1. Health and Healthcare Technologies Event University of Bath
Katie Finch
Medical Research Council
12th May 2011

2. MRC mission Encourage and support research to improve human health
Produce skilled researchers
Advance and disseminate knowledge and technology to improve the quality of life and economic competitiveness of the UK and worldwide
Promote dialogue with the public about medical research

3. Recent achievements New therapies Clinical practice Diagnostics
MRC contribution to over 10% of global pipeline of therapeutic antibodies, including Humira®.
Clinical practice
Compression stockings have no effect preventing DVT in stroke patients: saves NHS £7m and 320,000 nursing hours a year;
Use of CBT in social recovery of schizophrenia patients with psychosis; review of evidence of increased risk of cardiovascular disease.
Diagnostics
New cancer diagnostics based on test for minichromosome maintenance (MCM) proteins.
Screening programmes
Flexi-Scope bowel cancer screening to be rolled out over next four years.
Vaccines
MenAfriVac: 40¢ meningococcal meningitis vaccine received WHO prequalification in June 2010.
Therapeutic antibodies: MRC inventions at LMB in late 80s, early 90s spawned therapeutic antibody market, estimated value $40bn and growing. About a dozen new mAbs currently in phase III trials.
Clinical practice: An “intended consequence” of the MRC’s funding strategy is that we generate a solid evidence base to help regulators and advisory bodies make rational decisions.
Compression stockings – CLOTS trials, University of Edinburgh, funded by MRC; Chest, Heart & Stroke Scotland; CSO; UK Stroke Research Network.
Schizophrenia - Two MRC trial platform grants funded work referenced in a 2009 update to guidelines. Professor Fowler (University of East Anglia) led a trial on CBT in social recovery of patients with psychosis – positive results led to CBT recommended as an intervention for people with schizophrenia; Dr Osborn (UCL) reviewed evidence for adverse cardiovascular (CV) outcomes in people with severe mental health illnesses; NICE recommended all patients with schizophrenia be screened for CV risk factors.
Cancer diagnostics - Minichromosome maintenance (MCM) proteins are characteristically expressed in the nuclei of cancerous cells (work by Nick Coleman and Ron Laskey at MRC Cancer Cell Unit); test for cervical cancer on the market, also being pursued for lung and bowel cancer. NOTE: Ron Laskey is chairing the session.
Bowel cancer screening – announcement by David Cameron PM, 3 October. Screening programme based on Flexi-Scope test – its effectiveness was demonstrated by a 16-year trial funded by MRC, Cancer Research UK and NIHR. Single test reduced bowel cancer incidence by a third.
MenAfriVac – WHO prequalification (June 2010) followed phase II trial part-funded by MRC which showed vaccine to be safe and to generate up to 20 times more antibodies than current vaccine. Protection from group A meningitis infection that periodically sweeps through sub-Saharan Africa every 8-10 years.

4. MRC funding MRC gross research expenditure - £758.2m in 2009/10.
279 new grants to researchers.
£366 million on grants and training awards in universities and medical schools.
£375 million for over 500 programmes in our research units and institutes.
Over 4,500 publications in peer-reviewed journals in 2009.
Licensing income receipts of £66.2 million:
over £500 million total cash generated since 1998.
People
4,000 people employed in our units, institutes and centres.
Over 5,700 research active staff supported by the MRC.
£78.2 million on training and career development:
around 350 fellows and 1,500 postgraduate students.

5. UK Government Departments OSCHR
Partnership working
UK Government Departments OSCHR
Research community
Patients and carers
UK Clinical Research Collaboration
MRC MRCT
NIHR
NHS
International
Public
Universities
Regulatory bodies
Research councils
Partnerships are key to achieving our strategic aims and objectives.
NOTE: AMRC’s recent report ‘Ways and Means’ shows how the MRC lies at the heart of many interactions between medical research charities and other funders – MRC involvement can be pivotal in delivering the most impact from medical research funding.
Because of the complex inter-relationships within science funding, we can achieve more by working with others.
A great deal of research is now conducted on a scale that is not achievable by a single funding body (or country), for example, large facilities like Research Complex at Harwell (officially opened July 2010) , National Prevention Research Initiative (NPRI), UK Biobank, European and Developing Countries Clinical Trials Partnership (EDCTP).
Relationships with industry and regulators to help translate scientific discoveries into applications: ie new drugs, therapies and diagnostics; prevention strategies; clinical practice; economic benefits.
Learned societies
Medical charities
Industry
Parliamentarians Policy-makers

