Rapid responses are electronic comments to the editor. They enable our users
to debate issues raised in articles published on bmj.com. A rapid response
is first posted online. If you need the URL (web address) of an individual
response, simply click on the response headline and copy the URL from the
browser window. A proportion of responses will, after editing, be published
online and in the print journal as letters, which are indexed in PubMed.
Rapid responses are not indexed in PubMed and they are not journal articles.
The BMJ reserves the right to remove responses which are being
wilfully misrepresented as published articles or when it is brought to our
attention that a response spreads misinformation.
From March 2022, the word limit for rapid responses will be 600 words not
including references and author details. We will no longer post responses
that exceed this limit.
The word limit for letters selected from posted responses remains 300 words.
Prof Black’s Editorial is a welcome contribution to debate about the
appropriate use of routine NHS data for research. He recognises the vision
the UK Clinical Research Collaboration showed in inviting Prof Ian
Diamond, Chief Executive of the ESRC, to lead an R&D Advisory Group to NHS
Connecting for Health on opportunities for clinical research, public
health research and health services research.
I have some sympathy with the suggestion in the Editorial that, to
date, Health Services Research (HSR) has been given too little prominence.
In fact, HSR can take reassurance from the first paragraph of the Advisory
Group's Report (Reference 6). To quote: "The UK can significantly enhance
its clinical research capability by using, strictly within the bounds of
patient confidentiality, the electronic patient data that the UK's
National Programmes for IT in the NHS have the potential to allow. This
will have enormous benefits for all types of clinical, public health AND
HEALTH SERVICES RESEARCH and for many aspects of patient care". The
ambition for HSR could not be more clearly stated.
The "simulation exercises", chosen by the Advisory Group did not
exclude particular areas of research. They simply provided a framework in
which to spell out opportunities to:
• inform future developments of the NHS Care Records Service (CRS)
• highlight technical, regulatory and governance issues, and
• inform plans for any further simulations and full pilots to test
the capacity of the infrastructure, with appropriate safeguards, when this
becomes feasible.
The UKCRC and NHS Connecting for Health were not slow to act on the
"Diamond Report". A successful outline case for investment was submitted
as part of the 2007 Comprehensive Spending Review. Meanwhile, a task force
chaired by Sir Robert Boyd, reporting to the Care Record Development
Board, reviewed governance arrangements around access to
patient data for research and other purposes. Then from September 2007,
the Department of Health launched the preparatory phase of a "Research
Capability Programme" (RCP) led by the Director-General of Research and
Development and Director of IT Services. I am delighted to have been
appointed the chair of the programme board.
The programme will be advised by an "External Reference Group" (ERG)
of the recognised national research leaders in this field. Prof Black and
his colleagues in HSR will certainly have every opportunity to influence
the developing national agenda. In the interest of continuity, it is
gratifying that Prof Diamond has accepted the invitation to become the
first chair of the ERG. This will ensure that we can build upon the
excellent work to date of the Simulation Groups. It will also ensure that
the work of the DH Research Capability Programme is closely integrated
with the E-Health funding stream of the Office for Strategic Co-ordination
of Health Research (OSCHR), which Prof Diamond also chairs.
The primary objective of the RCP is to enable research to achieve its
full potential as a "core" activity for healthcare alongside other uses of
NHS data that lead to improvements in the quality and safety of care.
There is much to be done to achieve this objective, not least the full
engagement of the many other key stakeholders involved: the Information
Centre for Health and Social Care; the National Information Governance
Board; the Secondary Uses Service Programme; the NHS Number Programme; and
the Service Implementation Programme and National Clinical Leads, to name
but a few.
I welcome this opportunity to update the research community on
progress in this field since commitments were made to it two years ago by
the Prime Minister and the DH strategy document "Best Research for Best
Health". Prof Black is right to remind us of the potential opportunities.
We rely on his and the HSR community's help in delivering them. The
challenges involved should never be underestimated. But real progress can
be achieved in 2008 and the years ahead.
Competing interests:
None declared
Competing interests:
No competing interests
30 January 2008
Alexander F Markham
Professor of Medicine
University of Leeds, Brenner Building, St James's University Hospital, Leeds, LS9 7TF
Not too black an outlook for Health Services Research
Prof Black’s Editorial is a welcome contribution to debate about the
appropriate use of routine NHS data for research. He recognises the vision
the UK Clinical Research Collaboration showed in inviting Prof Ian
Diamond, Chief Executive of the ESRC, to lead an R&D Advisory Group to NHS
Connecting for Health on opportunities for clinical research, public
health research and health services research.
I have some sympathy with the suggestion in the Editorial that, to
date, Health Services Research (HSR) has been given too little prominence.
In fact, HSR can take reassurance from the first paragraph of the Advisory
Group's Report (Reference 6). To quote: "The UK can significantly enhance
its clinical research capability by using, strictly within the bounds of
patient confidentiality, the electronic patient data that the UK's
National Programmes for IT in the NHS have the potential to allow. This
will have enormous benefits for all types of clinical, public health AND
HEALTH SERVICES RESEARCH and for many aspects of patient care". The
ambition for HSR could not be more clearly stated.
The "simulation exercises", chosen by the Advisory Group did not
exclude particular areas of research. They simply provided a framework in
which to spell out opportunities to:
• inform future developments of the NHS Care Records Service (CRS)
• highlight technical, regulatory and governance issues, and
• inform plans for any further simulations and full pilots to test
the capacity of the infrastructure, with appropriate safeguards, when this
becomes feasible.
The UKCRC and NHS Connecting for Health were not slow to act on the
"Diamond Report". A successful outline case for investment was submitted
as part of the 2007 Comprehensive Spending Review. Meanwhile, a task force
chaired by Sir Robert Boyd, reporting to the Care Record Development
Board, reviewed governance arrangements around access to
patient data for research and other purposes. Then from September 2007,
the Department of Health launched the preparatory phase of a "Research
Capability Programme" (RCP) led by the Director-General of Research and
Development and Director of IT Services. I am delighted to have been
appointed the chair of the programme board.
The programme will be advised by an "External Reference Group" (ERG)
of the recognised national research leaders in this field. Prof Black and
his colleagues in HSR will certainly have every opportunity to influence
the developing national agenda. In the interest of continuity, it is
gratifying that Prof Diamond has accepted the invitation to become the
first chair of the ERG. This will ensure that we can build upon the
excellent work to date of the Simulation Groups. It will also ensure that
the work of the DH Research Capability Programme is closely integrated
with the E-Health funding stream of the Office for Strategic Co-ordination
of Health Research (OSCHR), which Prof Diamond also chairs.
The primary objective of the RCP is to enable research to achieve its
full potential as a "core" activity for healthcare alongside other uses of
NHS data that lead to improvements in the quality and safety of care.
There is much to be done to achieve this objective, not least the full
engagement of the many other key stakeholders involved: the Information
Centre for Health and Social Care; the National Information Governance
Board; the Secondary Uses Service Programme; the NHS Number Programme; and
the Service Implementation Programme and National Clinical Leads, to name
but a few.
I welcome this opportunity to update the research community on
progress in this field since commitments were made to it two years ago by
the Prime Minister and the DH strategy document "Best Research for Best
Health". Prof Black is right to remind us of the potential opportunities.
We rely on his and the HSR community's help in delivering them. The
challenges involved should never be underestimated. But real progress can
be achieved in 2008 and the years ahead.
Competing interests:
None declared
Competing interests: No competing interests