Cambridge Clinical Research Fellowships Scheme Fostering the future leaders of clinical research Fundraising case for support
Cambridge Clinical Research Fellowships Fostering the future leaders of clinical research Background Over the past half-century, medical care has been transformed through the application of science. Today, we live in a time when advances in molecular biology, imaging science, biomedical computing and bioengineering mean that there is the promise of even greater transformation to come over the next half-century. There is, however, a potential gap between basic research and improvements in routine medical care. This translational gap must be bridged through clinical research that evaluates new interventions in the ward and the clinic. In the first decade of this century, there was growing concern that clinical research was not keeping pace with rapid advances in basic scientific discovery. Expert groups made a number of recommendations to redress this balance 1. These included the recommendation that greater support should be made available to doctors who wish to make a career commitment to research. Around the same time, the postgraduate training of doctors was also being modernised, and this process included consideration of career tracks for clinical academics 2. From this, there emerged a clear training pathway for future leaders in clinical academic medicine. The need for research training pathways for nurses, midwives and allied health professionals has also been recognised 3. Clinical academics are doctors, nurses, midwives and allied health professionals who combine clinical practice with research and education. Most clinical academics are university employees, but in addition to academic work, they hold honorary contracts with the NHS and spend about half of their work time caring for patients. The importance of this model is that research is informed by the realities of patient care and that new interventions can be investigated and evaluated in a way that is integrated into the routine work of the hospital. 1 The Academy of Medical Sciences, Strengthening clinical Research, October 2003; Sir David Cooksey, A review of UK health research funding, December 2006 2 Report of the Academic Careers Sub-Committee of Modernising Medical Careers and the UK Clinical Research Collaboration, Medically and dentally-qualified academic staff: Recommendations for training the researchers and educators of the future, March 2005 3 Department of Health, Developing the role of the clinical academic researcher in the nursing, midwifery and allied health professions, 2012 1
Cambridge Clinical Research Fellowships Since 2007, Addenbrooke s Charitable Trust (ACT) has funded a clinical research fellowship programme at Cambridge University Hospitals NHS Foundation Trust (CUH). This programme has been targeted at outstanding doctors in the early stages of their career who have the potential and motivation to become the future leaders of academic medicine. In 2014, the programme was extended to build research capacity through developing early stage research training opportunities for nurses, midwives and allied health professionals. It offers intensive research training in an exceptional environment and provides an entry-point into a career in academic medicine and health research and a fast-track to the next stage of that career. Fellows are mentored by research-active senior doctors and healthcare professionals at CUH, many of whom will also be clinical academics at the University of Cambridge, with a global reputation in their field of medical research. It is the partnership between the hospital, the university and other research institutes on the Cambridge Biomedical Campus that creates an exceptional environment for research training. The mission of ACT is to support excellence in care, research and education at CUH. ACT is committed to the fellowship programme because we believe that fostering the clinical research leaders of tomorrow at an early stage in their careers will, over time, lead to more rapid translation of scientific discovery into improvements in healthcare and human health. The Charity is now seeking philanthropic support to ensure that the fellowship programme can be sustained and expanded in the future, providing entry-level opportunities for the next generation of clinical academics who have the potential to lead and shape future research for public benefit. Programme outcomes The 18 clinical academic fellowships (with medical backgrounds), awarded between 2007 and 2013 were reviewed as part of independent evaluation of the programme commissioned by ACT. This identified fellowship outputs for 14 fellows including 11 who had completed their fellowships. The evaluation also tracked the post-fellowship careers of these 11 former fellows. The main findings from this evaluation are summarised overleaf. 2
