What do health researchers want to see in the health bill?

Posted on August 31, 2011 by

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The Commons are debating the Health & Social Care Bill again next week. This bill is making huge changes to the NHS so will have a big impact on health research, a lot of which takes place within the NHS.

Since the bill was proposed there have been lots of changes – including some great commitments making it more research-friendly. But there are still lots of questions that need exploring and other changes that could be made to make sure the new system really supports good research.

I have been working with a coalition of organisations focused on health research to pull together all our questions and make recommendations for what the government needs to consider as they take the bill forward.

Background

The Health & Social Care Bill was published on 19 January 2011, proposing changes to the NHS. It started off being debated in the Commons.

Once it had completed committee stage, 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.

Following this pause, the government made some research-friendly changes to the Health & Social Care Bill.

Because it had been changed considerably, the bill went back into committee stage so MPs could scrutinise it clause by clause. It now needs to complete report stage and third reading in the Commons before it heads to the Lords to be debated.

What are the big things we’re concerned about?

We’ve put together a very detailed briefing packed with background here, but in brief:

  • Getting further detail of how the commitments to promote research and innovation will be delivered. The government made commitments to build research and innovation into the system but we’re still waiting for the detail on how they plan to do this, what a duty towards research on the secretary of state will actually mean, where research will fit in the new NHS Commissioning Board. Some initial plans sketching out what the NHS Commissioning Board might look like were published in July but there was little information about where research fits in the plans.
  • Developing and delivering effective research locally. The changes to the NHS and public health system shift a lot of responsibility to a more local level – clinical commissioning groups and local authorities. We’re concerned that those responsible for delivering healthcare value research and will support it (rather than becoming a barrier to projects getting off the ground) and that they understand how to use it to inform their decisions – to do this they need to have support and access to expertise in research.
  • Enabling the safe and secure use of patient data for research. The information contained in NHS patient records is a rich resource for medical research to improve healthcare. But there is currently no clear framework to ensure this confidential information can be used safely by researchers. There is lots of work going on alongside the health bill to improve the use of information by the NHS, the NHS Future Forum is also looking at this. So this is an opportunity to develop a safe and secure system for both patients and researchers which will allow valuable health research to be done.
  • Integrate meaningful patient and public involvement in research. Involving patients and the public in research – in both deciding what should be on the research agenda, designing the projects and taking part in the research – helps deliver high quality, more relevant research. This involvement is now a requirement of lots of research grants. But at the moment researchers aren’t generally experienced in doing this and they need support to do it well. We’re concerned that this involvement needs to be recognised as a valuable part of the system and researchers properly supported to do it so we can get the most benefits out of it and do better research.
  • Develop the health research workforce. To do good research, all the people working in the NHS – consultants, academics, nurses, midwives, therapists etc –  need to be supported to understand and use research and innovation to improve patient care. This means we need to get education and training right, for those coming through and those already working in the system. And we need to support individuals to have careers spanning both clinical practice and academic research. The government is in the process of developing proposals for how to develop health education and the NHS Future Forum is looking at this so now is a good opportunity to feed in our concerns from a research perspective.
  • Support innovation in the NHS. Adopting new ideas, technologies and processes, i.e. innovation – is essential for improving patient care. The NHS is a huge healthcare system so should be good at this, but we’re not as good at it as we should be. The government has recognised this, obviously getting better at innovation has huge potential for economic growth so is something we really want to foster, and is currently looking at ways to improve the system. Now, as the health bill is making big changes to the NHS and public health system, is a good opportunity to put in place changes that can foster innovation.
  • Establish streamlined and robust regulation and governance of health research. Our regulatory system for health research is very complex and the large amount of bureaucracy, duplication across the system etc means there are big delays in getting research projects off the ground. This not only makes them more expensive to do but can act as a disincentive for global industry deciding where to do their research (e.g. Pfizer recently moved much of its research & development out of the UK). The government has committed to establishing a single regulator of health research and putting in place measures to speed up the process of getting NHS research & development permissions, authorisation for clinical trials etc. But we don’t yet have a clear timetable for when all this is going to start happening.

What next?

The commons are debating the health bill on 6/7 September next week. The bill will then head over to the Lords, probably arriving in early October with committee stage likely before Christmas.

They’ll be lots of opportunities for research issues to be raised in the debates.

Posted in: Policy