Best Research for Best Health

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					Best Research for Best Health
DH Research Strategy and its implications for
                Sheffield
               STHNHSFT Trust Board
                 8th February 2006

               Brenda Zinober, Ph.D.
              Senior Research Manager

          www.sth-research.group.shef.ac.uk
            brenda.zinober@sth.nhs.uk
Overview
   DH R&D Strategy
    - background 1988-2005
    - Best Research for Best Health 2006

   Implications for Sheffield
    -   opportunities
    -   challenges
    -   the way forward
DH Research Strategy: background

   NHS established 1948
   No national research strategy
   1988 House of Lords Science &
    Technology Co.
   1991 - 2005
       - Developments
       - Problems
       - Re-assessment
   Best Research for Best Health 2006
DH Research Strategy: development
Development

 1991    First Director of R&D appointed

 1997    NHS R&D levy defined

         from    - SIFT-R levy
                 - Local schemes
                 - DH & Regional schemes

         for     - infrastructure
                 - service support

         STH 2005/06 ~ £7,000,000
DH Research Strategy: development

Development
 1998    National programmes
        - Cochrane Collaboration
        - Centre for Reviewers & Dissemination

        - Health Technology Assessment (HTA)
        - Service Delivery & Organisation (SDO)

        - New & Emerging Applications Technology
          (NEAT)
DH Research Strategy: development

Development
2001, 2005
Research Governance Framework

 “to ensure that health and social care research is
  conducted to high scientific and ethical standards
  that earn public confidence”

 Framework draws together guidelines and legislation,
  and formalises systems and obligations
DH Research Strategy: problems
   But problems of
    - leadership
    - failed attempts at rebasing the levy
    - lack of implementation strategies

    - disappearance of regional support
       structures
    - lack of accountability: activity and
       governance
    - R&D not a metric for Trust success

    - lack of dialogue and joined-up thinking
DH Research Strategy: re-assessment
Legislative framework
2002 – 05
       - Data Protection Act
       - Mental Capacity Act
       - Human Tissue Act

       - Local research ethics committees → COREC
       - EU Clinical Trials Directive
       - Medicines for Human Use (Clinical Trials)
         Regulations

       - Research Governance Framework 2nd Edition
DH Research Strategy - re-assessment
2003
Biotechnology Innovation and Growth Team
Academy of Medical Sciences

       - consequences for health and wealth from
          inadequate support for R&D
       - need for NHS/industry collaboration
       - need for supportive public and regulatory
          environment for innovation
       - requirement for sufficient and sustainable
          funding
DH Research Strategy - re-assessment
2004 - 05
Government Science and Innovation Investment
  Framework 2004 – 2014
The Walport Report on Clinical Academic Careers

Research for Patient Benefit Working Party
      → UK Clinical Research Collaboration
        (UKCRC)
      → £100,000,000 p.a. over and above
        inflation
      → need for NHS R&D strategy
Best Research for Best Health
Appointment of new Director of R&D
     Prof Sally Davies

Consultation process
   Targeted and open consultation process - Oct 05
   STH-UoS joint response with representation from
    SHU
   DH response – Jan 06
    Best Research for Best Health: 5 year strategy
DH Research Strategy 2005:
“Best Research for Best Health”

Challenges
Best Research for Best Health
Best Research for Best Health

Vision
“ to improve the health and wealth of the
  nation through research”

Mission
“to create a health research system in which
  the NHS supports outstanding individuals,
  working in world-class facilities, conducting
  leading-edge research, focused on the
  needs of patients and the public”
Best Research for Best Health: Goals
1. Establish the NHS as a internationally recognised centre of
    research excellence
    - NIHR Framework
2. Attract, develop and retain the best research professionals to
    conduct people-based research
    - Research Faculty
3. Commission research focused on improving health and social care
    - Projects, Programmes, Networks, CRFs, Units, Centres
4. Strengthen and streamline systems for research management and
    guidance
    - Governance, Advice, Ethics Systems
5. Act as sound custodians of public money for public good
    - Funding arrangements
      Best Research for Best Health:
             implementation

DH implementations plans 2005 -2010

   Work-streams with DH and UKCRC leads
   6 monthly updates
   Progressive roll-out
   Outcomes and deliverables

   www.dh.gov.uk/researchstrategy
Best Research for Best Health

National Institute for Health Research
                 (NIHR)

