Department of Health

Today the All-Party Parliamentary Group for Medical Research holds its summer reception in parliament. This annual event has become an important fixture on the health research calendar. The ‘great and the good’ assemble to focus on a key issue of the day and to network. At some point in proceedings they will be addressed by the Science Minister, David Willetts MP, or Health Minister, Earl Howe, or both.

This year’s event is headlined ‘healthy futures’ and aims to bring to light how investment in research has long-term economic and social benefits. This is all with an eye on the forthcoming General Election next May and a subsequent Comprehensive Spending Review (CSR).

In recent years, research funders have sought to understand better the impacts arising from the money they spend on research. Often this impact has been expressed qualitatively. But is has proved more difficult to place a financial value on impact. The first report to do so was published in 2008 when I was the Chief Executive of the Association of Medical Research Charities (AMRC).

The report looked at the economic returns arising from government and charity funding of cardiovascular research, also testing the methodology to a more limited extent on mental health research. The study, undertaken by the Health Economics Research Group at Brunel University, RAND Europe, and the Office of Health Economics, found that for every £1 invested by the government and charities in cardiovascular research, a total annual return of 39p was generated each year in perpetuity. The figure for mental health research was 37p per £.

Now the study – commissioned by Cancer Research UK, Wellcome Trust, the Academy of Medical Sciences and the Department of Health – has been repeated in cancer and published as a paper in BMC Medicine to coincide with the All-Party Parliamentary Group on Medical Research reception. You can read the paper here:
http://www.biomedcentral.com/1741-7015/12/99

The key findings in the study which are also published in report form as ‘Medical research: what it’s worth,’ are as follows:

The British public has funded £15b of cancer research over the 40 years to 2009 through taxes and charitable donations.

The time lag between investment in cancer research and it’s eventual impact to patients is around 15 years. This is similar to the figure obtained in the earlier study, and shows the long term nature of the payback from research funding.

Key cancer treatments and interventions have delivered the equivalent of £124b og health gains for UK patients in the 20 years up to the end of 2010.

The proportion of these benefits attributable to UK research was 17%.

Taking the spend, and allowing for the time lag and the proportion of benefits attributable to UK research, each £ invested in
cancer-related research by the UK taxpayer and charities generates returns of around 40p in every following year. Of this, 30p is the estimated benefit from research to the wider economy; the direct health benefits amount to 10p per annum for every £ spent. The overall annual rate of return is estimated to be 40%.

I am sure the study will be challenged by some and so it should.,Only through ever-greater scrutiny are we going to improve these
socio-economic models about research. But they seem of enormous value to me in trying to quantify the impact of money spent today, on society tomorrow. And if it makes policy-makers and newly-minted Ministers put their red pen away then all power to its elbow.

Click here for details of a National Institute for Health Research (NIHR) and Association of British Pharmaceuticals Industry (ABPI) joint conference on harnessing big data for health gains.  Takes place in London on 21st November.

The more it is used the more I dislike the term ‘big data.’  I mean, how to alienate your public in one go.  That’s why companies no longer use the word ‘big’ in advertising or references to inanimate objects. Hey ho.  I will be on the panel in the afternoon trying to put a human face on data.

Funnily enough on, the ABPI page listing this conference, they also have their statement on the House of Commons Science and Technology Report on Clinical Trials.  Here’s my blog on that report.

ABPI/NIHR Data conference

The Department of Health this morning announced the successful NIHR Collaborations for Leadership in Applied Health Research and Care (CLSHRCs).  The formal press release can be found here.

Thirteen CLAHRCs have been awarded over £120M in total following an open competition earlier this year.  The details of the latter can be found here. Further details on the CLAHRCs and the themes they will concentrate on will appear on NIHR’s website soon.  But here is the list of the CLAHRCs by name and links to local press coverage where I have found it.

Worth reiterating that, as with all NIHR funded schemes, each CLAHRC has a strategy and plan for promoting and advancing public involvement in their work.  But, interesting, 6 of them also have a research theme focusing on public involvement/engagement/experience: NW London; South London; East; Wessex; North West Coast; Oxford.

Congratulations to them all.

NIHR CLAHRC   North West London
NIHR   CLAHRC  East Midlands
NIHR CLAHRC Yorkshire & Humber
NIHR   CLAHRC  West Midlands
NIHR   CLAHRC  South London
NIHR CLAHRC   Greater Manchester
NIHR CLAHRC   East
NIHR CLAHRC   South West Peninsula
NIHR CLAHRC   Wessex
NIHR CLAHRC   West
NIHR CLAHRC   North West Coast
NIHR CLAHRC   London: City, North & East

NIHR CLAHRC  Oxford

The Health Service Journal (HSJ) has an ‘exclusive’ interview today with Dame Fiona Caldicott.  Dame Fiona has been chairing a review – of information governance in health and social care – ‘Caldicott2.’  Its report and recommendations are due out in just a few short weeks.

