Update on government activity to support research in the NHS

Posted on May 29, 2012 by

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Following the recently passed health bill, there are lots of changes underway in the NHS, some of these will have a big impact on research. Lord Willis, chair of AMRC, has been asking the Government about some of the ways they are supporting research in the NHS. The health minister, Earl Howe, has responded explaining how they are working with medical research charities and confirming that the NHS will continue to fund the patient care costs for those taking part in research funded by charities. He has also outlined how the department of health are ensuring patients are involved in the planning, conduct and use of research in the NHS and how the new NHS bodies – the NHS Commissioning Board and Clinical Commissioning Groups (CCGs) – are aiming to fullfil their new duties to promote research.

The questions

Lord Willis of Knaresborough: To ask Her Majesty’s Government what agreement they have reached with medical research charities over the financing of excess treatment costs.

To ask Her Majesty’s Government what role the medical charity sector will have in drawing up guidelines with the Department of Health to ensure that all NHS Trusts apply the same criteria when allocating costs linked to research infrastructures.

The Parliamentary Under-Secretary of State, Department of Health (Earl Howe): On 4 May 2012, the Department and the Association of Medical Research Charities announced the publication of new guidelines for attributing the cost of health and social care research and development. The department continues to work with medical research charities on implementation of the guidance by the research community.

Under the current system, the patient care costs (sometimes referred to as treatment costs) for patients who are taking part in research funded by Government and research charity partner organisations are funded through normal arrangements for commissioning patient care. The Government have made a commitment that clinical commissioning groups and the NHS Commissioning Board will ensure that these costs continue to be met through these arrangements.

Earl Howe is referring to the AcoRD guidlines agreed between AMRC and the Department of Health (DH), which set out what can and can’t be paid for by charities funding research in the NHS – the money they have raised must go directly to what it was donated for – funding research projects that lead to better health outcomes for patients so they can’t fund indirect costs like hospital infrastructure (more on the AcoRD guidelines here). Earl Howe has also said here that any patient care costs associated with trials will be met by CCGs as part of normal care, this isn’t in the AcoRD agreement but the government has committed to this being part of future regulations for the commissioning bodies. This is a great reinforcement that the Government is keen to work with charities to make sure these new guidelines work in practice.

Lord Willis of Knaresborough: To ask Her Majesty’s Government what steps they are taking to ensure that priorities for health-related research reflect the priorities of patients.

The Parliamentary Under-Secretary of State, Department of Health (Earl Howe): The department’s National Institute for Health Research (NIHR) encourages patients and the public to be actively involved in all NIHR-funded health and social care research, including setting research priorities. The NIHR funds INVOLVE which promotes active public participation in National Health Service, public health and social care research to improve the way that research is prioritised, commissioned, undertaken, communicated and used.

All the NIHR’s research programmes actively engage patients and the public in all stages of research. For example, any person or group can make a suggestion for research to the NIHR Health Technology Assessment (HTA) programme by completing an online suggestion form. Panels of independent experts decide which of the many suggestions received by the HTA programme should be commissioned as research. This decision-making process involves clarifying research questions that are most likely to fill the main gaps in knowledge for the NHS. Six HTA advisory panels are responsible for this work, and members include service user representatives.

It’s really important that the public, who fund research with their taxes and are ultimately the ones who stand to benefit from its findings, have a say in what research is conducted and how it is conducted. The public can also be hugely valuable in helping guide how those findings are communicated and used to improve patient care. Programmes like these involving patients in these activities are really welcome. Charities also have a role to play in ensuring that patients are informed and their voice is heard though online forums, campaigns and lay members on boards making funding decisions, for example.

Lord Willis of Knaresborough: To ask Her Majesty’s Government what steps they are taking to exercise the duties to promote research contained in the Health and Social Care Act 2012.

Earl Howe: The Health and Social Care Act 2012 places a duty on the Secretary of State to promote research on matters relevant to the health service. The Secretary of State currently supports research through two main routes and will continue to do so in the future. The first main route is through the National Institute for Health Research which provides the research evidence to underpin decisions about health by clinicians, managers and patients in the National Health Service. The second main route is through the NHS, which supports and enables research funded by Government, research charity partner organisations, and industry.

The Act places a duty on the NHS Commissioning Board such that, in the exercise of its functions, it must promote research on matters relevant to the health service. This duty will take effect from April 2013. The NHS Commissioning Board Authority is currently developing a research strategy setting out its intentions for how the board will exercise this duty.

The Act creates a duty for clinical commissioning groups (CCGs) to promote research, in line with the duty on the NHS Commissioning Board. The NHS Commissioning Board Authority is leading on authorisation of CCGs and, in April 2012, published clinical commissioning group authorisation: draft guide for applicants. As set out in this document, to meet the threshold for authorisation CCGs will be required to provide a statement certifying that systems and processes are in place to ensure that the CCG complies with its statutory duties and other requirements, including the commitment to promoting patients’ recruitment to and participation in research.

After great efforts by the medical research community and Peers in the House of Lords, the government accepted amendments to the Health and Social Care Bill, placing a strong duty at all levels of the NHS to promote research and the use of research evidence. As the new NHS bodies are getting up and running we’re beginning to get a better idea what these duties will look like in practice. AMRC and its members are continuing to look at how these duties will be implemented and are working with the Department of Health on this.