Intended for healthcare professionals

Education And Debate

Reforming clinical research and development in England

BMJ 2003; 327 doi: (Published 04 September 2003) Cite this as: BMJ 2003;327:550
  1. Nick McNally, assistant director of research and development (,
  2. Susan Kerrison, assistant director (research governance)1,
  3. Allyson M Pollock, director of research and development1
  1. 1University College London Hospitals NHS Trust, London NW1 2LT
  1. Correspondence to: N McNally

    The United Kingdom is trying to bring more non-governmental funding into NHS research through partnerships with the commercial and voluntary sectors. But it is still unclear exactly how the reforms in England will work and how trusts will resolve the tensions between patients' needs, financial viability, and the commercial exploitation of research findings

    Essential research into health services is often unattractive to commercial sector funders and requires government support.1 Although appreciable NHS funding has been earmarked for this purpose, critics have argued that much of the budget has disappeared into the general funds for service delivery.2 In 2000, the Department of Health announced a major overhaul of health related research within the NHS aimed at providing a clearer strategic direction.3 The reforms signal an increased role for the commercial sector in the identification of strategic objectives, setting priorities, and in the delivery and exploitation of clinical research. This paper provides an overview of the new funding and organisational arrangements for NHS research in England.

    Organisation of funding of health research

    Funding of health research in the United Kingdom is complex. Although most health related research is funded from the commercial sector, the Department of Health is a major contributor (table). In 2002-03 the Department of Health contributed £540m to research on health.4 The current pattern of funding (fig 1) reflects the work of the Culyer review, which was carried out because of concerns over the financial viability of large teaching hospitals after the introduction of the internal market in the NHS. In 1994, the Culyer taskforce recommended that Department of Health funding of health related research should be allocated to support research and development activity in NHS trusts and be clearly identifiable and distinct from funding for clinical services.5 Some 77% (£418m in 2002/03) of research funding is currently allocated to …

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