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1、FROM RESEARCH TO REALITYResearch and innovation in the NHS as key to enabling the 10-Year PlanSonja Marjanovic,Zuzanna Marciniak-Nuqui,Hampton Toole,Stephanie Stockwell,Sarah Parkinson,Sorana Bucseneanu,Jonathan Grant and Nick FahyFull reportFor more information on this publication,visit www.rand.or

2、g/t/RRA3808-1About RAND Europe RAND Europe is a not-for-profit research organisation that helps improve policy and decision making through research and analysis.To learn more about RAND Europe,visit www.randeurope.org.Research Integrity Our mission to help improve policy and decision making through

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4、nd exacting quality-assurance process;avoid both the appearance and reality of financial and other conflicts of interest through staff training,project screening,and a policy of mandatory disclosure;and pursue transparency in our research engagements through our commitment to the open publication of

5、 our research findings and recommendations,disclosure of the source of funding of published research,and policies to ensure intellectual independence.For more information,visit www.rand.org/about/research-integrity.RANDs publications do not necessarily reflect the opinions of its research clients an

6、d sponsors.Published by the RAND Corporation,Santa Monica,Calif.,and Cambridge,UK 2025 RAND CorporationR is a registered trademark.Cover:Adobe StockLimited Print and Electronic Distribution Rights This publication and trademark(s)contained herein are protected by law.This representation of RAND inte

7、llectual property is provided for noncommercial use only.Unauthorised posting of this publication online is prohibited;linking directly to its webpage on rand.org is encouraged.Permission is required from RAND to reproduce,or reuse in another form,any of its research products for commercial purposes

8、.For information on reprint and reuse permissions,please visit www.rand.org/pubs/permissions.iThis report shares the findings of a study commissioned by Wellcome and delivered by RAND Europe to help inform a vision for research and innovation in the health system,with a particular emphasis on the Na

9、tional Health Service(NHS).It discusses research and innovation as the fourth big shift needed to transform the NHS and help support the other key shifts emphasised by government in relation to the 10-Year Plan for heath and care:shifts from hospital to community care,from sickness to prevention and

10、 from analogue to digital.The reports contents are organised as follows:Section 1 summarises the key project insights.Section 2(Introduction)presents the projects context,aims and approach.Section 3 discusses evidence on the impact of research and innovation in the health system(in and around the NH

11、S)on patients,NHS service delivery and the wider health system,the economy and society.Section 4 presents case studies of research and innovation in five key areas to reflect on the importance of a research-and-innovation-active health system and to consider the potential for future benefits.The cas

12、e study areas include genomic testing,artificial intelligence(AI)applications in cancer detection and diagnosis,digital innovation in mental health,tech-enabled remote monitoring in healthcare and participatory research.Each case study considers the origins,evolution and progress of research and inn

13、ovation in the field,its impacts on patients,the NHS and wider economy and society,key enablers and barriers,and a vision of what good looks like ten years from now(i.e.ten years from January 2025).Section 5 begins by briefly overviewing the history of research and innovation in the NHS and then pre

14、sents an analysis of support mechanisms needed for a research-and-innovation active NHS in terms of the current landscape(what matters and key enabling organisations and initiatives),challenges that need addressing and a vision of what good looks like in the future relative to each support mechanism

15、.The support mechanisms for a research-and-innovation-active NHS discussed pertain to:(1)the NHS workforce,(2)data,information and evidence,(3)physical infrastructure,(4)funding,commissioning and procurement,(5)Research and Development(R&D)governance and regulation,(6)collaboration and coordination,

16、and(7)patient and public involvement,engagement and participation.Section 6(Conclusion)reflects on the insights gained in relation to the 10-Year Plan and the opportunities for research and innovation to support NHS reforms.For more information on this document,please contact Dr Sonja Marjanovic(Dir

17、ector of Healthcare Innovation,Industry and Policy at RAND Europe)at smarjanorandeurope.org and Dr Nick Fahy(Research Group Director,Health and Wellbeing,RAND Europe)at nfahyrandeurope.org.Preface:readers guideiiFrom research to reality:research and innovation in the NHS as key to enabling the 10-Ye

18、ar PlanAcknowledgementsThe authors would like to thank the many individuals and organisations that contributed to this reports successful completion.We are particularly grateful to all individuals who gave their time and expertise to inform this work through expert interviews:Oliver Harrison,Mike De

19、nis,Pooja Sikka,David Clark,Anke Ehlers,Janet Valentine,Natalie Banner,Chris Schonewald,David Snead,Naomi Allen,Ed Sykes,Philippa Garety,Thomas Ward,John Wright,Lloyd OMahoney,and Rajesh Jena.We also wish to thank all workshop participants.Their insights were invaluable in shaping the research direc

20、tion and findings.We would like to thank all Wellcome Trust colleagues who supported and contributed to this research.We are particularly grateful to Beth Thompson,Beck Smith,Megan Challis,Tom Harrison,Alastair Russell,Miranda Wolpert,Lynsey Bilsland,and Alex Callaghan for their unwavering commitmen

21、t to evidence-based insights and impact.We also appreciated the engaging discussions with colleagues at Nesta.We would like to thank Martin Szomszor who conducted the analysis of Research Excellence Framework impact case studies.Finally,we thank our quality assurance reviewers,Tom Ling and Sue Guthr

22、ie of RAND Europe,for their helpful advice and feedback throughout the research process.We also wish to thank our RAND Europe colleague,Agn Ulyt,for her contributions to the scoping research undertaken before the start of the project.Special thanks are due to Bethany Badcock-Merry for her assistance

23、 in managing the logistics and administrative aspects of the project,as well as to Jessica Plumridge and Clare Watkinson,who contributed to the final products design.iiiAbbreviationsABPI Association of the British Pharmaceutical IndustryADR Adverse Drug ReactionAF Atrial FibrillationAI Artificial In

24、telligenceAMRC Association of Medical Research CharitiesBHF British Heart FoundationBP Blood PressureBRC Biomedical Research CentreCBT Cognitive Behavioural TherapyCGM Continuous Glucose Monitoring CLAHRC Collaboration for Leadership in Applied Health Research and CareCOPD Chronic Obstructive Pulmon

25、ary Disease CPRG Clinical Practice Research Datalink CRUK Cancer Research UKDECIDE Digitally Enabled Care in Diverse EnvironmentsEVA Early Value Assessment ESRC Economic and Social Research CouncilEU European UnionGDP Gross Domestic ProductGVA Gross Value AddedHEE Health Education EnglandHES Hospita

26、l Episode StatisticsHIN Health Innovation NetworkHTA Health Technology Assessment ivFrom research to reality:research and innovation in the NHS as key to enabling the 10-Year PlanIAPT Improving Access to Psychological TherapiesICB Integrated Care BoardICS Integrated Care SystemIET Internet-Enabled T

27、herapyIRLS Innovation,Research and Life SciencesMHRA Medicines and Healthcare Products Regulatory AgencyMRC Medical Research Council MSAS Memorial Symptom Assessment ScaleNHS National Health ServiceNICE National Institute for Health and Care ExcellenceNIHR National Institute for Health and Care Rese

28、archOLS Office for Life SciencesOSCHR Office for Strategic Coordination of Health ResearchPPIE Patient and Public Involvement and EngagementPCN Primary Care NetworkQALY Quality-Adjusted Life YearR&D Research and DevelopmentRCT Randomised Control TrialREF Research Excellence FrameworkRTT Referral-to-

29、treatment SBRI Small Business Research InitiativeSTI Science,Technology and InnovationTEC Technologically Enabled CareTERM Technologically Enabled Remote Monitoring UK United KingdomUKRI UK Research and InnovationVC Venture Capital vSummaryThe context:why research and innovation is the key platform

30、for the NHS 10-Year PlanResearch and innovation are the fourth big shift needed to transform the NHS.Mainstreaming research and innovation throughout the National Health Service(NHS)is the fourth shift underpinning the 10-Year Plan.Without it,improvements in care quality,patient outcomes and experie

31、nce,productivity and the sustainability of NHS services cannot be achieved.Healthcare is a knowledge-intensive sector,and if research and innovation are not actively supported and enabled,the gap between what is possible to achieve and what materialises in practice will grow.The governments focus on

32、 developing a 10-Year Plan for health and care aims to respond to serious challenges to NHS sustainability and performance,emphasising three big shifts for the health care system to achieve by 2035:(1)from hospitals to communities,(2)from sickness to prevention and(3)from analogue to digital.1 These

33、 depend on a fourth shift:from seeing research and innovation as a nice to have to essential for transforming the NHS and making it fit for the present and the future.We call this shift:from research to reality.Lord Darzis independent investigation of the NHS in England highlights that research and

34、innovation have a key role to play in enabling a more sustainable NHS.Research and innovation should not be considered second-order priorities.The United Kingdom(UK)has a strong base in health research,from basic and applied biomedical research and clinical trials to evidence on how best to reorgani

35、se and reform the delivery of health services.From a health policy perspective,research and innovation should provide the evidence,insights and skills to support change and improvement throughout the NHS.However,this potential has not yet been realised;research and innovation in the NHS remains frag

36、mented,beset by systemic inefficiencies,with weak links between NHS policy priorities and wider industrial strategy.Overcoming these challenges and embedding research and innovation throughout the NHS will be pivotal in achieving the aims of the 10-Year Health Plan and bringing wider societal and ec

37、onomic benefits.Research aims and approachThe study aimed to inform a vision for research and innovation in the health system,with a particular emphasis on the NHS.This work is part of a wider collaborative project between the Wellcome Trust,RAND Europe and Nesta.RAND Europes work aimed to:Examine k

38、ey evidence on the importance and impact of research and innovation in and around the NHS.viFrom research to reality:research and innovation in the NHS as key to enabling the 10-Year PlanThe work was conducted from November 2024 to February 2025 and was informed by desk research,literature review,ca

39、se studies,and stakeholder engagement through interviews and a workshop.It also benefited from the RAND Europe research teams long-standing work on research,innovation and health-systems transformation.We identified key insights by triangulating findings across data sources and methods via thematic

