View the report at: Clinical researchers in the UK: reversing the decline to improve population health and promote economic growth.
The report says that “[f]uture clinical research is under threat due to a clearly documented decline in clinical research staff, both in absolute numbers and – more strikingly – in proportion to the expanding NHS workforce”.
It calls for a series of measures to be taken to address the decline, which include:
- establishing a national clinical research career framework
- enabling more flexible training pathways
- encouraging leaders and mentors
- ensuring more equitable pay and opportunities
Decline in clinically trained researchers
Clinically trained research staff include a wide range of professionals, including medical, dental, public health, nursing and midwives, who carry out research as part of their professional role.
Numbers of medically trained clinically trained researchers have been falling in recent decades. The Office for the Strategic Coordination of Health Research (OSCHR) convened a broad stakeholder ‘Task and Finish’ group to consider the issue at a national level. The group comprised of:
- chief scientific advisors from the UK four nations
- key representatives from the NHS
- government and charity research funders
- industry
- academic institutions
OSCHR commissioned the report to evaluate the current situation, pinpoint causes and identify the actions necessary to reverse the decline.
Analysis in the report reveals a clear fall in medically qualified research staff. The decline is even starker as a proportion of the workforce, with the UK not growing its clinical research capacity in parallel with the expansion of the NHS.
Data demonstrates that this trend is set to worsen over the coming decade as the existing clinical research workforce is ageing and not being replaced at a rate that maintains the current position.
Importance for health of the nation and economy
The decline in clinical researchers has serious consequences both for the NHS and UK economy.
Clinical research drives innovation to make the NHS more sustainable and deliver better patient outcomes. Clinically trained research staff play a central role in innovations that improve:
- treatments
- interventions
- diagnosis
- prevention strategies
Research-active hospitals consistently show lower mortality rates.
The UK has a global reputation for research in the life sciences sector, which helps drive growth in the economy. The report highlights that every £1 invested in medical research delivers a further 25p return for every year thereafter.
Clinical research attracts major inward investment from global industries who choose to base their biomedical research bases in the UK. It also acts as a driver for spin-outs in pharma, data science and new technologies.
Corrective action required for medically qualified researchers
This report focuses on recommended actions tailored to medically qualified researchers, those with a medical degree, such as:
- physicians
- surgeons
- anaesthetists
- general practitioners
A second report on nurses, midwives and allied health professionals will follow soon.
The report identifies a complex web of causes for the decline in medically qualified researchers, both at systemic and individual level. This includes student debt, financial pressures on individuals and organisations, increasing career uncertainty, changing workforce demographics, and changes to training programmes.
Addressing the decline does not necessarily require major new investment, as some of the systems and structures are in place. However, it does require an urgent and, importantly, coordinated approach across government and multiple stakeholders across the research and healthcare landscape.
The report calls for a small number of interventions designed to have the greatest impact to build a sustainable clinical research workforce for the future:
- establish a common national clinical research career framework to train clinical researchers capable of competing on an international stage
- ensure the national training pathway is flexible and fast to provide multiple entry-exit routes to training and more flexible timescales
- visible leadership and mentorship delivered by established researchers to inspire the next generation of clinical researchers from an early age
- equitable rates of pay and pay opportunities, establishing transparency for salary progression based on delivery of excellent research
- robust context-specific performance evaluation
- effective monitoring of the impact of these actions
Urgent action needed
Professor Patrick Chinnery, Chair of the Task and Finish Group and Executive Chair of the Medical Research Council (MRC), said:
Clinical research drives innovation to deliver better health outcomes for all and make the NHS more sustainable. This report sets out the urgency in reversing the well-documented decline in clinical researchers and proposes solutions to maintain the UK’s position as a global leader in the life sciences sector.
Coordinated steps across government and other key stakeholders are now vital to implement all the recommendations in this report. The MRC is already working with major funders to implement its actions.
Improved health outcomes
Professor Lucy Chappell, Chief Scientific Adviser at the Department of Health and Social Care and Chief Executive Officer of the National Institute for Health and Care Research, said:
Clinical researchers are essential for delivering high quality research and developing the evidence base to drive innovation and improvements in patient care. This report provides important insights into the opportunities and challenges facing the clinical research workforce.
By working together with others across the system to act on the key recommendations outlined in the report, we can attract, train and support outstanding clinical researchers to build upon the UK’s track record of scientific excellence, drive innovation across the health and care system and deliver improved health outcomes for all.
A national clinical research framework
Professor Ian Young, Chief Scientific Advisor for Northern Ireland Department of Health and Director of Health and Social Care Research and Development, said:
Northern Ireland (NI) has developed a reputation as a place to undertake health and social care research of high quality, with a strong clinical research infrastructure to support research activity.
This report demonstrates that through collaboration with academia, industry and other sectors, the NI clinical and medical community should benefit from a national clinical research framework providing flexible training programmes and opportunities to support Researchers to obtain the necessary skills and understanding of research and help remove barriers between clinical and research activity on their research career path.
I welcome the report recommendations and support progression in the research ecosystem to help enhance the Life Sciences sector and improve the health and wellbeing of people across Northern Ireland.
Valuable contributions
Professor Dame Anna Dominiczak, Regius Chair of Medicine, University of Glasgow, and Chief Scientist (Health) Scottish Government, said:
A vibrant and skilled clinical research community working in the NHS drives medical developments and innovations that can help transform healthcare in Scotland and across the UK.
This report shines a light on the valuable contributions that clinical researchers make to patients, the NHS, and the life sciences sector and the importance of nurturing this talent for the NHS of the future.
Collaborating with organisations
Professor Monica Busse, Director of Health and Care Research Wales Faculty, said:
The contribution that clinical researchers make to the R&D ecosystem cannot be underestimated when it comes to providing high quality care and innovative treatments to patients.
Health and Care Research Wales are committed to collaborating with organisations across Wales and the UK to tackle the complexities and challenges that are recognised not least in this report but by all of those clinicians and researchers working across the sector.
It is vital that we now focus on solutions, working closely with universities, system leaders across health, workforce and training organisations, research councils and UK government partners to make the environment more supportive and rewarding for these professions.
Further information
Case study: clinical researchers enabled rapid pandemic response
Clinical researchers led the rapid establishment of the UK’s RECOVERY trial, a world-leading trial to identify treatments for adults hospitalised with confirmed COVID-19.
Among many results, it identified the first effective treatment for severe COVID-19, dexamethasone. Its use was assessed to have saved 22,000 lives in the UK and an estimated one million globally by March 2021.
RECOVERY also informed the clinical community of the lack of effectiveness of many unsuccessful treatments that were being used, enabling rapid development of better treatment approaches.
Top image: Credit: sturti, E+ via Getty Images