1. Dr David Jackson Clinical Lead for Research YCRN Co-director WYCLRN Yorkshire Palliative Medicine Regional Learning Group April 2008 Clinical Research in Yorkshire: Infrastructure & management

2. Yorkshire Cancer Research Network

3. Background The NHS Cancer Plan 2000 –NCRN 2001 YCRN 2002 “Allow conduct of clinical trials and other well designed research, to enhance the quality, speed, co-ordination of clinical research and integration with cancer care” Best Research for Best Health 2006 –UKCRN Comprehensive Local Research Networks The Cancer Reform Strategy 2007

5. Yorkshire Cancer Research Network Population 2.6M Yorkshire Cancer Network –service Acute Trusts –Cancer centre –Cancer Units Unit alliances

6. NCRN Portfolio “Clinical trials & other well designed studies” –Elligibility Funding –NIHR, other government, non-commercial partners »Open competition, peer review »Clear value to the NHS »Strategic direction for research –Industry sponsored –Overseas government –Other high quality studies (e.g. EORTC) Formal adoption process –Cancer Prevention; screening

7. TrustNumber of open studies Airedale15 Bradford19 Calderdale & Huddersfield27 Harrogate20 Leeds115 Mid-Yorkshire24 York20 YCRN Portfolio

8. YCRN Functions National portfolio Approval processes –Local R&D –Ethics Training & education –GCP, communication Recruitment Follow-up

9. Core Team 7.6 WTE Research Team 9 WTE 1.1 WTE 1.9 WTE 0.9 WTE 2.3 WTE 1.6 WTE 2.7 WTE YCRN funded staff Budget –£730K YCRN staff –26.6 WTE Non-YCRN –59.8 WTE

10. YCRN funded staff Non-surgical oncology Haematology Breast surgery Genetics Psycho-oncology Paediatrics Palliative care

11. Recruitment

12. 16.3%13.8%12.2%15.2% –Vacancy control –Patchy portfolio coverage –Slow approval processes –Service support blocks

13. Strategic Plan Strategic development of portfolio Network site-specific groups Portfolio development officers Specialist clinical advisors –Hard-to-recruit areas Streamline regulatory processes Devolved teams across network –Integrated within local teams Developing & maintaining YCRN identity Training & Education Service User Partnership Group Funding Commissioning CLRN – service support costs

14. West Yorkshire Comprehensive Local Research Network

17. 0 5 10 15 20 25 30 Jan/Feb 05 Mar/Apr 05 May/Jun 05 Jul/Aug 05 Sep/Oct 05 Nov/Dec 05 Jan/Feb 06 Participants Recruited MHRN Impact of MHRN Involvement on Study Accrual Comparison of recruitment into Myeloma VII (pre-NCRN) and Myeloma IX (post-NCRN) Impact of MHRN on Study Accrual MHRN involvement in the project commenced in June 05. First recruitment recovery plan 19 September 2005 Recruitment plan updated February 2006 NCRN Accrual to NCRN Portfolio studies across the UK The main aim of research networks: increasing recruitment into research studies West Yorkshire Comprehensive Local Research Network

18. 25 Comprehensive Local Research Networks CLRNs

19. N&EY & NL CLRN WY CLRN West Yorkshire Comprehensive Local Research Network

20. Aim of UKCRN To provide the NHS infrastructure to support clinical research across all areas of disease and clinical need To help streamline the research management function for UKCRN portfolio studies supported by the networks To do this by: Establishing a managed set of clinical research networks Identifying a national portfolio of studies Funding infrastructure (NHS support costs) for portfolio studies Supporting the research management of these studies West Yorkshire Comprehensive Local Research Network

21. Research Funding ARCO 2005 –Attributing revenue costs of externally-funded non- commercial research in the NHS Research costs »Data collection & analysis »Research funding body (NIHR, Charity) NHS support costs »Additional tests, inpatient care »nursing support, research professionals »R&D support funding CLRN Treatment costs »Commissioning arrangements West Yorkshire Comprehensive Local Research Network

22. Comprehensive Local Research Networks NIHR / UKCRN All healthcare – primary, secondary, tertiary, MH –NHS service support costs Infrastructure & running costs Research staff Research active clinicians –Research Management & Governance Streamline across network –CSP / research passports –UKCRN portfolio Support for Topic Clinical Research Networks –Cancer & Stroke Primary Care Research Network West Yorkshire Comprehensive Local Research Network Replaces Culyer funding

23. Health Research Categories TOPIC BloodCancer CardiovascularDementias Congenital DisordersDiabetes EarMedicines for Children EyeMental Health InfectionStroke Inflammatory and ImmunePrimary Care Injuries and Accidents Metabolic and Endocrine Musculoskeletal Neurological Oral and Gastrointestinal Renal and Urogenital Reproductive Health and Childbirth Respiratory Skin West Yorkshire Comprehensive Local Research Network

25. Resources 08/09 Core team£413K –Clinical directors, management team Per capita£2,250K Activity based £1,424K FSF£112K –Operational plan Work in progress! –Sessional payments –RM&G infrastructure –Research infrastructure –Service support costs –“Unblocking blocks” West Yorkshire Comprehensive Local Research Network

26. Summary YCRN –Established & successful Need to maintain & increase recruitment WYCLRN –Rapid implementation & transition Streamlined RM&G Transparent funding streams –Strategic development of local portfolio »Strengths & weaknesses –Unblocking blocks »Local knowledge –Activity based funding