Smyth J F, Mossman J, Hall R, Hepburn S, Pinkerton R, Richards M, Thatcher N, Box J
Department of Clinical Oncology, University of Edinburgh, Western General Hospital.
BMJ. 1994 Aug 13;309(6952):457-61. doi: 10.1136/bmj.309.6952.457.
The United Kingdom Coordinating Committee on Cancer Research represents the major organizations funding cancer research in the United Kingdom. The deliberations of a working party convened by the committee to evaluate recently expressed concerns that the changes in the NHS threaten research, especially clinical trials to evaluate new treatments, are reported. A survey of contributors to trials coordinated by the committee showed that half are now experiencing difficulties in continuing to participate in clinical trials. The two major problems identified were lack of time and of staff, especially for NHS staff in non-teaching hospitals. Recent changes in junior doctors' hours and proposed reductions in the length of time for training will exacerbate this. It is possible to identify the direct and indirect excess costs of conducting research in the NHS, but currently the mechanism does not exist to designate funds specifically for this purpose. Consultation with the regional directors of research and development confirmed that the service increment for teaching and research is not the solution for this. Proposals are made to secure future clinical research in the NHS, including finance, indemnity, the licensing of new drugs, the greater use of nurse counsellors, and the value of cancer registries.
英国癌症研究协调委员会代表了英国资助癌症研究的主要组织。据报道，该委员会召集的一个工作组进行了审议，以评估最近人们表达的担忧，即国民医疗服务体系（NHS）的变革对研究构成威胁，尤其是评估新疗法的临床试验。对该委员会协调的试验参与者的一项调查显示，现在有一半的人在继续参与临床试验方面遇到困难。确定的两个主要问题是时间和人员不足，尤其是非教学医院的NHS工作人员。初级医生工作时间的近期变化以及提议缩短培训时间将使这一情况恶化。有可能确定在NHS开展研究的直接和间接额外成本，但目前不存在专门为此目的指定资金的机制。与区域研发主任的协商证实，教学和研究的服务增量并非解决此问题的办法。文中提出了确保NHS未来临床研究的建议，包括资金、赔偿、新药许可、更多地使用护士顾问以及癌症登记处的价值。