6. Coordinated public sector health research strategy
HM Treasury DH
BIS
OSCHR
Devolved Administrations
NIHR
MRC
OSCHR achievements [taken from OSCHR’s written evidence and Sir John Bell’s oral evidence to the House of Lords Science and Technology Committee, 12 Jan 2010:
A Shared Vision for UK Health Research – published vision means OSCHR partners develop strategies accordingly and know they are joined up with other public funders.
Translational medicine – an initial focus of OSCHR, along with public health research, public health records research, methodology research and human capital. MRC and NIHR have divided up translational research where one or the other leads and spends on behalf of other organisations: Eg single call for Experimental Medicine.
Looking ahead:
Capability Clusters – Most advanced OSCHR programme for interacting with industry, providing a place where industry can go and do the most challenging bit of the development pipeline: early phase IIa projects to decide quickly whether a molecule is effective or not – requires a lot of scientific input. Comes out of the Office for Life Sciences but led by OSCHR and involving all partners. Industry very enthusiastic, pushing to see them developed.
Collaboration Framework – Government-funded agencies and major charities have agreed to work within a single framework to ensure funding initiatives providing support for programmes in experimental medicine or cohort development, for example, fit within UK-wide strategy.
Public health research – 2008/09: map of public health research funding in the UK. Eg MRC leading on Ageing and Addiction & Mental health; NIHR leading on Obesity and Infection.
Fellowships survey published – part of OSCHR’s focus on capacity-building and ensuring the right mix of clinical specialties and academic research training for clinicians.
Research
Funding flow
Policy input

7. MRC remit and partners MRC - basic research to early clinical trials
Underpinning and aetiological
Prevention
Detection and Diagnosis
Treatment development and evaluation
Phase 1 & 2 trials
Basic
research
Discovery
Preclinical
Early
Clinical
Late
Clinical
HTA
MRC
EME
BBSRC
NIHR
Medical Charities
TSB

8. Strategy update

9. Research Changes Lives
MRC Strategic Plan
Over the next five years the MRC aims to support medical research which increases the pace of the transition to better health. We will achieve this through:
Strategic Aim One: Picking research that delivers
Strategic Aim Two: Research to people
Strategic Aim Three: Going global
Strategic Aim Four: Supporting scientists

10. Research Changes Lives
1. Picking research that delivers: Setting research priorities which are most likely to deliver improved health outcomes
Research priority theme one: Resilience, repair and replacement
Natural protection
Tissue disease and degeneration
Mental health and wellbeing
Repair and replacement
Research priority theme two: Living a long and healthy life
Genetics and disease
Life course perspective
Lifestyles affecting health
Environment and health
Strategic Aim One
Picking research that delivers: Setting research priorities which are most likely to deliver improved health outcomes
Research priority theme one: Resilience, repair and replacement
Natural protection – to explore resilience to disease and degeneration, understanding how it may be exploited for new inventions that ameliorate disease processes
Tissue disease and degeneration – to advance knowledge in the biology of ageing and degeneration of human tissue; to understand the mechanism and impact of chronic inflammation
Mental health and well-being – to explore the relationship between mental health, wellbeing and resilience to disease processes
Repair and replacement – to translate the burgeoning knowledge in regenerative medicine into new treatment strategies
Research priority theme two: Living a long and healthy life
Genetics and disease – to use genetics, imaging and biological indicators to understand predispositions for disease, and to target treatments to disease subtypes
Life course perspective – to drive forward interdisciplinary research addressing health and wellbeing from childhood to older age
Lifestyles affecting health – to determine the most effective strategies for tackling lifestyles that are detrimental to health
Environment and health – to explore the impacts of changes in our environment on health and wellbeing