40、analysis.Key findingsConsider impacts more closely through case studies in five key areas of strategic importance to the NHS(genomics,artificial intelligence,digital innovation in mental health,tech-enabled remote monitoring and participatory research).Examine the support mechanisms needed to enable

41、 a research-and-innovation-active NHS and deliver benefits for patients,the public,the NHS and wider health system,the economy and society,and identify what good would look like in relation to the support mechanisms in the future.Health research and innovation benefit the NHS,patients,the economy an

42、d society and should be a core part of wider efforts to put the NHS on a more stable footing.The benefits stemming from research and innovation span(1)improved care quality,safety and productivity,(2)enhanced job satisfaction and NHS workforce retention,(3)improved patient health outcomes(e.g.mortal

43、ity rates)and patient experience and(4)strengthened health system resilience for population health.Other benefits include positive impacts on the economy and broader society,such as those related to the UKs reputation as a global leader in research.Participating in research and clinical trials is li

44、nked to better NHS staff adherence to evidence-based practice,improved treatment protocols,high-quality care and earlier patient access to potentially lifesaving treatments.Research-active NHS organisations are linked to reduced mortality rates and increased patient confidence in healthcare professi

45、onals.Health research and innovation can also make NHS organisations more attractive as employers,create jobs and revenue,help reduce absenteeism and reap benefits from the UKs global reputation for scientific excellence.The UK has a strong health research base to build on in NHS transformation effo

46、rts.Commercially sponsored clinical trials are a visible example of how collaborative action to address current obstacles can bring health and economic benefits.However,the potential of research and innovation to support NHS transformation extends beyond trials alone and is key to delivering in the

47、three shifts the government identified:from hospitals to communities,from sickness to prevention and from analogue to digital.Basic research helps us understand the mechanisms underpinning health and disease,while applied research and innovation lead to novel prevention,diagnosis and personalised tr

48、eatment approaches(often in collaboration between the NHS,academia and industry).These approaches include technologies that facilitate viiearly diagnosis and timely treatment to prevent unnecessary hospital admissions and digital technologies that enable care in the community and reduce waiting list

49、s.Health services research and evaluation provide actionable insights to support the implementation of innovation in the health service across neighbourhoods and communities.Research and innovation should provide the evidence,insights and skills that enable change and improvement throughout the NHS.

50、However,the full potential to achieve this has not yet been realised.Research and innovation in the NHS happen sporadically and will take time to embed in NHS operations.There are seven support mechanisms for mainstreaming research and innovation throughout the NHS to help achieve success in transfo

51、rmation efforts.Each support mechanism matters in moving the NHS closer to a vision of what good looks like in the future:1.Workforce:A research-and-innovation-active NHS workforce is critical for achieving sustainable,high-quality,cost-effective healthcare.In ten years,achieving the fourth shift wi

52、ll have empowered NHS staff to help transform the NHS by ensuring evidence-based,innovative patient care.The NHS workforce will be motivated,skilled,rewarded and accountable for doing and adopting research and innovation,supported by better training and information.2.Data,information and evidence:Im

53、proved access to data,information and evidence is essential for ensuring best practice in NHS care and responding to unmet needs.In ten years,data,information and evidence will be more widely accessible to researchers and innovators and will be used,shared,combined and analysed safely and securely,w

54、ith public trust.An evidence-driven NHS will develop new solutions and adopt,spread and scale best practices.3.Physical infrastructure:Upgrades to basic physical infrastructure,alongside investments in key high-tech facilities,are crucial for the NHS to provide safe care and for patients to access g

55、lobal scientific advances.In ten years,the fourth shift will have attracted investment to improve the NHS estate to support excellence in research and innovation for patient care.The basics will be in place,reducing contradictions between world-leading facilities in some settings and dilapidated bui

56、ldings and out-of-date equipment,hardware and IT systems in others.4.Funding,commissioning and procurement:More strategic prioritisation of funding is crucial for reducing resource wastage and inefficient,ineffective care.In ten years,investments into research and innovation will be collaboratively

57、prioritised to align the innovation pipeline with health needs and affordability,supporting improvements across prevention,diagnosis and treatment.Both financial and non-financial incentives will encourage research and innovation activity in NHS organisations.viiiFrom research to reality:research an

58、d innovation in the NHS as key to enabling the 10-Year Plan5.Research and development(R&D)governance and regulation of innovation:Efficient,robust and innovation-friendly R&D governance and regulation that ensures patient safety underpins the ability of research and innovation to translate into NHS,

59、patient and economic benefits at scale.In ten years,close collaboration across research governance,innovation regulation and health technology assessment will cement a smoother pathway from lab to NHS practice,enabling patients rapid access to novel solutions and an attractive UK market for innovato

60、rs.6.Collaboration and coordination:Closer collaboration and coordination between local,regional and national bodies is pivotal for more efficient and effective progress with research and innovation,and its translation and spread throughout the NHS.In ten years,the fourth shift will have enabled pat

61、ients,the NHS and the economy to benefit from a landscape in which industrial policy and health policy initiatives reinforce each other,regional and national efforts are complementary,and the UK is a key partner in global developments.7.Patient and public involvement,engagement and participation:Inc

62、lusive patient and public involvement,engagement and participation in research and innovation determine whether the UK population have a fair say in shaping what the NHS does and how.In ten years,it will be the norm for patients and the public across diverse communities to engage in meaningful and f

63、lexible ways,helping to steer a culture of constant improvement focused on actual needs and greater trust.Existing infrastructure(such as potentially the NHS App)will enable more effective recruitment of patients into research,including clinical trials.ConclusionPrioritising actions in each support

64、mechanism area outlined will enable a feasible approach to translating research and innovations potential to support NHS reforms.A coordinated national strategy informed by dialogue between actors in the research,innovation,health policy and industrial strategy landscape can help achieve this.Only a

65、n NHS that embraces research and innovation can transition to meet the needs of the present and to futureproof the wider health system in a sustainable way.Realising this means linking multiple stages and actors across the NHS,academia,industry,patients and the public.We have outlined seven support

66、mechanisms to help ensure research and innovation deliver their potential and what must happen for this transition.As shown in Figure 1 below,these support mechanisms build on the health system building blocks outlined by the World Health Organization(WHO).2 An ecosystem of support mechanisms is fun

67、damental to delivering on the shift from seeing research and innovation as nice to have to essential to achieving the three big shifts the government outlined.More specifically,the shift from hospital to community needs to be informed by health services and public health research and innovation that

68、 can ixsupport feasible and effective,evidence-based policies.This shift must also be supported by patient access to innovative diagnostics,treatments and cures that can help avoid unnecessary hospital admissions.The shift from analogue to digital will require innovation in technology and data infra

69、structure,as well as research and evaluative evidence on workforce,service user,industry supplier and regulatory system determinants of implementation success.The shift from sickness to prevention will need to be informed by public health,health services and biomedical and life sciences research,lea

70、ding to the implementation of innovation that can help keep people healthy while still responding to pressing needs to reduce waiting times and address the post-COVID backlog.The support mechanisms are key to achieving the core values of modern health systems.We conceptualise these as being rooted i

71、n notions of excellence in care,effectiveness(including cost-effectiveness),efficiency,equity and supporting an evolving health system that is responsive,learning and adaptive.This vision includes proactively addressing the growing burden of chronic diseases and comorbidities,increasing health syste

72、m costs related to the evolving nature of health service demand,ageing populations and emerging infectious disease threats.A fourth shift to a research-and-innovation powered NHS must be a guiding principle of the future health service and the 10-Year Plan,with all actors empowered to help achieve i

73、t.An extended summary of this report is available as a separate paper.*For an extended summary of this report,please see:Marjanovic,S,Z Marciniak-Nuqui,H Toole,S Stockwell,S Parkinson,S Bucseneanu,J Grant and N Fahy.2025.From research to reality:research and innovation in the NHS as key to enabling

74、the 10-Year Plan Extended Summary.Santa Monica,Calif.:RAND Corporation.RR-A3808-1.xFrom research to reality:research and innovation in the NHS as key to enabling the 10-Year PlanFigure 1.The fourth shift from research to reality:research and innovation enable wider changexiTable of contentsPreface:r

75、eaders guide iAcknowledgements iiAbbreviations iiiSummary vChapter 1.Introduction 11.1.The project context 11.2.Project aims and approach 2Chapter 2.The contribution and impact of research and innovation in the NHS:an overview 42.1.An overview 52.2.Impact on the NHS and wider health system 72.3.Impa

76、cts on patients and population health 112.4.Impacts on the economy and wider society 132.5.Looking to the future:harnessing untapped potential 17Chapter 3.Current benefits and future potential:case studies in areas of transformative science and innovation in the NHS 183.1.Genomic screening and testi

77、ng in the NHS 183.2.AI applications in cancer screening and diagnosis 333.3.Digital and data-driven innovation in mental health 453.4.Technology-enabled remote monitoring in the NHS 603.5.Participatory,community research 72Chapter 4.Support mechanisms in the UK life sciences and health research and

78、innovation ecosystem:current status,challenges and what good looks like in the future 814.1.A brief history of research and innovation in the NHS 814.2.An ecosystem of support mechanisms for research and innovation in the NHS:key considerations 884.3.Research and innovation in the NHS:the current la

79、ndscape and a vision for the future 90Chapter 5.Conclusion 134References 139Appendix 1.Interviewees 187Appendix 2.The impact of UK university research on the NHS 188xiiFrom research to reality:research and innovation in the NHS as key to enabling the 10-Year PlanTable 1.Enablers and challenges to re

80、search and innovation in genomic testing and screening 30Table 2.Enablers and challenges to research and innovation in genomic testing and screening 42Table 3.Enablers and barriers influencing the progress in mental health research and innovation 56Table 4.Enablers and barriers influencing the progr

81、ess in mental health research and innovation 69Table 5.Enablers and barriers influencing the progress in participatory research 79Table A1.List of stakeholders interviewed for the project 187TablesFigure 1.The fourth shift from research to reality:research and innovation enable wider change xFigure

82、2.The research and innovation pathway 6Figure 3.Impacts from research and innovation in the NHS:an overview 8Figure 4.UK map showing collaborations between the NHS and universities based on the number of collaboratively authored papers 10Figure 5.Growth in NHS R&D expenditure(current prices)compared