Programme objective Programme outcome Develop a new generation of clinical academic researchers and expand capacity for translational research in the UK. The programme has attracted outstanding individuals and provided them with an entry point into training for a clinical academic career. Fellows have won a range of prizes and awards for their work, demonstrating their qualities and potential. Support research projects that are of patient benefit. The research undertaken by the fellows has informed future research towards improved healthcare through: Better understanding of disease mechanisms Developing and refining model systems to study diseases in the laboratory Generating data to inform the design of clinical trials Developing new methodologies and analytical techniques to diagnose cancers, assess responsiveness to treatment and predict prognosis Tailoring existing therapies to optimise therapeutic benefit over side effects Research outputs included an impressive range of publications in high impact journals and presentations at conferences. Position fellows for follow-on awards that will further develop their research experience and potential. 10 out of the 11 former fellows secured awards for doctoral-level study, including 5 awards from the Medical Research Council and the Wellcome Trust. Capitalise on the exceptional environment for clinical research in Cambridge. 9 mentors were Fellows of the Academy of Medical Sciences. The evaluation concludes that the CUH setting excels in meeting the institutional requirements for research training identified by the Academy of Medical Science. The full evaluation and an abbreviated summary report are available on ACT s website at: www.act4addenbrookes.org.uk/researchfellowships. 3
A Cambridge Clinical Research Fellowship is not the only entry point available for those wishing to embark upon a clinical academic career in the UK. The National Institute for Health Research also funds Academic Clinical Fellowships (NIHR ACF), a three-year training position to acquire clinical skills including 25% of time allocated to academic studies. The Cambridge programme differs in intensity, level of supervision and pace. Cambridge Fellows start their one year with an identified project and mentor already in place. The proposed project will have been subject to rigorous peer review through the application process. Fellows are bought-out from their clinical commitments to allow them to focus on research and to undertake the preparatory work that will position them for successful applications for highly competitive follow-on awards. Our evaluation suggests that these attributes of the Cambridge programme make it attractive to highly-motivated individuals. Case Studies Dr John Gounaris won an ACT fellowship in 2010. His research focused on better understanding the biology of endometrial and ovarian cancer and in developing disease models for use in the laboratory. This has the potential to provide new methods for screening and early diagnosis of ovarian cancer in women at risk. On completion of his ACT Fellowship John secured a prestigious MRC Clinical Research Training Fellowship to continue his training. John explained the ACT Fellowship provided me with an opportunity to transition into research in a fertile ground with interactions between researchers and clinicians, and better technical knowledge and understanding of the biology In 2011, Dr Nicholas Grigoropoulos was selected for the ACT fellowship programme and worked with Professor Ming Qing Du on a study to discover the genetic abnormalities of diffuse large B-cell lymphoma the most common aggressive lymphoma in the world. On completion of his fellowship, Nicholas said I m very pleased to be able to tell you that, in large part thanks to pilot data that was generated using the ACT fellowship, I have now been awarded full funding for a three year PhD project. I don t think this would have been possible without ACT, and I m very grateful. Dr Elizabeth Wallin was awarded an ACT fellowship in 2011. Her research focused on how cell biology is altered in autoimmune diseases and generated new knowledge to predict prognosis and the best ways of using existing therapies. On completing the fellowship, Elizabeth returned to clinical duties and then secured a MRC Clinical Research Training Fellowship for a PhD in renal immunology at the University of Oxford. Elizabeth continues to collaborate with Cambridge researchers. 4
Programme Budget Each Cambridge Clinical Research Fellowship costs in the region of 50,000 per year, which covers the gross salary costs of the fellow and a sum for research consumables. In 2015, ACT awarded twelve fellowships that were open to projects in any field of medicine and health research. ACT awarded fellowships in specific areas such as surgery and perinatal imaging, bringing the total annual value of the programme to 471,000. A fellowship in dermatology is funded from the bequest of Mr Maxwell Charnley, in whose memory the fellowship is named. A fellowship in perinatal imaging has been funded for three years by The Evelyn Trust and part funding for other fellowships has been provided by the Isaac Newton Trust (for 3 years), the Royal College of Surgeons of England and the Polycystic Kidney Disease Charity. ACT is very grateful for this support for fellowships in specific fields. In 2015, nearly half of the funding was provided by the National Institute for Health Research Biomedical Research Centre (NIHR BRC). The BRCs are based within the most outstanding NHS and University partnerships in the country and are leaders in the translation of fundamental biomedical research into clinical research that has a direct benefit to patients. The BRC s financial support for the Cambridge Clinical Research Fellowship Programme is an endorsement of the relevance and quality of the programme. ACT has, since 2007, supported