CSO Health Research Strategy

CHAPTER 4 - WORKING IN COLLABORATION

4.1 The benefits of collaborative working across disciplines is fully recognised and well established in research. However the practice of organisations from different sectors operating in close collaboration for mutual benefit has taken longer to develop.

4.2 Working in collaboration is one of the six guiding principles articulated in the Preface to this document. This chapter sets out what has been achieved to date and how this should be progressed in the future.

Strategic Collaborations with Industry

4.3 Since the creation of NRS, working closely with industry has been a key priority. The NRS Industry Partnership Forum was formed in 2010 to ensure close liaison between the NHS and the pharmaceutical industry. Co-chaired by CSO and the ABPI, it provides a forum for positive discussion on how NHS Boards and companies can streamline their delivery of clinical studies.

4.4 NRS currently has strategic collaborations with four industry partners:

• Announced in 9 February 2012, the Strategic Alliance with PPD is intended to cover a broad range of Phase I - III trials across multiple therapeutic areas
• NRS becoming a Quintiles Prime Site was announced at the inaugural NRS conference in October 2012, designed to increase the number of contract clinical trials conducted in Scotland.
• On 31 October 2013 the Minister for Public Health announced that NHS Research Scotland has been awarded Pfizer global INSPIRE status, making Scotland a location of choice for Pfizer studies.
• Most recently in May 2014, NRS entered into a Strategic Alliance with Roche, through which an increased number of contract and investigator initiated studies would be placed in Scotland.

4.5 Both Quintiles and PPD have bases in Scotland. These collaborations therefore contribute not just to Scotland's economic growth but also to the sustainability of our company base.

Strategic Partnerships

4.6 As indicated in the guiding principles, collaboration between the NHS and its academic partners is critical to the success of our strategic aims of increasing the volume of research undertaken in Scotland and maximising the value of our electronic health records. Health Science Scotland, a Scotland wide collaboration between the most research active Health Boards and their linked universities, is an excellent example of partnership in practice. It is recognized that there are opportunities to add greater value through better alignment of NRS and Health Science Scotland activities. CSO proposes to support both functions under the aegis of the NRS General Manager.

4.7 Other key partnerships include:

• Pharmaceutical, Medical Device and Biotech companies. Through collaboration with industrial partners a greater number of patients can benefit by participating in clinical trials, income can be generated for the NHS and the Scottish economy be supported. Although partnership with the pharmaceutical industry is already well developed, links with the Medical Device and Biotech sectors are less well established. Additionally, most of the trials placed through NRS come from overseas with few studies coming from the Scottish Medical Device and Biotech companies. CSO intends building on existing partnership arrangements and will enter into discussions with sector representatives and Scottish Enterprise with a view to increasing the number of medical device and biotech studies placed through NRS.
• Other Government Departments - It is critical to the successful delivery of our ambitions that Scotland plays positively into the UK research structures; for this reason the clinical themes of our NRS Networks and Specialty Groups mirror those in England. While Scotland will pursue policies that best suit our distinct NHS structures and way of working, in key areas such as funding, governance and research ethics we will continue to work closely with other organisations to harmonise procedures. This will include, for example, working with the Health Research Authority in England to improve the landscape for clinical researchers.
• NIHR - CSO currently contributes £8m per year to ensure that researchers based in Scotland can access key NIHR programmes such as Health Technology Assessment and Efficiency and Mechanism Evaluation. With CSO project grants focused on early phase work with clear translational potential, access to UK-wide funding streams is essential to translate CSO-funded development, feasibility and pilot studies into full scale evaluations. We shall continue to work with the research community to ensure that the wider research funding landscape is well understood, and that Scottish success in securing funds from UK funding streams is maintained.
• Medical Research Charities - Working in partnership with the charity sector is a priority for CSO, and for that reason we have recently announced joint funding initiatives with Prostate Cancer UK, Alzheimer's Research UK, the Stroke Association, Parkinson's UK, Action Duchenne and the Muscular Dystrophy Campaign. We will continue to work with leading medical research charities to explore possible co-funding opportunities, for both research projects and capacity building initiatives.