83、 to MRC and total Government Expenditure on R&D(GERD).85Figure 6.Key R&D and innovation funding flows in the the NHS 112Figure 8.The fourth shift:research and innovation enable a wider change 138Figure 7:NHS-Related Impact Case Studies 189Figure 8.Alluvial Diagram:funding flows 190Figure 9.Impact Wh

84、eel:NHS impact case study disciplines 191FiguresxiiiBox 1.Summary:The impacts of research and innovation in and around the NHS 4Box 2.Impact story:modelling study enables the MenB vaccine programme rollout in the UK 9Box 3.Impact story:The success of the CRASH-2 and CRASH-3 trials 12Box 4.The econom

85、ic impacts of a research and innovation active health system in and around the NHS 14Box 5.Impact story:the Born in Bradford air quality research 15Box 6.Impact story:the Clinical Practice Research Datalink(CPRD)16Box 7.Case study summary:Genomic screening and testing in the NHS 18Box 8.UK genomics

86、impact on patients and population health 25Box 9.UK genomics impacts on the NHS and wider health system 27Box 10.UK genomics impacts on the economy and society 28Box 11.CAR-T therapy 32Box 12:Case study summary-AI applications in cancer screening and diagnosis 33Box 13.AI and cancer diagnosis:emergi

87、ng evidence of impact on patients 39Box 14.AI and cancer diagnosis:emerging evidence of impact on the NHS 40Box 15.AI and cancer diagnosis:emerging evidence of economic impact potential 41Box 16.Case study summary:digital and data-driven innovation in mental health 45Box 17.Digital and data-driven i

88、nnovation in mental health:impacts on patients and population health 52Box 18.Digital and data-driven innovation in mental health:impacts on the NHS and health system 54Box 19.Digital and data-driven innovation in mental health:impacts on the economy and society 55Box 20.Large psychiatric data sets

89、and data linkage(Akrivia)59Box 21.Case study summary-technology-enabled remote monitoring in the NHS 60BoxesxivFrom research to reality:research and innovation in the NHS as key to enabling the 10-Year PlanBox 22.Technology-enabled remote monitoring impact on patients and population health 65Box 23.

90、Technology-enabled remote monitoring impact on healthcare services and wider health system performance 67Box 24.Technology-enabled remote monitoring impacts on the economy and society 68Box 25.Case study summary:participatory research in the NHS 72Box 26.Born in Bradford:how participatory research c

91、an reshape and facilitate health research in practice 75Box 27.Impacts of participatory research on patients and population health 76Box 28.Impacts on the NHS and wider health system 77Box 29.The role of participatory research in clinical trials 78Box 30.History of research and innovation in the NHS

92、:a summary 82Box 31.Section summary:an ecosystem of support mechanisms for research and innovation in the NHS 88Box 32.Section summary:the current landscape and a vision for the future 90Box 33.What matters-workforce considerations:key points 92Box 34.The current landscape of support mechanisms for

93、a research-and-innovation-active NHS workforce:key points 93Box 35.Challenges to a research and innovation active workforce:key points 96Box 36.A future vision for a research-and-innovation-active NHS workforce:what good looks like 98Box 37.What matters for data information and evidence:key points 9

94、9Box 38.Support mechanisms related to data,information and evidence:key points 99Box 39.Challenges related to data,information and evidence:key points 101Box 40.A future vision for the data,information and evidence environments framing research and innovation in and around the NHS 104Box 41.What mat

95、ters for physical infrastructure:key points 106Box 42.Support mechanisms related to physical infrastructure:key points 106Box 43.Challenges related to physical infrastructure:key points 107Box 44.A future vision for physical infrastructure framing research and innovation in and around the NHS 108xvB

96、ox 45.What matters for funding,commissioning and procuring research and innovation:key points 110Box 46.Support mechanisms related to funding,commissioning and procurement:key points 110Box 47.Challenges related to funding,commissioning and procurement of research and innovation:key points 113Box 48

97、.A future vision for funding,commissioning and procurement 115Box 49.What matters for R&D governance and regulation of innovation:key points 117Box 50.Support mechanisms related to R&D governance and regulation of innovation:key points 117Box 51.Improving the regulation and governance of clinical tr

98、ials 119Box 52.Challenges related to R&D governance and the regulation of healthcare innovation 120Box 53.A future vision for R&D governance and regulation of research and innovation 121Box 54.W hat matters for the collaboration and coordination of research and innovation:key points 123Box 55.Suppor

99、t mechanisms for collaboration and coordination:key points 124Box 56.Challenges related to collaboration and coordination 125Box 57.A future vision for collaboration and coordination of research and innovation in the NHS 126Box 58.What matters for patient and public involvement,engagement and partic

100、ipation:key points 128Box 59.Support mechanisms for patient and public involvement,engagement and participation:current landscape and developments over time 129Box 60.Challenges related to patient and public involvement,engagement and participation in healthcare research and innovation 130Box 61.A f

101、uture vision for patient and public engagement,involvement and participation in research and innovation 132Box 62.Conclusion:key points 1341From research to reality:research and innovation in the NHS as key to enabling the 10-Year PlanChapter 1.Introduction 1.1.The project contextHealth research and

102、 innovation have a key role to play in directing the National Health Service(NHS)towards a more sustainable future and should not be seen as a second-order priority.A research-and-innovation-active NHS is essential for high-quality healthcare,improved patient outcomes and the United Kingdoms(UKs)wid

103、er economic and industrial competitiveness.The transformative potential of a research-and-innovation-active NHS can only be harnessed via a system-wide shift from seeing research and innovation as a nice to have to central to efforts to transform the NHS.We call this shift:from research to reality.E

104、mbedding research and innovation throughout the NHS is the fourth big shift the government must focus on in the 10-Year Plan to enable its three intended healthcare shifts from hospitals to communities,sickness to prevention and analogue to digital.1 As healthcare is a knowledge-intensive sector,res

105、earch and innovation capacity and a learning-and-improvement culture throughout the NHS are critical for enabling such shifts in practice.Commercially sponsored clinical trials are a visible example of how collaborative action to address current obstacles would bring both health and economic benefit

106、s.However,research and innovations potential to support NHS transformation extends beyond trials alone.Basic research can help us understand the mechanisms underpinning health and disease,while applied research informs new prevention,diagnosis and more personalised treatment approaches.It also feeds

107、 into the development of innovations(often in collaboration between the NHS,academia and industry),including technologies that can facilitate early diagnosis and timely treatment to prevent unnecessary hospital admissions.This includes digital health innovations that can facilitate care in the commu

108、nity and help reduce waiting lists and patient backlogs.Health services research and evaluation provides actionable insights into implementing innovations and improving services in practice across UK neighbourhoods and communities.The UK governments 10-Year Plan presents a fresh opportunity to embed

109、 health research and innovation at the heart of the NHS,provide the evidence,insights and skills to support change and improvement throughout the NHS and nurture a learning health system.Although the UK has a strong health-research-and-innovation base,its potential has not yet been fully realised.Re

110、search and innovation in the NHS remain fragmented,beset by systemic inefficiencies,resource allocation and organisational governance approaches that do not optimally incentivise innovation,with weak links between NHS policy priorities and wider industrial strategy.Overcoming these challenges and em

111、bedding research and innovation throughout the NHS will be pivotal to achieving the aims of the 10-Year Plan and bringing wider societal and economic benefits.The 10-Year plan offers renewed scope to create the conditions to embed,spread and scale research and innovation in the NHS in a way that rec

112、ognises and proactively responds to the changing nature of scientific and technological developments and the changing global research and innovation landscape.21.2.Project aims and approach1.2.1.Aims and methodsIn this context,Wellcome commissioned RAND Europe to deliver a study to help inform a vis

113、ion for research and innovation in the health system,with a particular emphasis on the NHS.This work was part of a wider collaborative project between Wellcome,RAND Europe and Nesta.The project took place between 1 November 2024 and 15 February 2025.It was informed by desk research,a literature revi

114、ew,case studies and stakeholder engagement through interviews and a workshop.The work benefited from the RAND Europe research teams long-standing body of work on research,innovation and health systems transformation.To better understand the impact of research in the NHS,we also analysed Impact Case

115、Studies submitted to the Research Excellence Framework(REF)2021.The full analysis and methodology are available in Appendix 2:ICS NHS Analysis.More specifically,RAND Europes work aimed to:1.Examine key evidence on the importance and impact of research and innovation in and around the NHS.We achieved

116、 this using a focused narrative review of scholarly and grey literature via Web of Science to identify academic sources on the role and importance of healthcare and life sciences research in the NHS.We limited our search to review articles and papers published in the last five years.We identified re

117、levant studies outside this period by snowballing.We ran four searches,focusing on abstracts,using the following search strings:research in the NHS,research-active NHS,innovation in the NHS and innovation NHS.This search resulted in 2,220 hits,which we sifted based on titles and abstracts.To identif

118、y relevant grey literature,we undertook a search on Google.Due to the works rapid nature,we limited the search to sources listed on the first two pages using three search strings:impact of research in NHS,life sciences and the NHS,and innovation in the NHS.This search resulted in 63 hits,of which we

119、 downloaded 24.2.Consider impacts more closely through case studies in five key areas of strategic importance to the NHS(genomics,artificial intelligence,digital innovation in mental health,tech-enabled remote monitoring and participatory research).We achieved this through case studies informed by d

120、esk research and 16 key informant interviews conducted via MS Teams between 1 November and 19 December 2024 with informed consent(see Appendix 1).The interviews focused on understanding the evolution of research and innovation in each case study area,key impacts to date,key enablers and challenges a

121、nd a vision for what good would look like in the future in terms of support mechanisms needed to enable future transformative potential in each case study area.3From research to reality:research and innovation in the NHS as key to enabling the 10-Year Plan3.Examine the support mechanisms needed to e

122、nable a research and innovation-active NHS and identify what good would look like in relation to the support mechanisms for delivering benefits for patients and the public,the NHS and wider health system,the economy and society.This analysis was informed by desk research,insights from the interviews

