New funding boost for delivery of early stage clinical research across England

Published: 28 February 2022

The NIHR has announced nearly £161 million to fund 28 NIHR Clinical Research Facilities (CRFs), expanding the delivery of early phase clinical research in NHS hospitals across England.

CRFs support the delivery of early translational and experimental medicine research, from studies testing new treatments in patients for the very first time (first-in-human trials) through to early safety and efficacy trials (Phase IIa trials). They provide dedicated purpose-built facilities and expertise for the delivery of high-intensity studies funded by the NIHR, the life sciences industry and other organisations.

A total of 28 NIHR CRFs have been awarded funding in this latest round - six more than previously. About half of the funding has been awarded to NIHR CRFs outside of London, Oxford and Cambridge, including new CRFs in Norfolk and Bristol, delivering towards the government’s mission to level up domestic public investment in research and development.  

NIHR CRFs are a key part of the UK’s leading early stage clinical research infrastructure and play an important role in making the country a global hub for life sciences. Combined with the NIHR Clinical Research Network and its pivotal role in delivering Phase II and III trials, the NIHR supports research delivery across all phases of clinical research.

NIHR has increased its funding for CRFs by £49 million in this round of funding, as a signal of its aim to increase its work with the life sciences industry. These CRFs, which will run from 2022 to 2027, will also play a key role in realising the ambition in the vision for the future of UK clinical research delivery to bolster the delivery of innovative trials across all phases, all treatment types and all conditions. 

The NIHR CRFs have an expanded remit to support skills and workforce development, to grow expertise in delivering early translational and experimental medicine studies. This remit covers both people who lead and design trials and people in the essential supporting roles that deliver the research on the ground.  

Professor Lucy Chappell, Chief Executive of the NIHR and Chief Scientific Adviser to the Department of Health and Social Care, said: “NIHR’s CRFs scheme has been a key force in translational research across England, helping to position the nation as internationally competitive in early stage clinical research. 

“This new funding, a 43% increase, will allow the CRFs to continue to drive forward innovation in experimental medicine and support translation of exciting discoveries into new treatments for patients.”  

Minister for Innovation, Lord Kamall, said: “Clinical research has been vital in our fight against COVID-19 and in saving thousands of lives – whether through the rapid creation of vaccines or the identification of life-saving treatments like dexamethasone.  

“Funding more CRFs across the country means we can continue to build on this innovation to transform our health service and ensure the NHS is able to deliver world-class care.  

“As we build back better from the pandemic, I am committed to ensuring the UK remains a world leader in diverse, ground-breaking research.”

More than a decade of delivering innovative research 

The research delivered by the CRFs since first funded by the NIHR in 2007 has provided faster access for patients to novel treatments and supported growth in early stage research in England, translating new advances to patient benefit and wider economic gain.  

In the past year (FY20/21), NIHR CRFs have supported 4,984 studies, with nearly 20% being first-in-human trials. The CRFs leveraged £144 million of funding that year from the life sciences industry and other funders, representing a significant return on investment.  

The NIHR CRFs have delivered studies on a number of treatments that have gone on to be introduced into care for patients. For example, the NIHR Alder Hey CRF provided the leadership, expertise and environment for two of the first three international trials into a new drug for hard-to-treat forms of epilepsy. Epidyolex, a high quality and pharmaceutical grade medical cannabinoid, is now licenced in the US and UK for the treatment of Dravet and Lennox-Gastaut syndromes.  

Researchers working with the NIHR Exeter CRF have developed a simple at-home urine test to help doctors diagnose what type of diabetes a person has and ensure they receive the right treatment. Costing less than £11, the test is now used in nearly every hospital in the UK. As a result, some patients thought to have type 1 diabetes have been shown to have another type of diabetes and been able to stop insulin treatment.

At the forefront of early stage COVID-19 research 

The CRFs were a crucial component of the nation’s COVID-19 response, supporting the delivery of early phase experimental medicine studies and Urgent Public Health studies. The CRFs’ knowledge and expertise, as well as the availability of existing facilities and networks, ensured studies were delivered quickly, safely and in an efficient and coordinated way.  

For example, the NIHR Southampton CRF set-up a dedicated vaccine trials centre within a locked-down university sports hall in just four days. The team opened a Phase I study of the Oxford/AstraZeneca vaccine within a week, and by August 2020 had recruited nearly 700 people to early phase trials of the vaccine.  

The NIHR Royal Liverpool CRF recruited 60 participants in six weeks to the AGILE platform trial, a study designed to test potential new drugs to treat COVID-19. AGILE is distinct from other UK COVID-19 platform trials in that it tested new drugs, those that had never been tested in humans before, and repurposed drugs. The CRF team developed guidance on how to quickly identify new mild COVID cases (the trial’s recruitment strategy) and made this available to all other research sites across the UK.

During the pandemic, the CRFs altered their ways of working to ensure essential non-COVID studies could also continue. Many CRF staff were redeployed to the NHS frontline, with their skills and expertise enabling the rapid set up of Urgent Public Health trials and providing clinical research training to healthcare professionals with little previous research experience.

The newly funded facilities