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Delivering ‘Best Research for Best Health’ South West 17 June 2009

Delivering ‘Best Research for Best Health’ South West 17 June 2009. Russell Hamilton Director of Research and Development. Why does the Department of Health want a Research Intensive NHS?. Evidence for better health & care Quality gains from the research process

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Delivering ‘Best Research for Best Health’ South West 17 June 2009

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  1. Delivering‘Best Research for Best Health’ South West17 June 2009 Russell Hamilton Director of Research and Development

  2. Why does the Department of Health want a Research Intensive NHS? • Evidence for better health & care • Quality gains from the research process • International position in science • Anchor industry in the UK

  3. The Innovation Pathway DIFFUSION INVENTION EVALUATION ADOPTION • Spread • new things • new ideas • new techniques • new approaches • Creation • new things • new ideas • new techniques • new approaches • Assessment • new things • new ideas • new techniques • new approaches • Uptake • new things • new ideas • new techniques • new approaches Basic Research Applied Research Commissioning Patient Care MRC NIHR PCTs & SHAs NHS Providers

  4. The Innovation Pathway DIFFUSION INVENTION EVALUATION ADOPTION • Spread • new things • new ideas • new techniques • new approaches • Creation • new things • new ideas • new techniques • new approaches • Assessment • new things • new ideas • new techniques • new approaches • Uptake • new things • new ideas • new techniques • new approaches Basic Research Applied Research Commissioning Patient Care MRC NIHR PCTs & SHAs NHS Providers IncreasedQuality and Productivity

  5. Drivers for change “There is now a substantial gulf between basic discoveries and converting such discoveries into innovations that directly benefit patients or prevent disease”

  6. Drivers for change “The UK has the opportunity, through the NHS, to transform the efficiency and effectiveness of clinical trials conducted here” Improving National Health; Increasing National Wealth

  7. Drivers for change “The most significant contribution that the NHS can make to R&D lies in the applied domain, such as trials, clinical effectiveness, service delivery research, and public health.It is critical that incentives exist to reward R&D in the applied domain, which is not the case today.”

  8. New GovernmentStrategy 2006 Consultation 2005

  9. Best Research for Best Health Vision To improve the health and wealth of the nation through research. To create a health research system in which the NHS supports outstanding individuals, working in world class facilities, conducting leading-edge research, focused on the needs of patients and the public.

  10. Our goals for Best Research for Best Health • Transform research in the NHS • Increase the volume of applied health research for the benefit of patients and the public • Develop and support the people who conduct and contribute to applied health research Delivered through: • The creation of the National Institute for Health Research (NIHR)

  11. ….. The NHS Constitution

  12. Handbook to the NHS Constitution Research is a core part of the NHS because it enables the NHS to improve the current and future health of the population. Therefore, the NHS will do all it can to give patients, from every part of the country, with any illness or disease, a right to know about research that is of particular relevance to them and, if they choose, to take part in approved medical research that is appropriate for them.

  13. The Next Stage Review:High Quality Care for All

  14. The NHS Operating Framework The NHS must play its full part in supporting health research. All providers of NHS care will need to increase their participation in research. The national ambition is to double the number of patients taking part in clinical trials and other well-designed research studies within five years. SHAs are expected to ensure that NHS trusts work with the National Institute for Health Research Clinical Research Network locally to contribute to this progressive increase.

  15. Quality Accounts Subject to Parliamentary approval, all NHS providers will be required by law to publish Quality Accounts NHS providers who conduct research will be required to include in their Quality Accounts: • the number of patients recruited in the previous year to clinical research (i.e. research which has received Research Ethics Committee approval)

  16. SHA Duty to Promote Innovation SHAs will produce an Annual Innovation Report which sets out progress including: • the actions the SHA has taken to support the work of the NIHR Clinical Research Networks locally and to develop the collaborative capacity of the NHS to join in research studies and trials.

