Britain Against Cancer: improving research in the NHS

The annual Britain Against Cancer conference offers a great chance to hear from the key people in healthcare, including the Secretary of State for Health, Jeremy Hunt, his opposite number, Andy Burnham, and the National Clinical Director for Cancer, Sean Duffy.

We jointly hosted a hugely popular session on ‘research in the NHS’ with the National Cancer Research Institute.

We invited Sharmila Nebhrajani, Chief Executive of the Association of Medical Research Charities (AMRC), who helped run the session, to give her thoughts on the discussion.

It was a real pleasure to chair the session on health research at Britain Against Cancer last week. The room was buzzing with a mix of patients, researchers, policy makers, doctors, nurses, all focused on the key issue of how we put research at the heart of the NHS.

It’s my job to represent the charity funders of medical research. AMRC members spend around £1.2 billion on medical research in the UK. Although some money is spent on basic scientific research that underpins a lot of different sorts of disease, cancer receives the largest share of research money. This sustained investment means that, in many ways, the UK is already leading the world in cancer research.

It’s not all perfect though. Only around five per cent of the total figure is spent on research into preventing diseases and understanding how to coordinate healthcare for patients– and if we really are to win the battle against diseases like cancer we need more research in these areas.

And treatment isn’t just about drugs. Radiotherapy and surgery cure more people than drugs alone, so we need more research in these areas.

Celebrating successes

Kate Law, Director of Clinical and Population Research at Cancer Research UK, opened with a bold statement: ‘The UK is the envy of the world in cancer research.’

It’s hard to disagree. Through the work of the National Cancer Research Network, and concerted efforts of funders, the number of cancer patients taking part in clinical research in the UK is around 20 per cent, more than anywhere else in the world.

This means patients in the UK have many more chances to take part in research – through clinical trials – than anywhere else in the world.

Strengthening research in the NHS

But our survival rates for some cancers still lag behind the best in the world. So we still have more to do to make sure that the NHS quickly adopts new treatments for cancer patients.

Recent AMRC research found that while 87 per cent of clinicians and nurses in the NHS believe research is very important (it should be 100 per cent in my view!), fewer than 50 per cent of them viewed that research as part of their own personal responsibility.

So we will still have a way to go before research is just an everyday part of every clinician’s job.

We were lucky enough to have Professor Dion Morton on the panel. A bowel cancer surgeon, Professor Morton has done brilliant work to encourage research in Birmingham. He’s also spearheading an initiative to encourage more surgical research recognising the importance of surgery in curing cancer. Surgical trials are different from other types of trials, so we need to understand more about how best to run them and apply the findings in day-to-day practice.

Professor Morton also raised the idea that the General Medical Council could focus on research as part of the review of a doctor’s performance.

The patients’ perspective

Graham Hampson Silk talked about his experience of being diagnosed and treated for leukaemia to emphasise how important it was for patients to have the chance to be involved in research. His message was simple – he’s alive today because of the clinical trial he was allowed to join – but that others might not be so lucky.

Luck, he says, plays too big a part in the process. You’re lucky if you live in an area where a trial exists, lucky if your doctor knows of the trial and can tell you about it, and lucky if you are then able to join it. It was disheartening to hear that for some cancer types there are simply not enough trials available for patients to join.

Great resources exist (for example websites like CancerHelp UK make it much easier to see what trials are happening) to find those trial opportunities, but more are needed. The AMRC believes that patients should be able to self-refer to trials, for example, as a way of putting power back with the patient.

This idea that patients should feel confident to speak up about research really resonated with one of Cancer Research UK’s Cancer Campaigns Ambassadors, Ianthe Stark, who attended the session and talked about her own experience:

“The session for me showed the importance of patients actually having the confidence to ask doctors and nurses questions about research. Getting research into the NHS is absolutely crucial so medical staff can deliver world class care to patients. I know this from experience; because of her research in malignant melanoma, my GP diagnosed my cancer during a totally unrelated check of my blood pressure.”

What next?

It’s clear that research into cancer has made huge strides; that a patient’s access to clinical trials is wider than for most other disease categories; and that it’s still the most significant disease for research funding.

But the battles continue – to ensure that patients have access to research wherever they live, that the NHS quickly adopts new treatments wherever they are developed; and finally, as Graham so powerfully said, that we take luck out of the process.