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Seizing opportunities to embed research in clinical practice

In this article, the RCP’s academic vice president Professor Ramesh Arasaradnam writes about a new position statement on ‘Making research everybody’s business’ which has been published today and the importance of embedding research in clinical practice following the disruption caused by the pandemic.

Nearly two years ago, my NHS trust had the privilege of delivering the first COVID-19 vaccination ever administered outside of a clinical trial. It was a moment that many of us will still vividly remember, as pictures of Margaret Keenan receiving the Pfizer vaccine on 8 December 2020 were beamed around the world, offering hope of a way out of the pandemic which had transformed all our lives.

Clinical research was crucial to the development of vaccines and treatments for COVID-19 that have now saved millions of lives globally, and ultimately it is fundamental to the advancement of all healthcare. The UK’s COVID-19 research has been hugely successful, but at the same time the pandemic caused major disruption to non-COVID-19 studies, including redeploying many research delivery staff to provide direct patient care. The recovery of wider research activity must now be a key priority for the NHS, and can play a vital role in improving the effectiveness and efficiency of care at a time when the health service is under extreme pressure.

We know that research is something that many RCP members are keen to engage with. In a survey we conducted in early 2020, 57% of members told us that they wanted to be more involved in clinical research, with 80% finding research appealing because it would enable them to contribute to their field and improve care for patients. We also found that research opportunities are not spread equally, with disproportionately lower numbers of women and physicians working in rural hospitals taking part in research, despite expressing an interest in doing so. We need to harness this enthusiasm for clinical research to drive the recovery of activity and ensure that all those who want to participate can.

There have been some important steps forward to lay the groundwork for this in recent months. In particular, the new Health and Care Act which received Royal Assent in April included several provisions around clinical research which were welcomed by the RCP. These strengthened the duties on NHS England and integrated care systems (ICSs), which are now required to ‘facilitate and otherwise promote’ research, as well as explaining how they are doing so in their annual reports and business plans. It is essential that we now seize the opportunities created by the Act and normalise research as a core part of everyday care, something that has been a key focus for the RCP for a number of years through its Research for all agenda.

To help enable this, the RCP has today published a new position statement with the National Institute for Health and Care Research on Making research everybody’s business. It sets out a series for recommendations for stakeholders across the health and care sector with the overall aim of embedding research in clinical practice. The statement makes specific suggestions for ICSs to take forward locally – including around job planning, workforce strategies and ensuring training requirements for researchers are proportionate – as well further proposals for NHS England and Health Education England, regulators and funding bodies.

Research is something that all clinicians can contribute to in a variety of ways – from leading studies to supporting the recruitment of patients to trials – and we know that many will welcome the chance to do so. With the enormous benefits that research can provide for patients and the NHS now widely recognised following the events of the pandemic we have a unique opportunity to truly deliver research for all. No single organisation of institution can achieve this alone, it will require collective action across the health and care system as our new statement makes clear. But if we are successful the rewards will be huge, as that moment on 8 December 2020 reminds us.