  17. Embedding Research in the NHS NHS ConstitutionNHS commitment to the promotion and conduct of research NHS Operating FrameworkNHS must play its full part in supporting research; National ambition to double the number of patients in clinical research The NHS NHS Operating FrameworkSHAs to ensure that NHS trusts work with NIHR Clinical Research Network locally to contribute to the increased numbers of patients in clinical research Strategic Health Authorities Duty to Promote InnovationSHAs to support NIHR Clinical Research Networks locally; SHAs to develop the capacity of the NHS to support research NHS Operating FrameworkAll providers to increase their participation in research NHSProviders Primary Care Trusts Quality AccountsAll providers to report on the number of patients in clinical research Handbook to NHS ConstitutionThe NHS will do all it can to ensure that patients are made aware of research that is of particular relevance to them NHSPatients

  18. A Health Research System Faculty Associates Investigators &Senior Investigators Trainees Universities Infrastructure Research Clinical Research Networks Research Projects & Programmes NHS Trusts Patients&Public Clinical Research Facilities & Centres Research Units & Schools Research InformationSystems Research GovernanceSystems Systems

  19. Established throughtransparent programme management • ImplementationPlans for each element published on the web • Updated as soon as there is significant change • Are all updated every 6 months in any case • Next global update July 2009

  20. Faculty Associates Investigators &Senior Investigators Trainees Universities Infrastructure Research Clinical Research Networks Research Projects & Programmes NHS Trusts Patients&Public Clinical Research Facilities & Centres Research Units & Schools Research InformationSystems Research GovernanceSystems Systems

  21. Faculty Associates Investigators &Senior Investigators Trainees Universities Infrastructure Research Clinical Research Networks Research Projects & Programmes NHS Trusts Patients&Public Clinical Research Facilities & Centres Research Units & Schools Research InformationSystems Research GovernanceSystems Systems

  22. Infrastructure Clinical Research Networks “…the support and facilities the NHS needs for first class research…” Clinical Research Facilities & Centres

  23. Clinical Research Networks • Clinical Research Facilities • Experimental Medicine Facilities • Biomedical Research Centres & Units • Research Centres for Patient Safetyand Quality • Additional Clinical Trials Unit Support • Research Design Service Infrastructure Clinical Research Networks Clinical Research Facilities & Centres

  24. CANCER STROKE DIABETES DEMENTIA &NEURODEGEN MEDICINESfor CHILDREN MENTALHEALTH NIHR Topic-Specific Research Networks

  25. Target Achieved NIHR Clinical Research NetworkRecruitment to target NIHR MHRN studies ended October 07-08 150% RCTs 100% 50% 0% TAS QOF PACT Track Track Caddy Course Matisse Gendep GenPod IPCRESS Respond PAC-man MIDAS-ADHD Choices RCT Dr-Pt communicate

  26. NIHR Clinical Research NetworkSpeed of recruitment Before and after adoption by NIHR MHRN MHRN RCT of medicinal product RU-486

  27. NIHR Comprehensive Research Network Funding is increasingly ‘activity based’

  28. NIHR Research Networksin the South West NIHR Western CLRN Indicative budget for 2009/10: £13.3m(plus £205k FSF) 6 Topic LocalResearchNetworks Primary Care Local Research Network NIHR Peninsula CLRN Indicative budget for 2009/10: £7.3m(plus £116k FSF)

