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This Review sets out to propose a structure for the funding arrangements for the whole spectrum of health research, with the objective of obtaining the maximum benefit from research success and, where possible, eliminating duplication of effort. The Review found, however, that the UK is at risk of failing to reap the full economic, health and social benefits that the UK's public investment in health research should generate. There is no overarching UK health research strategy to ensure UK health priorities are considered through all types of research and there are two key gaps in the translation of health research: (i) translating ideas from basic and clinical research into the development of new products and approaches to treatment of disease and illness; (ii) implementing those new products and approaches into clinical practice.The Review also found that the wider funding arrangements for supporting translation of ideas from conception to practice could be more coherent or comprehensive and, where arrangements exist, they do not function well. The Review identified cultural, institutional and financial barriers to translating research into practice in the publicly funded research arena. But it also found that, in the private sector, the pharmaceuticals industry is facing increasing challenges in translating research into health and economic benefit. The Review has sought to make recommendations that will increase the translation of R&D into health and economic benefit for the UK, both in the public and private sectors. The Review recommends that the Government should seek to achieve better coordination of health research and more coherent funding arrangements to support translation by establishing an Office for Strategic Coordination of Health Research (OSCHR).
In the realm of health care, privacy protections are needed to preserve patients' dignity and prevent possible harms. Ten years ago, to address these concerns as well as set guidelines for ethical health research, Congress called for a set of federal standards now known as the HIPAA Privacy Rule. In its 2009 report, Beyond the HIPAA Privacy Rule: Enhancing Privacy, Improving Health Through Research, the Institute of Medicine's Committee on Health Research and the Privacy of Health Information concludes that the HIPAA Privacy Rule does not protect privacy as well as it should, and that it impedes important health research.
What are public health services? Countries across Europe understand what they are or what they should include differently. This study describes the experiences of nine countries detailing the ways they have opted to organize and finance public health services and train and employ their public health workforce. It covers England France Germany Italy the Netherlands Slovenia Sweden Poland and the Republic of Moldova and aims to give insights into current practice that will support decision-makers in their efforts to strengthen public health capacities and services. Each country chapter captures the historical background of public health services and the context in which they operate; sets out the main organizational structures; assesses the sources of public health financing and how it is allocated; explains the training and employment of the public health workforce; and analyses existing frameworks for quality and performance assessment. The study reveals a wide range of experience and variation across Europe and clearly illustrates two fundamentally different approaches to public health services: integration with curative health services (as in Slovenia or Sweden) or organization and provision through a separate parallel structure (Republic of Moldova). The case studies explore the context that explain this divergence and its implications. This study is the result of close collaboration between the European Observatory on Health Systems and Policies and the WHO Regional Office for Europe Division of Health Systems and Public Health. It accompanies two other Observatory publications Organization and financing of public health services in Europe and The role of public health organizations in addressing public health problems in Europe: the case of obesity alcohol and antimicrobial resistance (both forthcoming).
The Government recognises that many lifestyle-driven health problems are at alarming levels: obesity; high rates of sexually transmitted infections; a relatively large population of drug users; rising levels of harm from alcohol; 80,000 deaths a year from smoking; poor mental health; health inequalities between rich and poor. This white paper outlines the Government's proposals to protect the population from serious health threats; help people live longer, healthier and more fulfilling lives; and improve the health of the poorest. It aims to empower individuals to make healthy choices and give communities and local government the freedom, responsibility and funding to innovate and develop ways of improving public health in their area. The paper responds to Sir Michael Marmot's strategic review of health inequalities in England post 2010 - "Fair society, healthy lives" (available at http://www.marmotreview.org/AssetLibrary/pdfs/Reports/FairSocietyHealthyLives.pdf) and adopts its life course framework for tackling the wider social determinants of health. A new dedicated public health service - Public Health England - will be created to ensure excellence, expertise and responsiveness, particularly on health protection where a national response is vital. The paper gives a timetable showing how the proposals will be implemented and an annex sets out a vision of the role of the Director of Public Health. The Department is also publishing a fuller story on the health of England in "Our health and wellbeing today" (http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/documents/digitalasset/dh_122238.pdf), detailing the challenges and opportunities, and in 2011 will issue documents on major public health issues.
The Science and Technology Committee today agrees with, and commends, the scientific vision for the new UK Centre for Medical Research and Innovation, but expresses reservations about the project's location. It says the case for the centre's central London location near St Pancras station was not overwhelming and it could have been sited elsewhere. The advantages of co-location with universities and hospitals and access to good transport links, which the Committee accepts play a fundamental role in the centre's vision, come at a price: extra construction costs; a site incapable of expansion; and the concentration of medical sciences in the 'golden triangle' in the south of England. On the issue of funding, the Committee's concerns about the project's costs were assuaged by evidence from the Government that the taxpayer will not be liable to any further costs should the project overrun. On the management structure, the committee was told that an experienced team with a proven track record were now taking charge. The Committee is sympathetic to the local community's concerns about the project, and recognises attempts made by the centre's management to engage with the local community, but says it is saddened that efforts have not been as successful as they might have been. One way some benefit could accrue back to the local community is to ensure that the land released from the National Temperance Hospital site (the original site intended for the UKCMRI) is used for housing, including social housing.
This is an open access title available under the terms of a CC BY-NC 4.0 International licence. It is free to read at Oxford Scholarship Online and offered as a free PDF download from OUP and selected open access locations. Before new interventions are released into disease control programmes, it is essential that they are carefully evaluated in field trials'. These may be complex and expensive undertakings, requiring the follow-up of hundreds, or thousands, of individuals, often for long periods. Descriptions of the detailed procedures and methods used in the trials that have been conducted have rarely been published. A consequence of this, individuals planning such trials have few guidelines available and little access to knowledge accumulated previously, other than their own. In this manual, practical issues in trial design and conduct are discussed fully and in sufficient detail, that Field Trials of Health Interventions may be used as a toolbox' by field investigators. It has been compiled by an international group of over 30 authors with direct experience in the design, conduct, and analysis of field trials in low and middle income countries and is based on their accumulated knowledge and experience. Available as an open access book via Oxford Medicine Online, this new edition is a comprehensive revision, incorporating the new developments that have taken place in recent years with respect to trials, including seven new chapters on subjects ranging from trial governance, and preliminary studies to pilot testing.
The Cooksey Review ("A review of UK health research funding", ISBN 9780118404884), published in December 2006, was commissioned by the Chancellor of the Exchequer to examine the best design and institutional arrangements for a new single funding system for UK health research. The Committee's report supports the decision by Sir David Cooksey to broaden his review beyond its original terms of reference to make wider recommendations for the UK health research framework, for example relating to healthcare treatment priorities, as well as outlining a number of tasks for the Office of Science and Innovation to address. The Review found that although good progress has been made in some areas, further work is needed to ensure that publicly-funded health research is carried out in the most effective and efficient way and to facilitate translation of research findings into health and economic benefits. Amongst its recommendations, the Review proposed that a new body should be established, the Office for Strategic Coordination of Health Research (OSCHR), as the central co-ordinating body for all health research carried out by the NHS and the Medical Research Council. The Committee raises some concerns that although the pharmaceutical sector is of great importance, allied health research such as medical engineering and technology, preventive and public health research should not be overlooked. It also calls on the OSCHR to operate as a light touch organisation that does not complicate the existing successful administrative mechanisms of the Medical Research Council. More information on the Cooksey Review can be found at http://www.hm-treasury.gov.uk/independent_reviews/cooksey_review/cookseyreview_index.cfm

