, Corrigan N et al. High hospital research participation and improved colorectal cancer survival outcomes: a population-based study. Gut 2017;66:89–96. https://gut.bmj.com/content/66/1/89 [Accessed 1 March 2019].
Jonker L, Fisher SJ. The correlation between National Health Service trusts’ clinical trial activity and both mortality rates and care quality commission ratings: a retrospective cross-sectional study. Public Health 2018;187:1–6.https://www.sciencedirect.com/science/article/pii/S0033350618300015 [Accessed 1 March 2019].
[3] Royal College of Physicians. Research for all: building a research active medical workforce. RCP. 2016 https://www.rcplondon.ac.uk/projects/outputs/research-all
[4] KPMG. NIHR Clinical Research Network: Impact and Value Assessment. KPMG, 2016. www.nihr.ac.uk/life-sciencesindustry/documents/NIHR%20CRN%20Impact%20and... [Accessed 1 March 2019].

Who's involved

Organisations

Endorsers: 

  • Academy of Medical Sciences
  • National Institute for Health Research
  • Royal College of Anaesthetists
  • Royal College of Child Paediatrics and Health
  • Royal College of Emergency Medicine
  • Royal College of Nursing
  • Royal College of Obstetrician and Gynaecologists
  • Royal College of Ophthalmologists
  • Royal College of Pathologists
  • Royal College of Physicians and Surgeons of Glasgow
  • Royal College of Physicians of Edinburgh
  • Royal College of Psychiatrists
  • Royal College of Radiologists
  • Royal College of Surgeons
  • Faculty of Dental Surgery
  • Faculty of Pharmaceutical Medicine
  • Faculty of Public Health