The end of the year provides an opportunity for reflection and preparation for the coming year. I’m looking forward to speaking at Genesis 2013 later this week. Preparing for this talk has brought me to thinking about the enormous changes that have been brought about in the NHS clinical research environment. When I joined the Department of Health’s R&D Directorate early in 2005, Professor (now Dame) Sally Davies had been recently appointed Director General of R&D and led work to develop the government’s strategy for health research in the NHS, Best Research for Best Health, the first such strategy to be signed off by Cabinet. This led to the establishment of the National Institute for Health Research in 2006, with its dual aim of improving the health and wealth of the nation.
Contrast what we had 10 years ago with what is in place now.
Then we had : a group of research funders all supporting good research but not working together in a structured manner at the interface between their funding programmes; little visibility or co-ordination of the funds which flowed into the NHS to support research; non-one supporting “ market failure” research in a strategic way; industry conducting most early stage development in house and academic clinicians who tended to look across at industry as a source of income streams rather than as a partner also pushing forward frontiers to new treatments for patients.
Compare that with today’s hugely more integrated health research system, in which funders ( including our vibrant medical research charity sector) work together to ensure that there is expertise and capability to support non-commercial and industry research across the innovation pathway; there is significant , co-ordinated and transparent investment in infrastructure ( £0.5 billion per annum from NIHR alone); a network of world-class researchers who are keen and ready to work with industry and understand industry’s processes and requirements; clear routes of entry for industry with support to find research collaborations with the right expertise, patient cohorts and kit ; and motivated patients who want to be informed about and involved in research.
I remember well the first meetings of the Industry Road Map Group which I set up to bring together around the table, as equal partners, clinicians from the pharmaceutical and biopharmaceutical industry with NHS academic clinicians with new responsibilities for improving the performance of commercial clinical trials being conducted through the newly formed UK Clinical Research Network. There was a clear sense of unease to begin with until the challenges for both parties were acknowledged and joint problem-solving began to take hold. What a long way we’ve come. Since April 2013, the NIHR Clinical Research Network has recruited the first global patient in 20 mutli-national clinical trials – clear evidence of the much improved environment. Last year 99% of NHS Trusts recruited patients into NIHR CRN studies, with 63% of them supporting commercial studies. That figure has risen to 69% this year.
NIHR’s experimental medicine and translational research infrastructure is also attracting international recognition and interest, following selection through international peer review, funding of £900 million over five years from 2012 and headline-grabbing research such as: the first ever stem cell treatment in humans for inherited blindness resulting in extraordinary improvements for a patient at Moorfield’s NIHR Biomedical Research Centre (BRC); the first multi-gene test to predict patients’ responses to cancer treatment using the latest DNA sequencing tests launched in the NHS in May this year as a result of pioneering work at the NIHR BRC at Oxford; and an artificial pancreas prototype developed through the NIHR/Wellcome Clinical Research Facility at Cambridge and tested in over 100 patients with type 1 diabetes.
Since their inception in 2007/8, NIHR Biomedical Research Centres and Units have had 165 patent applications have been granted, 28 spin off companies formed , £284m in industry funding leveraged and 302 licensing deals approved. The list of innovations and their application across the wide range of disease areas is extensive.
Looking ahead – NIHR is working closely with other research funders to ensure the UK has the world class underpinning infrastructure to enable it to embrace the opportunities presented by the “omic revolution” and strat medicine. Next year watch for news on linkages with Genomics England, the Crick Institute, UK Biobank, the MRC’s UK Dementia Platform and national big data initiatives such as the Clinical Practice Research Datalink and Farr Institute.
An IPSOS MORI poll conducted in June 2012 revealed that 93% of the public believe its important that the NHS supports research into new treatments. The Government is committed to research in the NHS because it: improves health outcomes though advances in research; improves the quality of care by NHS participation in the research process; strengthens our international competitive position in science; and drives economic growth by supporting a healthier and more productive workforce and by attracting investment from life sciences companies.
The NIHR Office for Clinical Research Infrastructure (NOCRI) is our “sat-nav” for companies seeking collaborators in the NHS and its partner universities. No matter how large or small your company, you can be introduced to researchers within the NIHR clinical research infrastructure across the country who have expertise and access to patients in your clinical area of interest.
Clinical research in the NHS is undergoing a renaissance. Isn’t it time you took a fresh look?
Written By Dr Louise Wood, Department of Health
The One Nucleus blog is written by individuals and is not necessarily a reflection of the views held by One Nucleus.