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Conducting Research in the UK National Health Service

Conducting Research in the UK National Health Service. Dr Stephen Brett Reader In Critical Care. The National Health Service £127.5bn in 2012-2013 Funded from general taxation Additional 10% private Free at point of delivery Treatment based entirely on need- with caveats

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Conducting Research in the UK National Health Service

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  1. Conducting Research in the UK National Health Service Dr Stephen Brett Reader In Critical Care

  2. The National Health Service • £127.5bn in 2012-2013 • Funded from general taxation • Additional 10% private • Free at point of delivery • Treatment based entirely on need- with caveats • Major budgets now held by primary care • Purchaser provider split

  3. Research Types Funding Unfunded Charities Local National- Wellcome, Dunhill, ICF, Cancer Research UK BHF Government Medical Research Council National Institute for Health Research • Epidemiological • Basic science • Observational • Clinical trials • Outcomes • Health services research • Qualitative/social science

  4. Intensive care • Sickest patients in hospitals • Emergencies*** and major elective surgery • Specialist medical, nursing and AHP staff • Equipment for support of failing organs • Cardiovascular, respiratory, renal……… • In theory for people who can benefit • Mortality 20-25% ITU Discharge • Significant long term consequences for patient and family • Health and non-health related

  5. Context • Primary duty to patient care • Academic healthcare is better healthcare • Innovation to improve outcomes and efficiencies • Drive for patient safety • Focus on health economics • Encourage macroeconomic growth • Strict rules about patient confidentiality and data handling • Robust framework for both clinical and research governance

  6. Imperial College Healthcare NHS Trust

  7. Imperial College Healthcare NHS Trust

  8. Why conduct research in medicine? • New knowledge to improve health of individuals and populations • Innovation • Health- and macro- economic benefit • Excitement of new knowledge • Career advancement • Academic healthcare is better healthcare • Increase environment data richness • More specialisation and knowledge • More resources • Hawthorne effect • All-around Increased motivation

  9. Research questions • Learn about • Disease natural history • What does the disease do? • How does it do it? • Who has it? • How do we diagnose it and monitor it? • What does it cost us- human and financial? • Treatment • What to give? • How to give it? • How to monitor its effect? • System • How to deliver care?

  10. Publication type • Original primary • Basic science • Clinical • Observational • Interventional • Epidemiological • Qualitative • Systematic review • Meta analysis • Guidelines • Commentary • Editorial • Case reports • Educational things • etc

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