A national strategy for research and development: lessons from England

Area of Science:

• Health Services Research
• Public Health Research
• Health Policy and Management

Background:

• Concerns regarding basic and clinical research in England during the 1980s prompted a parliamentary review.
• The review unexpectedly recommended strengthening public health and health services research.
• This led to the establishment of a novel Research and Development (R&D) program within the National Health Service (NHS) in 1991.

Purpose of the Study:

• To review the achievements and challenges of the NHS R&D program during its initial five years.
• To identify lessons learned from this unique, integrated R&D management approach.
• To provide insights for other countries considering similar health research programs.

Main Methods:

• A review of the first five years of the NHS R&D program.
• Analysis of program achievements and identified concerns.
• Examination of the program's integration into the NHS management structure.

Main Results:

• The program achieved significant successes but faced ongoing challenges.
• Key concerns include: philosophical debates, maintaining political support, adapting to policy changes, central coordination, enhancing priority setting, and addressing insufficient human resources.
• The program's integration into NHS management was a unique and ambitious undertaking.

Conclusions:

• The NHS R&D program offers valuable lessons for national health research initiatives.
• Unified health systems can learn from the overall English experience.
• Pluralistic health systems may benefit from specific aspects of this integrated R&D model.