Below we examine the UK governments Department for Business, Innovation & Skills consultation regarding the nurse review of research councils from a public health perspective. We recommend that UK research funding focus more on spending money in ways that aid the UK population.
Strategic decision making
The two major aims of the UK research funding are to ensure that the UK continues to support world leading science and to invest public money in the best possible way. These two aims may lead to different priorities for research funding and it is important to strike a balance between these two objectives. In the past the priority has been to support world class science and whilst this priority is important and should be maintained there has been less emphasis on the need to invest public money in a way that is most beneficial to the UK and its population. We argue that this imbalance should be addressed in the future allocation of research funding. Specifically translational research to support the translation of research into world class health practice for the UK has been an ongoing neglected area for research funding. This gap in translation was identified in the Cooksey Report A review of UK health research funding published in December 2006. The gaps in translation persist and urgently require addressing through allocation of research funding. The Nurse review of research councils provides an opportunity to redress this balance and to prioritise translational research.
The Cooksey Review found that –
‘the UK is at risk of failing to reap the full economic, health and social benefits that the UK’s public investment in health research should generate. There is no overarching UK health research strategy to ensure UK health priorities are considered through all types of research and there are two key gaps in the translation of health research: - translating ideas from basic and clinical research into the development of new products and approaches to treatment of disease and illness; and - implementing those new products and approaches into clinical practice.’
In addition The Cooksey Review identified ‘cultural, institutional and financial barriers to translating research into practice in the publicly funded research arena.’
The review of the Research Councils provides an opportunity to ensure that funding is allocated specifically for translational research. This funding should be addressed to both of the identified gaps in translation (i) from research to products and approaches and (ii) implementation of those products and approaches into clinical practice.
In order to address these concerns there should be a greater account taken of national interests and in particular the interests of the NHS in allocating research funding. This should include funding specifically to evaluate how scientific developments and biomedical innovation can be incorporated into healthcare based on evidence of clinical effectiveness of those innovations. In addition to identifying how the developments can be most effectively incorporated into health care practice, research funding should be allocated to support the translation effort.
In doing so it must be recognised that, in the biomedical / health sector, the current emphasis on research excellence (largely based on evidence of publications in high impact journals) tends to favour basic biomedical research as against the more translational research, which needs to engage in a multi-disciplinary and less scientifically focused way with healthcare practice.
The development, adoption and uptake of biomedical resources is the area in which the PHG Foundation operates. We have recently published a Manifesto that highlights urgent priorities for policy makers. One of these priorities is for research funding to enSable the timely and robust evaluation of innovations in clinical practice by health systems, to facilitate these being implemented widely across health services.
Currently the balance does not sufficiently support strategically-focused funding of research, as opposed to investigator-led research. Mechanisms will need to be developed to strengthen and support the Medical Research Council and other Research Councils in identifying priorities for translational research: these should include seeking advice from a representative group including academic researchers and clinicians.
Collaborations and partnerships
The PHG Foundation is an independent non-governmental health policy think tank that comprises a multidisciplinary group of public health physicians, scientists, lawyers, health economists and social scientists. It characteristically engages in collaborative work with academics and other relevant stakeholders, often to deliver a specific policy goal, within a broader objective that incorporates basic science elements. Examples include the Collaborative Oncological Gene-environment Study (COGS) (www.cogseu.org). In this project, the PHG Foundation worked with other stakeholders to both deliver academic outputs, but also to hold a series of multidisciplinary workshops and develop recommendations for implementation. The rationale of this organisation is to add value to the research that is undertaken - with the aim of increasing its real world impact. For this reason we fundamentally oppose the view that the Research Councils should only be directed almost exclusively to the university sector.
We would like to see the Research Councils facilitating this type of collaboration, where the nature of the collaboration can actively promote translational activity in the form of promoting relevant professional engagement and advocacy to enhance translation. For this reason we welcome initiatives that invoke cross cutting collaboration between the Research Councils (e.g. the ESRC and MRC) and also between the MRC and the NHS. The funding that is being developed to support the 100,000 Genomes Project is a good example of where Research Councils are working together to support a translational activity, that holds great promise to improve health within the UK.