NHS Future Forum makes research-friendly recommendations

Posted on June 13, 2011 by

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The NHS Future Forum has reported today. They address some of our big concerns over health research, recommending to the government that commissioning consortia should have a duty towards research and that the new Public Health England must have independence from  the Department of Health so it can still give independent advice to government on how to tackle public health issues – including public health emergencies like swine flu. Now we’re waiting to see how the government will respond.

Background

In July 2010, the government published a white paper, Equity and Excellence: Liberating the NHS, which proposed changest to how the NHS works. The Health & Social Care Bill was published on 19 January 2011 and aims to make the legislative changes necessary to put these proposals into action. It makes little explicit mention of research but is reorganising the architecture in ways which will impact research.

The Bill completed committee stage in the Commons where, in response to growing concern over the proposals in it, it was paused to allow the government to “pause, listen and engage” and consider making changes to Bill.

They did this by establishing the NHS Future Forum which, led by Steve Field, set out to “listen” and make recommendations to government on how the reforms should be changed.

Organisations with concerns over how the reforms will effect health research – including medical research charities and the academy of medical sciences – sent a joint submission to the future forum. Our key messages were:

  • embed a duty to promote research throughout the system.
  • develop mechanisms to mitigate the impacts of localisation on research
  • clarify the payment of excess treatment costs in the new commissioning structures
  • create incentives for research
  • ensure independent advice to government is maintained
  • develop a system that supports and strengthens meaningful patient and public involvement in research

What does the report say?

I haven’t had time for a proper read yet but a quick scan through for mentions of research brings up:

(Page 12)

..At a national level, to ensure the provision of independent scientific advice to the public and the government is not compromised we advise against establishing Public Health England fully within the Department of Health.

The bill proposes to abolish the Health Protection Agency (HPA) which is currently an arm’s length body and establish Public Health England within the Department of Health. This will take over delivering the HPA’s functions which include research and providing evidence and advice on public health. Some of these public health issues and the discussion over how the government should act to tackle them can be very controversial, think swine flu, BSE and last week’s e-coli outbreak, so it is important, particularly to maintaining public confidence that those giving advice to government are independent of government. This recommendation to establish Public Health England as not fully within the Department of Health addresses that.

(Page 28)

…Support for research and innovation is also important for evidence based commissioning and practice so the report recommends that commissioning consortia should have a duty to promote research and innovation and the use of research evidence in the NHS.

This is brilliant. The Bill originally proposed that the new commissioning consortia that are going to be run by GPs would have a power to do research but not a duty to do it. One of our big concerns is that unless all the bodies making up the reformed NHS have a duty to do research and there is clear leadership from the top, it could slip down the list of priorities. And a lack of engagement at just one level in the NHS can result in delays. And delays can be a barrier to getting research projects off the ground, meaning it’s harder to trial new treatments in the UK and so ultimately improving healthcare takes longer and costs more. So this recommendation to give the new consortia a duty to do research is exactly what we want to see.

What next?

These are recommendations to the Prime Minister, Deputy Prime Minister and Secretary of State for Health. They  now need to have a look at these and announce what they plan to do, whether they will change the proposals in the Health & Social Care Bill and how. We called for more than the forum has recommended, particularly that the duty to do research should extend right up to the Secretary of State, so it will be interesting to see if the government has taken this on board.

Posted in: Policy