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A Trial for Every Patient

Research Meeting at the RCS, London

24 April 2025 (Last updated: 24 Apr 2025 13:31)

Cardiac Surgical Research in the United Kingdom and Ireland has had a great revival in the last few years. I had the pleasure of representing SCTS at the Royal College of Surgeons in London, to celebrate the five-year anniversary of the SCTS trials initiative.

The initiative began with the James Lind Alliance Priority Setting Partnership which identified the top 10 research priorities in cardiac surgery. The centrepiece of the five-year celebration was the launch of a toolkit to embed Equality, Diversity and Inclusion (EDI) in cardiac surgery research.

The EDI toolkit is a key step to realising the aims of the clinical trials initiative, outlined at the Plenary session of the SCTS meeting in 2023: “a trial for every patient - a patient for every trial”.

Attending the meeting were commissioners, methodologists, research staff and most importantly patients who have been integral to the 5-year journey, from its inception through to designing the toolkit.

Without doubt the highlight of the event was the keynote speech by Samantha Dias who described the urgent need for ‘the patient voice’ in research.  Samantha powerfully articulated the dangers of not making this a priority and the resulting consequences, which includes asking the wrong questions and getting the wrong answers. 

In 2020 a significant lack of research trials and research capacity in cardiac surgery was identified as an urgent problem.  At that point only two multi-centred randomised trials had been delivered in cardiac surgery. In many units the infrastructure to recruit patients into trials, in particular research nurses, had disappeared or in most cases had been subsumed by cardiology.

Having identified the top 10 research questions, clinical study groups consisting of clinicians, methodologies and most importantly patients were developed to address these priorities.

The results have been astonishing. There are now 10 multicentre trials and two NIHR programme grants in cardiac surgery. Over £25M in grants funding has been won. Capacity to deliver cardiac surgery trials has increased, with six clinical trials units (The South Tees ACU, York, Birmingham, Leicester, NHSBT, and Bristol) These clinical trials unit specialise in cardiac surgery trials with central integrated leadership, knowledge sharing across the units.

In units all over the country, hundreds of patients have been recruited into trials and multiple new PIs and Associated PIs which include NAHP have been created as a result and the cardiac surgery research nurse is making a comeback!

Furthermore, two trainee led projects (Rossini and Thermos) are currently recruiting in 28 UK centres.

Patients have played their part too, with patient commissioned research studies, PPI co-leadership and integral input into trial design and delivery

One key challenge has been to improve the diversity of the patients who are represented in these trials, and we hope to address that with the development of the novel toolkit. 

I want to say a huge thank you to Professor Murphy, Dr Anne Cheng and the rest of the University of Leicester Clinical Trials Unit who organised the event and particular thanks to Sarah Murray who has been a champion of patient representation for several years. 

Enoch Akowuah
SCTS President Elect

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