The RCP recently published Delivering research for all, calling for more research to be conducted in NHS trusts to support high-quality patient care. Our key recommendation is for trusts to use job planning to protect time for doctors, nurses and other clinicians to engage in research. The statement has been endorsed by 17 royal colleges and research institutions, including the government funded National Institute for Health Research. Academic vice president Professor Cheng-Hock Toh answers some common enquiries we have received about the statement and explains why we’re focusing on research – and what we’re going to do next.
Why are we doing this now?
The RCP plays a leading role in the delivery of high-quality patient care. We now know that research-active NHS trusts have improved outcomes for patients. There is published evidence that hospitals with high research participation have 30% lower mortality rates than those in hospitals that do not. Trusts conducting more research can also experience improved staff morale and recruitment.
This is why we wanted to make a clear, unambiguous statement that NHS trusts need to be more research active. The CQC has also recognised how important research is by including clinical research activity within its remit for trust inspections.
Why is the RCP leading on research?
In 2016, the RCP published Research for all. It examined the feelings and motivations of doctors regarding clinical research, as well as the obstacles they encountered to being involved. One resounding finding was that almost two-thirds (64%) of doctors said they’d like to spend more time on research. The most cited reason was ‘it is intellectually stimulating’. However, the most cited reason for why they are unable to do research is a lack of time.
Pressure on doctors’ time has only increased since 2016, and time for research has been squeezed. We can’t afford for research to be pushed further to the margins of the working lives of physicians when we know that research benefits and improves patient outcomes.
To prevent this, doctors need to be given protected time to do more research, including within direct clinical care programmed activities for patient-facing research.
Is it realistic to expect protected time for research given the pressures the NHS is under?
We all know the NHS faces many challenges. Staffing shortages and financial pressures clearly cannot be ignored, nor can the need to deliver more integrated care to support patients.
But the NHS cannot afford to store up problems for the future by letting research fall by the wayside. It was British researchers who first established the link between smoking and lung cancer. They also discovered penicillin and Parkinson’s disease, invented the contraceptive pill, and pioneered blood transfusions, general anaesthetics and IVF treatments.
Investing in research is likely to deliver huge long-term gains for patients and public health – which is, after all, what the NHS is there to do. Staff morale is also boosted by research activity and I believe that this is important, considering the current problems with recruitment and retention.
The RCP understands this is a tricky issue, and there will need to be detailed discussion about how doctors can be given protected time. But I am determined to push ahead and do all I can to make research a more important part of the everyday lives of clinicians.
Is research mandatory for all clinicians?
It’s not, but I believe all clinicians have something to contribute to research. That doesn’t just mean leading clinical trials, but things such as recruiting patients are absolutely crucial too.
We know research helps improve patient outcomes, so we as physicians should be doing all we can to support it. From personal experience in haematology, I know being involved in research means a more interesting and varied career.
I urge all those who are unsure to speak to their R&D department and find out what options are available. And have a look at the RCP website for top tips from two NHS physicians who have become involved in research – Professor Opinder Sahota and Dr Tina Dutt.
Are we talking about laboratory research?
Not necessarily. There are many ways that doctors can support improved patient care through research, from identifying opportunities for new research to recruiting patients, supporting colleagues or leading trials themselves. Indeed, we believe facilitation of research in trusts should be part of core activity and recognised as a key indicator of improving patient care.
What is the RCP going to do now to help realise these ambitions?
Publishing Delivering Research for all is just the next step in our drive to promote a more research-active NHS. The big challenge is embedding and integrating research into service delivery.
We will soon publish a business case for research which will be aimed directly at trusts. It will highlight the benefits that trusts will realise from becoming more research-active.
We are talking to the BMA, research and industry groups, patient groups, charities and of course decision-makers in the NHS to make the case for more clinical research. I am determined to bring as many different groups on board as possible if we’re going to deliver any meaningful change.
Finally, we will collect data from you, our fellows and members about involvement in research. Coupled with intelligence from CQC inspections and elsewhere, it will enable us to assess the impact of our work. As your academic vice president, I am here to support you to be active in research and energised by research activity.