Systematic Reviews for the NHS Professor Tom Walley Director of Systematic Reviews Infrastructure

“develop and support the people who conduct and contribute to applied health research “increase the volume of applied health research for the benefit of patients and the public” Delivered through the creation of the: National Institute for Health Research (NIHR) Best Research for Best Health

Infrastructure Clinical Research Facilities & Centres Clinical Research Networks Research Research Projects & Programmes Research Governance Systems Research Information Systems Systems Patients & Public Universities Investigators & Senior Investigators Associates Faculty Trainees Research Units & Schools NHS Bodies

Basic Research National Institute for Health Research This pathway covers the full range of interventions - pharmaceuticals, biologicals, biotechnologies, procedures, therapies and practices - for the full range of health and health care delivery - prevention, detection, diagnosis, prognosis, treatment, care. Research for Patient Benefit Programme Grants for Applied Research Health Technology Assessment Invention for Innovation Healthcare Commissioning NHS Providers Patient Care National Institute for Health and Care Excellence Guidance on Health & Healthcare Health Service and & Delivery Research Centre for Reviews & Dissemination, Cochrane, TARs NHS Evidence Access to Evidence Development Pathway Funding Medical Research Council Biomedical Research Units Biomedical Research Centres Public Health Research NHS Commissioning Board/ GP Commissioning Groups Duty of Innovation Efficacy & Mechanism Evaluation INVENTION EVALUATION ADOPTION DIFFUSION

INVENTION EVALUATION ADOPTION Creation Systematic Reviews AssessmentUptake DIFFUSION total hip replacement invented evidence that hip replacement is clinically and cost effective Effectiveness of hip prostheses in primary total hip replacement: a critical review of evidence and an economic model NICE guidance on hip replacement Basic Research Applied Research Commissioning Spread 97,000 hip replacements performed in England in 2007/08 Patient Care

Healthcare regulators and quality bodies Academic researchers including trainees Healthcare delivery professionals and their associations Research funders (non- NIHR) NHS decision- makers / wider community Patients and the pubic Life- sciences industry and trade associations Government own workstream via own channels Dissemination

Delivering through CCs Snapshot: Supply key stats Opinion formers: Identify key contacts Provide information around topic Agree standard messages Collates, designs, posts to Portal; Alerts internal audience of availability Manages list to avoid duplication Disseminate to own section of contact list Produces regular focus and publicizes Provide information around topic Collates and produces sheet/slides; posts to Portal Alerts internal audience of availability LEAD CC Develop patient pull activities Coordinate collective contributions Make own areas aware of campaigns

Low priority questions addressed Important outcomes not assessed Clinicians and patients not involved in setting research agendas Questions relevant to users of research? Over 50% studies designed without reference to systematic reviews of existing evidence Over 50% of studies fail to take adequate steps to reduce biases, e.g. unconcealed treatment allocation Appropriate research design, conduct and analysis? Over 50% of studies never published in full Biased under- reporting of studies with disappointing results Accessible, full research reports? Over 30% of trial interventions not described enough Over 50% planned study outcomes not reported Most new research not interpreted in context of systematic assessment of relevant evidence Unbiased and usable reports? Opportunities to add value 5 STAGES: FROM QUESTION TO REPORT Hyper-regulation of research Inefficient delivery of research Poor re-use of data Efficient research regulation and delivery? Low priority questions addressed Important outcomes not assessed Clinicians and patients not involved in setting research agendas Over 50% studies designed without reference to systematic reviews of existing evidence Over 50% of studies fail to take adequate steps to reduce biases, e.g. unconcealed treatment allocation Over 50% of studies never published in full Biased under- reporting of studies with disappointing results Over 30% of trial interventions not described enough Over 50% planned study outcomes not reported Most new research not interpreted in context of systematic assessment of relevant evidence Opportunities to add value Hyper-regulation of research Inefficient delivery of research Poor re-use of data Evidence Synthesis ~£10%, 60 Clinical Trials ~£90% 13

The NIHR’s Centre for Dissemination (NCD) will provide information for: Patients and the public Clinicians NHS Managers National policy makers

The NCD will provide information by: keeping track of systematic reviews and the outputs generated to identify those of relevance to the NHS disseminating the results of NIHR research in a manner which sets them in the context of existing evidence and of the NHS disseminating research outputs from other funders where these are likely to impact on NHS practice. being aware of the needs of the different users of research evidence.

