Why decentralised clinical trials are key to the future of the UK’s incredible research story

After the challenges of 2020 and 2021, there is now no doubt: the UK’s research sector is an elite operation. It delivered a world-leading scientific response to Covid-19 and continues to forge ahead with new discoveries that have the potential to impact every person on the planet.

That’s why UK prime minister Boris Johnson says: “I cannot think of a time when we have been more indebted to the astonishing power of Life Sciences, so much of it pioneered here in our United Kingdom.”

Consider the remarkable achievements of the last 18 months:

• One million lives were saved worldwide when the RECOVERY trial identified dexamethasone as the first effective treatment for severe Covid-19 infections.
  
  
• The UK’s successful vaccination rollout was underpinned by the development of the Oxford AstraZeneca vaccine and the partnerships between industry and the vaccine taskforce.
  
  
• Covid-19 testing capacity was rapidly bolstered through the growth of the UK’s diagnostics industry. Today, it continues to sequence emerging variants with pace and precision.

To achieve all of this, the UK’s research and healthcare sectors combined their existing strengths across several previously contemplated innovations that had not yet been fully embraced.

 A better future is possible

The pandemic has proven – in the starkest possible terms – the link between clinical research and better healthcare. Scientific research, and the decentralised clinical trials that now power so much of this activity, are crucial for realising better health and economic outcomes. The potential achievements of the coming years should generate huge excitement.

• The Academy of Medical Sciences finds research-active hospitals have better patient outcomes, including lower mortality rates. Those improved outcomes are not merely confined to study participants.
• Research into preventable diseases and chronic illnesses could eliminate up to 40 per cent of the burden on health services in England.
• Our Future Health aims to create a remarkable view of UK health by collecting information from millions of volunteers. This data will be key to helping researchers make new discoveries about human health and disease, transforming the prevention, detection and treatment of some of humanity’s most serious conditions.
• Jobs, investment and economic activity can all be stimulated by the clinical research sector, which achieved a turnover of more than £80bn in 2019.

The UK government has already committed to raising R&D investment to 2.4 per cent of GDP by 2027. With the country taking the first steps of its post-Brexit era, it cannot afford to abandon its scientific reputation. So despite other pressures, that R&D spending commitment must be reaffirmed.

Yet while a strategic investment of that level will go a long way to securing the UK’s position, two other actions are also essential to maximising the impact and opportunities presented by the life sciences sector.

1. Decentralised and hybrid clinical trials

With the NHS facing extreme capacity pressures, ongoing innovation will be critical to maintaining research momentum. The decentralisation of clinical trials, which was accelerated during Covid-19, must continue at pace.

Conducting trial activities away from primary and secondary care settings should, wherever possible, become a standard practice. It means hospitals and GP practices avoid unnecessary visitors when time and space are already at a premium. It also enables traditionally hard-to-reach communities to have better access to trials, giving studies better population representations and strengthening their data as a result. The Grail NHS-Galleri Trial, which is using our mobile healthcare units to reach 140,000 participants across the country, is one of the leading examples of this approach.

2. Ongoing collaboration

Collaboration will remain an essential part of any future progress. Relationships between the public, private and third sector should all be deepened, and we have already seen compelling examples of the power of this approach.

In September 2021, The Clinical Trials Alliance was launched. Made up of clinical research facilities, primary care networks and the NIHR Clinical Research Network, it aims to improve access to, and the quality of, clinical research in the London region.

It will be dedicated to delivering coordinated clinical trials and has come about after teams from across clinical research networks, universities and NHS organisations decided to formalise an arrangement that had proved incredibly successful during the pandemic.

Gratitude to an entire industry

None of this happens by accident. Patients, participants, health and care professionals, and the wider research community have all made enormous contributions to help the UK emerge from the worst of the pandemic. We’re grateful for their efforts and know their expertise will continue to develop life-saving medicines, diagnostics and vaccines that improve wider patient and public health.

Across the UK’s life sciences sector, there is so much to be excited about. By supporting innovation and technology within our research industry, we can all play a small part in ensuring the future of our health security.