Surgery specialty profile
Why you should deliver surgery research in the UK
Through the NIHR Clinical Research Network (CRN), 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 and the wider health and social care environment.
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 eleven participants 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.
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 57,900 participants into studies in 2018/19;
- saw an increase in the number of studies recruiting from 356 in 2017/18 to 403 in 2018/19;
- in 2018/19 76 per cent of all studies were successfully delivered on time and to target.
CRN Surgery works closely with a wide range of other CRN 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: ROSSINI 2
This phase III multi-arm, multi-stage (MAMS) randomised controlled trial is evaluating the use of three in-theatre interventions, individually or in combination, to reduce surgical site infection rates in patients undergoing abdominal surgery.
The interventions include a skin preparation solution that is applied to the skin before starting surgery, a skin drape (a thin impregnated plastic sheet applied to the skin before making the incision) and a sponge (an implant that contains antibiotics that is placed into the wound before closure).
This is an NIHR funded study with a built in pilot phase and is being delivered across 24 trusts. The study is supported by the CRN with the use of the early contact and engagement, site intelligence, effective study set up and performance monitoring services.
Case study: By-Band Sleeve
This phase III multi-centre, randomised controlled trial is comparing the effectiveness, cost effectiveness and acceptability of gastric bypass, adjustable gastric banding or sleeve gastrectomy surgery,
to treat severe and complex obesity.
This is an NIHR funded study and has exceeded the initial recruitment target of 1,841 participants. Over 4,500 participants have now been recruited to this study across
15 sites in England with the support of the CRN.