A few months ago, I was invited to join a new Ethics Review Advisory Group to look at ways to improve ethics review. Think Ethics aims to make ethics review a more rewarding experience for REC members, as well as for researchers and patients. I chose to get involved because I tick all three of those boxes as: a researcher; a REC member of nearly five years; and having taken part in clinical research as a participant before.
I enjoy being part of a REC and get a lot out of it both personally and professionally, but it can be quite a commitment with a lot of reading... I think that there are ways in which ethics review can be improved for both committee members and researchers and I am keen to play a part in that. I think that there are things that we could make easier and lessons we can learn from how we worked during the COVID-19 pandemic and Think Ethics is an opportunity to start doing this.
There has already been lots of work behind the scenes on this and we have had three meetings of the advisory group so far with minutes and details on the HRA website.
So what is Think Ethics?
Being a REC member is really rewarding but I sometimes have a love hate relationship with all the reading. It can be quite demanding and there are ways in which ethics review could be made easier for us and I am hoping to be a part of bringing about that change! Think Ethics is going to look at ways of making ethics review a more efficient process for us and make things more streamlined – not just for REC members, but for researchers too. There’s a number of strands of work and some further workshops planned where there will be an invitation for REC members – as well as researchers and public contributors – to get involved.
Looking at committee culture and the ways we review studies
As we know every committee is made up of different people and can have different ways of doing things. A big part of research is reproducibility and standardising methods so it’s quite ironic that our committees can be so different! We already have some standard processes for the RECs but there are ways of making these common across all the committees and things that could be written into our inductions to help with this.
I hope Think Ethics will bring about more consistency which will be helpful not only for REC members but also for HRA staff. Every committee is going to have some differences, but I think that there should be some more guidance to help spell out some common practices. And REC members will benefit from having clearer boundaries and instructions.
Streamlining documentation
I often find there is a lot of repetition in the documentation that comes to us as REC members. There are also some documents that come to us which I don’t think need to that could be processed by staff, for example insurance certificates. Think Ethics is going to look at the documentation that comes to RECs and review what is really necessary – such as what is it we really need to look at to do our jobs. I would like to see more filtered out so that we can focus on ethical issues. Think Ethics is about making it as easy as possible for us as we all have busy lives. I also think more people will be interested in both joining a REC and staying and we’ll be able to attract a wider variety of members if we take this approach.
Learning from COVID-19
Think Ethics also intends to learn lessons from the pandemic. I volunteered to work on a fast-tracked REC to review COVID-19 research and I think ethics review improved during the pandemic. A global pandemic is certainly different than a normal situation, but I think we should be aiming to learn lessons and treat other research with the urgency we did for COVID-19 studies as much as possible. There’s an ethical argument that the longer research is waiting to be approved, the longer that new knowledge and/or treatments will become available. Hence, the faster that research can be looked at / approved, the faster we can potentially improve and/or save lives (especially in the case of interventional research).
Although I miss face-to-face meetings, I think the remote working is making it easier for people who are working to join RECs as well as people who have disabilities and/or live in remote areas. It is easier to convene people if they can join any REC around the country and are no longer restricted to their nearest geographical committee. It makes me wonder if there might be scope to prioritise slightly more urgent studies for example interventional over observational) in the future or set up RECs specialising in disease areas or methodology for example qualitative or quantitative expertise) as opposed to geography. There is an opportunity to be more dynamic and flexible.
The future
The Advisory Group is great because there are REC members; patients; industry representatives; and researchers all on a call together pitching in ideas which would often all be very separate. It means myself and my five fellow REC members are getting to put across our opinions, but we are also hearing other perspectives perceptions of how ethics review works – such as what is good and what could be made even better. I hope we can make important changes that will help maintain the UK as a great and attractive place to do research.