Clinical Research in Scotland John Savill University of Edinburgh and Chief Scientist Office Scottish Government Health Directorates
Clinical Research in Scotland
John Savill University of Edinburgh
and Chief Scientist Office
Scottish Government Health Directorates
Scotland • 5.3M people
• National Health Service
• Stable population
• “Sick man of Europe”; high rates of “western” diseases
Scotland: The Clinical Research Engine
• One-eighth of UK researchers • One seventh of UK funding • Outperformed rest of UK on quality
in RAE 2008 • Core strengths in clinical
translational research
Scottish Clinical Research Strengths
• Neuroscience – stroke, schizophrenia, bipolar, cognitive decline;
• Inflammatory diseases – rheumatoid, liver cirrhosis, lung fibrosis and emphysema;
• Metabolic/vascular diseases – diabetes, obesity, coronary artery diseases;
• Cancer – solid tumours and leukaemias • Reproductive disorders – menorrhagia, pre-
eclampsia and infertility
Scotland’s Advantages in Clinical Research
• Electronic Records Linkage – for 5.3M people with a single, coherently structured health provider.
• Collaboration - Aberdeen - Dundee - Edinburgh - Glasgow (St. Andrews)
Electronic Records Linkage in Scotland
• Unique identifier: CHI number • NHS Information and Statistics Division
(probability matching) • 30-year coded historical datasets
(admissions, prescribing etc.) • Disease registers (Diabetes – Andrew
Morris) • 15-year follow up of WOSCOPS
Routine data for long term follow up • Primary prevention of heart disease
• Screened 81,000 men
• 6,595 participated
• Role of statins in CVD management
Log-rank p=<0.0001 Placebo
Pravastatin
WOSCOPS 15 year follow up Data mining in action
Original trial
Ford et al, N Eng J Med (2007) 357 1477-86
Scotland: Major Collaborations in Clinical Research
• Generation Scotland £10M (CSO/SE) • Translational Medicine Research Collaboration
£50M (Wyeth/SE) • Scottish Clinical Research Excellence Develop-
ment Scheme £4M pa (CSO/NES/SFC) • SINAPSE Imaging Consortium £40M (SFC £7M) • Scottish Health Informatics Platform £5M
(Wellcome etc.) • Scottish Translational Medicine Training Initiative
£3M (Wellcome) • Scottish Academic Health Sciences Collaboration
£15M pa (CSO)
Research infrastructure MRI PET/SPECT EEG/MEG
Shared expertise Greater critical mass Training Cohesion Optimise clinical trials Industry
SINAPSE
Chief Scientist Office Budget 2008/09
Total: £66.9M
Research budget: £17.5M - Grants - Units - Capacity Building and other programmes
Support for Science: £37.4m
Research Networks: £10M
Investing in Research, Improving Health
Its ambition is to
“place Scotland at the international forefront of clinical translational research and the development of systems medicine.”
Focus
• Patient benefit
• Improved population health
• Economic benefit
4 Main Aims
• Securing benefit
• Improving Population Health
• Valuing and Investing in NHS Research
• Building and Sustaining Skills
Dundee Clinical Research Centre Health Informatics Centre&Memo CRUK laboratories
Glasgow BHFGCRC Biomedical Research Centre Integrated CRF Beatson Oncology Centre Sackler Institute
Edinburgh Wellcome CRF Institute Med Cell Biol
Aberdeen IMS IAHS CRF
• Purpose built basic biomedical research institutes. • Integrated general clinical research facilities.
Regulatory affairs
VPN
Affiliated centres
+ +
The Translational Medicine Research Collaboration “Shared goals, complimentary strengths, shared risk and reward”
Umbrella agreement for shared and protected IP
The Scottish Academic Health Sciences Collaboration
(SAHSC)
SAHSC: NHS Scotland’s new platform to support research for patient benefit and foster related economic development.
NHS Boards Universities Grampian Aberdeen Greater Glasgow & Clyde Glasgow Lothian Edinburgh Tayside Dundee
Scottish Enterprise
Aims of the SAHSC
• Speeding the development of stratified/ personalised medicine;
• Doubling the number of patients participating in clinical studies by 2012;
• Increasing competitive clinical research funding from UK sources by ~£25M pa; and
• Developing mutually beneficial partnerships with Biotech and Pharma.
To improve the health and wealth of the Scottish population by:-
The SAHSC Platform
• Clinical Research Facilities (nurses, physiologists)
• Clinical Research Imaging Centres (radiographers, physicists)
• Clinical Trials Units (pharmacists, statisticians)
• Biorepositories (pathology staff) • Electronic Records Research Portals
(informaticians)
Health Boards and CSO work together to reconfigure by 2012 ~£15M pa of funding to underpin ~280 fulltime posts in coordinated:
SAHSC: Serving Scotland as a whole
• 4 Nodes: cluster of Boards local universities
• Networks: cancer dementia diabetes medicines for children mental health primary care stroke
Scotland: Addressing the needs of Pharma and Biotech
• Single point of contact: National Research Scotland Co-ordinating Centre, register of experts
• Feasibility: Information and Statistics Division
• Recruitment/ “Consent for Consent”: Primary Care Research Network
• “Cooksey 2”: Scottish Medicines Consortium
• Clusters: e.g. Edinburgh BioQuarter
NEJM Oct 2007
National Approaches to Clinical Trials
• Meetings • Mail • Media
McKinstry B, Hammersley V, Daly F, Sullivan F Recruitment and retention in a multicentre randomised controlled trial in Bells palsy: A case study BMC Medical Research Methodology 2007, 7:15 doi:10.1186/1471-2288-7-15
Scotland: Addressing the needs of Pharma and Biotech
• Single point of contact: National Research Scotland Co-ordinating Centre, register of experts
• Feasibility: Information and Statistics Division
• Recruitment/ “Consent for Consent”: Primary Care Research Network
• “Cooksey 2”: Scottish Medicines Consortium
• Clusters: e.g. Edinburgh BioQuarter
SCRM
Royal Infirmary
Queen’s Medical Research Institute
Chancellor’s Building
Little France Site/Edinburgh BioQuarter
The Scottish Academic Health Sciences Collaboration
*Broad, powerful, high quality *Embedded in conducive NHS system *Informatics as a USP *Collaboration and partnership add value *Keen to work with Biotech and Pharma *Obvious UK cluster