123、 conducted for the prior case study work package and a stakeholder workshop convened by Wellcome and facilitated by Nesta and RAND Europe on 5 December 2024.The workshop included 23 key stakeholders representing diverse individuals from research and innovation funders,academic and research organisat

124、ions,charities and non-governmental organisations,healthcare and patient and public involvement communities.We conducted all desk research using Google,Google Scholar,Web of Science and PubMed,as well as consulting websites of specific organisations or initiatives identified by snowballing from the

125、desk research or key informant interviews.In addition,we consulted RANDs internal Artificial Intelligence(AI)platform and SciSpace as a search source to complement the key databases.We reviewed all identified material and checked the content and sources before incorporating them.We used thematic ana

126、lysis to guide our findings and inferences based on desk-based analysis and synthesis,testing emerging insights from the stakeholder workshop,internal research team workshop and regular meetings.The research team was also sensitised by complex systems theoretical and conceptual perspectives on healt

127、h research and innovation(elaborated in Section 4).1.2.2.LimitationsWe conducted the study over a short timeframe,between 1 November 2024 and 15 February 2025,collecting most of the data before the end of 2024.As a result,we cannot claim to have covered all the potentially relevant literature on the

128、 impacts of research and innovation in and around the NHS on patients and population health,the NHS and wider health system,the economy and society.We also cannot claim to have spoken to all the individuals with potentially relevant insights to share on the wider support systems needed to enable a r

129、esearch-and-innovation-active NHS.However,we are confident that the diverse professional backgrounds,skills and experiences of those we spoke to,our use of both individual and group discussion approaches(interviews,workshop)and the breadth of sources consulted provide a robust and rounded analysis o

130、f the issues at play.The RAND Europe research team also benefits from a long history of research,evaluation and thought leadership on health services,health system transformation and innovation,lending further confidence to the findings and inferences.4Chapter 2.The contribution and impact of resear

131、ch and innovation in the NHS:an overview Box 1.Summary:The impacts of research and innovation in and around the NHSResearch and innovation in and around the NHS lead to a wide range of benefits.These span:Improving care quality,safety and productivity:Participation in research and clinical trials is

132、 linked to better NHS adherence to evidence-based practice,improved treatment protocols and high-quality,efficient care and greater openness to innovation.Enabling job satisfaction and workforce retention:Research activity can make NHS organisations more attractive as employers and contribute to job

133、 satisfaction.Improving patient health outcomes and experiences:Research and innovation give patients early access to novel,potentially life-saving treatments.Research activity is linked to reduced mortality rates and increased patient confidence in healthcare professionals.Contributing to health sy

134、stems resilience:Research underpinned the public health response to the COVID-19 pandemic,including surveillance research,pathogen genome sequencing,data modelling and vaccine innovation.All have key roles to play in pandemic preparedness.Research also informs adaptations in health service delivery

135、that support resilience.Supporting economic benefits:Alongside saving lives,health research and innovation create jobs and revenues,contributing to productivity.New treatments also improve peoples quality of life,supporting their continued employment and reducing absenteeism.Enabling wider societal

136、benefits and the UKs reputation as a global research leader:The UKs reputation as a clinical research leader helps attract international collaborators,increases research reach and impact,and creates spillover benefits(e.g.patents).5From research to reality:research and innovation in the NHS as key t

137、o enabling the 10-Year Plan2.1.An overviewResearch and innovation in the NHS can save lives,improve patient experience,population health and staff wellbeing,and bolster health system resilience.It can also support the economy and offer wider societal benefits,e.g.from the UKs reputation as a global

138、research leader.Research and innovations impact in and around the NHS concerns its influence on healthcare organisations and staff,patients and the wider public,and the wider economic and societal landscape.These impacts can be diverse.The NHS can also play multiple roles in research and innovation,

139、whether as the funder,participant,and/or beneficiary of research and innovation(see Appendix 2:ICS NHS Analysis,illustrating these roles based on an analysis of insights from Research Excellence Framework impact case studies).However,these roles are not mutually exclusive,and participation in all re

140、search forms is associated with benefits for the NHS.Research and innovation are distinct but interrelated and multifaceted concepts.Research can take many forms,e.g.curiosity-driven basic research,translational and applied research,clinical research and health services research.Likewise,healthcare

141、innovation is multi-faceted and relates to diverse products and technologies,including medicines,vaccines,diagnostics,various medical devices,digital technologies and innovative service models.Healthcare innovation refers to developing new products,technologies or services or applying existing ones

142、in new ways.3Discovery or creation represents the first step toward innovation,i.e.generating initial research insights.The discovery becomes an invention after identifying one or more potential applications.Once an invention translates into a novel and useful product,technology or service,it is an

143、innovation or invention put into practice.An innovation is commercialised with a view to subsequent implementation and potential diffusion(see Figure 2).While research feeds into innovation,innovation can also generate new research questions.Therefore,innovation can be demand-driven(a response to an

144、 identified unmet health need,sometimes described as the innovation pull)or supply-driven(a response to scientific advances that enable further research and development activity,sometimes described as the innovation push).However,unmet needs can also generate research investments that enable scienti

145、fic advances and further research and development(R&D)activity.Thus,supply and demand-driven innovation are not mutually exclusive concepts.Research and innovation are processes with distinct outputs(e.g.publications,patents,service models,new products,technologies and services).These processes are

146、complex,emergent and non-linear,whereby different phases in the research and innovation pathway co-evolve.Research and innovation can lead to benefits but can also have unintended consequences that need mitigation and management.Although we do not assume in this report that innovation is always bene

147、ficial,we have focused on contexts and cases where evidence suggests likely benefit.6Figure 2.The research and innovation pathway*,4,5*Adapted from Marjanovic,S,M Altenhofer,L Hocking,M Morgan Jones,S Parks,I Ghiga,C Cox,K Galai,and T Ling.2020.Innovating for improved healthcare:Policy and practice

148、for a thriving NHS,RAND Corporation,RR-2711-DH;and Fahy,N,N Mauer,and D Panteli.In press.From ideas to reality:An introduction to generating and implementing innovation in health systems.WHO,Regional Press for Europe.InventionInnovationCommercialisationImplementationResearch(e.g.basic,applied,transl

149、ational)Innovation pathway:early development,(clinical)testing/trials and validation,regulatory approval,manufacturing,marketing,distribution,commissioning and procurementResearch(e.g.health services,implementation science)Evaluation(e.g.research citations,impact,clinical trials,health technology as

150、sessment,real-world evaluation,post-marketing surveillance)The following contents explore research and innovations multifaceted impacts on healthcare service performance,patients,the economy and society,based on a focused narrative review of the evidence.The evidence suggests that active participati

151、on in research is associated with enhanced healthcare quality and safety,improvements in care delivery processes and better health outcomes.6 The benefits of research extend to healthcare institutions themselves,with the trial effect leading to improved patient outcomes,adherence to guidelines and a

152、 stronger reliance on evidence-based practices,7 supporting the taxpayer-funded public-service model of the NHS that aims to deliver high-quality care that is free at the point of use.However,the distribution of research and innovation activity across the NHS is uneven across teaching and general ho

153、spitals,rural and urban settings,and secondary and primary care.8 Healthcare professionals face many barriers to undertaking research in the NHS,including insufficient time and resources,bureaucratic and regulatory hurdles,difficulties initiating clinical trials and recruiting sufficient participant

154、s,and challenges around adopting innovation in practice.4,9,10 These issues are further discussed in Section 4.The UK has excellent health research strengths to build on,with expertise in strategic areas ranging from genomics,AI and machine learning to digital health,quantum computing,personalised m

155、edicine,medtech,neurotech and immunology,among others.11 It also has world-leading academic institutions,government support,innovative companies and the NHS.Moreover,the UK has strong foundations for translating research into practice and ensuring that medical innovations reach patients promptly thr

156、ough translational infrastructure such as 7From research to reality:research and innovation in the NHS as key to enabling the 10-Year PlanBiomedical Research Centres,Health Innovation Networks and others(as discussed in Section 4).10 The UKs response to the COVID-19 pandemic highlighted its potentia

157、l to undertake rapid research and innovation for patient benefit.The RECOVERY trial started in 2020 in the UK as an international randomised trial to test COVID-19 treatments for people admitted to hospital with COVID-19-related pneumonia.It has now been extended to test treatments for other types o

158、f pneumonia internationally.12 The success of the RECOVERY trial and the effectiveness of the COVID-19 Vaccine Taskforce(VTF)was made possible through close collaboration between the government,academia,the private sector,the NHS and the public.10 Understanding research and innovations potential imp

159、act on the NHS is key to keeping it at the centre of future NHS planning and strategies.It also highlights key areas for further exploration and potential strategies to enhance research and innovation engagement across the NHS.As Figure 3 shows,research and innovation in and around the NHS span impa

160、cts the NHS and health system,patients and population health,and the economy and society.We elaborate on each of these impact areas in the following sections.2.2.Impact on the NHS and wider health system 2.2.1.Healthcare quality,safety and productivityThe evidence base on the links between research

161、and innovation in the NHS and health service performance is still evolving.However,several studies point to benefits for health service deliverys quality,safety and/or productivity and workforce well-being and retention.Participating in research and innovation is linked to better quality and safer h

162、ealthcare.A 2015 systematic review by UK researchers found evidence of observable improvements in care delivery processes and,in some cases,in health outcomes internationally,including the UK.6 The authors updated the review in 2024 with further supporting evidence of the impact on healthcare throug

163、h improved treatment protocols,impacts on organisational cultures in healthcare and collaboration.13 The review highlighted that 86 of the 95 papers reported positive results for health organisations as an outcome of research engagement.13 This included improvements such as lower mortality and morbi

164、dity rates.13 8Figure 3.Impacts from research and innovation in the NHS:an overviewIMPACTS ON THE NHS AND HEALTH SYSTEM Participating in research and innovation can lead to safer,better-quality healthcare.This includes improvements in care delivery processes,health outcomes,treatment protocols and n

165、urturing organisational cultures committed to improvement.Clinical trials benefit participating NHS organisations by fostering evidence-based practice,adherence to guidelines,high-quality care and openness to innovation.This is known as the trial effect.Lord OShaughnessys review estimates that over

