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What do the extensive English NHS reforms mean for primary care research? How can we best take advantage of the new opportunities that will arise - and avoid being blindsided by any threats or confusions? One obvious imperative is to keep up-to-date with the changes and share ideas with colleagues and this Hot Topic aims to contribute to just those sorts of thought processes and conversations.
There are reasons to be cautiously optimistic. It seems clear that the government recognises the key role of research in the NHS. In November 2012, it published the first Mandate to the NHS Commissioning Board (Department of Health (DoH), 2012a), a mandate that the Board is legally required to follow. This contains a clear directive to promote and support participation by NHS organisations and patients in research. Importantly, particularly in the current climate, the Mandate spells out the significance of research not only for patient outcomes but also for economic growth. Making a success of partnership with public sector bodies, specifically including universities, is also stated as an objective for the Board.
Developments in terms of the NHS Constitution are also heartening. The Constitution is a 'declaratory document': it brings together the principles, values, rights and responsibilities that underpin the NHS. Because of its enduring nature, the Constitution is not amended without a 'clear and compelling' reason to do so (DoH, 2012b: 3). Nevertheless, the government is proposing to add not only a commitment to the 'use' of research (as well as its conduct and promotion) but also a new pledge to invite patients to participate in research. The new commitment to using research will be welcomed by members of the academic primary care community as an opportunity to further develop their knowledge exchange practices. Both the Board and clinical commissioning groups (CCGs) also have a duty to promote awareness of the Constitution among patients, staff and the wider public.
This raising of the profile of research in the Constitution is consistent with the unprecedented duties and powers, which the Health and...