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Delivering Surgery research

 

Contents

Delivering Surgery research?

Why you should come to the UK

Through the NIHR Clinical Research Network, the UK has a unique infrastructure to enable the timely set-up and delivery of surgical research across all the surgical disciplines including: breast, cardiothoracic, colorectal, general, head and neck, hepatobiliary, neurosurgery, orthopaedics, plastics and hand, transplantation, trauma/ emergency, upper gastrointestinal, urology and vascular. Our portfolio is wide-ranging and covers the whole of the perioperative pathway and aftercare of the patient.

We have the expertise and experience needed to deliver complex interventional trials to time and target, including the evaluation of new devices and techniques as well as studies which have a surgical intervention as one of the arms.

CRN Surgery is one of 30 specialities which bring together communities of leading research-interested clinicians and practitioners at both national and local levels. We provide researchers with the practical support they need to deliver surgical research studies to time and target in the NHS.

Leadership

We have a UK-wide network of leading academic clinicians and researchers who have experience in the successful delivery of high quality studies across the whole range of surgical disciplines.

Working closely with the Royal College of Surgeons (RCS) provides further reach into the surgical community and access to the UK’s key opinion leaders.

The Surgical Technology Evaluation Portal (STEP), developed by the NIHR and RCS, provides companies and innovators with a single point of access to rapid feedback to support the efficient development of new surgical medical devices and technologies.

Access to patients

There are around five million surgical admissions each year in England (a third of all hospital admissions) undertaken by around 17,000 surgeons working in NHS Trusts. These range from common elective procedures to emergency operations and complex procedures across the range of surgical disciplines.

Surgery is central to the whole management pathway of cancer including prevention, diagnosis, treatment, post-treatment and palliation. This is reflected in the research portfolio with one in seven patients recruited into cancer research studies involved in surgical studies. We have a national lead specifically for surgical oncology to provide expert leadership in this important area.

Study delivery

As a result of NIHR, RCS and charity-led (notably the National Cancer Research Institute) initiatives, which have included dedicated funding calls, national capacity-building and enhanced training workshops, there is a vibrant and engaged community of surgical researchers embedded in the NHS. This network of potential investigators allows you to select suitable study locations through our Study Support Service.

Our track record:

• the Surgery Specialty recruited over 48,000 participants into studies in 2017/18;

• they also saw an increase in the number of studies recruiting over the same time period;

• in 2017/18 they delivered 70 per cent of all studies to time and target.

Collaboration

CRN Surgery works closely with a wide range of the Clinical Research Network’s other specialties, notably Cancer, Cardiovascular Disease, Musculoskeletal Disorders and Injuries and Emergencies, to ensure a seamless “one-network” approach to the set-up and delivery of research studies across all the surgical specialties. Surgical Subspecialty Champions have been appointed in each of the Local Clinical Research Networks to foster engagement with their respective surgical communities and provide detailed local knowledge.

Collaborative working with the RCS has led to major enhancements to the surgical research infrastructure in the UK with the Rosetrees and RCS Surgical Trials Initiative supporting eight Surgical Trials Centres across England (Birmingham, Bristol, Leeds, Liverpool, London, Manchester, Oxford and York). These have the capacity and expertise to manage the specific challenges associated with interventional surgical research studies.

Case study: PET-NECK a randomised study to evaluate the efficacy and cost-effectiveness of PET-CT-guided surveillance compared with planned neck surgery in patients with head and neck cancer. 

With support from the Clinical Research Network, 564 patients were recruited across 43 NHS hospitals (exceeding the planned sample size of 500). Following publication in the New England Journal of Medicine, PET-CT guided surveillance has now become the standard of care in the NHS allowing many patients to avoid surgery and offering a per-person cost saving to the NHS of over £1,400 over two years.

Case study: DREAMS is a multi-centre study. Postoperative nausea and vomiting is one of the most common complications affecting patients after major surgery.

The DREAMS trial recruited 1,350 patients undergoing open or laparoscopic gastrointestinal surgery from across 48 UK sites. This multicentre study demonstrated that dexamethasone reduces emesis after major surgery and is now being incorporated into clinical guidelines. With support from the Clinical Research Network the trial completed six months ahead of the original recruitment window.

Case study: ROCSS-A randomised controlled trial of reinforcement of closure of stoma site using a biological mesh.

It recruited 748 patients (undergoing elective ileostomy/colostomy) 23 more patients than the recruitment target of 725, from 33 NHS Trusts over a three year period. It completed on time with the support of the Clinical Research Network. The results are now being analysed.

Find out more

You can visit our website at: www.nihr.ac.uk/surgery

Contact us

Access our Study Support Service online at: www.supportmystudy.nihr.ac.uk or get in touch:

Phone: 00 44 113 34 34 555

Email: supportmystudy@nihr.ac.uk