Medical research stalled as NHS focuses on small number of trials, experts say

Some important trials could be scrapped because of the government's focus on a smaller number of well-designed clinical trials.

A report outlines the scale of research waste that has occurred during the Pandemic, with rampant duplication of scientific efforts and weakly designed clinical trials exposing millions of patients to unproven treatments with little scientific benefit.

The National Institute for Health and Care Research (NIHR), which is part of the Department of Health and Social Care, funds medical research and provides additional staff for clinical trials.

When Covid struck, these staff and resources were mostly diverted towards researching vaccines or treatments for it, while scientists working in other areas either put existing trials on hold or struggled to recruit patients because of Covid restrictions.

The DHSC has instructed hospitals and universities to review the trials they sponsor and cut those that are not likely to deliver, such as studies that are hard to recruit patients or studies that are impractical due to the availability of staff.

To ensure the research system continues to recover from the Pandemic, we have asked sponsors and funders to conduct a review of their research, focusing on studies that are most viable, which will give as many as possible the chance of succeeding.

Some warn that the DHSC review could cause some studies to fall by the wayside.

It is a good idea in principle, but the process is taking so long that it is leaving people in limbo, and causing extra delays.

She is concerned that some studies that have failed to recruit enough participants could be judged unviable by the review and have their funding withdrawn, yet they might have been more successful had they not been delayed.

Sprigg said that some of the most important trials are the hardest to do.

It will be sad for a lot of fields of research, such as cancer research, where it looks like an awful lot of waste.

The concern is that if they are not nuanced enough in how they do this, they may force studies to close which would be fine.

The founder of TranspariMED, which campaigns for greater transparency in medical research, described it as a bold step that will benefit patients and taxpayers.

According to a report published by TranspariMED and Health Action International last week, most clinical trials of potential Covid drugs focused on only a handful of treatment options, while inconsistencies in their design made it difficult to pool data from similar studies to calculate an overall effect. The report said that by October 2020, nearly a third of the trials had not recruited a single patient.

The UK's recovery trial, the biggest randomized controlled trial of drugs against Covid-19 in the world, was a rare example of a study that delivered useful information through its flexible design.

The UK's outstanding Covid research programme clearly demonstrated the benefits of focusing NHS resources on a limited number of well-designed and well-resourced studies that quickly show which treatments work and which do not. The uncoordinated research chaos in most other countries produced no useful evidence.

Every study should have a procedure in place to ensure the wellbeing of participants if it closes early, as this is required by the Health Research Authority, according to the DHSC.