the programme from its relatively modest general funds in order to get it off the ground. Since 2013, additional funding from the NIHR BRC has made it possible to extend the programme. Now that the value of the programme has been demonstrated, we are opening up the opportunity for others to offer their support and be part of the future of medical research. Such support would allow us to sustain the increased number of fellowships in future years and to include support tailored to nurses and other health professionals. It would also provide a necessary safeguard against the possibility that BRC support might not always be available (the BRC award runs until March 2017 and any renewal of funding will depend upon the outcome of a national competition). Donor Engagement and Recognition Supporters of this programme will be given the opportunity to engage with the fellowship recipients and their research directly though events, meetings and reports. They will also be given the opportunity to join the 1766 Club, ACT s major donor forum, which exists to acknowledge the support from particularly generous donors, trusts and foundations, as well as offering opportunities to meet frontline hospital staff, senior clinicians and hospital leaders on the Cambridge Biomedical Campus as part of an exciting annual programme (for further information see www.act4addenbrookes.org.uk/1766club). The Cambridge Clinical Research Fellowship Programme also presents a unique naming right opportunity for those who wish to commit to co-funding a fellowship. Naming rights will be bestowed in return for a commitment to fund half the cost of a fellowship for three consecutive years (i.e. 75,000 over the three years). This would give the funder the opportunity to develop a special relationship with the three outstanding individuals appointed to the named fellowship over this period. 5
By harnessing CUH/ACT procedures and administration of the Fellowships, donors will benefit from Having three successive named Cambridge Clinical Research Fellows, selected through a competitive process from a high-achieving peer group, who will be working on specific and relevant clinical research projects while supported by dedicated mentoring by a world-class clinician or scientist from the Cambridge Biomedical Campus. Naming rights - donors who commit to fully funding three consecutive research fellowships will receive long-term recognition in media, printed or online, produced by ACT. Being able to specify areas of clinical research they would like to support. Strong reassurance that your named Cambridge Clinical Research Fellow and their project have been thoroughly vetted by the multidisciplinary Research Advisory Committee made up of senior clinicians and scientists at CUH. Further engagement, whereby ACT will provide regular opportunities to visit the campus and meet the fellows and learn about the progress of their research at first hand. Our donors receive regular updates and reports, tailored to their needs in terms of frequency and level of detail. Furthermore, donors have access to ongoing tracking procedures, which provides detailed information for the future evaluation of the programme. General administrative support provided by ACT, including fulfilling contractual administration for the programme. Monitoring and Evaluation All research fellows are required to produce a full project report on the completion of their research programme and this will be shared with all fellowship funders. ACT will also keep all funders regularly updated on progress throughout the duration of the study. ACT will continue to monitor and evaluate the research fellowship programme and track the progress of all research fellowship recipients for a minimum of five years and report back to funders. ACT will also continually assess the impact of the programme and regularly gather outcome data to help better understand and respond effectively to the challenges and opportunities for the CUH clinical academic workforce. Please refer to the Appendix for further details about ACT and the Cambridge Clinical Research Fellowship Programme. For further information please contact by phone on 01223 217757 or by email Mrs Samantha Sherratt, Deputy Director of Fundraising samantha.sheratt@act4addenbrookes.org,uk Dr Jenny Longmore, Director of Research Jenny.longmore@act4addenbrookes.org.uk Thank you 6
Appendices Cambridge Clinical Research Fellowships Fostering the future leaders of clinical research A/ About ACT ACT is the working name for Addenbrooke s Charitable Trust, the independent registered charity for Cambridge University Hospitals (CUH comprising Addenbrooke s and the Rosie hospitals). ACT is uniquely positioned at the heart of the Cambridge Biomedical Campus to bring world class research from the lab to the bedside. We do this by targeting funding on pivotal projects and equipment that can make a strategic difference to patient diagnosis, care and treatment. B/ How the Cambridge Clinical Research Fellowship Programme works in practice The Cambridge Clinical Research Fellowship Programme provides an entry point to the clinical research training pathway (see fig.1 below for a typical example for medical doctors) Fig. 1: Strategic positioning of Cambridge Clinical Research Fellowships in the clinical academic training path Each year, applications are invited through advertisements on the ACT and CUH websites, through social media and direct email. The call opens in February for doctors and in April for nurses, midwives and allied health professionals. The selection of the fellows takes place via a two stage process. 7