166、the past five years,the reduction in patients recruited for commercial research has cost the NHS 360m.Healthcare professionals involvement in research can lead to greater job satisfaction and has the potential to support workforce retention.Innovation in the NHS can help improve productivity by deli

167、vering better value for money and more efficient services.Research can support an adaptive health system that improves over time.RESEARCH AND INNOVATION Research can take many forms(curiosity driven basic research,translational and applied research,clinical research,health services research,implemen

168、tation science).Healthcare innovation is multi-faceted and can relate to products and technologies such as medicines,vaccines,diagnostics and various medical devices,digital technologies or innovative service models.Healthcare innovation refers to the development of new products,technologies or serv

169、ices or the application of existing ones in new ways.IMPACTS ON PATIENTS AND POPULATION HEALTH Research-active NHS hospitals tend to be associated with better patient outcomes and experience than those not involved in research.This results from increased NHS attentiveness to patient information,impr

170、oved staff collaboration and greater patient confidence in the healthcare professionals whose care they are under.Participation in clinical trials gives patients early access to novel treatments and knowledge.There are opportunity costs for the NHS resulting from not having clinical trial activity.R

171、esearch is also key in strengthening UKs resilience against future pandemics,supporting population health.Research was critical during the COVID-19 pandemic to informing public health decisions that protected populations across the UK.It was also key to the development of rapid diagnostic tests and

172、vaccines that saved lives.IMPACTS ON THE ECONOMY AND SOCIETY The life sciences and health research and innovation sectors not only save lives but also create jobs and revenue.In 2022,the UK life sciences sector contributed 36.9bn to the economy and supported 250,000 jobs,attracting significant inves

173、tment(4.5bn)for driving innovation and economic growth.In 2024,industry clinical trials supported 23,000 jobs and 1.4bn in gross value added.Research and innovation in the NHS can influence workforce productivity.New treatments enhance patients quality of life,enabling them to remain employed and re

174、duce absenteeism.In 2022,the adoption of new treatments in research-active hospitals was estimated to have prevented 6.3 million sick days.The UK is recognised as a clinical research leader,which helps attract international collaborators and increases research reach and impact.Clinical research acti

175、vities create spillover benefits that are at the intersection of academic reputation and economic growth(e.g.patents).9From research to reality:research and innovation in the NHS as key to enabling the 10-Year PlanBox 2.Impact story:modelling study enables the MenB vaccine programme rollout in the U

176、KResearch that led to the rollout of a new vaccine to protect young children from meningococcal group B disease(MenB),a leading infectious disease among young children,significantly impacted the UKs immunisation schedule.14 No vaccines existed for MenB before 2013,but once a vaccine was licensed,pol

177、icymakers required evidence of its cost-effectiveness and impact.Models were developed to estimate the impact of widespread immunisation on reducing meningitis cases and assess the cost-effectiveness of potential immunisation programmes.The results informed recommendations for a MenB vaccination sch

178、edule for babies,with a booster at 12 months,projecting over a quarter reduction in meningitis cases in the first five years.This evidence was crucial for the UK adopting the MenB vaccine in 2015,becoming the first country to include it in its routine immunisation programme.The programmes success wa

179、s evident,with Public Health England reporting that nine out of ten 1012-month-old babies were vaccinated by 2018,significantly reducing meningitis cases and saving lives.The modelling study also resulted in an estimated 136m per year of NHS cost savings due to the successful vaccination programme.1

180、4Clinical trials are also associated with benefits for the NHS institutions involved in running them regarding adherence to evidence-based practice,high-quality care and openness to innovation.Known as the trial effect,a Cochrane systematic review found that institutions involved in clinical trials

181、have better outcomes,increased reliance on evidence and improved adherence to guidelines by healthcare professionals.7 A 2018 retrospective cross-sectional study looking at the correlation between NHS clinical trials and mortality rates found that in general,there is some association between clinica

182、l trials at NHS institutions and Quality-of-Care(CQC)ratings.15 As Lord OShaughnessys review of clinical trials pointed out,research-active clinicians are also more likely to recommend innovative or newly-licensed treatments to patients.10 According to Frontier Economics recent report on the value o

183、f clinical trials,participation in clinical research influences the entire institutions working culture,generating more willingness to adopt innovation and novel medications.16 Clinical trials are also linked to improved collaboration between clinical staff and academic experts,facilitating a broade

184、r reach of knowledge about medical advancements.16 Based on the results of our analysis of Research Excellence Framework impact case studies(see Figure 4),research collaboration between academic organisations and NHS hospitals is widespread across the UK and not confined to local partnerships alone.

185、The map in Figure 4 shows institutional collaborations based on publications listed as underpinning research in NHS-featured impact case studies between universities(blue points)and hospitals(green points),with the connecting lines based on the amount of collaboratively authored papers.Thicker lines

186、 reflect a greater level of collaboration.Only collaborations between universities and hospitals were counted(i.e.not university-to-university collaboration),and point sizes are proportional to the number of publications.This figure shows a considerable collaboration between UK universities and hosp

187、itals,both locally and across the UK,as evidenced by the collaboration cords connecting the full breadth of the UK.Additionally,universities tend to produce more publications(i.e.their point size is generally larger),whereas hospitals contributions are more distributed,especially in metropolitan are

188、as.10Figure 4.UK map showing collaborations between the NHS and universities based on the number of collaboratively authored papersMuch of the evidence on the links between research activity in the NHS and care quality and safety focuses on secondary care.This point was alluded to in the 2024 NHS re

189、port on research in the NHS,which states that only around 3%of GP practices participate in commercial research activities such as clinical trials.17 Despite this,a 2024 qualitative study of general practitioners in England highlighted that research participation improved GP relationships with patien

190、ts and influenced GP work-style,including a higher reliance on evidence partly enabled through improved access to resources.18 A 2024 study protocol noted that the impact of research in the NHS on general practice must be understood in light of regional disparities in GP participation and engagement

191、 in clinical research,pointing to significant differences between GP research activity across the country.19 Disparities between rural and urban NHS organisations affect GP research activity and result in lower research participation rates in rural areas.20 Nevertheless,some evidence suggests that r

192、esearch benefits can extend beyond recognised centres of excellence across the UK.21 Although studies on the impact of research and innovation on rural NHS hospitals are limited,a 2019 Royal College of Physicians publication calls for wider-spread research participation to overcome the 11From resear

193、ch to reality:research and innovation in the NHS as key to enabling the 10-Year Planconcentration of research activity in southeast England and urban centres such as Manchester,Newcastle and Leeds.8 They argued that this could increase the positive research effect in smaller,rural trusts to better a

194、lign research in the NHS with the needs of patients most likely to benefit from it.8 A 2017 RAND Europe study explored the role of innovation in the NHS in enhancing productivity,highlighting its potential for delivering better value for money and more efficient services.The results also suggest inn

195、ovations potential for addressing the growing and changing demand for health services while maintaining high-quality care with limited resources.22 2.2.2.Job satisfaction and workforce retentionHealthcare professionals involvement in research can increase job satisfaction and support workforce reten

196、tion.17,23,24 There was growing evidence that medical and nursing professionals were leaving their jobs and/or reducing their working hours even before COVID-19 induced an NHS workforce crisis.2527 A 2019 literature review suggests that increased research opportunities for healthcare staff can posit

197、ively impact workforce retention and job satisfaction.28 A 2020 Royal College of Physicians study showed that most surveyed doctors reported positive attitudes towards research activity in the NHS,citing intellectual stimulation,improving patient care and continued skill development.8,29 A 2024 stud

198、y of the impact of research on general practice reinforced these findings,drawing on interviews with healthcare professionals in general practice who described greater job satisfaction and increased attractiveness of their institution as a workplace due to research involvement.18 Another 2024 study

199、of research interest and the culture of NHS staff suggests that healthcare professionals desire to engage in research has only increased after the COVID-19 pandemic due to greater awareness about the positive impact of research on health outcomes.30 A study focusing on developing a research impact t

200、ool for nursing,midwifery,allied health professions,healthcare science,pharmacy and psychology(NMAHPPs)revealed that clinicians involved in research are typically perceived as more credible by their peers.23 Despite this,many healthcare professionals find it challenging to engage in research due to

201、a lack of protected time,difficulties with research funding,and preconceived notions in less research-active professions like nursing.2.3.Impacts on patients and population health 2.3.1.Patient outcome and experienceA gradually evolving evidence base suggests that research-active NHS hospitals tend

202、to be associated with better patient outcomes and patient experience than those not involved in research.6,31Although an earlier 2011 systematic review suggested that the evidence on patient benefits related to being treated by clinicians or institutions participating in clinical trials was inconclu

203、sive and merited further research,7 recent evidence associates research-active NHS organisations with reduced mortality rates,albeit without clear causal relationships.For example,a 2012 retrospective observational study highlighted a correlation between research publications and hospital mortality

204、rates.32 Similarly,a 2015 study showed that research-active acute NHS Trusts 12had lower mortality rates for acute admissions,even after accounting for structural factors such as staffing levels.33 A 2017 study examining the impact of clinical trial involvement on colorectal cancer patients found a

205、strong association between participation in interventional clinical trials and lower patient mortality rates.21 A 2018 retrospective cross-sectional study also found a general association between clinical trials at NHS institutions and improved health outcomes and quality-of-care(CQC)ratings.15 Ther

206、e is also some evidence suggesting that hospitals engaged in clinical research have better patient experiences due to increased attentiveness to patient information,improved staff collaboration and greater patient confidence in their doctors.31 A 2024 paper on research in the NHS argued that partici

207、pation in clinical trials gives patients early access to novel treatments and knowledge,17 and an Association of the British Pharmaceutical Industry(ABPI)report pointed out that this is particularly important for patients who have exhausted all other treatment options,e.g.people with rare diseases.3

208、4 Box 3.Impact story:The success of the CRASH-2 and CRASH-3 trialsThe CRASH-2 trial,funded by the National Institute for Health and Care Research(NIHR)and led by the London School of Hygiene and Tropical Medicine,has significantly impacted global trauma care by demonstrating the life-saving potentia

