Building the NIHR NIHR: 10 years of delivering health and care research for the nation QEII Centre, London Wednesday 18 May 2016 Professor Dame Sally C. Davies FRS FMedSci Chief Medical Officer Department of Health

Improve health outcomes through advances in research Improve quality of care by NHS participation in the research process Drive economic growth through investment by life science industries Strengthen international competitive position in science Increase Health and Wealth Why is the Government committed to research in the NHS?

Recognition of barriers & Consultation 2005 New Government Strategy 2006 Getting it right and sign up

NHS R&D funding was allocated on a historical basis A mixed research culture in the NHS Insufficient translational research Dramatic fall in numbers of clinical academics Difficulty in developing sustainable capacity Problems with career paths for all professions in research Low applied evidence base Perception that applied health research was second class Insufficient patient engagement in research Inadequate systems to promote and support research Patients NHS Universities What were the challenges 10 years ago? Insufficient industry engagement

Where we came from Funding for research National Research Programmes £150m Support for Science £400m Priorities and Needs £100m Hospitals

What we did: Patients and public at the centre Patients & Public Universities NHS Trusts

Infrastructure Clinical Research Facilities, Centres & Units Clinical Research Networks Research Research Projects & Programmes Research Management Systems Research Information Systems Systems Patients & Public Universities Investigators & Senior Investigators Associates Faculty Trainees Research Schools NHS Trusts NIHR: A Health Research System

Impact: Clinical trials funded by the NIHR HTA programme

Impact: NIHR CRASH-2 Impact: British Armed Forces Txa now used in 75% of UK trauma patients NICE evidence summary: Unlicensed / off-label medicine: “Death due to bleeding was reduced if tranexamic acid was administered up to 3 hours from injury” Economic: Incremental cost of $64 international dollars (£43) per life saved Intracranial bleeding study: the effect of tranexamic acid in traumatic brain injury

Impact: Bronchiolitis of Infancy Discharge Study (BIDS) Treating infants with bronchiolitis using a lower level of supplemented oxygen saturation is just as safe and effective as a higher oxygen level, as well as being cheaper. Judges from the BMJ Awards said: “With this study, defining oxygen saturation targets with bronchiolitis can finally move from opinion based evidence to medicine. The study is elegantly designed and brings robust evidence to treatments decisions concerning one of the most common causes of hospital admissions in infants”. The award recognises original UK research published in the past year with the greatest potential to significantly improve health and healthcare 5 May 2016

Impact: NIHR Research Professors

Impact: Leveraged funding from the NIHR BRCs / BRUs

Impact: CRN recruitment

Impact: HRA timelines for ethics Prior to 2004: REC timelines were highly variable - some took more than a year From 2004: Single REC approval was introduced with a 60 day target to receive a final decision Now: 95% of applications to full REC receive final decision within 40 calendar days >90% of applications for proportionate REC reviews (low risk studies) receive a decision in 14 days

Impact: Delivering studies in the NHS

Impact: Clinical Practice Research Datalink A longitudinal database of anonymised routine primary care records Includes 21 million patient lives collected over 25 years 600 currently contributing GP practices > 5 million patients registered at contributing GP practices (1 in every 12 people in the UK) Services to support observational and interventional research using real world data 1.8 billion consultations Drug exposure Diagnoses and symptoms Referrals Laboratory tests Vaccination history Demographic data

Impact: Clinical Practice Research Datalink CPRD holds data on 21 million patient lives 2014/15: 223 studies were approved 2015/16: 229 studies were approved

Global performance of the UK research base Source: Our plan for growth: Science and Innovation. Department of Business, Innovation and Skills. December 2014.

Clinical academic careers Source: Medical Schools Council survey of staffing levels of medical Clinical Academics in UK medical schools (31 July 2013)

Progress: funding for NIHR programmes

Impact: Money

The people who made it happen

RAND Europe report – published today The NIHR is: Delivering benefits to patients Improving the health of the public nationally and internationally Making the nation’s healthcare system more effective, cost-effective and safer Putting patients and the public at the heart of research Supporting a research infrastructure in the NHS

Building the NIHR NIHR: 10 years of delivering health and care research for the nation QEII Centre, London Wednesday 18 May 2016 Professor Dame Sally C. Davies FRS FMedSci Chief Medical Officer Department of Health