You have to subscribe to HSJ to read the full interview but you can find the accompanying news report here.  It would seem Dame Fiona and her review team will be making a case for a duty to be placed on health and social care organisations to share information where it is in the patient’s interest.   This would become an additional principle to sit alongside the six that already exist following the first Caldicott review in 1997. How very sensible.  

Sounds like the review will be equally sensible when it comes to its recommendations on the the handling of patient data for research purposes.  Thank goodness.  

The pantomime about the use of patient data for research has been allowed to go on for too long.  The policy wonks and the odd lawyer have selfishly hogged the stage in their horse costume.  Meanwhile, the Big Brother doomsayers have hovered in the background with an intermittently tuneful chorus of pro-research voices standing in the wings, imploring us to hand over our data.  As both sides have exchanged the traditional chants of ‘Oh yes you will’ and ‘Oh no you won’t’ few among their number have noticed or cared about the lack of audience participation.

How appropriate therefore that a combination of a ‘Dame of the British Realm’ and the Great British Public should bring us all to our senses.  For, let’s not forget, this review actually went out and talked to citizens and patients.

A few years ago when we were developing the patient leaflet ‘Your health records save lives’ , we initially got together a group of experts.  Cue a hideous stalemate of opposing and frankly irrelevant views (from a patient perspective , anyway) based on people’s interpretation of policy and law.  So what did we do?  We took the debate outside the room and asked patients and GPs what they felt, what they wanted to know, and how best to present this.  The leaflet (link above) is the result of that.  Shame that, despite its success out there, we can’t seem to find someone to fund its further production and distribution.

With that…and no other comment…I shall leave you with this story today about the Department of Health commissioned report by the Royal College of General Practitioners (RCGP) on GP practices providing online access to medical records.

The patient?  S/he’s behind you…..

 

 

 

 

Rather than just tweet this as a link, I thought some background was needed.

This is a ten minute extract of a much longer interview I did with Professor Sally Davies, Chief Medical
Officer and Chief Scientific Officer at the Department of Health. The interview came at the beginning of a two-day
NIHR training camp in communications. In typically candid fashion, Dame Sally covers the role of the media, preparing for interviews,
leadership communications and the importance of public involvement to NIHR. Personally I think it’s quite a thoughtful dialogue.

The Secretary of State for Health, Jeremy Hunt, spoke at the King’s Fund annual conference today.  By all accounts it was impassioned and well-received.  There then followed what sounded like a lively panel discussion about patient experience (see their twitter feed).

Hunt’s announcement of a review into the idea of establishing an ‘Ofsted’ rating system for hospitals has captured the headlines – Ofsted is the body that is responsible for overseeing inspection of our schools.  The media coverage concentrates on the key points but here is the link to the Department of Health news release which gives a lot more detail on how the review will be conducted.  He also talked about the ‘Friends and Family Test’ that will be brought into being next year.  The panel seemed divided on the merits of the latter although all agreed that the business of capturing patient experience and feedback is only worthwhile if used to inform change.

Capturing and measuring the patient experience in health research is something that needs urgent consideration; in its own right but also as part of these wider initiatives.  So far we have only really seen the National Cancer Patient Experience (NCPE) focus on this question.  The Care Quality Commission (CQC) does not cover it in the National Patient Survey and once these things are up and running it is quite difficult to have them changed to reflect changing priorities – or that’s my impression anyway.

I wonder whether the health Ofsted will be called Hospbed?

So there I was yesterday afternoon,  with my biology ‘o’level a distant memory to put it mildly, speaking at the annual NIHR Senior Investigators Meeting thinking: ‘how did I ever get into this?’  The event brings together the very best of NIHR’s  researchers for an update on what’s happening across health research.  And this was mentioned at last night’s dinner and announced this morning.

The new Health Research Authority (HRA) have been given the Department of Health’s go-ahead to do a feasibility study into developing a simplified and streamlined HRA assessment for all research in the NHS.  If I have got this right, that potentially means a move away from the situation we can currently have, where NHS Trusts decide they all ought to do the same assessment before the research can get underway.  You got it, that means lots of duplication, delays, a waste of money and patients losing out.

So this would mean HRA would do the assessment and Trusts would only have to think about their ability to deliver the research, while local research ethics committees could concentrate on new issues it raises.

I’m sure that if I have got that rather crass paraphrasing of the announcement wrong, someone will put me right.

A long way to go but more radical than it sounds.