NHS funding of clinical trials

Clinical trials are the foundation for evidence-based medicine. In recognition, the NHS has allocated £1 billion per year until 2016 to support multicentre clinical trials research. The number and quality of surgical trials have lagged behind those of medical specialties. Plastic Surgery is a small speciality with approximately 420 consultants and 270 trainees. Similarly, current membership of The British Society for Surgery of the Hand (BSSH) is below 500. The Royal College of Surgeons has started an initiative to develop a nationwide surgical clinical trials portfolio. This is being facilitated by clinical Trials units at Oxford, Bristol, Birmingham, Liverpool/Manchester and Barts/The London. In addition, Surgical Specialty Leads (SSLs) were appointed to develop trial networks within their specialty.

Reconstructive Surgery Trials Network

I have been appointed as the SSL for Plastic and Hand Surgery by The British Association of Plastic, Reconstructive and Aesthetic Surgery (BAPRAS) and The British Society for Surgery of the Hand (BSSH). Over the next three years I will promote and encourage a culture of clinical trials and multicentre co-operation within these organisations. This initiative gives our members direct access to trials units. These units will provide support throughout the process from the initial project proposal through to analysis of trial data. I will help facilitate this by acting as a link between designated surgical trials centers and national clinical research networks within BAPRAS and the BSSH. This initiative must be inclusive and therefore it is open to all levels of healthcare professional, especially trainees. This is a valuable resource for our members as we now have direct access to epidemiologists, trials methodologists and statisticians experienced in running trials. As an association we can only benefit from this and ensure that our patients receive the best evidence based treatment.

Who can get involved?

This initiative is for every level of clinician. One key aim is to encourage trainees to develop and lead clinical trials, as has been achieved in other specialities. Clinical trials methodology will become part of the surgical curriculum and experience of clinical trials will be important for NHS consultant appointments.

Both patients and clinicians benefit from participating in clinical trials. I feel that plastic surgery and hand surgery are ideally placed for this Royal College Initiative and I hope we can develop a culture of coordinated national networking and team work.

Abhilash Jain MSc PhD FRCS(Plast)
Surgical Specialty Lead for Plastic and Hand Surgery