Purpose: provide a co-ordinating framework
Director: R&D Director Prof Sally Davies

Key partners: include academia, industry, UKCRC,
   medical research charities, NICE, NPSA/COREC
Virtual body with an Advisory Board
Best Research for Best Health
Research Faculty
DH lead      Sally Davies
Budget       not specified but held centrally
Purpose      attract, develop & retain research professionals
             all professions, NHS and academics eligible, by
             invitation

Implementation plan
Feb06   Implementation Group established
July 06 Implementation plan complete
Sept 06 Identification of Faculty members

STH action
Obtain early intelligence to maximise opportunities
Best Research for Best Health
Commissioning research
Projects, programmes, technology platforms, networks,
clinical research facilities, research units, research centres

DH lead            Peter Sneddon, Marc Taylor, Catherine Johns

Purpose            Stimulate research to address health priorities

Budget             Existing and new funds over a 3 year period

Implementation     April: Central Commissioning Facility, calls for bids
                   Sept: reviews
                   Dec: allocations

STH action
Analyse opportunities and alert researchers to schemes and support
Best Research for Best Health
    Projects
     RfPB *
     RISC *

    Programmes
     HTA,
     SDO,
     Research Capacity development,
     National Horizon Scanning Centre,
     Methodology,
     Policy Research,
     Cochrane Centre, Cochrane Reviews,
     Centre for reviews and Dissemination,
     Technology Assessment Reviews
     Invention for Innovation (NEAT &HTD)
     Challenge Fund for Innovation*
*New funding stream
Best Research for Best Health
   Programme grants*
    - prestigious awards aimed at attracting top researchers
    - stability of funding: 3-5 years
    -series of related projects that form a coherent theme
    - budget rising to £75m, with grants of £2m
    - allocated to trusts to enable them to tackle areas of high
    priority or need
    - April 06 call for outline proposals, June shortlisting

STH action      Identify areas of strength that meet the criteria
                Prioritise
                Develop outline proposal(s)
* New funding
Best Research for Best Health
Technology Platforms*
DH lead          Catherine Johns
Purpose          To establish a dedicated funding stream to support
                 NHS costs of selected technology platforms for
                 health research in NHS providers
Budget           Rising from £8m - £50m p.a.*

Implementation   First round: Diagnostic imaging
                 March 06 call for bids
                 May 06      submit proposals
                 Oct 06       funding released

STH action       Feb 06      identify bidding team, review research
                                      strengths/clinical needs
                 March 06    review call, decide whether to bid

*New funding
Best Research for Best Health
   Networks: topic specific & comprehensive
DH lead               Catherine Johns and UKCRN
Purpose               to support and conduct RCTs of interventions
                      funded by commercial and grant sources , across
                      the full disease spectrum, enabling patients across
                      the country to participate in clinical trials
Budget                not specified

Implementation        Cancer – in place
                      April 06 – funding for new networks e.g. diabetes,
                      stroke, dementias & neurodegenerative diseases - £2m
                      March 06 – announcement of comprehensive research
                      network across all non-topic specific areas. Establishment
                      incremental over 3 year transitional period.**

STH action Support implementation of stroke network
                      Keep “unsuccessful” bid topics under review
                      Maximise opportunities for comprehensive networks
**Recycled R&D levy
Best Research for Best Health
Clinical Research Facilities for experimental medicine:
   generic and cancer

DH lead          Catherine Johns
Purpose          to provide purpose –built, cutting-edge CRFs for
                 the conduct of research to ensure that advances in
                 biomedical research result in improvements in
                 health care, and to nurture future researchers

Budget           not specified - Wellcome, Wolfson, BHF,MRC, DH

Implementation   Jan 06 - bids submitted
                 July 06 – outcome announced

STH action       Focusing on commissioning of STH-UoS CRF in
                 RHH due to open in Sept 2006, until announcement
Best Research for Best Health
Units
DH lead          Peter Sneddon
Purpose          support policy making
                 provide expert advice
                 Support development and management of clinical
                 trials
                 support research activity locally
Budget           not specified