  29. NIHR Biomedical Research Units NIHR Biomedical Research Centres * Specialist BRCs Newcastle* • Leeds • Musculoskeletal • Nottingham • Hearing • Respiratory • Gastrointestinal Manchester* • Liverpool • Gastrointestinal Cambridge • Leicester • Cardiovascular • Sheffield • Cardiovascular • Musculoskeletal Liverpool* Imperial • Oxford • Musculoskeletal University College • Birmingham • Gastrointestinal Oxford Great Ormond St* • Brompton • Cardiovascular • Respiratory • Bristol • Cardiovascular Moorfields* Guy’s & St Thomas’ • Barts & London • Cardiovascular Maudsley* Marsden* • Southampton • Nutrition, Diet, Lifestyle • Respiratory NIHR Collaborations for Leadership in Applied Health Research and Care (CLAHRCs) NIHR-supported ClinicalResearch Facilities • Newcastle • Cancer • CRII CRF • NIHR CRF • Leeds • Cancer SouthYorkshire • Hull/York • NIHR CRF • Sheffield • Cancer Development Leeds, York &Bradford • Manchester • Cancer • Millennium CRF • CRII CRF Nottinghamshire, Derbyshire & Lincolnshire, Greater Manchester • Liverpool • Cancer Development Leicestershire, Northamptonshire & Rutland • Leicester • Cancer Birmingham &Black Country • Birmingham • Cancer • Millennium CRF • CRII CRF Cambridgeshire & Peterborough • Cambridge • Cancer • Millennium CRF • CRII CRF South WestPeninsula • Oxford • Cancer • CRII CRF North WestLondon • Southampton • Cancer • Millennium CRF • London • Cancer x 5 • CRII CRFx 4 • Peninsula • NIHR CRF • Brighton • NIHR CRF

  30. NIHR Research Infrastructurein South West Biomedical Research Unit - Cardiovascular £3.8m over 5 years AdditionalCTU Support ResearchDesignService(SHA wide) £5.2m over 5 years CLAHRC £10m over5 years Clinical Research Facility £4.5m over 5 years

  31. Faculty Associates Investigators &Senior Investigators Trainees Universities Infrastructure Research Clinical Research Networks Research Projects & Programmes NHS Trusts Patients&Public Clinical Research Facilities & Centres Research Units & Schools Research InformationSystems Research GovernanceSystems Systems

  32. At national level www.nihr.ac.uk • At local level Medical Schools Council (2009) Clinical Academic Staffing Levels in UK Medical Schools as at 31 July 2008 A research-intensive NHSis a partnership between the NHS and academia

  33. Faculty Associates Investigators &Senior Investigators Trainees “…outstanding individuals…”

  34. Faculty Associates Investigators &Senior Investigators Trainees NIHR Trainees (1) • NIHR Fellowships • Research Training Fellowships • Postdoctoral Fellowships • Career Development Fellowships • Senior Fellowships • NIHR Clinician Scientist Fellowship • 15 in South West (10 in Bristol, 5 in Peninsula)

  35. Faculty Associates Investigators &Senior Investigators Trainees NIHR Trainees (2) • NIHR Integrated Academic Training Scheme • Academic Clinical Fellowships • 14 in South West (8 in Bristol, 6 in Peninsula) • Clinical Lectureships • 5 in South West (3 in Bristol, 2 in Peninsula)

  36. Faculty Associates Investigators &Senior Investigators Trainees NIHR Trainees • Increased funding for existing NIHR Training Schemes • Increased funding for Clinician Scientist Fellowshipsand Research Training Fellowships • Increased support for project costs in most Fellowships Launch of new NIHR Training Schemes • NIHR Clinical Academic Training Pathway for Nurses,Midwives and AHPs • NIHR Healthcare Scientists Fellowships • NIHR Research Methods Programme • Research Capacity Development for the NIHR SDO Programme

  37. Faculty Associates Investigators &Senior Investigators Trainees NIHR Senior Investigators • First 100, of 200 announced in March 2008, second 63 announced March 2009 • 4 Senior Investigators so far in South West • Directory on www.nihr.ac.uk • Selected by independent peer review panel • Selection criteria: • Quality and volume of internationally-excellent research • Relevance of the research portfolio to the health of patients and the public • Impact of the research on improvements in healthcare and public health • Leadership of the individual in patient and public research

  38. Faculty Associates Investigators &Senior Investigators Trainees Universities Infrastructure Research Clinical Research Networks Research Projects & Programmes NHS Trusts Patients&Public Clinical Research Facilities & Centres Research Units & Schools Research InformationSystems Research GovernanceSystems Systems