209、l of tranexamic acid for trauma patients.35 This low-cost drug,previously used to reduce bleeding during surgery,was tested on over 20,000 trauma victims across 40 countries.The trials results,published in The Lancet,showed that administering tranexamic acid within three hours of injury could preven

210、t nearly 20%of trauma deaths,potentially saving around 400 lives annually in the UK and over 100,000 worldwide.The findings led to widespread changes in treatment practices,with tranexamic acid now recommended by the National Institute for Health and Care Excellence(NICE)and included in the World He

211、alth Organizations list of essential medicines.By 2016,it became standard care for severe injuries in England,with 90%of severely injured patients receiving the treatment.35 The British and United States(US)Armies have also adopted it in their combat care guidelines,and the UK government invested in

212、 developing a tranexamic acid autoinjector for military use.The trials success has spurred further research,including the CRASH-3 trial,which demonstrated that tranexamic acid reduces head injury deaths by 20%.352.3.2.Health system resilience to support population health Translational research is im

213、portant for strengthening the UKs resilience against future pandemics.The COVID-19 pandemic showcased the impact of scientific innovations like genomic sequencing,vaccine development and data modelling,achieved through rapid collaboration among various sectors.10 The pandemic accentuated the importa

214、nce of diagnostic lab capacity,vaccine strategies,real-time NHS research,efficient data sharing,public communication and genomic tools for surveillance.36 However,despite a rapid research response,the initial absence of infrastructure linking genomic sequencing with patient data emphasised the impor

215、tance of proactively integrating research and innovation into the NHS for timely,evidence-based responses to future pandemics.3613From research to reality:research and innovation in the NHS as key to enabling the 10-Year PlanThere is evidence to suggest that research activity in the NHS can support

216、adaptation and innovation,forming the foundations for healthcare resilience.A narrative meta-synthesis looking at balancing adaptation,innovation and resilience in different healthcare settings suggested introducing innovation boosts resilience.37 Maximising innovation-related benefits requires bala

217、ncing short-term adaptations,which can lead to complex,unintended outcomes without significant system changes and long-term adaptations that involve wider system restructuring and adoption.37 2.4.Impacts on the economy and wider society 2.4.1.Economic impacts and productivityA growing body of litera

218、ture links investment in health research with high economic returns.While evidence is scarce on the impacts of research and innovation in the NHS,specifically on economic benefits,some insights are beginning to emerge.Further evidence may accrue with growing government emphasis on value for money,bu

219、siness cases,evaluation,learning and accountability.However,the historical siloes between health policy and life sciences industrial strategy mean NHS interventions are not systematically evaluated for their benefits to patients,health systems and the wider economy.Such economic benefits span revenu

220、e generation,returns on investment,jobs and attracting investment.The life sciences,health research and health innovation sectors are key to innovation in health tech,diagnosis,treatments and vaccines,which save lives,create jobs and revenue and strengthen the UKs global competitiveness.Box 4 provid

221、es some examples of the economic contributions of research and innovation in and around the NHS.14Box 4.The economic impacts of a research and innovation active health system in and around the NHS According to the 2023 Government Advanced Manufacturing Plan,the life sciences sector generates over 90

222、bn turnover,38 with official statistics suggesting the sector exports goods worth 24bn.39 A series of papers co-authored by RAND Europe researchers between 2008 and 2018 found that medical researchs internal rate of return on investment,in terms of the additional health gains,ranges between 710%per

223、annum,with an additional 15%rate of return through broader economic benefits.4042 These estimates are conservative compared to estimates in other countries that use different estimation methodologies,e.g.Aus$3.32 in additional economic output(GDP)generated for every Aus$1 of research funding in Aust

224、ralia in a study in 2023.43 Investment in UK life sciences also significantly impacts job creation and economic growth through innovation,productivity gains,talent acquisition and the creation of vibrant innovation ecosystems.44 A 2024 report by Frontier Economics found that the clinical trials indu

225、stry directly employed about 21,000 people in the UK in 2022,contributing 1.9bn to the economy.16 This impact rises to 3.2bn and 36,000 jobs when supply chain activities are included.16 Additionally,industry contracts with NHS providers for clinical trials support around 13,000 NHS jobs.16 According

226、 to the same report,industry clinical trials support 23,000 jobs and 1.4bn in gross value added(GVA),including indirect and induced effects.16 Based on a 2022 report by the BioIndustry Association and PwC,the UK life sciences sector contributes approximately 36.9bn to the economy and supports approx

227、imately 250,000 jobs,attracting significant venture capital(VC)investment(4.5bn)for driving innovation and economic growth.11 According to a published interview with Professor Chowdary,participating in research offers significant financial benefits for the NHS,primarily through savings on drug costs

228、.She reported that the Royal Free Haemophilia Centre saved approximately 15m over the past decade by engaging in various trials,including gene therapy.45 A KPMG report supports this,showing that clinical research contributed an estimated 8 billion to the UK economy and created around 47,467 full-tim

229、e jobs in England between 2017 and 2019.46Public investment in health and other relevant research in the UK results in further private investment.41,47 A 2016 economic study found that for every 1 of public investment in research,an additional 0.831.07 is expended on private sector R&D.41 A 2023 stu

230、dy by Becker and colleagues found that investment in research through UK Research and Innovation(UKRI)is linked with spillover effects of private sector investment in innovation,particularly in regions with high concentration of research and for larger or high-tech firms.48 A report by Frontier Econ

231、omics estimated these spillover benefits at around 1.1bn.16 Two 2024 studies commissioned by ABPI highlighted that NHS-industry partnerships bring value to patients through improved patient 15From research to reality:research and innovation in the NHS as key to enabling the 10-Year Planoutcomes alon

232、gside value to the UKs economy.16,48 Spillovers from public investment in other fields of life sciences have also been observed in the US.49,50Research and innovation in the NHS have the potential to influence wider productivity,given that health significantly impacts a persons working ability.16 Po

233、or health results in more absences from work and lower levels of productivity.Ill health can also affect employment indirectly,as individuals may need to care for others.New treatments can enhance patients quality of life,enabling them to remain employed and reduce absenteeism.16 Research for the AB

234、PI suggests that increased use of four innovative medicine classes*could yield a 17.9bn productivity gain for the UK.51 At the same time,quicker adoption of new treatments in research-active hospitals was estimated to have prevented 6.3 million sick days in 2022.16 Of these,44%were attributed to ind

235、ustry clinical trials,resulting in approximately 3 million sick days avoided,equating to 0.9bn in GVA.16 Despite these benefits,falling levels of commercial research in the NHS are leading to significant opportunity costs related to reduced research and innovation and reduced funding flows into the

236、NHS.10 As Lord OShaughnessy found in his 2023 review on Commercial Clinical Trials,one reason for the decreasing numbers of clinical trials in the UK is that industry partners see the UK as an untrustworthy and unstable partner,compounded by the Medicines and Healthcare Products Regulatory Agency(MH

237、RA)administrative backlogs and long bureaucratic processes.52 Along with increasing competition from other countries and NHS workforce shortages,this led to a drop in clinical trials in the UK.52 The review estimates that the reduction in patients recruited for commercial research over the past five

238、 years has cost the NHS approximately 360m,with an estimated 570m in potential funding to cover the costs of running commercial trials lost.10 Box 5.Impact story:the Born in Bradford air quality researchBorn in Bradford(BiB)is a large-scale longitudinal birth cohort study based in Bradford,following

239、 13,500 babies born between 2007 and 2010 and their families.For more information on BiB,read Box 26.Born in Bradford:how participatory research can reshape and facilitate health research in practice.in Section 3.5).53 Born in Bradford focuses on multiple health and social issues,such as genetics,me

240、ntal health and the environment.54 BiBs recent research pointed to the importance of air quality for health,leading to the introduction of the Clean Air Zone in Bradford.55 The introduction of the Clean Air Zone in Bradford is estimated to have led to 700 fewer respiratory health-related GP visits a

241、nd saved the NHS over 30,000 after one year.55,56*The four medicine classes are direct oral anticoagulants,sodium-glucose cotransporter-2 inhibitors,severe asthma biologics and vasopressin V2-receptor antagonists.162.4.2.Wider societal benefits:the UKs reputation as a global leader in research The U

242、K has a proven track record of successful clinical research with high scientific impact,boosting its international reputation as a centre for scientific excellence.As a result,many international organisations wish to conduct research in the UK and engage in collaborative work.8 International collabo

243、rations tend to enable greater reach than national initiatives,leading to the potential for increased impact.57 Such impact can accrue through diverse collaboration mechanisms,such as contributions to international advisory boards and participation in international clinical trials,creating partnersh

244、ips that allow UK researchers to contribute to developing new medical advances,including by hosting pan-European Union(EU)clinical trials and training up-and-coming researchers across the EU and beyond.57Some evidence suggests that collaboration with industry,including on clinical trials,contributes

245、 to the UKs status as a global leader in achieving scientific excellence in clinical research.16 A bibliometric analysis described in a 2024 Frontier Economics report examined publications from industry clinical trials,their spillover benefits into commercial activities and future collaborations.16

246、The analysis used UK documents related to clinical trials with pharmaceutical industry involvement.The study found that 27%of publications were by authors with industry affiliations and funding acknowledgement,62%by authors with industry affiliations,and 10%acknowledged industry funding without indu

247、stry-affiliated authors.16Some evidence suggests that clinical research activities create spillover benefits at the intersection of academic reputation and economic growth.One example is the number of patents resulting from clinical trials.16 The Frontier Economics ABPI-funded study revealed that in

248、dustry clinical trial publications were cited 330 times in patent literature,with 283 patents in the Derwent Innovations Index referencing these publications.16 This highlights the role of clinical trials in the development of innovative treatments and in supporting economic growth.16 Another exampl

249、e is the Clinical Practice Research Datalink(CPRD)resource,which enables access to anonymised patient data and has helped advance clinical guidance and good practice for over 35 years,impacting over 3,500 publications in diverse research and innovation areas.58Box 6.Impact story:the Clinical Practic

