Piggy bank

We have a responsibility to spend our supporters’ donations wisely

Our research is funded by the public – around 80p in every pound donated to us is spent on this vital work – so we have a responsibility to make sure our supporters’ cash gets spent on the very best science that will make a difference to people with cancer.

We’ve written before about how our funding committees allocate millions of pounds, raised by our supporters, to scientists, doctors and nurses across the UK. But we thought it might be helpful to lift the lid on the finer points of our funding processes in a bit more detail.

The following story is an illustration of what happens when someone applies to us for funding.

We’ve changed the name of the researcher, but all the details are taken from a real-life situation.

It starts with a bright idea…

Dr Sally Labcoat is a children’s cancer doctor at Northerntown University Hospital, specialising in treating children and young adults with brain tumours.

Recently she’s seen several new drugs come onto the market that look promising for her patients, and thinks that a combination of two of them might be useful for treating a relatively rare type of brain tumour.

But she doesn’t know for sure whether mixing the drugs together will be safe and effective, nor what the best dose might be.

To answer these questions, Dr Labcoat decides to apply to Cancer Research UK for a grant to allow her to carry out a clinical trial involving more than a hundred children and young people with this type of brain tumour across Europe.

…And an online application form

To start the process, Dr Labcoat logs onto our electronic Grant Management System (eGMS), an online system that helps researchers apply to us for money for research. eGMS asks questions about every aspect of her idea – the background for the trial, its aims and methods and exactly how much it will cost.

Dr Labcoat also has to provide details of co-investigators and all of their experience, as well as where patients will be recruited and who will coordinate it.

eGMS automatically sends all this information through to the people who manage the appropriate funding committee. In this case, the application is sent to our Clinical Trials Awards and Advisory Committee (CTAAC).

Off to the reviewers

Once submitted, Dr Labcoat’s application is picked up by Naomi, one of our Application and Award Officers, who checks it over to make sure everything is present and correct.

She also confirms that all the financial details comply with our Grant Conditions, which set out our expectations when it comes to the researchers we fund. These cover everything from best scientific practice and our rules around publishing and patenting research, to what grantees should and shouldn’t be spending our supporters’ money on.

While Naomi’s looking at the administrative ‘nuts and bolts’ of the application, Andy – a Research Funding Manager – is looking over the science side of things. It’s his job to find at least three top scientists from Dr Labcoat’s research field to scrutinise her application – a process called ‘peer review’. It’s no mean feat getting all those scientific opinions together – Andy and his team end up asking 15 different researchers before six of them agree to look at the application.

The reviewers make sure that the results of Dr Labcoat’s trial are likely to make a difference to brain tumour patients, and the methods she’s chosen are going to make the results meaningful.

Luckily, it’s a strong application and the reviewers are happy, saying things like “This is a critically important area of research” and pointing out that Dr Labcoat has an “excellent track record”. This bodes well for the next stage – but it’s no guarantee.

Next stop, the funding committee

Three times a year, 25 world-class scientists who are experts in their field come from far and wide to form our CTAAC committee and decide which clinical trial applications to fund.

In March 2013, they meet over two days in London to consider Dr Labcoat’s application along with more than 20 others. But not everything can be funded – we can’t spend money we don’t have, so the committee’s budget is fixed, based on the funds available at the time.

The committee scrutinise all the applications, looking at the researchers’ experience and credentials, the quality of the research, the place where the research will be based and the reviewers’ comments.

And while we don’t allocate certain amounts of money to particular cancer types, the committee will also consider how well the proposals fit with our overall research strategy, and whether they are good value for money.

By the end of the two-day meeting, every application has been allocated a ‘score’ and the money is shared between the top scorers until it runs out. The committee try to fund everything worthwhile, and work hard to suggest savings where they can, so more projects can be funded.

Dr Labcoat’s proposed trial ticks many of the committee’s boxes. Not only is she an experienced researcher with favourable reviews for her application, but the proposal of an international trial involving a rare cancer in children sits nicely within our research strategy (which focuses on hard-to-treat cancers where there’s a real need for improvements in survival). So it’s a “yes” for Sally and her team, and their trial will be funded.

What happens afterwards?

After the committee meeting Reena, one of the research funding team, gives Dr Labcoat a call to break the good news. She also passes on any recommendations the committee have made that will make the trial even better.

One of the Application and Award Officers creates a Grant Award Letter – a type of contract that commits Cancer Research UK to paying for the first year of the trial. Getting the money for subsequent years will depend on how the trial fares, as we’ll see below.

Once she has her Grant Award Letter, Dr Labcoat can hire her research team, get all the ethical approval and red tape sorted out, and – finally – start recruiting patients onto her trial.

Is that it?

Not at all! We keep a close eye on all the research we fund from start to finish, making sure everything is going to plan and is sticking to our high standards. This means that Dr Labcoat will need to write a Scientific Milestone Report every year showing what she’s achieved so far and what will happen in future. Next year’s committee will use this to decide whether to continue funding her trial.

And there’s more. While the committee keeps an eye on the science, our Grant Finance team keeps an eye on the money. Every three years, the University of Northerntown will have to report how much has been spent from Dr Labcoat’s grant. Then, when the trial is over, any unspent funds come back to us, to go towards other lifesaving research projects.

This can add up to millions of pounds every year, so it’s an important part of the finance team’s work.

We also regularly visit universities and other research institutions, taking a magnifying glass to their financial systems to look out for anything we’re not 100 per cent happy with. It means we can be confident that our supporters’ hard-earned and generously-given money is being spent in the most efficient and effective way possible – saving lives through funding the best cancer research.

Kat Arney and Sarah Beaton