In Correspondence in this week's edition of The Lancet, The Academy of Medical Royal Colleges* in the UK issue a consensus statement calling for the UK Government to work with the medical profession and the pharmaceutical industry to bolster the UK's clinical research base. They also discuss the need to encourage and support NHS clinicians, managers, and patients to become more involved in clinical research. The Correspondence and accompanying Comment from Lancet Editor Dr Richard Horton coincide with a report launched by The Royal College of Physicians, UK — Innovating for health: Patients, physicians, the pharmaceutical industry and the NHS. Dr Horton chaired the working group and wrote the final report.
The Royal Colleges say in their statement: "Since the National Health Service (NHS) began 60 years ago, there have been extraordinary advances in medicine. Nearly a quarter of the world's top 100 medicines have been developed in the UK, traditionally a leading centre for medicines development and clinical trials. Previous decades of investment and collaboration have been the foundations for this great leap forward."
The consensus statement says that the Royal Colleges welcome Lord Darzi's report High quality care for all: NHS next stage review, since it focuses on patient needs and call for the creation of new partnerships between the NHS, industry, and universities to pioneer new treatments. Leading experts must also recruit and collaborate on clinical trials.
The statement concludes: "Collectively, these measures contribute to enhanced access to modern medicines on the basis of clinical need. However, previous policy statements have failed to bring about significant change. There needs to be real action with clear mechanisms and timeframes for implementation. We urge the Government to work in partnership with the medical profession and the pharmaceutical industry to ensure that patients are able to access innovative, life-enhancing medicines and other interventions. There is a need to encourage and support NHS clinicians, managers, and patients to become involved with clinical research. It is only by working collaboratively and retaining long-term investment that we will ensure the UK remains an attractive location for future clinical trials with the consequent benefits to our patients."
In the accompanying Comment, Dr Horton says "the unhelpful war of words between clinicians, medical researchers, and pharma needs to stop. All three groups depend on one another for success."
He discusses some of the 42 recommendations made by the report, including, for patients, making access to medicines and medicines information a priority. Medical students and doctors need more rigorous exposure to medicines throughout their careers, and knowledge about the quality of prescribing needs to become a core educational objective for doctors.
Dr Horton says: "Research posed a special concern. Pharma is a huge investor in UK academic medicine. Without industry support, the UK would be far less successful in its basic science and clinical research base. Yet, thanks to a weak NHS research culture, cheaper facilities elsewhere (eg, China), and the UK's stifling regulatory bureaucracy, industry research investment in the UK is slowly leaking away. NHS leaders need to wake up to this reality... Stronger partnerships between industry and academia need to be forged...There is a real risk that the UK will become a second-class nation in research for health unless it acts now."
Among his other conclusions, Dr Horton adds doctors should be far more open to other professions, notably pharmacy. He says: "Pharmacists have a massively neglected role in the delivery of health care. Their contribution to effective and safe medicine use should be scaled up considerably."
He concludes: "The NHS, which has been organised mainly around delivery of clinical care, needs to take much greater responsibility for education and research. The nexus of care-education-research is the hallmark of our best institutions in medicine. The combination of clinical practice, continuous learning, and knowledge creation and translation can be integrated into almost all NHS care settings. Pharma has an indispensible role in making this vision a reality. The RCP also has an important part to play in guiding the future of this vision.
"'Medicines and medicine are inextricably connected', the RCP working party argues. After years of neglect, it is now time to put medicines positively at the centre of professional and policy action."
For more information, please contact Clare Settle, Academy of Medical Royal Colleges, London, T) +44 (0) 207 486 0067 E) clare.settle@aomrc.org.uk / carol.fitzgerald@aomrc.org.uk / carol.black@aomrc.org.uk
Lancet Press Office: T) +44 (0) 20 7424 4949 E) pressoffice@lancet.com
For full Correspondence and Comment see: http://press.thelancet.com/researchletterandcomment.pdf
Notes to Editors: The following are co-signatories to this consensus statement:
Professor Dame Carol Black Chairman of the Academy of Medical Royal Colleges;
Professor Andy Adam, President of the Royal College of Radiologists;
Professor Sabaratnam Arulkumaran, President of the Royal College of Obstetricians and Gynaecologists
Dr Susan Bews, President of the Faculty of Pharmaceutical Medicine;
Professor Dinesh Bhugra, President of the Royal College of Psychiatrists;
Miss Brenda Billington, President of the Royal College of Ophthalmologists;
Professor David Coggon, President of the Faculty of Occupational Medicine;
Professor John Donohoe, President of the Royal College of Physicians of Ireland;
Professor Neil Douglas, President of the Royal College of Physicians of Edinburgh;
Professor Steve Field, Chairman of the Council of the Royal College of General Practitioners;
Professor Ian Gilmore, President of the Royal College of Physicians of London;
Dr Patricia Hamilton, President of the Royal College of Paediatrics and Child Health;
Professor David Haslam. President of the Royal College of General Practitioners;
Dr Judith Hulf, President of the Royal College of Anaesthetists
Professor Frank Keane, President of the Royal College of Surgeons in Ireland;
Professor Alan Maryon Davis, President of the Faculty of Public Health;
Mr John Black, President of the Royal College of Surgeons of England;
Professor Adrian Newland, President of the Royal College of Pathologists;
Mr John Orr, President of the Royal College of Surgeons of Edinburgh;
Dr Jim Wardrope, President of the College of Emergency Medicine;
Professor Brian Williams; President of the Royal College of Physicians and Surgeons of Glasgow;
Mr Derrick Willmot, Dean of the Faculty of Dental Surgery
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The Lancet