The Department of Health has published a discussion paper which gives us an insight into how they see local commissioners and organisations working together to support research. It’s a good read and sets out some pretty straightforward advice for new or evolving organisations, many of which will have had little to do with research in the past. It also gives a clue to the key role the Academic Health Science Networks (AHSNs) will have in bringing together and coordinating research activity across commissioners and providers.
The NHS Commissioning Board (NHSCB) and Clinical Commissioning Groups (CCGs) have new duties to promote research and the use of research evidence when they get up and running in 2013. This means there are lots of new organisations across England that will have new roles, and some organisations that will remain but maybe with slightly altered functions. It’s important that everyone understands how they fit into the new mix and what their responsibilities are. These organisations are pretty busy getting up and running so it’s important that they get the support they need to perform their functions and meet their duties and this discussion paper aims to provide a bit of this.
What’s in the discussion paper?
CCGs will only be commissioning healthcare so the old Primary Care Trusts’ (PCT) functions do not directly transfer to them. So whereas PCTs used to be responsible for approving research, CCGs won’t necessarily have to.
Responsibility for research governance generally lies with providers of health care services, such as GP surgeries and hospitals rather than CCGs who are commissioning these services. However, many research support services will already exist from the PCT and the paper encourages these to be retained if appropriate.
It also suggests that the new organisations might want to group together and share services such as R&D permissions or legal advice to gain economies of scale and streamline processes. These services might be hosted by local care providers, commissioners (CCGs or NHSCB) or the NIHR Clinical Research Network or an Academic Health Science Network (AHSN).
The paper includes an annex of suggested services and activities that health care commissioners, local authorities, research sponsors, care providers and research employers might require or should take on to support research and the use of research evidence.
- Care commissioners and local authorities: should develop a research culture and support capacity and participation among clinicians, managers, patients and the public. They should also ensure excess treatments costs of research are covered and participate in the local AHSN and other local research collaborations.
- Sponsors of research (e.g. industry, universities or charities): should put in place agreements and contracts with clear allocation of responsibilities, overseeing research management (delivery, safety etc.), ensuring appropriate funding, peer review and ensuring regulatory approvals are in place – including supporting researchers and coordinators in the approval process.
- Care provider (e.g. GP, clinic or hospital): due to the many different sizes and types of organisations delivering care this list is quite long and varied. It includes communicating their ability to do research, supporting set-up and delivery of research, meeting contractual requirements, participating in the local AHSN and other local research collaboratives, playing a role in shared services and providing training.
- Researcher employers (industry, universities or care providers): including managing grant funding, supporting grant development and collaboration and providing training.
There’s also a mention for Health and Wellbeing Boards and Healthwatch to promote a research culture and offering advice on using evidence. In particular the paper suggests that Healthwatch will play a role in “promoting NHS offering to patients to participate in research studies and equitable access“. Delivering this is one of the commitments in the NHS Constitution which the government is consulting on now – more about this here.
This advice is brilliant support for the new NHS bodies and other organisations that are to be part of the reformed NHS. It’s good that this conversation is beginning so we can start to see how research will be supported across the NHS and how we can engage with this. With so many organisations with so much to do, how these organisations will support research needs to be set out clearly.
Here at AMRC we have a major strand of work looking at how the new NHS structures are coming together to meet their duty to promote research. We’ve already held a workshop bringing together research funders and individuals working at all levels of the NHS to look at what’s already happening to support research, and we are holding a breakfast in parliament in January to give MPs and peers a chance to feed in. The outcomes of both meetings will help shape a Vision for research in the NHS, helping us to engage with new and existing NHS organisations to ensure research is at the heart of their mission to improve the health and wellbeing of their patients.