250、e Research Datalink(CPRD)The Clinical Practice Research Datalink(CPRD)is a Department of Health and Social Care(DHSC)database collecting anonymised patient data from GPs across the UK.59 Established in 1987,CPRD includes longitudinal,broadly representative data for the UK population.59,60 The data l

251、inks to other health-related information,including from secondary care.60 CPRD collates data on around 60 million patients,providing a valuable resource for researchers worldwide.59 Research involving CPRD data has resulted in over 3,500 peer-reviewed publications and supported the development of cl

252、inical guidance and best practice in the UK.59 It remains an important resource for enhancing public health and epidemiological research,improving patient safety and informing healthcare policy and planning,including chronic disease management.6017From research to reality:research and innovation in

253、the NHS as key to enabling the 10-Year Plan2.5.Looking to the future:harnessing untapped potentialA research-and-innovation-active NHS has many implications for healthcare service performance,patient outcomes and experience,economic growth and societal well-being.10 Section 3 builds on these insight

254、s further,discussing how we achieved transformative impacts in some key strategic areas:genomic testing(Section 3.1),AI applications in cancer screening and diagnosis(Section 3.2),digital innovation in mental health(Section 3.3),technology-enabled remote monitoring(Section 3.4),and participatory res

255、earch(Section 3.5).We also discuss how to maximise the potential and impact in these key areas for NHS transformation,sustainability and excellence.Without a renewed focus on making the most of the potential of research and innovation,patients will not have ready access to treatments that can save l

256、ives,leading to an inefficient use of constrained health service resources.Simultaneously,the NHS risks missing opportunities to deliver excellence in care,while the economy and wider society risks being adversely affected through reduced quality of life,lower productivity and wider industrial compe

257、titiveness.We are currently seeing a decline in healthcare professionals engagement in research,as highlighted in Lord Darzis independent investigation of the NHS.24 In addition,declining levels of commercially funded research and innovation pose further opportunity costs to capturing the range of p

258、ossible benefits(and as we have illustrated thus far),emphasising the need for timely and urgent action.Despite many positive associations,the literature highlights several challenges that need to be addressed to fully realise the benefits of research and innovation in healthcare settings sustainabl

259、y and at scale.Barriers span issues related to workforce skills,capabilities and leadership for research and innovation;incentives(including freeing up time for health professionals to engage),accountabilities and culture;the data infrastructure and information and evidence environments;physical inf

260、rastructure related to needed facilities and equipment;funding,procurement and commissioning;governance of R&D and regulation;collaboration and coordination and support for opportunities across different regions and urban and rural settings and primary,community and secondary care;and challenges to

261、the engagement of service users in research,including but not confined to challenges to recruitment into research studies and trials.We discuss these issues further in Section 4 of this report,52,6163 considering the status quo and where we could get to in the future if we take actions to address th

262、e current challenges and make the most of the untapped potential.18Chapter 3.Current benefits and future potential:case studies in areas of transformative science and innovation in the NHS Research and innovation have a significant impact on the NHS,patients and population health,as well as on the e

263、conomy and wider society(see Section 3).We consider these impacts more closely through five case studies focusing on genomic testing(Section 3.1),AI applications in cancer screening and diagnosis(section 3.2),digital innovation in mental health(section 3.3),technology-enabled remote monitoring(secti

264、on 3.4),and participatory research(Section 3.5).3.1.Genomic screening and testing in the NHSBox 7.Case study summary:Genomic screening and testing in the NHSSince the discovery of DNAs structure in 1953,the UK has played a key role in advancing research and innovation in genetics and genomics.The NH

265、S has been a key partner in these efforts,providing patient samples for research and trials,clinical data,expertise,infrastructure and care pathways for genomic medicine.Examples of flagship UK initiatives include:The Human Genome Project,Wellcome Sanger Institute and Wellcome Genome Campus,UK Bioba

266、nk,Genomics England and the related 100,000 Genomes Project and Genomic Medicine Centres,the Genomics Medicine Service,the National Genomics Board,Our Future Health and NHS Genomic Networks of Excellence.19From research to reality:research and innovation in the NHS as key to enabling the 10-Year Pla

267、nImpacts on the economy and wider society:The genomics sector brings revenue and supports enterprise creation and jobs.According to government data,the UK genomics sector had a turnover of 3.6bn in 2021/2022,and the British Industry Association estimates that the sector could reach a market capitali

268、sation of 50bn by 2040.The Association of British Pharmaceutical Industries points to the number of genomics-related jobs doubling between 2016/2017 and 2021/2022,from 3,200 to 6,800.A Future Vision for Success:Genomic Screening and Testing in the NHSA critical mass of well-trained NHS and health sy

269、stem staff and interdisciplinary teams will help ensure that scientific advances in genomics and related disciplines reach the health service and patients across the UK to improve care quality,patient outcomes and experiences,and wider economic and societal benefits.Better data access,sharing and li

270、nkage,and the convergence of technologies(e.g.genomics,quantum,synthetic biology and AI)will enable new application areas,such as improving patient care and population health throughout the life course through better prediction of needs,timelier intervention and better health system resource allocat

271、ion.Impacts on patients and population health:Impacts on the NHS and wider health system:Genomics research and innovation has improved the diagnosis and treatment of cancers,rare diseases and developmental disorders,informed disease prevention and management approaches in areas like Parkinsons disea

272、se,dementia,diabetes and heart health and helped inform public health decisions and medical innovation during the COVID-19 pandemic.NHS transformation efforts have been bolstered by a Genomics Medicine Service that is directly informed by genomic data and research,enabling evidence-based practice.Ge

273、nomics England,as a government-owned company,enabled national research programmes in high-risk areas that would not have otherwise been possible,such as newborn screening.Genomics research provided the impetus for establishing governance and oversight frameworks enabling genomic sequencing to be mad

274、e available in the NHS for diverse indications.20Organisations contributing to genomic science and genomic medicine will have more clarity on funding,commissioning and procurement flows,reducing uncertainty about rewards for their efforts and helping foster healthy collaboration.R&D governance and r

275、egulatory requirements for data access,sharing,use and reuse will be more streamlined and simpler to navigate,supporting greater efficiency in genomic research,innovation and adoption in the NHS.More localised genomic medicine in the community will be enabled via access to long-read sequencing techn

276、ology in primary care,shortening turnaround times to results for patients(3060 min)and enabling better collaboration and coordination between local and national genomic medicine efforts.Active public engagement and outreach,coupled with transparency in ways of working of genomic initiatives,will sup

277、port more diverse participants in research and innovation efforts,increasing the accuracy of genomic testing,reducing inequalities,improving the relevance of genomic medicine for diverse populations,and enhancing public trust.3.1.1.IntroductionThe UK has historically been a leader in genomics resear

278、ch.The NHS has played a key role in supporting research and innovation in this area,leading to major advances in clinical care,including disease prediction,risk management and diagnosis using clinical predictive tests and genetic testing.64,65 It also helps predict how an individual might respond to

279、 a drug(i.e.pharmacogenomics)and can inform what an effective treatment might be based on a persons genetic traits,facilitating more targeted and personalised treatments.66 These applications are already revolutionising NHS care,most notably in cancer and rare diseases.67,68 They have also made majo

280、r contributions to viral genome sequencing,testing and informing vaccine development efforts during the COVID-19 pandemic.3.1.2.Origins,history and evolution of genomics research and innovation in the United KingdomKey initiatives and the role of the NHSSince the discovery of the structure of DNA in

281、 1953,the UK has played a key role globally in leading advances in genomics and its applications for patient,population and health services benefit.The UK was a partner in early efforts related to the Human Genome Project,69 which ran from 1990 to 2003;UK contributions came via the Sanger Institute,

282、funded by the Wellcome Trust,and with the Medical Research Council(MRC).70 The Wellcome Trust also founded the Wellcome 21From research to reality:research and innovation in the NHS as key to enabling the 10-Year PlanSanger Institute in 1992 and opened the Wellcome Genome Campus in 1994 to help with

283、 the UKs contribution to human genome sequencing.Building on the momentum of the Human Genome Project,the UK set out an early plan and programme of work in 2003 to enable the NHS to seize the benefits of genetics and committed to funding genetics and genomics research and development.71 The UK Bioba

284、nk was then established in 2006 to store genetic and other health information,including de-identified biological samples,to support research advances and discoveries.72 Since then,the UK Biobank has facilitated large-scale cohort studies that informed precision medicine efforts,providing researchers

285、 with genetic data from half a million volunteers73 and enabling genome-wide association studies examining DNA differences in individuals with and without certain diseases.When linked with lifestyle,health and other data,these datasets help researchers understand the role of various factors in disea

286、se.Between 2001 and 2008,the UK government invested approximately 70m into supporting genetics and genomics,paving the way for further advances within the NHS.71 A key milestone was the establishment of Genomics England in 2013,a company owned by the Department of Health and Social Care(DHSC),to del

287、iver the 100,000 Genomes Project via the NHS Genomic Medicine Centres(GMCs),and with implementation support from Illumina.74 The 100,000 Genomes Project focused on integrating whole genome sequencing and clinical real-world outcomes data to better understand the mutations associated with various typ

288、es of cancer and rare diseases.Its impacts have been felt in both research and care,contributing to further strengthening genomics research capacity in the UK and making a significant difference for many patients who otherwise may not have received a diagnosis for their conditions,enabling the possi

289、bility of earlier treatment(Int4a).Since the early days of genomic sequencing efforts in the UK,the NHS has played a central role in providing patient samples for research and trials,essential clinical data,expertise and infrastructure and pathways for genomic medicine.For example:NHS England has cr

290、eated pathways for genomic medicine use in the health service,including through the Genomics Medicine Service.The GMS,launched in 2018,is responsible for delivering genomic medicine services.75 It aims to enable faster diagnosis,improve the effectiveness of medicines,reduce adverse drug reactions an

291、d increase the number of people surviving cancer and getting diagnosed and treated for rare diseases.75 The GMS employs a unique approach to centralised data,enabling data from the 100,000 Genomes Project(conducted by Genomics England)to integrate directly into NHS clinical practice(Int4a).This nove