  39. Faculty Associates Investigators &Senior Investigators Trainees Universities Infrastructure Research Clinical Research Networks Research Projects & Programmes NHS Trusts Patients&Public Clinical Research Facilities & Centres Research Units & Schools Research InformationSystems Research GovernanceSystems Systems

  40. Research “…leading-edge research focused on the needs of patients and the public…” Research Projects & Programmes Research Units & Schools

  41. Research for Patient Benefit • response-mode projects • Evaluations & Trials • HTA commissioned projects • HTA commissioned systematic reviews • HTA response-mode studies • Public Health Research • Health Services Research • EME (funded by MRC) • Service Delivery & Organisation • commissioned & responsive projects • Research for Innovation Speculation and Creativity (RISC) • response-mode projects • Invention for Innovation • NEAT • HTD • Health Technology Collaboratives • Programme Grants for Applied Research • response-mode programmes Research Research Projects & Programmes Research Units & Schools

  42. School for Primary Care Research • School for Social Care Research • Research Units • Clinical Trial Units • Collaborative Research Initiatives • National Prevention Research Initiative • UKCRC Public Health Research Centres of Excellence • UKCRC Translational Infection Research Initiative • MRC-NIHR patient cohorts Research Research Projects & Programmes Research Units & Schools

  43. DIFFUSION INVENTION EVALUATION ADOPTION Centre for Evidence-based Purchasing NHS Purchasing & Supplies Agency Basic Research Development Pathway Funding MRC Efficacy & Mechanism Evaluation Invention for Innovation Biomedical Research Centres This pathway covers the full range of interventions - pharmaceuticals, biologicals, biotechnologies, procedures, therapies and practices - for the full range of health and health care delivery - prevention, detection, diagnosis, prognosis, treatment, care. Biomedical Research Units Patient Safety and QualityResearch Centres Research for Innovation,Speculation & Creativity Research for Patient Benefit Health Services Research National Institutefor Health Research Programme Grants forApplied Research Public Health Research Service Delivery & Organisation Health Technology Assessment Collabs for Ldrshp in Appl Hlth Res and Care Ctr for Reviews & Dissemination, Cochrane, TARs National Institute for Health & Clinical Excellence Guidance on Health & Healthcare NHS Evidence Access to Evidence NHS Institute for Innovation & Improvement Support for the NHS Strategic Health Authorities Duty of Innovation PrimaryCare Trusts Healthcare Commissioning NHS Providers Patient Care

  44. NIHR-funded Researchin the South West Health Technology Assessment • 55 projects • £14.8 million • main research areas: • Congenital & Chromosomal • Pregnancy, childbirth, newborn • Respiratory, Vascular and Skin • Endocrine, nutrition metabolism • Brain and nervous system • Injuries and poisoning • Genito-urinary • Bone and joint • Cancers • Mental health • Methodology • Infection

  45. NIHR HTA ProgrammeBudget Growth Increased funding under Best Research for Best Health Increased funding from recent CSR £M

  46. Clinical Trials funded by NIHR HTA Programme

  47. NIHR-funded Researchin the South West Service Delivery & Organisation 5 projects £1.4m Programme Grants forApplied Research 8 programmes £13.2m Research forPatient Benefit 17 projects £3.3m

  48. NIHR-funded Researchin the South West • …and • School for Primary Care Research • Research for Innovation, Speculation and Creativity • Invention for Innovation

  49. NIHR-funded Researchin the South West • …and • MRC-NIHR Patient Cohort • UKCRC Centre of Excellence in Public Health Research (collab) • National PreventionResearch Initiative[3 of 26 and 2 of 14]

  50. Faculty Associates Investigators &Senior Investigators Trainees Universities Infrastructure Research Clinical Research Networks Research Projects & Programmes NHS Trusts Patients&Public Clinical Research Facilities & Centres Research Units & Schools Research InformationSystems Research GovernanceSystems Systems

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