Health and social care reforms on trial

What better starting point for today’s blog than the comments of two leading clinicians speaking about the importance of clinical trials to patient outcomes.  First, Dr Duncan Wheatley, a Clinical Oncologist and Lead for Research in the South West Peninsula, who is quoted in a BBC Cornwall story today about medical research at the Royal Cornwall Hospitals Trust as saying:

‘It makes a huge difference. Obviously we can’t guarantee that the new treatment will always be better than the old treatment, but patients who go into the study, even if they get the normal treatment, generally get slightly more intensive care.”

The story talks more specifically about how research has trebled there over the last three years with now over 300 studies underway and over 1400 patients involved.  It looks as though the Trust is in the process of building its research pages but I hope they follow-up the press coverage today with a bit of showcasing on the Trust home page as well.   I believe most of the research there takes place at the Knowledge Spa facility in Truro and that charity involvement occurs across a number of disease areas including MS and arthritis.

The second quote is from a little earlier in the month, this time from Prof David Newby who is NHS Lothian’s R&D Director.  In this Scotsman piece about NHS Lothian’s strategy to increase the number of non-commercial trials by a fifth he says: 

‘That’s why our research and development policies are so important. It provides major benefits for patients in our area.’

And today you may have seen the story about the breast cancer drug that migth be effective against lung cancer (more trials needed) or indeed this one about the £1 million funding being provided by Arthritis Research UK for a clinical trial in Birmingham to improve treatment for those with Sjorgen’s syndrome. 

It is the degree to which health and social reforms enable us to grow such research activity in England that they will be judged by the members of AMRC.  With the Academy’s report and recommendations on research regulation now out there and the results of the NW Exemplar Pilot published today I feel we might be close to having a finely-tuned engine for clincal trials.  

But it is the chassis  around us – namely the NHS and how it is run – that might now fall apart around us in Keystone Cops fashion.

And for those of you who remain unclear why medical research charities remain concerned about the impact of the NHS reforms, I encourage you to cast your eye over the appendix to the response we put in to the Department of Health’s ‘Information Revolution’ consultation two weeks ago. 

This summarises some focus group research (quoted in the Academy’s report) that we did into patient and GP attitudes to clinical research and use of patient data. The basic message coming out of it is that most GPs are simply not set-up to do, nor engaged with, research to the extent one would hope. 

So what’s one to do when presented with reforms that put GPs in the driving seat for how our health service is run? 

I hope that some of my concerns might be allayed by an NIHR seminar I am attending next week on embedding research in the new NHS.  In the meantime the scenario reminds me of a relative who bought a Range Rover with a diesel engine and decided to put a petrol engine in it.  To cut along story short, the vibrations were so bad that the chassis fell off.

Perhaps a clinical trial for how these reforms might best support research would be wise?  But, then again, Andrew Lansley is a man in a hurry.

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