CAMBRIDGE CLINICAL RESEARCH FELLOWSHIP PROGRAMME CYCLE NURSES, MIDWIVES, AHPS DOCTORS Apr-Oct Call for applications open Feb Call for applications opens Coaching sessions Nov Applications undergo first stage peer review Mar /Apr Applications undergo first stage peer review Dec Short listed candidates submit full application May Short listed candidates submit full application Following Peer review June Jan candidates interviewed Feb Fellows selected July Peer review candidates interviewed May / Fellowships begin Aug Fellows selected June Sept /Oct Fellowships begin POST FELLOWSHIP Experience and pilot data helps fellows leverage new major funding Fellows complete PhD and continue training Research findings are published and translated into clinical practice for the benefit of patients 8
C/ The role of the CUH Research Advisory Committee (RAC) All applications for research grants (including the Cambridge Clinical Research Fellowship programme) are reviewed by the CUH Research Advisory Committee (RAC) which makes recommendations to ACTs Grants Committee. The RAC advises ACT on the scientific merit, relevance to healthcare and feasibility of all research projects and also maintains an overview of compliance with requirements for ethical review. For the fellowships specific criteria are applied such as quality and dedication of the candidate, quality of the proposed research and supervision and prospects for securing follow-on funding. RAC members cover a broad range of clinical and scientific expertise and comprise 50:50 from CUH and University of Cambridge staff. Members serve for four years (with opportunity for renewal) and the committee is Chaired Dr John Bradley, Consultant Physician and Nephrologist as well as Director of the NIHR Cambridge Biomedical Research Centre. The committee meets at least quarterly and is answerable to CUH s Research Board. ACT is very grateful for the dedication and hard work of the committee members, who bring their extensive knowledge and experience on a voluntary basis. D/ Members of the Research Advisory Committee Professor John R Bradley (Chair) Director of National Institute for Health Research, Cambridge Biomedical Research Centre and Director of Research and Development, Cambridge University Hospitals NHS Foundation Trust Dr Richard Baird Academic Consultant in Breast Cancer Therapeutics, Addenbrooke s Hospital Dr Stephen Barclay HEFCE Clinical Senior Lecturer in General Practice and Palliative Care, General Practitioner and Honorary Consultant Physician in Palliative Medicine Dr Bristi Basu Consultant Medical Oncologist in Experimental Cancer Therapeutics, Addenbrooke s Hospital Professor Andrew Bradley Kidney Transplant Surgeon and Professor of Surgery, Addenbrooke s Hospital Dr Charlotte Coles Consultant Clinical Oncologist, Addenbrooke s Hospital Dr Pippa Corrie Consultant and Associate Lecturer in Medical Oncology, Addenbrooke s Hospital Professor Christi Deaton Professor of Clinical Nursing Research, Addenbrooke s Hospital Professor Ming Du 9
Professor of Pathology, University of Cambridge Professor David Dunger Professor of Paediatrics, Addenbrooke s Hospital Dr Rebecca Fitzgerald MRC Clinician Scientist/ Honorary Consultant Gastroenterologist, Addenbrooke s Hospital Prof J Hill Gaston Foundation Professor of Rheumatology, Addenbrooke s Hospital Dr Thomas Hiemstra Senior Clinical Trials Fellow and Honorary Consultant, Addenbrooke s Hospital Dr David Jayne Consultant in Nephrology and Vasculitis at the Department of Clinical Medicine, Addenbrooke's Hospital Dr Raj Jena Consultant Clinical Oncologist, Addenbrooke s Hospital Ms Sara Jones Lead Research Nurse, Addenbrooke s Hospital Professor David Lomas Professor of Clinical MRI, Lead Clinician MRI Services, Department of Radiology, Addenbrooke s Hospital and the University of Cambridge Professor Andrew McCaskie Professor of Orthopaedic Surgery, University of Cambridge Professor David Menon Head of the Department of Anaesthesia, Principal Investigator in the Wolfson Brain Imaging Centre, and Co-Chair of the Acute Brain Injury Programme at the University of Cambridge Dr Ken Poole Clinical Lecturer (University of Cambridge) and Honorary Consultant in Rheumatology and Metabolic Bone Disease, Addenbrooke s Hospital Dr Elana Provenzano Clinical Consultant, Addenbrooke s Hospital Professor David Rubinsztein Professor of Molecular Neurogenetics, University of Cambridge Professor Gordon Smith Professor and Head of the Department of Obstetrics and Gynaecology, University of Cambridge Ms Katherine Taylor Consultant Radiographer, Addenbrooke s Hospital 10
Professor Ian Wilkinson Reader in Clinical Pharmacology at the University of Cambridge and Honorary Consultant at Cambridge University Hospitals E/ Evaluation of the Cambridge Clinical Research Fellowship Programme The Cambridge Clinical Research Fellowship Programme evaluation and a summary are available on the ACT website at: www.act4addenbrookes.org.uk/researchfellowships This evaluation contains details regarding fellows research outputs, destination (i.e. next employment or training posting), leveraged funding, awards and other accolades. 11