AUKUH welcomes the Cooksey Report into UK Health Research funding. It is essential that the research culture within the NHS be strengthened. The critical interrelationship between specialist service provision, research and education cannot be overemphasised: without high-quality health research and education, quality of care will be at risk.

  The following detailed comments focus on some of the areas of key interest to AUKUH.

VOLUME OF FUNDING

  The Chancellor has promised £1 billion annually research yet the combined budgets for NHS R&D and the MRC amount to more than £1.3 billion. It would be helpful if the Select Committee could probe the continuing commitment to a £1.3 billion baseline.

STRONGER HEALTH SERVICE RESEARCH CULTURE

  This is essential. Clinical research is on a terminal decline and AUKUH very much hopes that the new strategies will reverse this. It is absolutely vital that a research culture is present in all major Acute Trusts. Care must be taken not to undermine the excellent and internationally competitive research being conducted outside the five "centres of excellence". Equally valuable are the contributions of smaller scale or blue-skies research projects.

"FAST TRACK" APPROVAL PROCESS

  Presently, there is no way that any clinical research can be fast tracked. The administrative burden on the investigator and the Trust is enormous when performing this work (eg COREC application, MHRA inspections etc). As yet, there is no sign that these burdens will be reduced or simplified; this must happen before any fast track system can be developed.

INCENTIVES FOR NHS ORGANISATIONS AND EMPLOYEES TO CARRY OUT RESEARCH

  This is an admirable aim; nevertheless measuring the quality of research output is a very difficult task and open to a numbers of problems. Simple measures such as journal impact factors or paper citation numbers often fail to measure the clinical impact of research. A considerable amount of careful work is required here to deliver this. In the past, decisions have been made using a simple, inappropriate option when assessing research quality with respect to effects on clinical practice.

  AUKUH agrees that incentives are very important however many potential researchers do not need incentives—they are already keen. They simply need to be given the opportunity to carry out their work eg funding, less administrative burden etc. It is vital that this new arrangement does not add to this burden.

MPET USED TO SUPPORT TRAINING OF CLINICAL ACADEMIC STAFF TO BE RING-FENCED AND TRANSFERRED TO DH R&D BUDGET

  AUKUH welcomes the move to protect that part of MPET funding used to support training of clinical academic staff. However transferral to the DH R&D budget may not fully protect the funding—if the R&D budget is stretched it may be that its training budget will be the first to suffer. It is of equal importance that the funding for the clinical academics associated with Medical Schools is ring-fenced; otherwise Trusts will not be able to retain and recruit top quality researchers and research-trainers.

NHS AND UNIVERSITY COLLABORATION

  AUKUH recognises that universities have a vital contribution to make to the UK's health research agenda. The Association works closely with the Council of Heads of Medical Schools (CHMS) on issues of shared interest.

  AUKUH supports the development of a national model framework to improve university-NHS collaboration. However, the UKCRC as currently configured is not best placed to develop a model framework to improve university/NHS collaboration. The UKCRC has consistently turned down requests from AUKUH and CHMS 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.

  The removal of existing barriers to partnership between the NHS and universities is essential and AUKUH welcomes the development of a solution to the issue of VAT and the use of university research buildings. The AUKUH Finance Directors group would welcome the opportunity to contribute to a workable solution to this problem.

AUTONOMY

  Autonomy is a vital concept in scientific research which needs to be free from political interference. The current ban on stem cell research in the USA is a clear example of the adverse effects of such interference. In addition one must question the practicality of requiring OSCHR to report to two masters—both the DH and DTI—how will competing priorities be resolved in practice?

January 2007