11. Research Changes Lives
2. Research to people: Bringing the benefits of excellent research to all sections of society
Translation of research
Regulation, ethics, governance and working with decision-makers
Communication
3. Going global: Accelerating progress in international health research
Partnerships and shaping the agenda
Global health
4. Supporting scientists: Sustaining a robust and flourishing environment for world-class medical research
Capacity
Use of population-based data
Research environment
Strategic Aim Two
Research to people: Bringing the benefits of excellent research to all sections of society
Translation of research – to bring the health impacts of fundamental research to people more quickly
Regulation, ethics, governance and working with decision-makers – to uphold and guide ethical research practice and the highest standards of research governance; to enhance the regulatory process by providing innovative approaches
Communication – to enhance communication with the scientists, the public, policy-makers and partners
Strategic Aim Three
Going global: Accelerating progress in international health research
Partnerships and shaping the agenda – to provide international leadership in partnerships which enhance the competitiveness of the UK knowledge and health base
Global health – to support global health research that addresses the inequalities in health which arise particularly in developing countries
Strategic Aim Four
Supporting scientists: Sustaining a robust and flourishing environment for world-class medical research
Capacity – to strengthen and sustain a skilled research workforce through targeted support for excellent training and the development of world-class research leaders
Use of population-based data – to exploit fully the complexity and benefits of population-based data; to maximise sharing and linkage of data, and to develop data collection and storage
Research environment – to provide a world-class research environment

12. Spending Review–key messages
Overall Science and Research resource budget maintained at 2010/11 levels in cash terms
MRC resource expenditure will be maintained at 2010/11 level in real terms (~10% cash increase by 2014/15)
£220m capital to MRC from DH budget for UKCMRI construction costs
MRC capital budget reduced by 57%

13. Spending Review–Impact
Reform, Research Concentration, Economic Impact, Working in Partnership are all important themes on which we are expected to deliver
All ROs are expected to manage demand
Efficiency savings target for MRC: £53.3m by 2014/15, to be achieved in part by implementing Wakeham recommendations and pay restraint
Both targets will be very challenging
All MRC savings to be recycled into our science programmes

14. MRC Delivery Plan Strategic programmatic themes
Major activities that will rapidly deliver gains in health and wellbeing, together with increased economic impact.
National capability
Develop and sustain research infrastructure for delivering highest quality biomedical research, driving interdisciplinarity and engaging with partners.
Cross-council and multidisciplinary priorities
Lead on Lifelong Health and Wellbeing and work with other research councils on other priority challenges.
Other government initiatives
Translational medicine, NC3Rs, Stem cells, TSB
Skills base
Strengthen and sustain skilled research workforce, support future research leaders and respond to industry needs for well-trained researchers.
Programmatic themes: Detailed on following slide.
National capability: eg UKCMRI (with Wellcome Trust, Cancer Research UK, UCL), LMB, UK Biobank (with Wellcome Trust, Northwest RDA, DH, Scottish Govt), Methodology research.
Cross-council programmes: LLHW (MRC lead), Living with Environmental Change and others; work with STFC re national and international facilities, particularly Diamond and ESRF; public engagement; RCUK international offices.
Other govt initiatives:
Translational: partner with TSB and OLS Clusters with stratified medicine and regenerative medicine highest priorities; investment in developmental pathway and developmental clinical studies; meeting needs of industry.
NC3Rs: maintain joint contribution with BBSRC.
Stem cells: see regenerative medicine in programmatic themes on next slide.
TSB: Working with TSB is central to many MRC strategic funding initiatives.
Skills base: PhD studentships – reduce numbers slightly but increased training support for each student so maintained investment overall; Fellowships – increase number of early and intermediate fellowships, sustain investment in senior fellows; Clinical research training – increase number of intermediate fellowships

15. Strategic programmatic themes
New frontiers in biomedical research
Living a long and healthy life
Health research is global
Population health sciences
Stratified medicine
Regenerative medicine, stem cells and tissue repair
Systems medicine
Mental health and wellbeing
Lifestyle and behaviour: obesity, addiction
Healthy ageing
International leadership
Global health
e-Health research
Population-based cohorts
Public health infections research
1. New frontiers:
Strategic alignment with industry in research, training and translational investments;
Joint working with TSB, NIHR and research councils in key areas of medical advance
For example, the Inflammation and Immunology Initiative: £10m in two new research consortiums – collaborations between industry and academia following workshops in areas of COPD and rheumatoid arthritis;
Strengthen drive toward novel therapeutic and diagnostic interventions.
2. Long and healthy life:
Strategic investment in mental health;
Strategies for tackling lifestyles that are detrimental to health such as obesity and addiction;
Healthy ageing (For example, the MRC leads on Lifelong Health and Wellbeing: the cross-research council programme into healthy ageing);
3. Global:
International leadership in partnerships – particularly South East and Southern Asia, and influencing the European scientific agenda;
Working in partnerships to optimise funding to support global health research – trials (with DFID and Wellcome Trust), MRC units in The Gambia and Uganda, and partnership with Indian Council for Medical Research under the Global Alliance for Chronic Diseases.
4. Population health sciences:
Optimise contribution of population health sciences to public health research (with NIHR and UK Health Depts, ESRC, Wellcome Trust and other funders);
Exploiting the benefits of population-based data to inform development and implementation of public health policies (use of e-health records);
Achieve an integrated response to emerging infectious diseases (with NIHR)

