Making research a priority
Sharmila Nebhrajani, chief executive of the Association of Medical Research Charities: We found in our survey that while most doctors wanted to be involved in research less than half of them felt it was their personal job (even lower again for GPs) and many felt they had no time or support of the NHS to do research. I think the answer is to make sure the contracts allow time. Also, research is an integral part of good care and not something done as a sideline
Stephen Smye, director of research and development at Leeds Teaching Hospitals NHS trust and director of the NIHR Comprehensive Clinical Research Network: An informal surevy of NHS trusts iN England showed that approximately 60% now included research KPIs in their board performance reports.
Sara Osborne, head of policy at Cancer Research UK: We know that cancer patients really value being told about research opportunities - and agree that it is important for the whole of the NHS to understand the importance of research. We have to find a way of engaging NHS managers, and boards, so that they can understand the value of participating in research projects.
Stephen Smye: NHS managers are key collaborators in the research enterprise and we need to ensure they are supported with the necessary management information, including numbers of studies and patients recruited in their organisation. Many managers now accept that research activity is linked in part to clinical quality
Ben Bray, quality improvement fellow, Royal College of Physicians: There are a lot of potential benefits of organisations (hospitals etc) in supporting research that do align with management priorities. For example:
• Helping to recruit and retain the best healthcare staff
• Improving the reputation and prestige of the organisation
Emma Munro, trust lead research nurse, Portsmouth Hospitals NHS trust: The facilities are available but it is about getting the managers engaged and understanding the benefits of research so that the facilities are accessible.
Pressure from patients
Sharmila Nebhrajani: Patients can be very important here - overwhelmingly patients tell us they want the opportunity to be involved in research and could be a very important force in encouraging clinicians and hospitals and GP practices to tell them about research. The recent clinical trials gateway initiative was a good start and the more patients ask the higher up research will be on the agenda
Emma Munro: The research nurse is integral to the successful delivery of the trial both in supporting the patient and ensuring data quality. As patients do, the research nurses also feel frustrated at the lack of results being disseminated in an accessible format to patients.
Stephen Smye: Many organisations recognise that, in future, patients may increasingly exercise their choice based in part on research activity of the provider
Implementing the results of research
Sharmila Nebhrajani: Its not only about getting more research done but also ensuring the NHS adopts the results of the research done. We know our adoption rates for the outcomes of research are "low and slow" as I heard one person describe them at a party conference recently. Publicising the results of research may help - and involving patients and clinicians in study design may make for a better study and also make them more likely to change practice as a result of the research.
Ben Bray: The NHS should be involved at all stages of research: identifying priorities and areas for study, carrying out studies, engaging patients in research and implementing the findings of research into evidence based practice. We know that even very effective treatments can take make years before they become part of everyday practice: if NHS organisations are actively involved in other research activities then this implementation might be quicker.
Saul Faust, active in infectious disease research at University Hospitals Southampton NHS foundation trust: For implementation as a whole, we need to ensure integrated thinking between CCGs, national commissioning for specialist services, the new academic health science networks (designed to implement innovation) and researchers from all disciplines.
Careers in research
Sharmila Nebhrajani: The Royal Colleges and the GMC also have an important role to play in planning careers that allow a more porous boundary between clinical and academic career paths as they two separate quite early now - and perhaps for the GMC making research a more core element of the re-validation process for clinicians.
Ben Bray: Just from a doctor perspective here, supporting clinicians in training who might be interested in a career in reserach is very important. This is about awareness raising, providing information and support in developing an academic career (including organising time out of training, applying for funding etc) and supporting clinical adademics so that it remains an attractive career choice
The role of middle management
Saul Faust: At the moment many CEOs and senior management are engaged, but often researchers struggle when NHS middle management don't undertstand how to support the activity – going forward we need all the ideas – plus clinical research made a core part of the NHS management training scheme.
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