The NCD will provide information by (contd): using multi-media, workshops, etc to disseminate information and produce teaching or other support materials. using an approach to dissemination that acknowledges other elements of the NIHR and how NIHR fits within the health care system. acting in an advisory role to the Department of Health by assessing the outputs of research managed by the NIHR’s three commissioning centres for their policy, clinical and/or social care relevance and sensitivity.

UK Cochrane Activity UK activity (% of global) Review groups48% Authors31% Recent* new reviews45% Recent* updates51% * November 2012 – February 2013: % with authors from UK

Total support: nearly £40 million NIHR funding for Cochrane UK – last decade

The UK Cochrane Centre (UKCC) Provides a focal point in the UK in relation to The Cochrane Collaboration Improves the accessibility, understanding, and usefulness of the findings of Cochrane reviews for the NHS. Oversees the UKCC’s knowledge broker role. Organises meetings of UK Contributors to The Cochrane Collaboration. Provides UK-based authors of Cochrane reviews with a range of training opportunities in preparing and maintaining Cochrane reviews.

The UK Cochrane Centre (UKCC) Continued Supports editorial teams of Cochrane Review Groups (CRGs) in the production of high quality reviews. Supports the preparation and maintenance of Cochrane reviews of diagnostic test accuracy. Provides training in the conduct of systematic reviews to people within the NHS who are engaged in the preparation of non-Cochrane systematic reviews (e.g. NICE). Supports consumer involvement in the work of The Cochrane Collaboration.

Cochrane – only one player in the market “We will build greater recognition of Cochrane’s role as an essential link between primary research and health decision- making”

17 Procurement Centre of Expertise CRD (NCD) and UKCC Procurements 17 th October 2013

18 Enter the presentation's title using the menu option View > Header and Footer Procurement - Our Role Provide you with support and guidance through the process Ensure that the process is transparent Opportunity to engage with potential suppliers Listen to your ideas and proposals Develop an offer in conjunction with suppliers

19 Process Central Government focus is to ensure procurement process as ‘lean’ as possible – pre market engagement Prior Information Notice (PIN) – both issued Supplier Information Event - Today Supplier opportunity to discuss and outline potential proposals Develop ITT, Return offer, evaluate and award Enter the presentation's title using the menu option View > Header and Footer

20 Objectives Contracts in place to start by April 2015 Ensure that there is a planned transition and implementation Ensure the contracts provide the best value efficiency and quality of the service Enter the presentation's title using the menu option View > Header and Footer

21 Timeline Indicative – Timescales are subject to change at Authorities discretion. Achieved already PIN x 2, Supplier event ITT & OJEU (x 2) published in mid November 2013 Return dates December 2013 Evaluation within December and January 2013 Award contracts March/April 2014 Enter the presentation's title using the menu option View > Header and Footer

22 Commercial considerations Information requirement for bidders Evaluation / response required - proportionate Consideration of consortiums provide opportunities for SMEs Develop appropriate cost models capability surrounding specialist skills Innovative solutions Service provision v quality v costs Enter the presentation's title using the menu option View > Header and Footer

23 Practical information The Procurement will be run on the Departments ‘BMS’ e- tendering portal, suppliers are encouraged to register their Organisation and contact details if not already registered. Details will be distributed to supplier contacts. Registering on BMS - of-health/about/procurement of-health/about/procurement Invitation to Tender documents will be published on Transparency website ‘Contracts Finder’ and a Contract notice published. Interested suppliers will be advised. Enter the presentation's title using the menu option View > Header and Footer

24 BMS System If you have a question about using BMS, or telephone Thank you Enter the presentation's title using the menu option View > Header and Footer