Healthy Skepticism Library item: 7053

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Publication type: Journal Article

Cole A.
Cooksey report recommends central coordinating body for research.
BMJ 2006 Dec 16; 333:(7581):1239
http://www.bmj.com/cgi/content/full/333/7581/1239-c

Abstract:

The long awaited report by Sir David Cooksey on UK healthcare research has proposed a new model of structured coordination between the NHS, the Medical Research Council (MRC), and the healthcare industry to ensure more research is translated into tangible benefits for patients.

But the report, commissioned by the chancellor, Gordon Brown, has decided against merging the two main funding bodies, the MRC and the NHS’s National Institute for Health Research (NIHR).

Instead the report proposes a central coordinating body, the Office for Strategic Coordination of Health Research, which will oversee all health research funding, determine strategy, and monitor progress against targets.

In addition, a joint MRC-NIHR Translational Medicine Funding Board will direct money towards projects that promise “health and economic benefits.”

But the MRC and NIHR will continue to operate independently. Indeed, the report wants to see a clearer demarcation of their roles. And it says that the institute should move from a virtual organisation, with no physical headquarters, to a real body by April 2009 and become an executive agency of the Department of Health.

Healthcare research is failing to realise its potential, said Sir David, a former chairman of the Joint Healthcare Research Delivery Group, the coordinating body between the MRC and NIHR, because of “perverse incentives that value basic science more highly than applied research.”

He confessed that he had felt frustrated with the joint delivery group because “although people were using the same words, they were speaking different languages. On a voluntary basis we couldn’t break that down but this [report] puts in the architecture that makes it possible.”

He proposes that an urgent review determines the United Kingdom’s health priorities, focusing particularly on areas of unmet need. From this would emerge a list of priority research projects, which could be fast tracked through to implementation.

“If we can focus the funding-not just from the public sector but also the pharmaceutical industry-on where it will really make a difference we should get more effective outcomes for the patient, the nation and the industry.”

He also wants to see acceleration in bringing new drugs to market. Currently this takes 12 years on average. The report proposes a new route for drug development, including earlier “conditional licensing” of new drugs, faster uptake, and involving the National Institute for Health and Clinical Excellence (NICE) at an earlier stage.

Sir David strongly supports the present ring fencing of funding for NHS research and proposes extending this to areas such as training clinical academic staff. He also urges further investment in health technology assessment to help identify cost effective ideas and technologies.

But some are concerned that the new arrangements could disguise a cut in funding, noting that when announcing the report Gordon Brown referred to a total health research budget of “at least £1bn [1.5bn; $2bn].” The combined MRC and NIHR budget for 2007-8 was expected to be £1.3bn.

“A cut of such magnitude would be very damaging,” said a spokesman for the BMA. “We need to see more investment in these areas-certainly not less.” (See Editorials, doi: 10.1136/bmj.39059.444120.80.)

• Eleven new biomedical research centres of excellence are to be set up across England to help translate advances in basic medical research into clinical practice, the health department has announced. The centres, in London, Oxford, Cambridge, Liverpool and Newcastle, will receive £450m over the next five years, starting in April 2007.