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Conducting Research in the UK National Health Service. Dr Stephen Brett Reader In Critical Care. The National Health Service £127.5bn in 2012-2013 Funded from general taxation Additional 10% private Free at point of delivery Treatment based entirely on need- with caveats - PowerPoint PPT Presentation
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Conducting Research in the UK National Health Service
Dr Stephen BrettReader In Critical Care
The National Health Service
£127.5bn in 2012-2013
Funded from general taxationAdditional 10% private
Free at point of delivery
Treatment based entirely on need- with caveats
Major budgets now held by primary care
Purchaser provider split
Research
Types
EpidemiologicalBasic scienceObservationalClinical trialsOutcomesHealth services researchQualitative/social science
Funding
UnfundedCharities
• Local• National- Wellcome, Dunhill,
ICF, Cancer Research UK BHF
Government• Medical Research Council• National Institute for Health
Research
Intensive care
Sickest patients in hospitalsEmergencies*** and major elective surgerySpecialist medical, nursing and AHP staffEquipment for support of failing organs
• Cardiovascular, respiratory, renal………In theory for people who can benefitMortality 20-25% ITU DischargeSignificant long term consequences for patient and
family• Health and non-health related
Context
1. Primary duty to patient care2. Academic healthcare is better healthcare3. Innovation to improve outcomes and efficiencies4. Drive for patient safety5. Focus on health economics6. Encourage macroeconomic growth7. Strict rules about patient confidentiality and data
handling8. Robust framework for both clinical and research
governance
Imperial College Healthcare NHS Trust
Imperial College Healthcare NHS Trust
Why conduct research in medicine?
1. New knowledge to improve health of individuals and populations2. Innovation3. Health- and macro- economic benefit4. Excitement of new knowledge5. Career advancement6. Academic healthcare is better healthcare
Increase environment data richnessMore specialisation and knowledgeMore resourcesHawthorne effectAll-around Increased motivation
Research questions
Learn aboutDisease natural history
What does the disease do?How does it do it?Who has it?How do we diagnose it and monitor it?What does it cost us- human and financial?
TreatmentWhat to give?How to give it?How to monitor its effect?
SystemHow to deliver care?
Publication type
Original primaryBasic scienceClinical
ObservationalInterventional
EpidemiologicalQualitative
Systematic reviewMeta analysisGuidelinesCommentary
EditorialCase reportsEducational thingsetc
