Clinical academic training in a changing landscape. JP Neilson NIHR Dean for Training [DATE] Imperial 2011

INVENTION EVALUATION ADOPTION Creation new things new ideas new techniques new approaches Assessment new things new ideas new techniques new approaches Uptake new things new ideas new techniques new approaches DIFFUSION Spread new things new ideas new techniques new approaches Basic Research Applied Research NIHR CommissioningPatient Care PCTsMRC NHS Providers The Innovation Pathway

INVENTION EVALUATION ADOPTION DIFFUSION Biomedical Research Centres Biomedical Research Units Clinical Research Facilities Experimental Cancer Research Centres Centres for Leadership in Applied Health Research and Care NIHR Evidence Synthesis National Institute for Health and Clinical Excellence NHS Evidence NIHR Evidence Synthesis Academic Health Science Centres Health Innovation Education Clusters Bridging the Translational Gaps

Primary outcomesRR (95% CI)Number of trials, participants Death or cerebral palsy 0.85 (0.74 to 0.98)*four trials; 4446 infants Death (fetal and later)0.95 (0.80 to 1.12)four trials; 4446 infants Cerebral palsy 0.71 (0.55 to 0.91)*four trials; 4446 infants Any neurological impairment 1.03 (0.87 to 1.21)one trial; 1255 infants Death or substantial gross motor dysfunction 0.84 (0.71 to 1.00)three trials; 4387 infants * significantly in favour of magnesium sulphate MgSO4 vs placebo/no treatment: primary outcomes Doyle 2009 Cochrane Review

Cerebral palsy 53 34, 171 6% Death or CP 4224, % Cerebral palsy 53 34, 171 6% Death or CP 4224, % Outcome NNT 95% CI Baseline Risk Fetal Neuroprotective Intent Trials Number needed to treat to prevent one case Fetal Neuroprotective Intent Trials Number needed to treat to prevent one case

To improve the health and wealth of the nation through research National Institute for Health Research Strategic Aim

Transform research in the NHS Increase the volume of applied health research for the benefit of patients and the public Develop and support the people who conduct and contribute to applied health research National Institute for Health Research Goals

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

Doctors and Dentists NIHR Integrated Academic Training All Professions NIHR Fellowships Nurses, Midwives, Allied Health Professionals Clinical Academic Training NIHR Clinical Lectureship NIHR Clinician Scientist Award Masters in Health Economics NIHR Doctoral Research Fellowship NIHR Post- Doctoral Fellowship NIHR Career Development Fellowship NIHR Senior Research Fellowship NIHR/CNO Masters in Clinical Research NIHR/CNO Clinical Doctoral Research Fellowships Level of Award Other Awards Senior/ Pre-Chair NIHR Research Career Pathways Senior Post-Doc Early Post-Doc Doctoral Pre-Doctoral/ Masters Undergraduate NIHR/CNO/HEFCE Senior Academic Clinical Lecturer In-Practice Fellowships and NIHR Academic Clinical Fellowships NIHR/CNO Clinical Lectureships CSO Health Care Scientist Doctoral Fellowship CSO Health Care Scientist PostDoctoral Fellowship

Liberating the NHS: Developing the Healthcare Workforce A consultation on proposals

‘The Government is committed to the promotion and conduct of research as a core NHS role. Research is vital in providing the new knowledge needed to improve health outcomes and reduce inequalities. Research is even more important when resources are under pressure – it identifies new ways of preventing, diagnosing and treating disease. It is essential if we are to increase the quality and productivity of the NHS, and to support growth in the economy. A thriving life sciences industry is critical to the ability of the NHS to deliver world-class health outcomes. The Department will continue to promote the role of Biomedical Research Centres and Units, Academic Health Science Centres and Collaborations for Leadership in Applied Health Research and Care, to develop research and to unlock synergies between research, education and patient care’. Equity and excellence: liberating the NHS. July 2010