Blog | Reflecting on the Lord O'Shaughnessy review

We welcome the thoughtful and insightful independent report published 26 May 2023: Commercial clinical trials in the UK: the Lord O’Shaughnessy review.  

Calling out our falling global ranking in the delivery of clinical trials, Lord O’Shaughnessy makes 27 recommendations to safeguard our position as a global leader by not only revitalising our clinical trial activity along traditional lines, but creating an environment where innovation can flourish. These recommendations support an ambitious target to increase participation in commercial clinical trials by twofold within the next two years, and double it once more by 2027.   

The review highlights the issues of clinical trial underrepresentation, and the opportunity to use primary care as a powerful resource for recruitment. It also acknowledges the importance of primary care recruitment for common long-term conditions, such as cardiovascular disease, musculoskeletal conditions, chronic respiratory diseases, mental health conditions and dementia which collectively impact over 20 million people living in the UK. These conditions, along with cancer, are the subject of particular focus, and we eagerly anticipate a government publication outlining a major conditions strategy.

Clinical research within primary care

Recruitment in primary care is of critical importance if we are to address historical biases and underrepresentation within clinical trials. As the review outlines, "Life science companies want and need to make sure their trial cohorts are as diverse as possible so that they can prove, with confidence, that their medicines will benefit people from all ethnicities and backgrounds”.

Primary care has a unique opportunity to address this need, opening doors to clinical trials for a wider population and promoting representative research that benefits us all. By harnessing the power of primary care data and deploying technologies such as Recruit within everyday GP clinical systems, EMIS [now Optum] are addressing recommendations from this review and working with academia, the Life Sciences industry and the NHS to embed clinical research at the heart of patient care in the UK.

Finally, we whole-heartedly support the recommendation to ensure commercially led trials provide appropriate funding to GPs to allow our clinicians the time to participate in clinical research. With the NHS under unprecedented strain, it is crucial to offer financial support for backfill and/or support staff, to allow clinical trial activity to be successfully embedded into NHS working practices without impacting on patient care.

This report provides a pragmatic plan to operationalise elements of previous reviews including last year’s Data Saves Lives paper and 2021’s Saving and Improving Lives paper. We welcome the opportunity to contribute to maintaining the UK’s position as a global leader in healthcare sciences, innovation, healthcare research and technology.

About the author

Dr Lucy Mackillop

Chief medical officer - Data and Research

Dr Lucy Mackillop is the Chief Medical Officer for Data and Research, and Caldicott Guardian at Optum and a practising Consultant Obstetric Physician. With a career deeply rooted in both clinical practice and academic research, she also holds an honorary senior clinical lectureship with the Nuffield Department of Women’s and Reproductive Health at the University of Oxford. Lucy is a Fellow of both the Royal College of Physicians and the Royal College of Obstetricians and Gynaecologists. At Optum, she combines her clinical expertise with a passion for data-driven innovation, playing a pivotal role in developing solutions that enhance patient care and streamline healthcare workflows.