Question 13: Are there other key areas of partnership CSO should be seeking to build?

Partnership in Innovation

4.8 In addition to the above partnerships, the Scottish Government published its 'Health and Wealth in Scotland: a Statement of Intent for Innovation in Health' in June 2012. This highlighted the ambition of Scotland to be a world leading centre for innovation in health through partnership working between Government, NHSScotland, industry and academia. An Innovation Partnership Board has been established to lead work on improving uptake of innovative health technologies and treatments, with Health Innovation Partnerships established in Medical Technologies, Digital Health and a Strategic Engagement Group created for Medicines. Collaborative research involving the NHS and other partners, including industry, will have an integral role in the realisation of this ambition.

4.9 Scottish Health Innovations Ltd (SHIL) is a significant contributor to the innovation agenda. Funded by CSO, SHIL works in partnership with the NHS to identify and progress innovative ideas coming from NHS staff. Examples include:

• The U-NET, a type of groin wound dressing the first product to be licensed out by SHIL.
• The ACR (Ambulance Child Restraint) is an innovative, flexible, fully adjustable system for the safe, effective handling of young patients being transported in ambulances. It is now widely used in ambulances across the UK.
• The Nasal Clip. The nose clip is a single use product for treating non-complicated nose bleeds by applying appropriate pressure to the nose thus stemming the blood flow.
• The Prism Glasses are a Class 1 medical device designed to be used in stroke treatment as well as phantom limb pain.

International Partnership

4.10 Working collaboratively in Scotland is relatively easy because of our culture and scale. However if we are to realise our ambition of being world class in our research we must look outwith our geographical boundaries for independent advice on strategic issues. It is some years now since CSO convened its Chief Scientist Committee, with its membership drawn largely from within Scotland and its remit focused on specific Scottish issues. If Scotland is to deliver on its Global ambitions then it must have access to advice on a similar scale.

4.11 CSO therefore wishes to explore the creation of a new CSO International Advisory Board to provide expert advice on strategic research issues. Meeting once a year, with membership comprising key global leaders in their field, it would provide high level advice on the steps Scotland should be taking to deliver on its aspirations.

Question 14: Would the creation of a CSO International Advisory Board be a positive step in raising Scotland's research profile and supporting our ambition? What should be the make-up of such a Board?

Partnership within the Health Directorates

4.12 While it is essential for CSO to continue to be outward looking in delivering success, we must also ensure that we use our research expertise to support key initiatives of importance to the Health Directorates. Underpinned by the Healthcare Quality Strategy for Scotland, the NHS in Scotland has made significant strides in improving patient safety and the quality of care in recent years. Quality Improvement is now a unifying theme of NHSScotland and increasingly across public service. To date NHSScotland has been heavily reliant on international expertise to drive changes forward and there has been limited research to develop new knowledge, or publication of our work in respected peer reviewed journals. As a consequence there is considerable scope to expand the volume of research related to quality improvement science in the context of the Scottish health care system.

4.13 For this reason CSO is a partner in the recent creation of a Scottish Improvement Science Collaborating Centre (SISCC), co-funded in collaboration with NHS Education Scotland, the Scottish Funding Council and the Health Foundation.

4.14 The vision for the SISCC is of a national resource and centre of expertise in improvement science research, development and knowledge translation. It will serve practitioners, policymakers and researchers, putting evidence at the heart of quality improvement in Scotland's health and care. It will foster innovation in creating, disseminating and applying improvement knowledge, and will design and execute research to lead to improvement in quality of health and care. The Centre will be based at the University of Dundee but it will be a large-scale collaboration involving universities, health boards, local authorities, patients, carers, communities and advocacy groups.

Question 15: Are there other areas where CSO funded research could better support the Health Directorates Quality agenda?