Protecting health research in the UK: culture and collaboration

Abstract

From the discoveries of Fleming and Lister to the more recent work on aromatase inhibitors done by the Royal Marsden Hospital and Institute for Cancer Research, research and health care have had a long and illustrious relationship in the UK. This relationship resulted in many discoveries and innovations that have benefited patients worldwide, and it is also clear that patients have better outcomes when they are managed in research-active settings. However, this symbiotic relationship is under threat, from both an increasing divergence of academia and the National Health Service (NHS), and a worsening research culture. According to a new report from the Academy of Medical Sciences, a misalignment of incentives has arisen in the UK, as academia focuses on achieving targets in the Research Excellence Framework, whereas the NHS is increasingly working towards operational and financial targets. Despite the growing number of clinicians in the UK, the number of clinical academics has fallen and national investment in research and development in many places is either flat or falling. Results from the largest survey into research culture, published by Wellcome this week, reveal that less than a third of scientists feel secure pursuing a research career. Participants described growing pressure in research, which is decreasing collaboration and creating conditions for aggressive behaviour, including bullying and harassment. Participants cited many factors, such as a proliferation of metrics and their prioritisation above research quality, lack of diversity, and increasing commercialisation of higher education. Both reports call for a rethink of incentives within research and promotion of best practice. A focus on short-term results, operational goals, and proxy measures in both academia and the NHS risks the creation of two divergent systems and erosion of the collaboration required for good research. It is vital to ensure integration of research into the NHS and to build a positive research culture, to protect the benefits research brings to patients and to realise the ultimate goal of biomedical research—better health. Challenging social structures and changing research culturesAcademia can be a rewarding place to work, but not always and not for everybody. Precarity, inequality, and discrimination are stubbornly persistent, and bullying and harassment can make for a toxic environment. In the UK, a range of scientific organisations and funders are addressing these problems by emphasising the need for a positive research culture to promote quality scholarship. In 2018, a conference convened by the Royal Society of London, UK, explored the cultures necessary to support excellent research and researchers,1 following on from work in 2014 by the Nuffield Council on Bioethics on the culture of scientific research in the UK. Full-Text PDF