conducting research in the uk national health service dr stephen brett reader in critical care
Post on 29-Dec-2015
214 Views
Preview:
TRANSCRIPT
Conducting Research in the UK National Health Service
Dr Stephen Brett
Reader In Critical Care
The National Health Service
£127.5bn in 2012-2013
Funded from general taxationAdditional 10% private
Free at point of delivery
Treatment based entirely on need- with caveats
Major budgets now held by primary care
Purchaser provider split
Research
Types
Epidemiological
Basic science
Observational
Clinical trials
Outcomes
Health services research
Qualitative/social science
Funding
Unfunded
Charities• Local• National- Wellcome, Dunhill,
ICF, Cancer Research UK BHF
Government• Medical Research Council• National Institute for Health
Research
Intensive care
Sickest patients in hospitals
Emergencies*** and major elective surgery
Specialist medical, nursing and AHP staff
Equipment for support of failing organs• Cardiovascular, respiratory, renal………
In theory for people who can benefit
Mortality 20-25% ITU Discharge
Significant long term consequences for patient and family• Health and non-health related
Context
1. Primary duty to patient care
2. Academic healthcare is better healthcare
3. Innovation to improve outcomes and efficiencies
4. Drive for patient safety
5. Focus on health economics
6. Encourage macroeconomic growth
7. Strict rules about patient confidentiality and data handling
8. Robust framework for both clinical and research governance
Imperial College Healthcare NHS Trust
Imperial College Healthcare NHS Trust
Why conduct research in medicine?
1. New knowledge to improve health of individuals and populations
2. Innovation
3. Health- and macro- economic benefit
4. Excitement of new knowledge
5. Career advancement
6. Academic healthcare is better healthcareIncrease environment data richnessMore specialisation and knowledgeMore resourcesHawthorne effectAll-around Increased motivation
Research questions
Learn aboutDisease natural history
What does the disease do?How does it do it?Who has it?How do we diagnose it and monitor it?What does it cost us- human and financial?
TreatmentWhat to give?How to give it?How to monitor its effect?
SystemHow to deliver care?
Publication type
Original primaryBasic scienceClinical
ObservationalInterventional
EpidemiologicalQualitative
Systematic reviewMeta analysisGuidelinesCommentary
EditorialCase reportsEducational thingsetc
top related