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Integrating research into the NHS

Integrating research into the NHS. Overview. The Challenge Systems and Infrastructure for supporting research in the NHS Background The opportunities of BRfBH Infrastructure Places People Systems R&D Research systems. The Challenge. BIGT report AMS Report WPB Working Party

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Integrating research into the NHS

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  1. Integrating research into the NHS

  2. Overview • The Challenge • Systems and Infrastructure for supporting research in the NHS • Background • The opportunities of BRfBH • Infrastructure • Places • People • Systems • R&D • Research systems

  3. The Challenge • BIGT report • AMS Report • WPB Working Party • UKCRC Liam O’Toole and JFK • The over-riding need of funders, researchers and participants • Safe, swift and sensible research • Making Research Easier

  4. Amateur Approach • Regulation administered by people with limited experience of clinical research • Investigators wrestling with paperwork and the “day job” • Dominance of cell and molecular research resulting in de-skilled workforce • Lack of career structure for doctors and nurses • Feast-famine cycle induced by funding

  5. Background BRfBH • Historical perspective • The Levy • Future • CRII • Technology platforms • BRC • Programmes • Projects • Response mode funding

  6. Winners and opportunists • Limited resources • Alternative routes to funding • Relative spends of • NHS R&D-MRC • Charities and • Industry

  7. Infrastructure

  8. Clinical Research Facilities • Well appointed and fit for purpose • Protected from service pressures • Administrative support • Clinical epidemiology, bio-informatics and biostatistics • IT needs • Integrated NHS and University • e-CRF • Secure • Auditable • Pharmaco-vigilance • Funding

  9. Physical Environment • Location • Dedicated rooms and beds • Offices and storage • Laboratories • Future proofing • Outreach

  10. Intellectual Environment • Valuing clinical research • Uniting universities and NHS • Facilitating research • Quality and Safety for patients and Staff • Having a strategy • Comprehensive or Specific • Priorities in research

  11. Regulation and Governance

  12. The R&D Office • Joint office with University • Key issues • Sponsorship • Finance • CTA • Governance • Indemnity • Governance • Monitoring and Audit • Intellectual property

  13. Staffing R&D • The Office • Finance Manager • Research governance managers • Audit team • Clinical leads • Peer review • The Investigators • Certified CI and PIs • Research staff

  14. Research Support • Information Management and Technology • Ensure that studies are registered • Manage paperwork • Auditable data collection for trials compliance • Finding evidence: databases and library skills • Biostatistics • RDSU • Clinical Epidemiology

  15. Attitudes • Professionalising clinical research • Finding the solutions to clinical research problems • The well found laboratory • Providing the resources necessary to conduct clinical research • “Can do”

  16. Funding Sources • Research councils and charities • Governmental bodies • NHS R&D • HTA • FSA • Investigator lead, industry funded • “Own account” research • Contract commercial research

  17. Managing money - CRFs • Core funding • Charging for use • Commercial research income • Planning for Refreshment • The true cost of research • Training and staff development • Monitoring • IT

  18. Education and TrainingBuilding Capacity • Staff training • Introducing students • F2 trainee rotations • MMC Lecturers • Pre-doc and Post-doc • Training Fellows • Research Nurses • Multi-professional research

  19. Applying Research Findings • The “D” of R and D! • The step before NICE • Focus on savings • Clinical Effectiveness • Audit • N.B. Researchers are not always best at introducing change • Explicit bridge with NHS Trust Strategy

  20. RAE Grants in Publications out NHS The NHS Plan Healthier Nation NSFs Meeting the Needs of Patients Measuring Quality • Developing people • Developing skills

  21. Networking • Wellcome Trust and the CRII • Nurse Managers Association • Operations Managers • Directors • UKCRC • International

  22. What works • Federation • Facilitation • Identifying problems and offering solutions • Pooling resources • Facilities • People

  23. Future Challenges • True networking • Cat herding • Curbing competitiveness • Metrics of success • Regulation change fatigue • Regulating multi-centre research

  24. For the Forum • Governance “Highway” • Study passports • FEC • Intellectual Property policy • With the NHS Innovations and Hubs • Metrics of success

  25. Integrative and Translational ResearchMaking Research Easier • Facilitating Research from bedside to bench and back again • Promoting and providing excellence

  26. Summary • The right environment • The right staff • Understanding the problems • Developing the solutions • Setting priorities

  27. Acknowledgements • Christine McGrath • Michelle Cawte • Chris Counsell • Janet Messer • Noreen Caine • Catherine Johns

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