COVID-19 and Brexit. The perfect storm for Clinical Research in the UK or its greatest opportunity?
The 23rd March 2021 marks the 1st anniversary of the United Kingdom government’s decision to lockdown the country as a result of the global COVID-19 pandemic. The milestone has been marked by a one-minute silence across the country and the lighting of a candle in many homes. It has been an extraordinary year for many reasons. The UK has had to deal with the health and social impact of a deadly global pandemic on top of the economic impact of withdrawing from the European Union after more than 40 years.
One of these major events on its own would be a driver for significant change. The result of both at the same time has been profound for all aspects of life but particularly healthcare and, by association, clinical research.
Public Health in the UK has been hugely impacted and the effect of the NHS managing high levels of COVID 19 infection and the 4th highest death rate per capita globally 1, means that the management of other conditions and other services have had a lower priority over the past 12 months. The knock-on effect of this means that non acute care and other initiatives such as digital innovation and technology programmes have a low priority in the service at this time. This is likely to continue through 2021 and into 2022 whilst the NHS catches up. However, as we will see, the need for better adoption and use of technology has become a real pressing need as the healthcare services try to manage the increasing patient demand with decreasing resources.
The way that people live and the way that business is done has changed forever. Zoom, Microsoft Teams, and Google Meet are now part of everyone’s day to day life, not just the business community. Healthcare and clinical research have been influenced by this change as much as any other. According to research by the Royal College of General Practitioners2, in the UK over 70% of everyday doctor/patient consultation is now done remotely, a complete reverse from the previous year when around 70% were face to face. Utilising technology to manage patient data and better adoption of telemedicine have quickly become normalised in the delivery of healthcare. This has positive implications for companies such as IOMED who whilst not directly involved in the delivery of patient care, are pushing the boundaries in how healthcare uses and manages its patient data.
In clinical research, effective remote recruitment of subjects for studies has become one of the most talked about topics in the research community. The fact that people have had travel restrictions has given rise to quicker acceptance of technology and alternative methods of patient and subject engagement. Patient reported outcomes and real-world data are becoming the norm with both sponsors and regulators now more readily accepting these as valid types of source data.
The United Kingdom clinical trial market is worth an estimated £2.7bn (€3.2bn) and is the largest in Europe and, globally, second only to the United states.3 However its position was already under threat as it is increasingly seen as a more difficult place to conduct research. A report by the World Economic Forum shows the UK as only 8th on the Global Competitiveness Index4. Brexit has made this an even more pressing problem.
A report commissioned by Cancer Research UK (CRUK) to explore the impacts of Brexit on the future of clinical trials as a whole and cancer trials in particular in the United Kingdom (UK) and European Union (EU), concluded that there are five areas that the UK needs to address if clinical research is to maintain or increase its competitiveness position post Brexit -
- Access to Medicines
The report states that there is a clear need for:
“A more streamlined and efficient approach…to allow the effective collection and sharing of anonymised patient and trial data while protecting patients’ rights and interests.”
In addition, to try and help to maintain the UK’s leadership in Clinical Research, the Association of the British Pharmaceuticals Industry (ABPI) report on clinical trials in the UK has included an initiative –
“Harnessing the UK’s data infrastructure for medicines R&D through having well-governed data with appropriate access to health data for industry, supported by a suitably skilled bioinformatics workforce “
It is clear that there is an appetite for change and to better use the information and data that the UK has to secure its clinical research leadership position.
What emerges after a difficult and confusing year for the people and business of the UK is a need to move forward and to try and return to normality whilst learning lessons from all that has happened. For a business such as IOMED it is a great opportunity to help answer the challenges of how to do better and smarter clinical research. It has never been so high up in the news, with the general public discussing clinical efficacy and epidemiological data. That is not something I would have not believed a little while ago!
For the research community, the opportunity must be to capture and utilise the interest and goodwill of the public toward clinical investigation. Real people with real conditions make for real world data. It seems that in the UK right now there has never been a better opportunity to make use of that.
 Statista (March 2021). Coronavirus (COVID-19) deaths worldwide per one million population as of March 29, 2021, by country. Retrieved from: https://www.statista.com/statistics/1104709/coronavirus-deaths-worldwide-per-million-inhabitants/
 Royal College of General Practitioners (April 30th, 2020). Around 7 in 10 patients now receive GP care remotely in bid to keep patients safe during pandemic, says RCGP. Retrieved from: https://www.rcgp.org.uk/about-us/news/2020/april/around-7-in-10-patients-now-receive-gp-care-remotely-in-bid-to-keep-patients-safe-during-pandemic.aspx
 ABPI Clinical Trials Report ( September 2019). Clinical trials How the UK is researching medicines of the future. Retrieved from: https://www.abpi.org.uk/media/7607/rmi-0128-0919-clinical-trials-report.pdf
 Global Economic Forum (2019). The Global Competitiveness Report 2019. Retrieved from: http://www3.weforum.org/docs/WEF_TheGlobalCompetitivenessReport2019