Clinical academic training in a changing landscape.

JP NeilsonNIHR Dean for Training

[DATE]Imperial 2011

INVENTION EVALUATION ADOPTION

Creationnew thingsnew ideasnew techniquesnew approaches

Assessmentnew thingsnew ideasnew techniquesnew approaches

Uptakenew thingsnew ideasnew techniquesnew approaches

DIFFUSION

Spreadnew thingsnew ideasnew techniquesnew approaches

Basic Research Applied Research

NIHR

Commissioning Patient Care

PCTsMRC NHS Providers

The Innovation Pathway

INVENTION EVALUATION ADOPTION DIFFUSION

Biomedical Research Centres

Biomedical Research Units

Clinical Research Facilities

Experimental CancerResearch Centres

Centres for Leadership in AppliedHealth Research and Care

NIHR Evidence Synthesis

National Institute for Healthand Clinical Excellence

NHS Evidence

NIHR Evidence Synthesis

Academic Health Science CentresHealth Innovation Education Clusters

Bridging the Translational Gaps

Primary outcomes RR (95% CI) Number of trials, participants

Death or cerebral palsy 0.85 (0.74 to 0.98)* four trials; 4446 infants

Death (fetal and later) 0.95 (0.80 to 1.12) four trials; 4446 infants

Cerebral palsy 0.71 (0.55 to 0.91)* four trials; 4446 infants

Any neurological impairment 1.03 (0.87 to 1.21) one trial; 1255 infants

Death or substantial gross motor dysfunction

0.84 (0.71 to 1.00) three trials; 4387 infants

* significantly in favour of magnesium sulphate

MgSO4 vs placebo/no treatment: primary outcomes

Doyle 2009 Cochrane Review

Cerebral palsy 53 34, 171

6%

Death or CP 42 24, 346

17%

Outcome NNT 95% CI

Baseline Risk

Fetal Neuroprotective Intent TrialsNumber needed to treat to prevent one case

To improve the health and wealth of the nation through research

National Institute for Health Research

Strategic Aim

www.nihr.ac.uk

Transform research in the NHSIncrease the volume of applied health research for the

benefit of patients and the publicDevelop and support the people who conduct and

contribute to applied health research

National Institute for Health Research

Goals

www.nihr.ac.uk

Infrastructure

Clinical Research Facilities, Centres

& Units

Clinical Research Networks

Research

Research Projects & Programmes

Research Governance

Systems

Research Information

Systems

Systems

Patients&

Public

Universities

Investigators &Senior

InvestigatorsAssociates

Faculty

Trainees

Research Schools

NHS Trusts

The NIHR Health Research System

Doctors and DentistsNIHR Integrated Academic

Training

All ProfessionsNIHR Fellowships

Nurses, Midwives, Allied Health Professionals

Clinical Academic Training

NIHR Clinical Lectureship

NIHR Clinician Scientist Award

Masters in Health

Economics

NIHR Doctoral Research Fellowship

NIHR Post-Doctoral

Fellowship

NIHR Career Development

Fellowship

NIHR Senior Research Fellowship

NIHR/CNO Masters in Clinical

Research

NIHR/CNO Clinical Doctoral Research

Fellowships

Level of AwardOther Awards

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Senior/Pre-Chair

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NIHR Research Career Pathways

SeniorPost-Doc

Early Post-Doc

Doctoral

Pre-Doctoral/Masters

Undergraduate

NIHR/CNO/HEFCE Senior Academic Clinical Lecturer

In-Practice Fellowshipsand NIHR Academic Clinical Fellowships

NIHR/CNO Clinical

Lectureships

CSO Health Care Scientist

Doctoral Fellowship

CSO Health Care ScientistPostDoctoral Fellowship

Liberating the NHS:

Developing the Healthcare Workforce

A consultation on proposals

www.nihr.ac.uk

www.nihr.ac.uk

‘The Government is committed to the promotion and conduct of research as a core NHS role. Research is vital in providing the new knowledge needed to improve health outcomes and reduce inequalities. Research is even more important when resources are under pressure – it identifies new ways of preventing, diagnosing and treating disease. It is essential if we are to increase the quality and productivity of the NHS, and to support growth in the economy. A thriving life sciences industry is critical to the ability of the NHS to deliver world-class health outcomes. The Department will continue to promote the role of Biomedical Research Centres and Units, Academic Health Science Centres and Collaborations for Leadership in Applied Health Research and Care, to develop research and to unlock synergies between research, education and patient care’.

Equity and excellence: liberating the NHS.

July 2010