Wakeham Review

Wakeham Review
Name	Wakeham Review
Author	Lord Wakeham
Date	2006
Subject	NHS research governance and funding
Jurisdiction	United Kingdom

Wakeham Review is a 2006 independent review of health research funding and governance commissioned to assess links between policy, practice and biomedical science in the United Kingdom. Chaired by Lord Wakeham, the review examined interactions among agencies such as the Department of Health, the Medical Research Council, the National Health Service and funders including the Wellcome Trust and Cancer Research UK. The report influenced reforms that connected bodies like the NHS Research and Development Directorate with translational programmes exemplified by the National Institute for Health and Care Excellence and clinical initiatives such as the Clinical Research Network.

Background and Commissioning

The review was commissioned against a backdrop of inquiries and reports including the Cooksey Review of UK Health Research Funding and debates involving the House of Commons Health Committee, the Office for Science and Technology and the Academy of Medical Sciences. Concerns raised after episodes such as the reorganisation of the 1974 NHS research functions and issues highlighted by the Culyer report prompted the Secretary of State for Health to seek an independent appraisal. Lord Wakeham, previously linked to bodies like the House of Lords and the Conservative Party, led a panel drawing on expertise from institutions including the MRC, the Wellcome Trust, University College London, University of Oxford and the University of Cambridge.

Scope and Objectives

The review targeted interfaces among statutory agencies and charitable funders such as the Wellcome Trust, British Heart Foundation and Macmillan Cancer Support. Objectives included clarifying roles for the National Institute for Health Research model, aligning priorities of the MRC with the Department of Health and proposing mechanisms to translate discoveries from centres like the Francis Crick Institute into clinical practice in hospitals like St Thomas' Hospital. The remit covered governance, funding flows involving the Research Councils UK landscape, and oversight arrangements paralleling those in reports by the King's Fund and the Nuffield Trust.

Key Findings and Recommendations

The panel identified fragmentation across funders including the Wellcome Trust and the European Research Council and recommended clearer lines of accountability akin to models used by the National Institutes of Health in the United States and the Canadian Institutes of Health Research in Canada. Key recommendations called for strengthening the National Institute for Health Research as a coordinating body, reallocating resources to support translational platforms such as clinical trials units affiliated with the Royal College of Physicians and the Royal College of Surgeons of England, and enhancing capacity at universities like Imperial College London and King's College London. The report urged improved metrics for impact drawing on methodologies used by the MRC and the Research Excellence Framework.

Impact and Implementation

Following publication, elements of the report informed policy shifts within the Department of Health and contributed to structural changes in the National Institute for Health Research and the reconfiguration of infrastructure funding through partnerships with the Wellcome Trust and the Research Councils UK portfolio. Implementation intersected with initiatives led by the NHS Confederation and the Academy of Medical Sciences, and influenced commissioning practices at bodies such as the National Institute for Health and Care Excellence and the Health Research Authority. Hospitals within the NHS Foundation Trust framework and academic health science centres including University Hospital Birmingham and Cambridge Biomedical Campus adopted new arrangements for research governance and contracting.

Criticism and Reception

Reactions came from stakeholders including the Association of Medical Research Charities, the British Medical Association and the Royal Society. Critics argued that recommendations duplicated aspects of the Cooksey Review or risked centralising control in ways reminiscent of controversies surrounding the National Health Service reform and Healthcare Commission episodes. Academic commentators from University of Edinburgh and Queen Mary University of London debated implications for basic science funding versus applied research, while parliamentary scrutiny by the House of Commons Science and Technology Committee questioned implementation timetables and accountability mechanisms tied to the Department of Health.

Legacy and Subsequent Developments

The review's legacy includes influencing the maturation of the National Institute for Health Research and encouraging partnerships between public funders and charities such as the Wellcome Trust and Cancer Research UK. Subsequent developments involved alignment with frameworks like the Research Excellence Framework and collaborations across international agencies including the European Commission and the World Health Organization. Elements of the review continue to be referenced in policy debates within the House of Commons and among institutions such as the Academy of Medical Sciences and the Health Foundation as the UK health research landscape evolves amid pressures from events like Brexit and public health responses to crises such as the COVID-19 pandemic.

Category:United Kingdom medical research