Extending the clinical research network approach to all of healthcare

Abstract

The development of Clinical Research Networks (CRN) has been central to the work conducted by Health Departments and research funders to promote and support clinical research within the NHS in the UK. In England, the National Institute for Health Research has supported the delivery of clinical research within the NHS primarily through CRN. CRN provide the essential infrastructure within the NHS for the set up and delivery of clinical research within a high-quality peer-reviewed portfolio of studies. The success of the National Cancer Research Network is summarized in Chapter 5. In this chapter progress in five other topics, and more recently in primary care and comprehensively across the NHS, is summarized. In each of the 'topic-specific' networks (Dementias and Neurodegenerative Diseases, Diabetes, Medicines for Children, Mental Health, Stroke) there has been a rapid and substantial increase in portfolios and in the recruitment of patients into studies in these portfolios. The processes and the key success factors are described. The CRN have worked to support research supported by pharmaceutical, biotechnology and medical device companies and there has been substantial progress in improving the speed, cost and delivery of these 'industry' studies. In particular, work to support the increased speed of set up and delivery of industry studies, and to embed this firmly in the NHS, was explored in the North West of England in an Exemplar Programme which showed substantial reductions in study set-up times and improved recruitment into studies and showed how healthcare (NHS) organizations can overcome delays in set up times when they actively manage the process. Seven out of 20 international studies reported that the first patient to be entered anywhere in the world was from the UK. In addition, the CRN have supported research management and governance, workforce development and clinical trials unit collaboration and coordination. International peer reviews of all of the CRN have been positive and resulted in the continuation of the system for a further 5 years in all cases.

Engagement in research: an innovative three-stage review of the benefits for health-care performance

“…57 The objectives of the Clinical Research Network Coordinating Centre 58 are more restrictive than those described above for the research networks in the USA and focus on aspects such as increasing the efficiency of clinical research processes and increasing the number of NHS trusts that are involved in clinical research. This might suggest that any improvements in health care that result from the research KEY THEORIES, REVIEWS AND ANALYSES -DEVELOPING AN ANALYTIC MATRIX NIHR Journals Library www.journalslibrary.nihr.ac.uk engagement would be far from the main purpose of the network, but in fact such impacts were identified as possible outcomes.…”

Evidence-based neonatal medicine in Latin America: what can we learn from the International Neonatal Immunotherapy Study and trials of IVIg?

“…Essas redes têm fornecido infraestrutura essencial para a criação e realização de ensaios clínicos de alta qualidade e outras pesquisas em uma variedade de especialidades ao utilizar equipes de coordenação centrais e periféricas. Como resultado, entre 2006 e 2011, o núme-ro de pacientes recrutados para ensaios clínicos e outros estudos na Inglaterra aumentou de cerca de 30.000 para mais de 550.000 por ano 8 . Uma dessas Redes de Pesquisa Clínica é a Medicines for Children Research Network (MCRN), que apoia ensaios clínicos em uma ampla gama de condições pediátricas e tratamentos, incluindo intervenções não-farmacêuticas, e que inclui uma Rede Neonatal 8,9 .…”

The Royal College of Physicians Simms Lecture, 6 December 2011: Clinical research networks and the benefits of intensive healthcare systems

“…9 A key component of the support for clinical research in the NHS in the UK has been the development of clinical research networks (CRN). [10][11][12] These were established sequentially in cancer, mental health, dementias and neurodegenerative diseases, diabetes, medicines for children, stroke, primary care and a comprehensive network, and are now collectively referred to in England as the NIHR CRN. In 2010-11, 564,698 people were entered into NIHR CRN portfolio studies, representing more than a doubling of previous documented recruitment; this also means that approximately 1% of the population of England entered trials or studies in each year.…”

“…The job of the network vidual success in increasing research activity within the NHS. The longest period of observation relates to cancer in the National Institute for Health Research Cancer Research Network (NCRN) (Fig 1), 11 which we discuss further here.…”