The Peninsula Medical School welcomes Sir David Cooksey's excellent report. The School is particularly pleased that the need for a central coherent strategy has been identified to optimise the contribution of healthcare research to UK plc and national health gain. The detail of that strategy is likely to inform the precise governance arrangements and modus operandi of OSCHR.

OSCHR

  The School strongly supports the appointment of Professor John Bell as Chair of OSCHR. Too great a reliance on setting research priorities via a "top-down" approach should be avoided however 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 the School 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, involving University partners.

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. The Peninsula Medical School is one such Regional Centre, acting as a hub for the entirety of the new NHS Local Research Networks and having secured experimental medicine funding for population genetic studies. Internationally competitive research and research of key relevance to high quality clinical care and Regional Economies must also be supported in regional centres, such as ours, if the full benefits of the UK's health research endeavours are to be realised.

  Real opportunities exist 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.

HEALTHCARE COMMISSION

  It is recommended that the Healthcare Commission's targets should reflect research activity in quality adjusted terms. The School suggests 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

  The School welcomes the suggestion that support for the training of clinical academics be ring fenced.

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

  The School 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.

  As a "new" medical school, we are particularly pleased that the requirement to further develop our infrastructure has been recognised but would welcome clarification of how the £50 million is to be disbursed.

UNIVERSITY/NHS COLLABORATION

  The School is concerned that there is no mention of the Department for Education and Skills in the Cooksey Review. The School's clinical academic staff relate to non clinical researchers in both the Universities of Exeter and Plymouth. Our 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.

  We are pleased 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

  The Medical School would like to request clarification on the definition of translational medicine and, indeed, why there is a need for a new Board in addition to OSCHR.

January 2007