16. Training and careers
Development of new postdoc collaborative fellowships with industry
Sustain support for MRC early and intermediate fellowships
Improve the attractiveness of MRC Senior Fellowships to the best candidates
Potentially open up MRC studentships to excellent EU students in strategic skills shortages
Survey: signals from students and early researchers

17. Translation
What is it? - turning discoveries into clinical benefits, while maintaining the basic research that drives it.
MRC’s translational strategy is:
building on the MRC’s existing role in pushing forward basic knowledge to improve people’s health and wealth;
strengthening the support and oversight of the translational processes.
Basic medical research
Prototype discovery and design
Pre-clinical development
Early clinical trials
Late clinical trials

18. Translational research
Overall spend on Managed Programs to Increase to £50 M pa by 2014 (have allocated £47 M since 2008)
Developmental Pathway Funding Scheme
Developmental Clinical Studies
Translational Stem Cell Research Committee
Developing novel ways of supporting translational activities
Enhance support for Experimental Medicine
Maximising best use of resources and infrastructure
Increasing the UK capacity/capability for translational research
Developing novel ways of supporting translational activities
Building on Devolved Portfolios and Translators Pilots
Pre-competitive and collaborative approaches

19. Working with industry
Widen our engagement and adapt to a changing innovation ecosystem
Pharmaceutical
Biotech
Devices and diagnostics
Research partnerships
Explore and fund innovative models of pre-competitive and collaborative research partnerships
Stratified Medicine and Systems Medicine agendas
Regenerative medicine
Health Sciences Collaborations, partnerships with TSB
Opportunities for MRC to add value and provide leadership
MRC leading for other research councils on engagement at policy level with Pharma companies

20. Funding

21. Roles of Boards and Panels
Primary decision making bodies on MRC funding
Grants, Units and Institutes
Ensure balance of portfolio is right for area of responsibility
Shape strategy in their areas: directly, through Strategy Board and via interaction with Overview Groups
Join up with other bodies to ensure seamless support for science
Consider the impact and value of the research in their areas

22. Boards and Overview Groups
Strategy Board
Molecular and Cellular Medicine Board
Population and Systems Medicine Board
Infections and Immunity
Board
Neurosciences and Mental Health
Board
Population Health Sciences Group
Translational programmes
Training programmes
Translational Research Group
Global Health Group
Strategy Board: Sets top-level strategy, budgets and special initiatives
Research Boards: Funding projects, programmes, units, assessing performance, strategy development and implementation
Overview groups: Steering delivery and strategy, cross-board monitoring
Executive Board (not pictured) ensures delivery
Also not pictured: Wider cross-funder initiatives.
Training and Careers Group

23. Types of Research Support
Question Driven
Research grant
Personal Support Driven
Fellowship
The project / programme
The people
The ‘place (s)’
The person
The project
The ‘place’

24. Which Scheme? Standard “response mode” grants Research grants
New investigator research grants
Programme grants
Strategic initiatives (Calls)
Personal support – variety of fellowships
Eligibility
Awards to promote collaboration
Between HEIs (Partnership grants)
With industry (MRC Industry Collaboration Awards)
Short awards for personal development
Discipline hopping
People exchange

25. Training and Careers Group
MRC Fellowship Panels
Strategy Board
Training and Careers Group
Clinical Panel
Clinical Research Training Fellowship
Clinician Scientist Fellowship
Senior Clinical Fellowship
Non-Clinical Panel
Career Development Award
Senior Non-Clinical Fellowship
Strategic Panels
Biomedical Informatics Fellowships Panel
Career Development Award in Biostatistics / Methodology Research / Economics of Health / Population Health Scientist Fellowships Panel

26. Senior Clinical Lectureship
MRC post doctoral fellowships Non Clinical, Clinical and some of Strategic Skill fellowships
Senior Non-Clinical
Career Development Award
Yrs Post PhD -1 1 2 3 4 5 6 7 8 9 11 12
CRTF
Clinical Lectureship
Clinician Scientist
Senior Clinical Lectureship
Senior Clinical
Population Health Science
Bioinformatics, Biostats, Economics of Health
NIHR ‘Walport’ Lectureships aligned with MRC clinical fellowship schemes
Methodology Development
Key:

