The British National Health Service must strive to become the world’s leading health research and development platform. We’ve seen some great examples of the potential we have for world-class research during the pandemic, with examples like the RECOVERY trial and the Covid vaccine platform, and through the partnerships with Moderna, Grail and BioNTech ever since. However, these examples of cooperation with industry are often ad hoc arrangements. In general, funding and prestige are concentrated on research labs and early stage trials, but when it comes to helping healthcare companies through the commercialization stages of their products, funding from both the public and private sectors is much harder to come by. This makes it difficult for startups partnering with the NHS to scale up and sell their products in the domestic and international markets.
Instead, we need a systematic approach to exploit our strengths, such as the scale of the NHS, the diversity of our population and the in-depth patient phenotyping that our data allow. That gives us the ability to generate massive amounts of real-world data on medicines and healthcare technologies, such as pricing, performance and safety, that can prepare companies to scale and bring their innovations to market.
To achieve that, there are obstacles to overcome. For example, setting up research projects takes a lot of time. We have very bureaucratic processes that make the UK one of the slowest places in Europe to set up research studies.
Patients need more access to research. However, there is currently very little information about where clinical trials take place in the country and what kind of patients they recruit. We need a clinicaltrials.gov.uk website to provide that kind of information.
There is a significant issue when it comes to whether the patient consents to participate in an R&D. Legally, patients cannot be contacted for that purpose unless they have explicitly indicated that they want to be contacted for a research project or clinical trial. The catch-22 is that most patients are obviously unaware of this and you cannot legally contact them to inform them. We must allow ethically approved researchers to proactively approach people to participate in studies that may be of benefit to them.
For example, during the pandemic, many of those protections were overridden by emergency legislation governing the use of health data during a public health emergency. This enabled various research projects to take place. One such project, involving Health Data Research UK and the British Heart Foundation, looked at the number of people who had missed regular cardiovascular checks due to Covid. The study found that about half a million people who missed their appointments should have been on statins long ago. Without that medication, they are currently at an increased risk of stroke and heart attack. We actually know who these people are and we would like to be able to inform and support them as soon as possible by offering tests to check their blood pressure and cholesterol and prescribing the right medication.
This kind of approach can be applied to any disease, linking public health research with the delivery of personalized care. It requires a new approach to using patient data, based on public trust and not emergency legislation, but it is the kind of paradigm shift needed to make the NHS a leading platform for preventive healthcare and medical R&D.
This article appears in the July/August 2023 edition of WIRED UK magazine.