Intended for healthcare professionals

Education And Debate

Conducting clinical research in the new NHS: the model of cancer

BMJ 1994; 309 doi: (Published 13 August 1994) Cite this as: BMJ 1994;309:457
  1. J F Smyth,
  2. J Mossman,
  3. R Hall,
  4. S Hepburn,
  5. R Pinkerton,
  6. M Richards,
  7. N Thatcher,
  8. J Box
  1. Department of Clinical Oncology, University of Edinburgh, Western General Hospital, Edinburgh EH4 2XU
  2. United Kingdom Coordinating Committee on Cancer Research, PO Box 123
  3. Lincoln's Inn Fields, London WC2A 2PX
  4. Urology Department, Level 3, Freeman Hospital, High Heaton, Newcastle upon Tyne NE7 7DN
  5. Royal Marsden Hospital, Sutton, Surrey SM2 5PT
  6. Imperial Cancer Research Fund Breast Cancer Unit, Guy's Hospital, London SE1 9RT
  7. Department of Medical Oncology, Christie Hospital, Withington, Manchester M20 9BX
  8. Medical Research Council, London W1N 4AL
  1. Correspondence to: Professor Smyth.

    The United Kingdom Coordinating Committee on Cancer Research represents the major organisations funding cancer research in the United Kingdom. The deliberations of a working party convened by the committee to evaluate recently expressed concerns that the changes in the NHS threaten research, especially clinical trials to evaluate new treatments, are reported. A survey of contributors to trials coordinated by the committee showed that half are now experiencing difficulties in continuing to participate in clinical trials. The two major problems identified were lack of time and of staff, especially for NHS staff in non-teaching hospitals. Recent changes in junior doctors’ hours and proposed reductions in the lenght of time for training will exacerbate this. It is possible to identify the direct and indirect excess costs of conducting research in the NHS, but currently the mechanism does not exist to designate funds specifically for this purpose. Consultation with the regional directors of research and development confirmed that the service increment for teaching and research is not the solution for this. Proposals are made to secure future clinical research in the NHS, including finance, indemnity, the licensing of new drugs, the greater use of nurse counsellors, and the value of cancer registries.


    The United Kingdom Coordinating Committee on Cancer Research is an independent body representing the major organisations funding cancer research in the United Kingdom. Clinical cancer research can cover many aspects of malignant diseases, and it is important to distinguish research involving NHS organisational and managerial issues from those dealing with the evaluation of (new) treatments. It is the latter that is of particular concern to the committee. We seek to encourage, promote, and facilitate cancer research, particularly through the medium of randomised clinical trials. This has never been easy, and the changes now being introduced in the NHS are further exacerbating …

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