SummaryThe importance of evidence-based care for patients with diabetes is well established, and the evidence required to make decisions about patient care is generated through research and audit. The rigours of the research process and the need to enrol large numbers of patient volunteers in a timely manner has meant that most studies are now conducted at multiple sites. Research infrastructure is costly to implement, but is important for successful clinical research projects. By establishing permanent networks this infrastructure can be maintained and built upon.Research nursing has evolved as a new but very important discipline within the nursing profession in recent years and it has been pivotal for the success of many studies. In this article we examine the potential for clinical research networks to facilitate high quality clinical research and in particular the development of the research nurse role.

Aim:This study aimed to evaluate the impact of local approval times on the schedule of a large multicentre study in the UK. Method: We reviewed the approval times of 178 applications that were made to the UK National Health Services Trusts (across 159 hospitals and 19 primary care trusts). Results: The mean time for approval was 82 days; more than half the submissions (94; 53%) took longer than 60 days for a decision. The reason for taking over 60 days varied but review of the trial documentation revealed that delays occurred in the Hospital R&D Office for 25 (14%) submissions, at the hospital or primary care trust level for 14 (8%) submissions, while the investigator was responsible for 23 (13%) applications taking longer than 60 days. Conclusion: Local submissions are a source of delayed start up in many centres participating in clinical trials; however, reasons for delay are not consistent across the applications and cannot be attributed to one specific part of the local approval process. Int J Pharm Med 2006; 20 (5): 317-320 ORIGINAL RESEARCH ARTICLE

The care of patients with diabetes using insulin in the UK is moving inexorably to primary care. To ensure that the service provided is of the highest quality, and meets the needs of patients and the requirements of the National Service Framework, it is important that primary carers are provided with the support they need. While some general practitioners and practice nurses have developed specialist skills, little is known about the needs of general practice to manage the delivery of this service. There is an abundance of available support including training, national and local guidelines and information. How much of this is known to general practice and is designed to accommodate the increasingly busy lives of health care providers in general practice is not clear. This paper presents the results from a survey of general practices in the New Forest Primary Care Trust and identifies needs that GPs and nurses have stated as important for the management of people with diabetes using insulin. Although awareness of the requirements for high quality care is high among GPs and practice nurses, there is a lack of confidence in managing insulin. Both GPs and nurses identified training, simplified guidelines and improved information on insulin products as their priority needs for supporting the service for patients on insulin. Copyright © 2006 John Wiley & Sons, Ltd.