What changes to the NHS mean for clinical academics

Posted on November 30, 2010 by


Yesterday evening, the Lords were talking Academic Health Partnerships and exploring where research fits in the government’s plans for the NHS, particularly focusing on what this might mean for clinical academics. It’s quite a short debate and summarises a lot of the issues for research.


Research is a big part of healthcare and is led by clinical academics – doctors who see patients and do research. Research takes place across the NHS with many collaborations between academics and clinicians. Recently five academic health science centres have been established in England – at Imperial College, King’s College, University College London, Manchester and Cambridge – to bring research, teaching and patient care all together in one place with the aim of speeding up the translation of research developments  into benefits for patients.

The government’s plans for the NHS were laid out in the white paper published in July – see detailed briefing focusing on what it says for medical research here.  There has been a period of consultation on the ideas in the white paper and a Health Bill to start putting these ideas into practice is expected before Christmas.

What did the debate cover?

Baroness Finlay had called the debate. Other speakers included Lord Kakkar, a surgeon and vice-chair of the APPG Medical Research, Baroness Donaghy who is a non-executive Director at Kings College Hospital (one of the academic health science centres). Earl Howe was the health minister responding to all their questions.

There was a lot of discussion about the value of partnerships  in academic health, bringing together research and healthcare and creating the ideal environment to develop treatments for patients. Concerns were raised about how new pressures, initiatives etc might alter the focus on research.

The Academic Health Science Centres (ASHCs) were created with a fixed term of five years funding awarded in March 2009. This comes from research councils, the National Institute of Health Research (the bit of the NHS focused on research) and other funders. Questions were raised about the support for these centres in the future which Earl Howe responded to:

The coalition Government confirmed in the White Paper that they see an important role for AHSCs in delivering the translational research agenda, unlocking synergies between research, education and patient care. As regards their potential development as institutions, which the noble Lord, Lord Kakkar, invited us to consider, as he knows, AHSC status was awarded in March 2009 for a period of five years and will be subject to review. However, we will be working with interested parties to determine the next steps for AHSCs, and I take his suggestions fully on board.

Earl Howe went on to outline a series of other initiatives focused on improving translation of research into treatments

  • Biomedical research centres
  • biomedical research units
  • collaborations for leadership in applied health research and care
  • health innovation and education clusters – which are cross-sector partnerships between NHS organisations, the higher education sector and industry

Government support for these had been outlined in July’s white paper Equity and excellence: Liberating the NHS in the section on research (page 24)

The Department will continue to promote the role of Biomedical Research Centres and Units, Academic Health Science Centres and Collaborations for Leadership in Applied Health Research and Care, to develop research and to unlock synergies between research, education and patient care.

Education was also touched on in detail, from attracting and developing skilled people to become clinical academics to the possible adverse impacts on health science centres of changes to university funding proposed by the Browne review:

Baroness Thornton …we also need to look at the implications of the Browne review of university funding because we need to know how the leg that concerns teaching and universities will be affected. Presumably the cutbacks in the funding of higher education will have an impact on AHSCs in relationships with universities as they collaborate with them.

Earl Howe mentioned that a consultation on a new framework for education and training will be published shortly.

Also covered were incentives for research and innovation – Earl Howe responded with a nod to a lot of the levers already in place:

The noble Baroness, Lady Finlay, asked what levers would be in the new system to encourage research and innovation. My noble friend Lord Alderdice was absolutely right: it is largely thanks to the noble Lord, Lord Darzi, and to Dame Sally Davies in the department that these levers exist and will continue to operate. I have referred to a number of the ways in which the NIHR is continuing to support the system-not least the BRCs, BRUs and so on-by pulling through ideas from the laboratory into new approaches to healthcare. It is through these and the AHSCs that we will continue to see a drive to research and innovation in the new system.

And he also gave a clue to the role of research in the new NHS commissioning board’s remit (this is the new board proposed in the white paper which will provide leadership on commissioning, practice, performance and quality for all the GP consortia commissioning on the ground)

We expect that the board will promote the conduct of research and patient participation.

What next?

We are waiting for the Health Bill expected before Christmas. A white paper on public health is also being published today. Both of these will tell us more about where research will fit and how it will be supported and incentivised. And there will be lots of debate around all of this so plenty

Posted in: Policy