Putting East London at the forefront of clinical research

Clinical trials are important for helping to improve health outcomes for our community.  A Clinical Research Facility (CRF) is both a physical place and importantly a team of skilled healthcare professionals who help to deliver research studies.  Barts Health is a highly research-active organisation, and last year recruited more people into clinical trials than ever before. Next year, we will be opening a pioneering CRF at The Royal London Hospital. In this blog we spoke to Consultant Nephrologist Kieran McCafferty, the newly appointed CRF Director, to find out how the new facility will significantly enhance research capacity and capabilities in East London.

Note the views expressed herein are those solely of the author.

“People, both in the UK and globally, are living longer. However, this increase in lifespan does not necessarily equate to better health. Many people are experiencing longer periods of chronic illness or disability, which increases the burden on healthcare systems. As the world’s population is ageing, the need for pioneering, effective, and affordable innovations in healthcare has never been greater.

In East London, we have one of the fastest-growing, youngest, and most diverse population both in the country and across Europe. This diversity offers a unique and valuable opportunity, particularly in the field of healthcare and clinical research.

Firstly, it ensures that the benefits of research are equitably distributed. This is essential for developing medical treatments and interventions that are robust, inclusive and impactful for diverse communities, not just those traditionally overrepresented in research. Consequently, these efforts benefit not only the local community but also contribute significantly to global medical knowledge and practice, ultimately, improving health outcomes for everyone.

Additionally, it means that our researchers have access to a rich variety of health data. This helps us to better identify health disparities and understand the specific needs of different communities. For example, certain diseases can be more prevalent in specific ethnic groups, and understanding these patterns can enable better, more targeted prevention and treatment strategies. This data-driven approach ultimately leads to more equitable healthcare delivery.

The importance of clinical research

Clinical research is crucial in developing new healthcare innovations that can rise to the challenges of our precious health system. Here in East London, we are proud to be home to Barts Health NHS Trust, the largest Trust in London and second largest in the UK, which is consistently among the top Trusts for commercial clinical trials. We are also home to world-renowned research university, Queen Mary University of London (QMUL), which ranks 14th globally for research quality and is highly cited in medical research.

Located in one of the best-connected cities in the world, it means we have something very special to offer. We have the scientific skills needed to discover new innovations and the practical experience of modern-day healthcare to know how they should be delivered. Our diverse population provides a unique opportunity for clinical trials that are both representative and impactful.

Healthcare organisations and institutions being actively involved in clinical research is an excellent marker of high-quality care. They are also well placed to improve their staff’s skills and ensure that patient treatments are based on the best available evidence. This in turn encourages a continuous culture of learning and innovation, ultimately, benefiting both the local community and the wider healthcare system.

Unfortunately, in recent years, the UK has seen a decline in its commercial clinical trials activity. According to research from the Association of the British Pharmaceutical Industry (ABPI), the number of patients enrolled in commercially led studies supported by the NIHR dropped by 44% from 2017-2018 to 2021-2022, falling from approximately 50,000 to around 28,000 annually.

Nationally, there has been significant attention on how to increase the delivery of commercial clinical trials. Lord O’Shaughnessy’s report last year highlighted a decline in the number of commercial studies opening in the UK over recent years. The UK competes with other countries to be chosen to deliver commercial trials. While the UK has an excellent international reputation for well-run trials with robust trial data, delays in study approval and set up compared to other countries has meant that the UK was less attractive for internationally sponsored studies. However, despite the large volume of often complex interventional trials opened at Barts Health/QMUL, our trial set up is quicker than the national average and is also shorter than all other large academic centres in London.

Opening more trials increases opportunities for our patients to access early-stage innovative treatments that could potentially enhance, prolong, or even save their lives. Hospital consultants involved in research studies are also more inclined to champion for the adoption of innovative therapies or devices once they are approved. Research-active NHS bodies typically achieve better health outcomes for their patients on average. We were delighted that Barts Health recruited more patients to clinical trials in the last year than at any time before, strengthening our capabilities and ongoing contributions to clinical research and patient care.

Enhancing research provision in East London

Next year to enhance our own capabilities here in North East London, we will be opening an early phase CRF in Whitechapel. A pioneering facility which has been generously funded by the NIHR and Barts Charity, it will cover 1,250 sqm, which is five times larger than our current space at The Royal London Hospital

The new facility will allow us to conduct a wider range of research, particularly for those requiring overnight stays and longer-term blood sampling. This is currently very challenging, but the new facility will open doors to earlier phase trials. It provides a fantastic opportunity for our team across Barts Health and our academic researchers to offer these trials to patients, as well as making Barts a more attractive place to work.

Most importantly, it will enable patients to access cutting-edge, novel therapies for a wide range of diseases. Our efforts are underpinned by a robust governance team, strong patient and public input into our strategy, and a team of research-active clinicians guiding our direction.

My role is to lead our team through any challenges that come up in clinical research. I want to enable a cultural change to make research a natural part of everyday clinical care and to drum up support for it, particularly in such a fast-paced environment. It’s important to champion the benefits of research, not just for the patients participating, but for everyone involved. Patients who take part in research often have a very positive experience with their healthcare, which is wonderful to see.

Improving outcomes for our community

Many of the health challenges facing our community are non-communicable diseases, with high rates of diabetes, heart disease, kidney disease, and obesity. As our population ages, dementia will become increasingly significant for research opportunities. The establishment of the Academic Centre for Healthy Ageing (ACHA), supported by substantial investment from Barts Charity, is a promising initiative aimed at exploring novel treatments and improving care for older individuals.

Aligned with our CRF goals, we aim to increase patient participation in research and support any clinical trials emerging from ACHA at Whipps Cross Hospital, where we also have a CRF.

The benefits are manifold. By collaborating with the life sciences industry, we can advance preclinical research and provide early evidence for innovations generated by Barts Life Sciences and industry partnerships. This collaboration helps translate ideas from bench to bedside, ensuring that new interventions are rigorously tested and proven effective within our richly diverse community.

This integration of research into clinical practice not only supports medical advancements but also enhances the quality of care we provide to our patients, addressing their specific needs and contributing to improved health outcomes across our community.

Driving real change

I’m in the business of medicine to improve outcomes for my patients. For instance, in renal care, the way we treat kidney disease has evolved significantly in the last decade compared to the previous three. That’s all down to the many new trials that have come along for patients with kidney disease. It’s incredibly rewarding to be able to tell patients that we have new medicines available for them. Kidney disease can be challenging, and many people struggle with it, so it’s amazing to be able to offer them the chance to potentially transform their outcomes.

What makes it even more special is having conducted trials right here in our community in East London. It allows us to confidently say that these treatments have been studied among patients we see every day and they are beneficial. Incorporating them into routine care is a step forward we can take with confidence.

You conduct research, see its direct benefits on patients, you then contribute to national guidelines on how we use these medicines, and then apply those guidelines to improve the lives of our real life patients. It’s really great to be a part of this cycle – closing the loop from research to practical application. It’s not just about doing research for its own sake; it’s about driving real change in clinical practice, and that’s what makes it so fulfilling.

About the author

Kieran McCafferty is a Consultant Nephrologist at Barts Health NHS Trust and Senior Lecturer and Queen Mary University London. His main clinical interests are diabetic kidney disease and haemodialysis. He is clinical director of the Barts Health CRF and is the Health and Care Research Director for the North London NIHR RDN