Reflecting on 2021 - a blog by Matt Westmore

Last updated on 20 Dec 2021

Matt Westmore, HRA Chief Executive, reflects on 2021 and shares his pride at the role the HRA has played in the pandemic and beyond as we embed change for the long term.

As 2021 draws to a close, I wanted to reflect on another challenging year for us all, the UK health research system, and the Health Research Authority.

COVID-19, of course, remained the biggest single challenge we faced this year and I think the HRA has responded to it extremely strongly.

Thanks to the hard work, adaptability and dedication of our staff, Research Ethics Committee, Confidentiality Advisory Group and Public Involvement Network members, and our Technical Assurance reviewers, we continued our business-as-usual role of protecting and promoting the interests and opportunities of people in research, and worked to help the NHS and the wider UK research system recover.

Crucially, we were also able to capitalise on the chance to innovate in the face of COVID-19. We have made some major changes to how we do things, which we are now embedding for the long term.

Key to our work is our social mission – to protect and promote the interests of people in research by making it easy to do high-quality, responsible research. To that end, many of the changes we’ve been working on this year are designed to streamline processes, improve efficiency, support researchers and participants, and help us collaborate with our partners effectively.

Our fast-track ethics review service, which launched in January 2021, came as a direct result of our experience during COVID-19. It cuts the time taken to provide ethical review in half – taking just 14 days for fast-tracked global trials for all health areas, not just COVID-19. Our fast track ethics review is now available as an option within combined review for global trials.

We moved to virtual research ethics committee meetings at the start of the pandemic, and this year made the decision to keep these rather than returning to face-to-face meetings. This change does make it harder in some ways, but we see benefits in diversity and inclusion for committee members, and it’s easier for research teams to engage with the committee and join in the discussions. We also plan to hold some face-to-face development days for our members in 2022.

Another area where we’ve made changes is public involvement in research. Of course, this is always important, expected, and possible. But like many other things in the pandemic, it was more difficult. In 2020, we established a service to match study teams with the right patient and public groups, who could provide input quickly at short notice. This involved 56 groups representing 47 host organisations. This year we shared our findings at a virtual conference in January, and we are now working with partners across the sector to build on that work, develop a shared commitment to public involvement and offer more support to research teams.

Speaking of partners, the reason we were able to do what we did during the pandemic was because we already had an integrated health research system, which is embedded within our national health services. We could prioritise, coordinate, and deliver research in ways other countries simply couldn’t. A tangible example is our combined review service with the Medicines and Healthcare products Regulatory Agency (MHRA). We receive around 1,000 applications per year for clinical trials of medicinal products, which also needed MHRA approval. Previously, this would have required two separate applications to the two different bodies, resulting in additional effort, poorer experience, and longer processes for the research community. That, of course, translates into delayed research opportunities and delayed treatments for patients. Now researchers submit one application. This reduces burden, improves consistency, and has cut the overall time taken for the researcher to gain approval from both agencies in half compared with 2019. From January 2022, this will be the way all clinical trials of medicinal products (or CTIMPs) are handled.

We have also developed Think Ethics, a root and branch look at how we ensure the ethics service is proportionate and focused on what matters to participants. That will result in a much easier and quicker process for low-risk research, and much shorter and easier to understand patient-facing materials, such as consent information.

We’ve continued to champion transparency; we published our first annual transparency report and hosted the first Make it Public conference, which was attended by more than 600 delegates. We launched a partnership with ISRCTN, which means clinical trials will be automatically registered to guarantee a full picture of research taking place in the UK from January 2022. We’ve also made great strides forward to support research involving data-driven technologies and artificial intelligence.

As we move into 2022, we will continue to innovate, streamline, and deliver our dual purpose of protecting the interests of participants in research and making it easy to do good research in the UK.

We will continue to play our part in delivering the vision for the Future of UK Clinical Research Delivery – creating a patient-centred, pro-innovation and data-enabled clinical research environment and in delivering the Life Sciences Vision. We will be working with our partners across the Department of Health and Social Care, and across the UK to support the UK research sector not only recover from the pandemic, but do so with improved resilience to future health shocks and grow for the benefit of patients and the economy.

We were proud to reach the grand age of 10 this year, but like Rudolph we remain the youthful reindeer leading the way for health and social care research through the storm of COVID-19 and beyond.

Whether the Christmas break is a time for joy or quieter and more contemplative, I wish you well for it and look forward to seeing you all next year. When the real Rudolph rests it will be up, up and away for us again!

Matt Westmore

Chief Executive, Health Research Authority

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