15 June 2011
Failure to generate, support and implement surgical research means NHS patients are missing out on groundbreaking new procedures and therapies, warns a new report by the Royal College of Surgeons. A funding bias towards drug therapies; slow uptake of new techniques by surgeons and the NHS; and a lack of defined career pathways, mentors and role models for aspiring surgical researchers are among the issues flagged.
In 2009, just eleven surgical trials were funded by the Medical Research Council (MRC) and the National Institute of Health Research (NIHR) combined, this despite the fact that one in four NHS procedures are surgical. Surgery cures more cancers than any other form of intervention, including radiotherapy and chemotherapy and the RCS believes that the continued development and research into these types of curative treatments is vital.
The report, From Theory to Theatre: Overcoming barriers to innovation in surgery, published today (June 15) makes 15 achievable and affordable recommendations which, if implemented, will benefit patients in future years. Among the recommendations is a call to Government, through its Plan for Growth initiative, to undertake a full review of public funding of translational research in surgery. Currently only 1.5 per cent of the £1.5billion Government funding into medical research goes into surgical research. Other recommendations include:
- The Department of Health and surgical profession should explore how best to spread information on new technologies throughout the NHS.
- The NHS Commissioning Board (NCB) should use all available means to encourage the spread of surgical innovation.
- Participation in relevant established clinical audits should be mandated through commissioning contracts.
- Providers of NHS services should be incentivised to support surgical trials.
- As part of the NHS’ “duty to promote innovation” introduced in the new Health and Social Care Bill, the NCB should publish annual updates on which new proven techniques have been adopted in NHS practice.
- Research modules should be incorporated into surgical training, with surgical trainees encouraged to participate in ongoing research.
- A network of experienced researchers and mentors should be available to aspiring researchers.
The report also flags up the difficulty the profession faces in halting the decline in surgeons interested in carrying out research. With pressure to treat as many patients as possible, surgical training currently focuses on clinical roles within the NHS. The RCS urges Surgical Specialty Associations to explore what scope is available for understanding and conducting research in the surgical curriculum. A recent opinion poll carried out by ipsosMORI for the Association of Medical Research Charities showed an overwhelming support and willingness of patients to personally participate in research projects and the RCS would like to see the profession to respond with similar enthusiasm.
Professor Norman Williams, President-elect of The Royal College of Surgeons, said:
“In the past decade alone we have seen surgical procedures become safer, less invasive and more effective, both clinically and financially. The current funding bias towards medical research needs to be addressed. We cannot afford to neglect the kind of research that has brought, among others, cures for many forms of cancer, keyhole surgery, advancement in transplant surgery and the rapid developments we are now seeing in robotic surgery. We hope these recommendations are a starting point for research funders, politicians and surgeons to come together to meet the challenge of developing, supporting and spreading surgical innovation in the NHS.
Professor Martin Birchall, Consutlant Surgeon, Laryngologist and pioneer of laryngeal and stem cell transplantation said:
“For innovation to become a widespread part of new clinical practice, a large amount of effort, time and cost needs to go into detailed laboratory work, meeting the public safety requirements, and finally performing often difficult clinical trials. The latter body of work can seem so daunting that the amazing group of innovator-surgeons we are gifted with in the UK can often be discouraged from taking their ideas and science into the clinic. The need to link world-class science in our internationally top-performing universities to saving the lives of surgical patients means that these challenges are not only important, but urgent. It is absolutely critical that we keep pushing forward the boundaries of research for surgery, a field of healthcare that touches nearly everyone in Britain at some time.”
This is phase I of the RCS Surgical Research Report. Phase II will follow in September 2011.