RCoA response to Academy of Medical Sciences report ‘Transforming health through innovation: Integrating the NHS and academia’

Published: 13/01/2020

Professor Ravi Mahajan, President of the Royal College of Anaesthetists, said:

The Royal College of Anaesthetists (RCoA) welcomes the Academy of Medical Sciences report ‘Transforming health through innovation: Integrating the NHS and academia’. Many of the issues raised resonate with anaesthesia, perioperative and pain medicine, in particular the reduction in clinical academic appointments of anaesthetists by UK universities, and the challenges of combining postgraduate clinical training with research training within existing structures. We are supportive of the recommendations, in particular the call for a pilot scheme for NHS consultants to be funded to deliver research within their job plans.

“The RCoA has several nationally coordinated and novel approaches to clinical research which provide value for taxpayer money, ensure wide participation of NHS trusts and therefore reassuringly generalisable results for research – both observational and interventional. The National Institute of Academic Anaesthesia (NIAA) brings together all relevant stakeholders across anaesthesia – the Royal College, the Association, the journal Anaesthesia and British Journal of Anaesthesia, and the specialist societies – in a unique cross-specialty partnership and serves to coordinate funding and activity across the specialty.  The NIAA enabled the creation of a Health Services Research Centre at the RCoA, that has supported the delivery of several important research programmes including the Sprint National Anaesthesia Projects, which involve more than 90% of NHS hospitals, and the Perioperative Quality Improvement Programme which is currently recruiting in over 130 hospitals in England and Wales. Both programmes have led to practice changing research which has immediate impact on health service delivery. The HQIP funded National Emergency Laparotomy Audit works collaboratively with clinical researchers to deliver pragmatic, large scale and efficient clinical trials of novel interventions – for example the EPOCH study recently published in the Lancet and the NIHR funded Flo-ELA study which will recruit over 7000 NHS patients.

“Trainees have taken matters into their own hands, with the development of the national Research and Audit Confederation of Trainees (RAFT), and regional trainee research networks (TRNs) covering the whole of the UK, delivering both observational and interventional clinical research. All of these examples have two common attributes – a citizen science approach which both involves and rewards (through manuscript authorship) thousands of front-line clinicians, and through this, a ‘without walls’ approach to research participation – ensuring that the results of studies are generalisable to all NHS hospitals, not just the ‘ivory towers’. The development of the NIAA Perioperative Medicine Clinical Trials Network will further support our specialty’s ambitions to grow new lead researchers, while supporting clinician engagement of all our colleagues, and we are grateful for the collaboration of the NIHR in recognising the contribution of NHS consultants, trainees and trainee networks in study delivery, through our annual joint awards.

“The continuation and expansion of these efforts is dependent on the contribution of NHS clinicians. With an increasing understanding of fatigue and burnout in NHS staff, it is clear that time must be provided within job plans to support sustained engagement. We therefore welcome the recommendations from the Academy of Medical Sciences and urge Trusts and other stakeholders to support them.”