NHS: Innovation

Lord Sharkey Excerpts

Thursday 11th June 2015 Lords Chamber

[Lord Sharkey (LD)]

My Lords, I, too, congratulate the noble Lord, Lord Wills, on securing this debate and on his compelling opening speech. Like him and all other speakers, I very much look forward to the maiden speech of the noble Lord, Lord Prior, in a few moments. I declare an interest as chair of the Association of Medical Research Charities.

In the context of the NHS, “innovation” has a wide range of applications. It covers, of course, innovations in care and treatment, but also medical research, which is where I shall focus most of my remarks this afternoon. A great many things have changed in the NHS in the last 15 years, as other noble Lords have said. Very significant advances have been made, and many of them are the fruits of the UK’s acknowledged excellence in medical research. We recognised this explicitly in our debates on the then Health and Social Care Bill in 2012, which imposed for a first time an explicit duty on the Secretary of State, NHS England and CCGs to,

“promote research on matters relevant to the health service, and the use in the health service of evidence obtained from research”.

It is generally accepted that the UK’s leading role in medical research is of enormous value to patients and the country. That leading role depends to a very large extent on the active participation and leadership of the NHS itself. The Government recognise that, and so does the NHS. In October last year, the NHS published its Five Year Forward View; this document devoted four pages to innovation, usefully not only setting out aspirations but detailing some of the steps needed to achieve those aspirations. The document explicitly confirmed continued support for the NIHR. That is a very good thing.

The NIHR is, with the AMRC and the medical research charities, one of the key funders of medical research, which in the NHS has undergone a kind of renaissance since the advent of the NIHR. It is all the more impressive when you realise that the NIHR’s budget is less than 1% of the overall NHS budget. That is a much smaller percentage commitment to R&D than is the norm for other knowledge-based organisations. There is a real business case, as I said before, for increasing the NIHR’s budget, apart from compensating for inflation. For every £1 of government and charity spend on health research there is a return of between 37p and 40p every year, in perpetuity. This is obviously a vital area. Could the Minister use his very best efforts to persuade his colleagues that a significant part of the promised extra £8 billion should find its way into the NIHR budget? While I am talking about money, when are we likely to see the guidance on excess treatment costs that was promised for before Christmas?

Despite some progress and good intentions, the research landscape in the NHS is not yet entirely encouraging. Around three weeks ago, Cancer Research UK published a report that it had commissioned entitled Every Patient a Research Patient?. The organisation stole or borrowed the title from the Prime Minister’s own stated aspiration that every patient will be a research patient. However, this report says that it has,

“found mounting and pressing concern”,

about research in the NHS. It identified a number of constraints, including,

“the ability of people to commit time to research, in the face of mounting service pressures … the availability of key skills and experience within the workforce”,

and of course generalised financial pressures.

The Chief Medical Officer, Professor Dame Sally Davies, commented on the report. She said:

“There is considerably more to do to improve the commitment, culture, capacity and capability of the NHS to promote, support and conduct research”.

Are there mechanisms in place to measure progress on the lines set out by the Chief Medical Officer? How will we know when we are making progress?

The final area I shall touch on briefly is data. Patient data, actual and potential, are an almost unimaginably important resource. Proper collection, dissemination and analysis of data will allow the next great leap forward in medical science. The NHS explicitly recognises this and has set up the National Information Board to lead the effort. We need real drive and leadership in this area. As my colleague the noble Lord, Lord Turnberg, said, the debacle over care.data has made progress very much more difficult. The Wellcome Trust noted at a recent hearing of the Health Select Committee on patient data that some researchers funded by medical research charities are experiencing significant difficulties and delays when trying to access data from the Health and Social Care Information Centre. Often these delays are more than 12 months. In some cases, researchers have not been allowed to access data at all, even when patient consent has been given and the data anonymised. I am sure the Minister is well aware that the situation is as difficult as it is urgent. Better use of patient data can lead to significantly better outcomes for those patients. I know the department is aware of this and all the other issues I have mentioned and is aware of the need for an overarching NHS research strategy and is working on that. Finally for the Minister’s list of questions, when does he expect to be able to publish a draft of this research strategy tying all these issues together?