Comprehensive Local Research Network

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Comprehensive Local Research NetworkNCRNWorkin
g in Partnership
Dr David Jackson Clinical Lead for Research YCRN
Co-director WYCLRN NCRN Roadshow, Leeds, 5th
June 2008
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• Development of research networks
• Policy
• Background
• CLRN
• Structure
• Functions
• Networks in Yorkshire
• Partnership with CLRN
• Opportunities threats
• Ongoing challenges

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Background

• The NHS Cancer Plan 2000
• NCRN 2000
• YCRN 2002
• Allow conduct of clinical trials and other well
  designed research, to enhance the quality, speed,
  co-ordination of clinical research and
  integration with cancer care
• Best Research for Best Health 2006
• NIHR UKCRN
• Comprehensive Local Research Networks
• The Cancer Reform Strategy 2007

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Best Research for Best Health

• To create a health research system in which the
  NHS supports outstanding individuals, working in
  world class facilities, conducting cutting edge
  research, focused on the needs of patients and
  the public
• To achieve this we will
• Establish the NHS as an internationally
  recognised centre of research excellence
• Attract, develop and retain the best research
  professionals to conduct people-based research
• Commission research focused on improving health
  and care
• Strengthen and streamline systems for research
  management and governance
• Act as sound custodians of public money for
  public good

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Research networks

• FIRST PHASE
• NCRN 200020M
• MHRN 2003 4M
• SECOND PHASE (TCRNs)
• MCRN, DRN, SRN, DeNDRoN 200516M
• THIRD PHASE
• Primary Care Research Network 2007
  2M Comprehensive Research Network 200790M

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Health Research Categories
TOPIC TOPIC
Blood Cancer
Cardiovascular Dementias
Congenital Disorders Diabetes
Ear Medicines for Children
Eye Mental Health
Infection Stroke
Inflammatory and Immune Primary Care
Injuries and Accidents
Metabolic and Endocrine
Musculoskeletal
Neurological
Oral and Gastrointestinal
Renal and Urogenital
Reproductive Health and Childbirth
Respiratory
Skin
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NCRNAccrual to NCRN Portfolio studies across the
UK
MHRN Impact of MHRN Involvement on Study Accrual
MHRN involvement in the project commenced in June
05.
First recruitment recovery plan 19 September 2005
Recruitment plan updated February 2006
Comparison of recruitment into Myeloma VII
(pre-NCRN) and Myeloma IX (post-NCRN)
Impact of MHRN on Study Accrual

The main aim of research networks increasing
recruitment into research studies
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UK Clinical Research Network

• To provide the NHS infrastructure to support
  clinical research across all areas of disease and
  clinical need
• To help streamline the research management
  function for UKCRN portfolio studies supported by
  the networks
• To do this by
• Establishing a managed set of clinical research
  networks
• Identifying a national portfolio of studies
• Funding infrastructure (NHS support costs) for
  portfolio studies
• Supporting the research management of these
  studies

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25 Comprehensive Local Research Networks (CLRNs)
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UKCRN Portfolio

• Clinical trials other well designed studies
• Elligibility
• Funding
• NIHR, other government, non-commercial partners
• Open competition, peer review
• Clear value to the NHS
• Strategic direction for research
• Industry sponsored
• Overseas government
• Other high quality studies (e.g. EORTC)
• Formal adoption process
• National database recruitment data

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WYCLRN Portfolio

• April 2007 to present
• 121 studies
• 303 study/site combinations
• 2116 patients recruited
• Of these
• NCRN portfolio
• 86 studies
• 1014 patients recruited

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Research Funding

• ARCO 2005
• Attributing revenue costs of externally-funded
  non-commercial research in the NHS
• Research costs
• Data collection analysis
• Research funding body (NIHR, Charity)
• Treatment costs
• Commissioning arrangements
• NHS support costs
• Additional tests, inpatient care
• nursing support, research professionals
• RD support funding CLRN

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CLRN funding

• All healthcare primary, secondary, tertiary, MH
• NHS service support costs
• Infrastructure running costs
• Research staff
• Research active clinicians
• Research Management Governance
• Streamline across network
• CSP / research passports
• UKCRN portfolio
• Support for Topic Clinical Research Networks
• Cancer Stroke
• Primary Care Research Network

Replaces Culyer funding
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Bottom line

• CLRN funding replaces previous Culyer (RD)
  funding
• went to (the bottom line of) NHS Trusts
• Only source of funding to support NHS RD
• After Transitional Funding disappears
• Only to support UKCRN Portfolio studies
• Not own account and local charity funded
• Money follows (Portfolio) research for first time

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What is a Comprehensive Local Research Network?