292、l approach has enabled Genomics England to directly implement a live national clinical service while also contributing to ongoing research.Consequently,this approach necessitated new funding,resources,and a consent model to support both research and service delivery activities(Int4a).NHS England fac

293、ilitates access to genomic samples and data through the NHS Genomics Medicines Service(GMS)Research Collaborative.A partnership with Genomics England and the NIHR,this initiative offers anonymised genomic and clinical data and expert advice.NHS patients can also contribute to the National Genomic Re

294、search Library,supplying de-identified samples and data for research.76 NHS England also provides crucial infrastructure and skills to translate genomic 22research into practice within the health service.As part of the NHS GMS,NHS England commissions seven genomic laboratory hubs(NHS Clinical Genomi

295、c Services)to analyse genomic and related health data,as well as to provide and coordinate treatment and genomic counselling services for patients and families.77 Alongside these hubs,Health Education England and the GMS are focusing their efforts on building a workforce that can deliver genomic med

296、icine while working with patient groups and communities and maintaining adequate data infrastructure.For example,Health Education England began delivering the Genomics Education Programme in 2014 to help NHS staff develop the skills needed to deliver genomic medicine.78 The GMS has also convened a G

297、enomics Clinical Reference Group to advise on clinical practice,policy and strategy and maintains the National Genomic Test Directory.75 As of October 2022,this service had sequenced approximately 33,000 whole genome equivalents through the service for 190 clinical indications,with the service expan

298、ding to serve more patients with rare diseases and cancers within the NHS since its inception in 2018.79 Genomics England is a crucial part of the UKs national infrastructure for genomics and has played a significant role in helping accelerate the pace of genomics advances and improving the represen

299、tativeness of UK genomic data.Following a 2021 spending review,Genomics England embarked on new programmes of work,including workstreams to accelerate genomic sequencing turnaround times(especially for cancer),facilitated by Oxford Nanopore technology(Int4a)and to increase participation in genomics

300、programmes amongst underserved groups.In doing so,Genomics England has sought to improve the accuracy of genomic sequencing insights across diverse populations through the Diverse Data Initiative(Int4b),establishing an inclusive patient and public input panel and commencing a Newborn Screening progr

301、amme.Building on the progress of genomics research infrastructure to date,the UK government announced the Our Future Health research programme in 2019,aiming to create a large-scale dataset where consenting participants health and lifestyle data will be linked with genetic data.In doing so,the progr

302、amme complements the work of the UK Biobank and Genomics England,adding further capacity and infrastructure for long-term,large-scale population studies to support biomedical advances(Int4a).803.1.3.A long term-strategic vision,planning and a systems shaping approach Organisations within the UK land

303、scape have made substantial strides in genomics research in the past decade.The route to achieving impact through genomics has not been easy,and there are several aspects of genomic medicine(related to factors such as workforce,ethical frameworks,data and participant diversity and funding flows,for

304、example)that make it difficult to integrate and mainstream into care pathways.There has nonetheless been much progress,underpinned by government strategies throughout the years.In 2022,NHS England published the first five-year genomic strategy for the NHS,Accelerating genomic medicine in the NHS,81

305、alongside a strategy implementation plan,The Genome UK:2022 to 2025 implementation plan for England.79 The strategy led to a plan for genomic medicine services rollout across all levels of care in the UK while ensuring equitable access and benefits for all patient groups and improving the robustness

306、 of UK digital and data transformation.This implementation plan emphasised 23From research to reality:research and innovation in the NHS as key to enabling the 10-Year Planthe central role of the NHS in advancing pharmacogenomics,evaluating genomic medicine applications,offering molecular testing fo

307、r rare genetic disorders and cancer,sequencing pathogens for surveillance and providing international leadership in genomic medicine.It also highlighted the importance of NHSs efforts in developing data infrastructure,collaborating with research communities,and providing access to clinical test sequ

308、ences.In implementing these plans and strategies,the NHS is taking an active role in looking at ways to embed genomic medicine.For example,in January 2024,NHS England established NHS Genomic Networks of Excellence82 to generate evidence about and develop the model for the adoption of genomic advance

309、s in the NHS and to enable scale and spread.These networks consist of the NHS,academia,third-sector and industry stakeholders across eight areas and underscore the importance of collaboration across the genomics landscape.*Further progress is being made with national support and funding for genomic

310、laboratory hubs since their establishment,as well as funding for posts in the NHS GMS alliances and transformation projects(such as an NHS-England-funded project for liquid biopsy and ctDNA use in the NHS).83 While there is still a need to establish sustainable,clear and scalable commissioning model

311、s,progress with adoption is gradually evolving(Int4a).Government investments,a policy focus and commitment to bolstering genomic medicine,NHS contributions to research,and industry collaboration have helped place genomics at the heart of UK life sciences research and innovation and introduce it to h

312、ealth service delivery.Within the UK,there is a long history of public-private partnerships to support genomics research,innovation and service delivery.Major national initiatives and institutions such as the UK Biobank,the 100,000 Genomes Project and the Wellcome Sanger Institute entail collaborati

313、on between the NHS,academic organisations and industry partners,as well as patient and public engagement.Many also include international collaborations.In most recent initiatives,such as the Our Future Health programme,the NHS has partnered with companies to provide biological sample receipt and pro

314、cessing services,genotype assay design and genotyping services.NHS England has created a commercial partnership with GRAIL for genomic cancer testing,including a trial of these services and wider roll out,should early results indicate the programme is effective.These partnerships with the private se

315、ctor help the government and the NHS to take advantage of the considerable expertise and skills built up over the last several decades within the UK and support the wider research and innovation ecosystem.84,85Collaboration,research and innovation have evolved with due attention to robust governance

316、 and oversight.The National Genomics Board(established in 2018 to help oversee and advise the UK governments genomic healthcare policy),as well as the work of the MHRA and the National Institute for Health and Care Excellence(NICE),has contributed to regulation and evaluation of innovations that are

317、 reaching the NHS.The NHS GMS,working with MHRA,NICE and the Accelerated Access Collaborative,are also conducting horizon scanning activities to stay abreast of developments in genomic testing.83 Despite these efforts,some regulatory hurdles persist.One*Prenatal genomics,tumour biomarker testing,hae

318、mato-oncology,rare and inherited diseases,infectious diseases,cardiovascular diseases,pharmacogenomics and medicines optimisation and genomics AI.24such hurdle relates to the blurred boundaries between research and service delivery in genomics that can complicate clarity on which regulatory pathways

319、 need to be followed(i.e.for research or service delivery approvals).This lack of clarity can risk regulatory criteria for service delivery being applied to research,potentially complicating a seamless flow and pipeline of research into practice.There are also risks associated with genetic data and

320、the protection of privacy,as information related to an individual can potentially also reveal information about relatives.This raises questions about how to handle and report back on incidental findings(i.e.results that were not the primary aim of a genetic test).83Finally,progress with the efforts

321、of key organisations,such as Genomics England,benefited from efforts to secure active patient and public involvement to inform decisions about research areas and health service needs.According to an interviewee,a patient and public engagement panel of 2530 individuals contributes actively and is par

322、t of the governance structures of Genomics England today(e.g.access to data committee,ethics advisory committee,research network committee)(Int4b).As the interviewee highlighted,patient engagement has been key in Genomics Englands work.It is currently proving critical in advancing a recent newborn s

323、creening programme,whose design and implementation have been heavily influenced by discussion of ethical considerations around which conditions to screen for(depending on actionability of genetic results),the need for genetic counselling and mental health services,the need to have accurate testing f

324、or people from ethnic minorities,the implications of newborn genetic screening for the wider family,consent processes and how to handle incidental results.863.1.4.ImpactsAs a result of advances in genomics research and innovation and its use in the NHS,the UK is already benefiting in terms of impact

325、s on population health and healthcare service delivery,as well as harnessing benefits from a thriving genomics life sciences sector and industry.Impacts on patients and population healthGenomics applications are revolutionising patient care in the NHS in many areas,most notably in cancer and rare di

326、seases.87,88 The impacts of genomic screening on population health are considerable.Through genomic testing,patients can receive an earlier and more accurate diagnosis.This means patients can often receive better care earlier,and further disease progression can be avoided in some cases.89 Understand

327、ing genetic mutations also enables more personalised medicine,and predictive genetic testing can improve health and well-being at a population level.Patients also benefit from pharmacogenomic services by receiving treatments that work better for them as individuals(depending on their genetic make-up

328、)and by avoiding adverse drug reactions.90 Box 8 illustrates some examples of the impact on patients and population health:25From research to reality:research and innovation in the NHS as key to enabling the 10-Year Plan1.Improving cancer diagnosis and treatment:Understanding gene mutations and dise

329、ase risk and informing targeted therapies:The Wellcome Sanger research informed the development of targeted cancer therapies(e.g.Cancer Genome Project,91 Human Cancer Models Initiative).92 The 100,000 Genomes Project helped identify BRCA1 and BRCA2 gene mutations that increase breast and ovarian can

330、cer risk,informing targeted therapies(PARP inhibitors)that improve patient outcomes,help avoid unnecessary treatment and support preventative measures.93,94 Cancer pharmacogenomics and optimising treatment:The 100,000 Genomes Project also helped advance the understanding of drug metabolism and suppo

331、rted developments in pharmacogenomics,allowing patients to get onto more appropriate treatments to optimise drug response(brain,colon,lung,sarcomas and ovarian cancer).95 NHS GMS pharmacogenetic testing helped identify which patients may experience severe side effects from specific chemotherapy drug

332、s,enabling clinicians to tailor cancer plans to produce fewer adverse drug reactions.96,972.Improving diagnosis and treatment of rare diseases and developmental disorders:Receiving an accurate diagnosis:Approximately 80%of rare diseases have a genetic basis,and many are difficult to diagnose.Accordi

333、ng to a 2021 study,approximately 25%of patients with a rare disease received a diagnosis due to whole genome sequencing in the NHS and building on the 100,000 Genomes Project.Such beneficiaries include children with developmental disorders who could receive better-targeted therapies,people with neurological disorders(e.g.specific types of epilepsy)and metabolic disorders(e.g.mitochondrial diseases