Research now right at the heart of the NHS

Posted on February 2, 2012 by

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Following all the debate in the Lords over the past months, the government have made some changes to the Health & Social Care Bill. This includes a brilliant change for health research, aimed at ensuring it is a core role of the NHS – placing a strong duty across the Secretary of State, the NHS Commissioning Board and Clinical Commissioning Groups to promote research and the use of research evidence.

Report stage – the next debate where these amendments will be made to the bill – starts on Wednesday next week.

Background

The Health & Social Care Bill hits report stage in the Lords on Wednesday 8th February. This is an opportunity for issues that still haven’t been resolved to be raised again (through tabling amendments and discussing them) and if progress is not made, peers may consider pushing some of these amendments to a vote. There are a few days scheduled for this.

The government has also tabled some amendments to the bill – changes they plan to make following the discussion we have had so far.

Alongside this, they have published a briefing note explaining the thinking behind these amendments.

Anything interesting for health research?

There are three amendments which are great news for health research.

Clause 5

EARL HOWE

 Page 3, line 16, leave out “have regard to the need to”

Clause 22

EARL HOWE

Page 19, line 13, leave out “have regard to the need to”

Clause 25

EARL HOWE

 Page 37, line 34, leave out “have regard to the need to”

The bill places a duty on the Secretary of State, the NHS Commissioning Board and Clinical Commissioning Groups (CCGs) to “have regard to the need to promote” research and the use of research evidence.

We thought the shared duty across the system was great, but “have regard to the need to promote” really wasn’t strong enough to reflect the core role of research within the NHS. If the Secretary of State, the board and the CCGs really were going to compelled and given the power to build research right into the middle of the system, we thought it needed to be stronger. The government agreed and has now changed the wording of this duty to far stronger “must promote”. So the duty on the Secretary of State, Board and CCGs is now:

Duty as to research

In exercising functions in relation to the health service, the Secretary of
State must promote

(a)research on matters relevant to the health service, and

(b)the use in the health service of evidence obtained from
research.”

The government explain their thinking in their briefing note:

Duties to promote research – Amendments 3, 17, 27

14. The Bill currently places a duty on the Secretary of State, the Board and CCGs
to have regard to the need to promote research within the health service. A
number of Peers suggested that the duties as worded were not strong enough.
In particular, Lord Willis stated that “the Bill should say simply, “The
Secretary of State must promote”. That is a clear definition, a clear statement of intent.”

15. On reflection, we agree that this wording more accurately reflects the intention
for the clause. Therefore, we have tabled this amendment to amend the duties
on the Secretary of State, the Board, and CCGs to require each to promote
research within the health service

They have also proposed amendments on education and training (another area we were concerned about because to do research well, the NHS needs a well trained and supported workforce to do it). These include extending a similar duty across the Secretary of State, the NHS Commissioning Board and CCGs to have regard to the need to promote education and training.

What now?

Lord Willis, Lord Turnberg and Baroness Morgan raised a number of other concerns about health research and the bill in a letter to Earl Howe last week (here with an explanation of the specific issues they raised).

  • Ensuring the independence of the Health Research Authority (HRA)
  • Ensuring the necessary accountability and reporting structures are in place to embed and monitor research throughout the health system
  • Reviewing the policy on attribution of costs associated with charity funded research
  • Unlocking the potential of patient data for research: ensuring a secure and proportionate framework.
  • Providing clarity on the proposals for education and training

These included pushing for research to be specifically mandated as a duty the board and CCGs must report on (Ensuring the necessary accountability and reporting structures are in place to embed and monitor research throughout the health system).

They will now be looking at the amendments the government have proposed today to decide whether they address all their concerns or whether they need to continue pushing some of these issues at report stage.

Posted in: Policy, Research