Bioengineering

Great Britain: Parliament: House of Commons: Science and Technology Committee

Published: 2010-03-25

Total Pages: 240


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This report finds that the UK has an excellent research base but is still failing to maximise its potential by translating research into wealth and health. The road to economic recovery will depend, in part, on exploitation of the UK's research base, which in turn requires efficient translation to generate returns on investments. Some areas of bioengineering, such as stem cells, have clearly benefited from strong Government leadership and support, backed up by generous levels of funding from both the public and private sectors. Others, such as genetically modified (GM) crops, are less well supported and funded. This is curious when GM crops are considered by the Government to be safe and offer potential benefits. GM crops are certainly the poor cousin in the bioengineering family, and we strongly urge the Government to signal its support for GM crops as well as improving the regulatory situation in Europe. Regulation of bioengineering is complex and researchers have found that regulations inhibit research and translation, either because of regulatory complexity (stem cells) or a flawed operation of the regulatory process (GM crops). There are good indications that the UK is learning from past experiences in bioengineering when handling new emerging technologies, such as synthetic biology. The Government and Research Councils have recognised the value of synthetic biology early, and are providing funding. The Committee is also concerned that while research is well funded there is not enough forethought about synthetic biology translation, for example developing DNA synthesis capability, which would provide the UK with an excellent opportunity to get ahead internationally. If this is not addressed, synthetic biology runs the risk of becoming yet another story of the UK failing to capitalise on a strong research base and falling behind internationally.
Healthcare decision makers in search of reliable information that compares health interventions increasingly turn to systematic reviews for the best summary of the evidence. Systematic reviews identify, select, assess, and synthesize the findings of similar but separate studies, and can help clarify what is known and not known about the potential benefits and harms of drugs, devices, and other healthcare services. Systematic reviews can be helpful for clinicians who want to integrate research findings into their daily practices, for patients to make well-informed choices about their own care, for professional medical societies and other organizations that develop clinical practice guidelines. Too often systematic reviews are of uncertain or poor quality. There are no universally accepted standards for developing systematic reviews leading to variability in how conflicts of interest and biases are handled, how evidence is appraised, and the overall scientific rigor of the process. In Finding What Works in Health Care the Institute of Medicine (IOM) recommends 21 standards for developing high-quality systematic reviews of comparative effectiveness research. The standards address the entire systematic review process from the initial steps of formulating the topic and building the review team to producing a detailed final report that synthesizes what the evidence shows and where knowledge gaps remain. Finding What Works in Health Care also proposes a framework for improving the quality of the science underpinning systematic reviews. This book will serve as a vital resource for both sponsors and producers of systematic reviews of comparative effectiveness research.
One of the tasks of the Committee has been to scrutinise the relevant, major appointments by the Secretary of State for Trade and Industry. Based on a single evidence session, the aim has been: to satisfy Parliament that the post has been filled by someone of sufficient calibre; identify their views and principles; and alert them to the interests and concerns of the Committee. This report concerns Sir John Chisholm who was appointed as Chairman of the MRC in October 2006. The Committee have serious reservation as to whether he is the right person to guide the MRC Executive through the coming period of change.