NHS England’s long-term plan presents an opportunity for research to assume its rightful status as integral to the sustainability of the NHS. If it adopts the proposals made by the Association of Medical Research Charities (AMRC), the public will benefit from improved care, informed by research. In addition, the NHS will make financial savings. But, Shaun Griffin, interim head of policy and public affairs at the AMRC warns the plan can’t be delivered unless the strategy equips its workforce to deliver research.
The duty of NHS England and the Secretary of State to promote research is enshrined in law. Although research was highlighted in the 2014 Five Year Forward View, it was only in 2017 that NHS England signalled its commitment, endorsing a set of 12 actions to support and apply research in the NHS.
Now, the 2018 five-year funding settlement and its long-term plan (LTP) present a huge opportunity for NHS England to reset the ambitions for the health and care system and recognise the fundamental importance of research and innovation (R&I) to its future sustainability. While the National Institute for Health Research (NIHR) is key to achieving this and should have increased funding in future to do so, NHS England has a vital leadership role in ensuring that appropriate policies, funding and culture support those ambitions.
The evidence is stark: an influential NIHR-funded study shows that patients cared for in research-active acute NHS trusts are more likely to experience better outcomes. That view is held by the public too: Half of those responding to a 2018 HRA-NIHR-funded omnibus poll believe patients receive better care if their hospital carries out research.
The AMRC’s response to the LTP
Members of the Association of Medical Research Charites (AMRC) fund research into the causes of disease, new diagnostics and treatments, disease prevention, disease management and health services. They are uniquely close to their patient communities, and patient voice is central in setting their agendas.
In developing our response to the LTP, we worked with our members to develop a series of proposals for how NHS England should support R&I. Engagement with patients, carers and the public are at the centre of those proposals, and a step change increase is needed if we are to deliver the benefits that they want. We recommend that NHS England should:
- Embed engagement with patients, carers and the public in R&I and commit to supporting a doubling of the numbers of patients involved in clinical trials over the next five years.
- Invest in research that supports people living with multiple long-term conditions by working with the NIHR and others to prioritise the identification of clusters of disease and support more ‘real world’ studies, like the pioneering Salford Lung Study.
- Ring fence time for clinicians and support for staff to conduct research by exploring best practice in ensuring clinicians have sufficient time for research, to inform national policy over the next year.
- Make data and digital support research and deliver patient benefit by working to improve the utility of NHS data for research; acting to coalesce charities, funders and commercial organisations in developing digital health initiatives; and ensuring preparedness for the adoption of emerging technologies including AI, with patient and public support and safeguards.
- Support charities, patients and carers in navigating the web of organisations and initiatives by making use of the unique bridging role of charities to better align patient care, R&I, and ensure research is seen as integral to care.
Batteries must be included
We call for ring-fenced time for clinicians and support for staff to conduct research in our submission. Of course, front-line staff must be a priority. But a long-term plan must have a strategic approach to embed research within the workforce over its lifetime.
The UK is unique in the world in the huge connection the public has to medical research charities – you only need to walk down the high street to see that. Sadly, uptake of clinical research opportunities is being held back because clinicians simply don’t have the time. In 2013, 62 per cent of 400 health professionals we polled said lack of time was a barrier to their participation. Surveys by others, including Cancer Research UK, concur.
Without an adequately supported workforce, the full potential of R&I to benefit patients will not be seen. We want NHS England to have a national policy to make resource available so that clinicians can have protected time for research. Providing that time in contracts and job plans would emphasise the value of research as a core role in the NHS and encourage more clinicians to seek out research opportunities.
In the long term, the NHS will see financial and efficiency savings as the fruits of investment in R&I lead to new treatment pathways and innovative medicines for patient benefit.
The LTP is due for publication before Christmas. Let’s hope NHS England includes a set of batteries in its commitment to embed R&I by investing in a research-ready workforce.
Shaun Griffin is interim head of policy and public affairs at the AMRC. Follow him and the AMRC on Twitter @drshaungriffin and @amrc.
More information on the contribution medical research charities make to research is available here. The AMRC’s full submission to NHS England is available here.