We have submitted evidence to the bill team working on the draft Care and Support Bill, raising issues for MPs and peers to consider as they scrutinise the draft Bill. This Bill includes clauses to establish the Health Research Authority (HRA) and Health Education England (HEE) as non-departmental public bodies (they are already getting up and running at the moment). Both of these bodies are important for health research. The Health Research Authority acts as a regulator of health research, and Health Education England will coordinate the education and training of the NHS workforce, that includes giving them the skills to get engaged with and conduct research themselves.
The Care and Support Bill aims to cover a lot of complex legislation. The government therefore decided to publish it as a draft Bill this year to allow parliamentarians to scrutinise the proposals in detail and make recommendations on how these can be improved. These recommendations will then inform the development of a final version of the Bill, which will be introduced for normal scrutiny in a later session of parliament. The draft Care and Support Bill was published in July.
We are particularly interested in it from a research perspective because it includes clauses to establish the Health Research Authority and Health Education England as non-departmental public bodies, both of which play an important role in embedding research throughout the NHS.
What have we said?
Throughout the passage of the Health and Social Care Act 2012, we joined with charities and other organisations funding and supporting medical research in the UK to emphasise the value of streamlined regulation, and good education & training to embed research throughout the NHS. We have joined together again to comment on the proposals in this draft Bill.
Health Education England
The draft Bill includes clauses to establish HEE as a non-departmental public body and, in doing this, lays out more detail about the duties and responsibilities upon it and how it will operate.
Education and training of the NHS workforce is really important for research. Everyone working in the NHS needs to have the skills and support to be able to get engaged with research and to be able to understand and take up research findings to improve care. We also need defined career paths and flexibility to allow people working in the NHS the option to choose research as a career, and combine research and clinical practice throughout their career.
So we were really pleased to see a duty on HEE to promote research included in this draft Bill. But we were disappointed that this was the relatively weak “to have regard to the need to promote research”. As you might remember during the passage of the Health and Social Care Act 2012, the research duty on the Secretary of State for Health, NHS Commissioning Board and Clinical Commissioning Groups was strengthened from “have regard for the need to…” to simply “promote research” and is now a strong duty across the NHS. We think that a consistent duty is needed on HEE to ensure that the workforce is equipped through education and training with the necessary skills and support to enable all the NHS bodies to deliver on their duty to promote research.
We’ve also raised some points about the importance of fostering a strong partnership between academia and the NHS – which the government is championing with the creation of Academic Health Science Centres and Academic Health Science Networks, which bring the NHS and universities closer together in partnership – and the valuable role education and training can play in building these links.
The Health Research Authority
The Academy of Medical Sciences originally recommended the creation of single health research authority to help streamline the system of regulating health research which all new projects have to negotiate. So we are really pleased to see the creation of the HRA and, as it is already up and running as a special health authority, really pleased to see the progress it is already making.
The draft bill proposes to make the HRA an non-departmental government body.
In doing this it clarifies how the HRA will interact with other bodies, particularly when regulation is devolved so the HRA – which will have authority across the UK – will need to work alongside existing legislation and regulators in devolved nations.
as part of a national system of research governance, promoting a proportionate approach among all those involved in research, including for example NHS providers.
We’d really like more detail on how the HRA will work with those responsible for research governance in the NHS – particularly the National Institute for Health Research (NIHR) which is taking steps to streamline the process of obtaining research permissions from NHS Trusts, delays in which have been identified as a significant barrier to research projects in the UK.
We also emphasised the importance of the HRA earning public confidence if it is going to be a truly effective regulator. To do this, alongside delivering a clear, effective and proportionate regulatory pathway, it must have a recognisable ‘brand’, communicating its work and listening to the views of the public, researchers, academia, industry and charities when deciding how to regulate ethically sensitive areas.
A committee of MPs and Peers will go through the draft Bill in detail, discussing the proposals within it. All the evidence gathered now will inform their discussion and they may invite individuals to come and speak to them as they explore specific areas. At the end they will produce a report, making recommendations for how the draft Bill can be improved. More information should be available here soon.