27. Timelines Note deadlines
Process – is there an outline or pre-sub stage?
Plan ahead – need apply 1 year in advance
Process time for grants i.e. time until a decision
usually 14 weeks (3 months) for applications declined at triage stage
within 23 weeks for a funding decision by a Board/Panel (6 months)
Start date is usually 6 months after funding decision

28. Lifelong Health and Wellbeing: A Strategy for Collaborative Ageing Research in the UK28

29. The challenge of an ageing population
The UK’s population is ageing
Life expectancy has increased by 30 years in last century
Overall decrease in fertility rate
Currently one in six people is over 65 this will rise to one in four by 2033
Over 85s are the fastest growing segment of the population
Inequalities - life expectancy varies between UK regions by 14 years
The Drivers
Ageing is a major risk factor for disease and disability
Increased pressure on public services, welfare, health and social care – current models are unsustainable
Social and economic opportunities 29 29

30. Lifelong Health and Wellbeing (LLHW)
Current major cross-Research Council programme in ageing
Strategic coordination of ageing research across the Research Councils
Supports research targeting factors throughout life that determine health and wellbeing in older age
LLHW Strategic Aims
Develop interventions that lead to improved health and quality of life in older age
Inform policy and practice including services and technologies to support independent living
Increase capacity and capability in ageing-relevant research 30 30

31. LLHW Joint funding initiative
Funding partnership between five research councils and four health departments
Support for multi-disciplinary research addressing factors that influence health and quality of life in older age
Build capacity in multi-disciplinary ageing research community
£30m commitment since 2008 to three LLHW phases 31 31 31

32. Strategy for Collaborative Ageing Research in the UK
Developed by Research Councils and UK Health Departments under LLHW programme – published September 2010
Purpose
Identify opportunities for greater impact through cross-sector approaches
Build on existing strengths
Add value to initiatives and activities of individual funders
Create new partnerships, across academic disciplines and stakeholder communities – Government, private and third sector
Set priority areas for LLHW programme over CSR2011 32 32

33. Achieving good cognitive function and mental wellbeing in later life
Priorities for CSR 2011
Achieving good cognitive function and mental wellbeing in later life
Promoting physical health in older age
Extending healthy working lives
Enhancing mobility and independence in an ageing population 33 33

34. Successful proposals
Encompass the remit of more than one Research Council – creative multi-disciplinary approaches
Not usually supported by individual funders
Research excellence, impact and importance
Robust methodology and design
Add value to the programme
Encourage stakeholder engagement and capacity building 34 34

35. you should start early’
‘If you want to age well,
you should start early’ 35 35

36. 36

38. Assessment Process (MRC)
(short-listed applications only)
All short-listed applications are assessed by the Research Boards/Panels
Applicants can respond to the reviewers comments (Grants)
Discuss reviewers critique at interview (Fellowships)
applications scored (1-10)
feedback will be given on all applications reviewed by the Board/Panel

39. Assessment process (MRC)
Referee Assessment (all grant and fellowship applications)
applications refereed – reviewers
UK and International
applications scored (1-10)
Board/Panel Assessment (grants)
Triage (shortlisting)
allows Boards/Panel to focus on those proposals most likely to be funded
decisions are made based on the views of the reviewers & Board/Panel members
unattributed reviewers’ reports fed back to applicant
Mention
No fixed numbers or % for cut off point at triage (~30% of applications)
Dependent on:
number of applications submitted
Funds available to award at that meeting
Approx. x2-3 the value of applications that the Board can fund are assessed at the meeting – are flexible
Note – take this approach since Research Organisations do not want to limit at source and cannot put such large numbers to Boards/Panels to review.

40. Core Assessment Criteria- Grants
importance
scientific potential
people and Track record
environment
research plans
resources (justification; good value for money)
ethical issues or risks to human participants
appropriate use of animals
Referees
Triage
Board

41. And finally… Review internally mentors for new applicants
Tip: get a second opinion, proof read & spell check
MRC is looking for quality not quantity

42. Need & Potential for Impact
Remember…
Your application will only be as strong as its weakest link
Design
Deliverability
Need & Potential for Impact
Ethics
Resources