When budgets are tight, involvement in clinical research can improve hospitals’ finances and patient health, writes Jonathan Sheffield

The NHS has been charged with making £20bn of efficiency savings within the term of the coalition government, which has led some large teaching hospitals to say tight budgets could have an impact on hospitals’ ability to conduct clinical research studies in the future.

‘When every penny counts, trusts are taking a more active interest in how they can develop all income streams’

From the perspective of these hospitals, budgetary cuts are placing clinical services under pressure. The argument seems to be that current clinical tariffs do not reflect the expenses incurred by some trusts, which is particularly relevant to teaching hospitals engaged in complex procedures.

To cover costs, teaching hospitals are having to supplement their clinical funding with health and education funding. 

But it does not follow that this environment places the conduct of clinical research in jeopardy. In fact, the need for increased efficiency and budget savings should strengthen the position of clinical research as core business in the NHS.

Through the National Institute for Health Research’s Clinical Research Network, the Department of Health is putting more than £300m a year into funding consultant time, specialist research nurses, data support staff and the use of NHS facilities (such as x-ray machines and scanners) for research purposes. 

That support is earmarked specifically for research use, to make sure research activity enhances treatment options for patients without adversely affecting NHS resources. This is an extremely important distinction because it means trusts can continue to commit to offering patients research opportunities, even in stringent economic times.

Test tubes

Patient interest

There is no doubt patients want to know about the research opportunities available to them. In May 2012, a OnePoll survey on behalf of the NIHR Clinical Research Network found 82 per cent of patients felt it was important for the NHS to offer opportunities to take part in healthcare research. 

In 2011-12, 99 per cent of trusts were involved in delivering clinical research studies on the network’s portfolio, and 600,000 patients were taking part.

‘Research enhances treatment options and helps to deliver quality care without detracting from the bottom line’

NHS organisations of all types and sizes are increasing the reach of research and giving more patients the chance to take part. Care, mental health and ambulance trusts, which are traditionally areas of lower research activity, were among the top 10 trusts to achieve the largest percentage increase in the amount of research studies they undertook in 2011-12.

For most trusts, income from clinical research activity is a relatively small part of the overall budget. But in a climate where every penny counts, trusts are taking a more active interest in how they can develop all income streams, including funds from conducting research.

It would be wrong to say trusts are engaging more with the research agenda because it is income-generating − patient care is absolutely the driver behind their commitment to clinical research, not income generation. But it is the case that we are seeing more interest and a change of attitude towards life sciences industry studies in particular. 

Improving treatment

This change in attitude is being supported by a number of key initiatives. The establishment of academic health science networks will encourage collaboration between the life sciences industry and the NHS, helping to accelerate the adoption and diffusion of world leading research in England.

‘Clinical research is well placed to make a positive contribution to the health and wealth of the nation’

At the same time, the life sciences community has been closely involved in developing the Clinical Research Network’s new commercial feasibility service. A pilot of the new service was launched in November 2012 with the aim of helping the industry carry out studies more reliably within the NHS. 

We need to make the most of these opportunities because research enhances treatment options and helps to deliver higher quality of care without detracting from the bottom line. That is an attractive option when funds are tight.

To help NHS trusts understand opportunities presented by research, the network is working with the Health Finance Managers Association to raise awareness of research funding mechanisms. A training package is planned for launch this year.

Clinical research is well placed to make a positive contribution to the health and wealth of the nation. It is a valuable tool for driving innovation and efficiency throughout the NHS that, at a time of squeezed budgets, needs to be embraced. Patient care remains the focus of everyone in the NHS. Sidelining the most effective way of improving treatment and services is not a viable option.

Jonathan Sheffield is chief executive of the National Institute for Health Research Clinical Research Network