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Is the NHS willing to help clinicians and patients reduce uncertainties about the effects of treatments?

Robert JG Chalmers, Ray Jobling and Iain Chalmers
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DOI: https://doi.org/10.7861/clinmedicine.5-3-230
Clin Med May 2005
Robert JG Chalmers
Dermatology Centre, Hope Hospital, Salford, Manchester
Roles: Consultant Dermatologist
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Ray Jobling
The Psoriasis Association, Northampton
Roles: National Chairman
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Iain Chalmers
James Lind Alliance Secretariat, Oxford
Roles: Editor
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Abstract

Uncertainty is an inevitable component of clinical practice. Clinicians have a responsibility to minimise it by keeping up-to-date with current knowledge: but what is the responsibility of individual clinicians in reducing collective uncertainty? In all fields of medicine there are important questions relevant to both patients and clinicians, which can be answered only by clinical research. Unfortunately, much of the clinical research that attracts funding does not address the questions that both patients and clinicians regard as important. Furthermore, although the NHS has a proud record of innovation and clinical research, recent changes are jeopardising the ability and willingness of NHS clinicians to continue undertaking such work. A combination of increased bureaucracy in obtaining research ethics and local research and development (R&D) governance approval and the pressures on management to deliver service targets threaten to strangle research by NHS clinicians. Policy makers argue for informed patient choice, modernisation and improved quality. It is not in the interest of patients when research designed to address important therapeutic uncertainties is seen as an optional extra, rather than an intrinsic element of a health service interested in improving quality. The NHS needs to listen to its users, ie the patients, and to its clinical staff, and to encourage them to engage in research to help reduce those uncertainties.

Key Words
  • health policy
  • NHS clinical research
  • patient involvement
  • psoriasis
  • uncertainty
  • © 2005 Royal College of Physicians
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Is the NHS willing to help clinicians and patients reduce uncertainties?
Robert JG Chalmers, Ray Jobling, Iain Chalmers
Clinical Medicine May 2005, 5 (3) 230-234; DOI: 10.7861/clinmedicine.5-3-230

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Is the NHS willing to help clinicians and patients reduce uncertainties?
Robert JG Chalmers, Ray Jobling, Iain Chalmers
Clinical Medicine May 2005, 5 (3) 230-234; DOI: 10.7861/clinmedicine.5-3-230
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