Implementation   Continued support for Policy Research Units,
                 Academic Units, Clinical Trials Units, R&D Support
                 Units (RDSU)
STH action       Strengthen relationship with local RDSU to obtain
                 increased support for training, protocol
                 development and collaboration on studies
Best Research for Best Health
Biomedical Research Centres: single / multiple clinical
   research areas

DH lead               Peter Sneddon
Purpose               to support critical mass of staff and infrastructure
                      on biomedical innovation and translational research
                      with substantial levels of funding
Budget                £100m p.a. determined by scale and nature of
                      research activity**
Implementation        early March Pre-qualifying questionnaire
                      mid April       shortlist and call for full application
                      July – submission, Oct – decision, April 07 funding

STH action            Review pre-qualifying questionnaire with UoS&SHU
                      and decide whether to proceed

**New funding/ recycled levy?
Best Research for Best Health
          Research Centres for NHS Service Quality
                        and Safety
DH lead          Peter Sneddon
Purpose          To create a critical mass of research focused on
                 service delivery and organisation
                 To provide substantial levels of funding to create
                 an environment where innovative services can be
                 readily developed and evaluated
Funding          £2m to fund two centres for 5 years

Implementation   March 06 call for expressions of interest
                 May 06   call for full proposals
                 July 06    deadline for full proposals
                 Oct 06     successful centres selected
                 April 07   funding awarded

STH action       review call for expression of interest together with ScHaRR
Best Research for Best Health
   Governance, Advice, Ethics Systems
DH lead          Marc Taylor
Purpose          to support a vibrant and efficient research
                 environment … through world-class networks for
                 research management and governance, by
                 providing expert support for regulatory approvals
                 through unified and streamlined procedures
Budget           £2m p.a. by end of 08/09
Implementation   Year 1: development and set up
                 Year 2: introduction of national advice and R&D
                         management systems
                 Year 3: integrated national systems
STH action       Engage actively in national initiative via R&D
                 Forum
                 Continue to streamline across North Trent/South
                 Yorkshire
Best Research for Best Health
Funding arrangements
DH lead           Catherine Johns
Purpose           implement transparent, sustainable, activity based
                  system
                  eliminate cross subsidies
                  minimise destabilisation of NHS organisations*
                  use varied funding mechanisms dependent upon
                  individual schemes
Implementation    transitional funding over 3 year period i.e. removal
                  of levy and awarding funding though new schemes
                  resulting in greater or lesser level than current
                  allocation, some to best researchers/centres, some
                  on a population basis

* “R&D is working closely with DH colleagues responsible for
   implementation of Payment by Results to ensure that the impact of
   changes at NHS organisation level is properly considered”
Best Research for Best Health
Transitional funding arrangements
STH R&D response to Best Research
for Best Health

  To summarise,

  DH R&D strategy
   Tremendous opportunities
   Highly competitive


  Challenge
   get in early/recognise snowball effect
   focus initially on our current strengths
   build strengths where there are major
    opportunities
Best Research for Best Health
Threats

 Failure to be proactive will prevent STH becoming a
 premiere civic research Trust with consequent

     Loss of status
     Loss of funding
       - infrastructure
       - research
     Failure to attract staff
     Strained relationship with academic partners
STH Research Strategy
Recommendations

   Minimise loss of levy funding through application for
    infrastructure funding e.g. Faculty membership and
    comprehensive network

   Enhance research profile and funding through
        - strategic application for prestigious, large,
        long term funding e.g. technology platforms,
        programme grants, biomedical research centre,
        topic specific networks – new areas / second
        rounds
        - encouraging researchers to apply for project
        grants
STH Research Strategy

Process
   Disseminate information to researchers and STH
    staff
   Agree immediate and long term strategy and
    priorities with academic partners
   Review and strengthen bid support mechanisms
   Appoint a Director of R&D with expertise, local
    knowledge, time and commitment
Any Questions?
 DH R&D Strategy - background

       Indicative Funding for Health Research in
        the UK and STH

         UK                                 STH

                      Industry                               Industry
                                      £110k
  £1700m
                      Research                               Grant:
                      Charities                   £3826m     Charities & Gvt
£650m      £5000m     Government                             Own Acct
                      Funding
                                   £9055m
                    Total £7350m                           Total £12990m

				
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