A really exciting document was published by the Department of Health this week – the draft mandate for the NHS commissioning board. This sets out the objective for the NHS to achieve.
The Health and Social Care Act 2012 put a duty on the NHS Commissioning Board to have regard to the need to promote research and the use of research evidence. This is our first clue as to what this duty might look like in practice – objective 17 of the draft mandate is all about research.
The government is consulting on the proposed objectives in this mandate until 26 September so we’ll be taking a look at the detail and responding.
What does the draft mandate say about research?
Page 26 of the draft mandate is about Promoting growth, research and innovation. This pulls out the economic value of the NHS – both in making us all healthier, and in attracting life sciences industry to invest in research in the UK. It recognises the role of the board in supporting this and ensuring the NHS is good at health research by:
- Working with research funders
- Improving adoption and spread of new technologies
- supporting patient participation in research
It references the government’s strategy for UK life sciences that was published back in December alongside David Nicholson’s recommendations to improve innovation in the NHS. It also touches on the international potential of the NHS – our huge public health system offers globally unique research opportunities – and foresees a role for the NHS Commissioning Board in developing this international engagement.
Objective 17 of the mandate is focused on research and innovation.
Objective 17: Ensure that the new commissioning system promotes and supports participation by NHS organisations and NHS patients in research funded by both commercial and non-commercial organisations, to improve patient outcomes and to contribute to economic growth through the life science industries:
– Ensure payment of treatment costs for NHS patients who are taking part in research funded by Government and Research Charity partner organisations; and
– Promote access to clinically appropriate drugs and technologies
recommended by NICE, in line with the NHS Constitution
It’s good to see the commitment to engage with non-commercial organisations here and re-statement of the commitment made back in June 2011 to ensure payment of treatment costs for patients who are taking part in research (sometimes known as Excess Treatment Costs). Lack of clarity over payment of these costs had previously led to delays and barriers to research projects getting off the ground.
Annex B of the the draft mandate explains how the government will measure their success in fulfilling objective 17 (page 11/12)
Key measures for assessing progress
• Evidence that the treatment costs for patients who are taking part in research in the NHS are paid by the Board when it commissions services.
• Evidence that the Board has used its systems and processes to ensure that treatment costs for patients who are taking part in research in the NHS are paid by CCGs when they commission services.
• Evidence that patient recruitment to research in the NHS has increased.
• Evidence that performance of the NHS in initiating and delivering clinical research to time and target has increased.
• Develop and publish an innovation scorecard to track compliance with NICE Technology Appraisals.
And Annex D (page 34/35) gives more detail on the options and support available to patients to find out about opportunities to be involved in research and deciding whether or not they want to take part.
Interesting to see here that from April 2013, Clinical Commissioning Groups will be required to promote patients’ recruitment to and participation in research.
8. Choosing to participate in research
a. What choices are available?
You can expect to be offered the opportunity to participate in ethically approved research which is relevant to you, and will be free to choose whether you wish to do so. This is not a legal right.
b. When is choice not available?
If there is currently no research being conducted which is relevant to you, or if you do not meet the criteria for inclusion in a particular research study.
c. Who is responsible for giving me choice?
You should discuss with the clinical team (e.g. the hospital doctor, GP, nurse etc) that is providing your care.
d. Where can I find information to support my choice?
Information to help you decide about participating in research:
The UK Clinical Trials Gateway provides information about clinical trials that are currently taking place:
You can get mobile phone access to the UK Clinical Trials Gateway via the iTunes and Android stores. Search for “clinical trials” to find the applications for iphone, ipad, android phone and tablet computers
e. What organisations can I approach for support in making decisions?
The organisations whose websites are listed in section (d) above can help support you in deciding about participating in research.
From April 2013, clinical commissioning groups will be required to promote patients’ recruitment to and participation in research.
f. How do I complain if the choices outlined in section (a) are not available?
You should raise the matter (in writing or by speaking to them) with your practitioner, e.g. your nurse or doctor, or with your Primary Care Trust (or clinical commissioning group or the NHS Commissioning Board, from April 2013) but not to both. Your complaint should be resolved within 12 months. For assistance with your complaint, contact the Patient Advice and Liaison Service available in all hospitals or the Independent Complaints Advocacy Service.
If your Primary Care Trust is unable to resolve the complaint to your satisfaction, you have the right to refer the complaint to the independent Health Service Ombudsman. www.ombudsman.org.uk
The consultation on the mandate is open until 26 September. Directly relating to the research and innovation section it asks:
11. Does the draft mandate properly reflect the role of the NHS in supporting broader social and economic objectives?
We will be taking a detailed look at the proposed mandate and objectives and feeding back.