• Primary vehicle for NHS infrastructure (service
  support)
• From April 2009
• Clinical Director and Network Manager and core
  team
• Network Executive Network Board
• Host organisation
• Research management governance for portfolio
• A typical CLRN
• NHS staff
• Management, sessions for clinicians
• nurses, data managers, secretarial
• infrastructure in primary care
• diagnostics and service costs
• running costs

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Resources

• Year 1 (2007/08) - Allocated to all networks asap
• Core team (5 posts) 300k pa per CLRN
• Per capita allocation (1.5M per 2M pop)
• Research management and governance
• Research Infrastructure staff (includes sessions
  for clinicians)
• In addition to existing transition funding and
  TCRN funding
• Year 2 (2008/09)
• Additional activity based resources
• Increased operational staff and non-staff costs
• Rising to 90M pa any necessary increases
  thereafter

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West YorkshireComprehensive Local Research
Network
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NHS Organisation R D Department
Airedale NHS Trust Airedale NHS Trust
Bradford Teaching Hospitals NHS Foundation Trust Bradford Teaching Hospitals NHS Foundation Trust
Calderdale and Huddersfield NHS Foundation Trust Calderdale and Huddersfield NHS Foundation Trust
Calderdale PCT  
Kirklees PCT  
Leeds Teaching Hospitals NHS Trust Leeds Teaching Hospitals NHS Trust
Mid Yorkshire Hospitals NHS Trust Mid Yorkshire Hospitals NHS Trust
Bradford District Care Trust West Yorkshire Mental Health RD Consortium
Leeds Mental Health Teaching NHS Trust  
South West Yorkshire Mental Health NHS Trust  
Bradford and Airedale PCT West Yorkshire Primary Care R D Unit
Leeds PCT  
Wakefield District PCT  
Yorkshire Ambulance Service NHS Trust Yorkshire Ambulance Service NHS Trust
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RMG Structure
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Resources

• 08/09
• Core team 413K
• Clinical directors, management team
• Per capita 2,250K
• Activity based 1,424K
• FSF 112K
• 4,199K

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Operational plan

• Work in progress!
• RMG infrastructure
• Options appraisal
• Research infrastructure
• Service support costs
• Unblocking blocks
• Funding distributed to Trusts
• Activity based specialty level
• Areas for development
• Performance management

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YCRN

• Budget
• 826K
• Staff
• 26.4 WTE
• Non-YCRN
• 56.4 WTE

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YCRN Functions

• National portfolio
• Local implementation
• Approval processes
• Local RD
• Ethics
• Training education
• GCP, communication
• Recruitment
• Follow-up

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Recruitment
16.3
13.8
12.2
15.2

• Vacancy control
• Patchy portfolio coverage
• Slow approval processes
• Service support blocks

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YCRN WYCLRN
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Opportunities for YCRN

• Streamlining regulatory processes
• Nationally CSP
• Network RMG structure
• Transparent funding for service support
• Radiology, pharmacy, pathology
• National costing models
• Unblocking blocks
• Additional funding for research infrastructure
• Building on strengths activity based funding
• Quick wins to increase recruitment
• Reward for research active clinicians
• Strengthen links with industry

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Perceived threats

• Lag in new funding stream
• Destabilising infrastructure
• Research team
• RD structure
• Rich specialty
• Inequality between different CLRNs
• Duplication of effort between YCRN CLRN

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Opportunities for CLRN

• Sharing good practice
• Awareness of blocks
• Devolved research teams
• Line management
• Training education
• Professional development
• Network identity
• Identify new areas for investment

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Challenges

• RMG bureaucracy
• Trust statutory obligations
• Treatment costs
• Commissioners
• Activity based funding
• Costing models
• Real time
• Accuracy of data
• Rapid implementation transiton

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Conclusions
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CLRN aims

• Ensure patients healthcare professionals can
  take part in and benefit from clinical research 
• Improve quality, speed and coordination of
  clinical research by removing barriers to
  research within the NHS
• Streamline and performance manage NHS support for
  clinical studies
• Unify and streamline administrative procedures
  associated with regulation, governance, reporting
  and approvals
• Strengthen research collaboration with industry
• Further integrate health research and patient
  care.

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• Shared aims
• Huge opportunities
• Transparent funding
• Activity based
• Streamlined RMG
• Active involvement in CLRN
• Executive
• Board

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