The NHS should be ‘ambitious’ in boosting the number of GP practices who undertake commercial research, a paper presented to the NHS England board has said.
Currently only around 3% of practices take part in commercial clinical trials, the report said.
Yet as the focus of delivery of services shifts from secondary care to local communities it is vital that patients can get access to research in primary care services, the NHS board heard.
Integrated Care Boards must also do more to offer research to patients across all pathways with only three ICBs having published a research strategy to date, the report noted.
This indicates that research activity is being driven by providers and not currently by the ICBs.
Research activity across NHS organisations varies. In 2022/23, 100% of NHS acute trusts recruited patients into the National Institute for Health Research (NIHR) portfolio studies with 74% recruiting into commercial contract studies. Yet only 44% of general practices recruited into NIHR studies.
Work being done to increase the amount of clinical research done in the UK has meant that in March 2024, the average monthly recruitment to all studies was 88,402, compared to a pre-pandemic baseline of 61,000 with average monthly recruitment to commercial studies at 10,974, compared to 3,200.
But numbers recruited into interventional studies is starting to decline again with 70% of studies slipping on planned sign ups compared with 82% in October last year.
The report also confirmed that there is potential for the NHS to consider financial incentives to encourage research activity.
It follows a review from Lord O’Shaughnessy published last year which argued that ‘primary care is a negligible provider of clinical trials activity’ and that doctors lack incentives to take part in commercially funded research.
One suggested mechanism for delivering financial incentives to GPs was via the QOF, or equivalent schemes in devolved nations.
Lord O’Shaughnessy said that NHS bodies carrying out research tend ‘to provide better health outcomes for their patients’.
The review found that primary care provides opportunities ‘for delivering population-scale trials’ and at the moment there is ‘too much reliance on hospital settings’.
RCGP chair Professor Kamila Hawthorne said: ‘With the vast majority of NHS contacts being delivered in primary care, it goes without saying that primary care research is important and valuable. It can be used to shape the way practices offer and deliver care to patients – and improve the treatments and care they receive.
‘We would encourage practices to take part in research, if they feel able to, and to this end our Research Ready scheme was developed to support this. Almost 2,000 practices are also part of the RCGP’s Research and Surveillance Centre network, which collects data, for example on rates of influenza, to feed in to local and national planning.’
The NHS’s ambition to significantly increase the number of GP practices involved in commercial research is a commendable and forward-thinking initiative. With only around 3% of practices currently participating in clinical trials, expanding research in primary care is crucial as the focus shifts towards local community services. This expansion will ensure patients gain better access to cutting-edge treatments and innovations directly from their local GP practices. Encouragingly, the work to boost clinical research has already led to impressive increases in study recruitment numbers, highlighting the potential for further growth. Additionally, financial incentives through mechanisms like the QOF could provide the necessary motivation for GPs to engage more in research activities.