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I read with interest Chris Salisbury's article in the January edition of the BJGP.1 I should declare interest in the issues raised as research manager for three PCTs and a researcher with long experience in both health and social care.
Research governance became my responsibility in April 2002 as a result of national directives. While the areas that had to be covered were made clear, we started with virtually nothing in the way of detailed procedure and guidance. This has gradually improved, and the work not only of the NHS R&D Forum, but also local support from Trent Focus has been very welcome in bringing in what has often been a complicated and sometimes stressful process. This appears to be in total contrast to the major changes in the running of ethics committees, where detailed procedures and timescales have been the order of the day.
Research governance is still a long way from being a system that minimises bureaucracy while also ensuring that research of a reasonable quality takes place. Your writers' comments about the amount of time it takes for research staff are well founded; however, the same applies to those given the responsibility for giving management approval. Research in the NHS is a crucial activity for the improvement of patient care, which can absorb significant amounts of patient and staff time.
Quality, and to some extent quantity, appear to me to be the key issues. We have to remember that the origins of research governance are in some very questionable research practices in places such as Alder Hey Children's Hospital. Ensuring that PCTs know about all research being carried out in them and that it has management approval is something I would hope most of your readers would support. Local experience, particularly in the field of commercial drug trials, suggests that there is room for improvement not only in the quality of some projects, but also in carrying out work where benefits to patients outweigh the potential side effects. We do, however, want to support good research — be it commercial, academic or in-house in origin.
It is a pity that a lack of central guidance and support has led to the bureaucratic minefield that research governance can be. Its existence in a less onerous form is something we should all support.