“We can make great strides if we can pool expertise from different sections of the medical chain, but we need an organisation and a structure with which to do that.” Professor Noman Williams, Director, NCBRSI.
There are many examples which illustrate the type of technical advances possible when bringing complementary strands of scientific, technological and clinical pursuit together. For example, transplantation, delivered with the clinical and scientific input of the early surgical pioneers, of whom James Murray received a Nobel Prize; joint replacement and modern cardiac surgery which was developed through the application of physics and material science by John Charnley.
Currently though, the process of surgical innovation follows a tortuous path with no recognised mechanism for developing an idea, taking it from its inception through to multi-centre clinical trial and eventually into routine clinical practice. Similarly the interface between basic science, translational research and surgery is weak meaning that opportunities which may arise to benefit patients frequently result from serendipity rather than strategic collaborative activity*.
Through its own activity and the Bowel & Cancer Research grants programme, the NCBRSI will act as a national resource to assist groups around the country to develop concepts, provide proof of principle, perform appropriate clinical trials and if successful disseminate their findings throughout the NHS and beyond.
Its 3 units; the human tissue laboratory, the Clinical Effectiveness Unit and the Surgical Innovation Unit will work inter-dependently to promote the:
- Effective interfacing of surgery and experimental medicine to promote translation
- Effective pathways for technological innovation (development, safe evaluation and dissemination) from industry to the patient (through developing pathways of engagement from patient to clinician to industry)
- Effective trials of interventions based on the development and adoption of valid outcome measures
There are existing research networks set up to provide an infrastructure for clinical trials within the NHS (the Comprehensive Clinical Research Network) or in relation to specific diseases, for example cancer but these are geared mainly to pharmaceutical interventions rather than surgical procedures. To deliver the improvements in research intended by the proposed more multi-disciplinary approach, illustrated by the principles outlined above, a new framework needs to be delivered with key participators located under one roof.
This will be delivered through the National Centre for Bowel Research and Surgical Innovation.
* Cooksey D. A review of health research funding:
Norwich: HMSO; Dec 2006 (http://www.hm-treasury.gov.uk/d/pbr06_cooksey_final_report_636.pdf).