Memorandum 5
Submission from the Council of Heads of
Medical Schools
CHMS congratulates Sir David Cooksey on the
excellence of his report and on his perspicacity in identifying
as the key issue the lack of a central coherent strategy to optimise
the contribution of healthcare research to UK plc. UK Medical
Schools look forward to working with OSCHR, the MRC and NIHR to
develop an overarching UK health research strategy.
CHMS represents the interests and ambitions
of UK Medical Schools as they relate to the generation of national
health, wealth and knowledge creation through bio-medical research
and the profession of medicine. CHMS seeks to exploit for the
benefit of all, the unique position the organisation occupies,
embracing undergraduate medical education, the entirety of health
related research and a critical interface with the health service.
The CHMS Chair, Professor Sir John Tooke would
be pleased to give oral evidence to the Select Committee to explain
in detail how Medical Schools might optimise their contribution
to the successful implementation of the Cooksey Report's laudable
objectives.
CHMS seeks here to comment on a few of the key
recommendations:
OSCHR
We support strongly the appointment of Professor
John Bell as Chair of OSCHR. Medical Schools will be keen to assist
him in developing and setting the strategy. They are ideally placed
to identify tractable areas of research and contribute to the
translational agenda. Too great a reliance on setting research
priorities via a top-down' approach should be avoided and it must
be recognised that some of the most significant medical advances
have emerged from research on low incidence conditions which nonetheless
involve mechanisms with far reaching implications. The work of
OSCHR must complement "bottom up" approaches as pursued
by many clinical researchers.
A preponderance of targets has become an intractable
part of NHS culture and CHMS is keen that this is not replicated
within the methods of working of OSCHR. The means by which OSCHR
will set objectives and assess outcomes should be clarified. A
top heavy administrative framework could potentially stifle research
initiatives most particularly blue skies research.
BIOMEDICAL RESEARCH
CENTRES
The creation of a small number of major, truly
internationally excellent biomedical research centres is crucial
if the UK is to be globally competitive and benefit fully from
the investment in Research and Development. Increasingly sophisticated
characterisation of populations including genetic studies, which
the NHS is well positioned to facilitate, will be required to
take advantage of the knowledge of the human genome, inter
alia. Such studies will require the development and sustenance
of national research networks supported by strong regional centres,
which will in turn accelerate the productivity of the Biomedical
Research Centres. Internationally competitive research and research
of key relevance to high quality clinical care and Regional Economies
must also be supported in regional centres if the full benefits
of the UK's health research endeavours are to be realised.
PARTNERSHIPS
In translating its own mission into practical
outcomes, CHMS has already developed close links with AUKUH, AMS,
ABPI, AMRC etc and welcomes the recognition of the importance
of these relationships.
Real opportunities are available to explore
links between medical schools, the NHS and industry, collaborations
vital to increasing the competitiveness of the UK in health research.
More needs to be done to incentivise research in the NHS. Industry
needs to make industrial careers and short term industrial experience
more appealing to academics and it is important that academe better
recognises the value of engaging with pharma. The "Forging
Partnerships" event held by CHMS in collaboration with ABPI
and the Academy of Medical Sciences in December 2006 aimed to
begin to strengthen these links, establishing a dialogue between
universities, the health service and industrial partners which
must continue.
HEALTHCARE COMMISSION
It is recommended that the Healthcare Commission's
targets should reflect research activity in quality adjusted terms.
We suggest citations, impact factors and the perceived quality
of the research funders could be taken into account here, although
it must be borne in mind that such simple factors often fail to
measure the clinical impact of research.
RING-FENCED
FUNDING
We welcome the suggestion that support for the
training of clinical academics be ring fenced. The annual CHMS
Survey of Clinical Academic Staffing numbers is recognised as
the gold standard in terms of the quality of information therein
and is used throughout the sector. Last year saw the number of
clinical academics in the UK fall below 3,000 for the first time
since 2000 when the survey was initiated. We are pleased that
the need to encourage the brightest young doctors into a clinical
academic career has been recognised.
THE ROLES
OF THE
NIHR AND MRC
Changes to NHS research funding under "Best
Research for Best Health" whilst promising, are as yet untested
in practice whilst the MRC has a proven track-record of making
competitively awarded, rigorously peer-reviewed research allocations.
It is critically important that the integrity of the MRC system
of rigorous peer-review is not compromised under the proposed
framework and that the NHS R&D system continues to embrace
such existing best-practice.
It is essential that the MRC, as well as the
NIHR, and crucially the HTA, continue to fund large phase three
clinical trials, particularly those complex interventions in a
community-based setting.
CAPACITY DEVELOPMENT
Adequate support for trials units is vital in
order to allow capacity to conduct trials and well-designed studies.
The chronic shortage of non-medical researchers, predominantly
non-clinical methodologists such as health economists and statisticians,
engaged in this area must be addressed.
RAE
CHMS would welcome clarification from the NHS
R&D Directorate as to whether funding awarded from the NIHR
to Trusts should be allowed to "count" in the RAE returns
of the Trusts' partner universities. It is anticipated that university
employed clinical academic staff, those holding an honorary NHS
contract, will be those applying for research funding through
the NIHR and pursuing research on this basis.
The Medical Schools are particularly pleased
that the requirement further to develop their infrastructure has
been recognised but would welcome clarification of how the £50
million is to be disbursed.
UNIVERSITY/NHS COLLABORATION
CHMS is concerned that there is no mention of
the Department for Education and Skills in the Cooksey Review.
Universities have a vital contribution to make to the UK's research
agenda and as such representation from the DfES as well as DH
and DTI should be sought in the coordination of the UK's health
research strategy.
CHMS would suggest that UKCRC as currently configured
is not best placed to develop a model framework to improve university/NHS
collaboration. UKCRC has consistently turned down requests from
CHMS and AUKUH that Medical Schools and university hospitals are
central to the delivery of the research agenda and must have a
place on the UKCRC Board. If this policy is not reversed, CHMS
and AUKUH should be charged with developing the necessary framework.
CHMS is delighted that the team recognised the
issue around VAT and the use by others of university research
buildings. We suggest that the British University Finance Directors
be commissioned to develop a workable solution to the problem,
in collaboration with the Association of UK University Hospitals'
Finance Directors group.
TRANSITIONAL MEDICINE
FUNDING BOARD
CHMS would like to request clarification on
the definition of translational medicine and, indeed, why there
is a need for a new Board. Will its scope, for example, also include
research likely to benefit public health, as distinct from clinical
medicine? If so, secure public health representation on the board
should be sought. If this is not the case, there should be a clear
focus for the coordination of public health research, particularly
in light of the current low investment from the DH in public health
research and development.
FORUM FOR
COLLABORATION FOR
HEALTH RESEARCH
IN INTERNATIONAL
DEVELOPMENT
CHMS would welcome clarification on the structure
of this forum. If research representation on this body is solely
from members of the NIHR, CHMS is concerned that many experts
with discipline specific knowledge but lacking an honorary NHS
contract will be excluded from participating.
January 2007
| 
