Doctors should be given protected time to conduct clinical research, says the Royal College of Physicians (RCP).
Findings from the 2023 census of UK consultant physicians conducted by the RCP, Royal College of Physicians and Surgeons of Glasgow and the Royal College of Physicians of Edinburgh, show that over a third of doctors (36%) want to participate in research but that a lack of ringfenced time in job plans is the main thing stopping them.
According to the census, only 41% of UK consultant physician respondents were involved in research, with time constraints cited as the most significant barrier to greater involvement in it.
The main barrier to participating in research was time in job plans (52%), followed by facing barriers to undertaking research in their organisation (12%), being unsure how to take research proposals forward (11%), and a lack of confidence (10%).
When asked about their ideal job structure, 1 in 4 respondents said they would prioritise research activity over all other Supporting Professional Activities (SPA), and akin to direct clinical care. For those who were able to participate in clinical research, their top reasons for doing so were that it improves patient care, enhances clinical skills and increases job satisfaction. Given the critical benefits of research— including improving healthcare delivery and advancing physicians’ own development—the RCP is calling for ringfenced time for research to be expanded across all specialties and consistently protected in job plans right from the start of doctors’ careers. Such a move would not only strengthen the evidence base for better patient outcomes but also help retain skilled physicians by enhancing job satisfaction.
The survey also revealed the gender imbalance in research amongst physicians. In 2023, of the 41% (1,234 of 2,992) of UK consultant physicians reporting that they undertake any research activity, 63% (772) were male, compared to 37% (462) who were female. Findings from the 2022 UK consultant physician census showed that men were 1.6 times more likely to undertake research as a consultant physician compared to women.
The RCP is committed to improving access to clinical research and supporting the integration of research into everyday care. The RCP and National Institute for Health and Care Research joint position statement sets out recommendations for how to make research part of everyday practice for all clinicians.
Commenting on the findings, Professor Tom Solomon CBE, academic vice president at the RCP, said: “The Covid-19 pandemic showcased the brilliance of the NHS in terms of clinical research, with world-leading studies to develop new treatments, diagnostics, and vaccines. None of these could be delivered without the dedicated research of NHS clinicians, and the innovative work of clinical academics.
“Clinical research is a cornerstone of medical advancement, and it is vital that NHS doctors are given the time and resources they need to pursue research alongside their clinical duties. The benefits are clear—not only does research lead to life-saving innovations in patient care, it also enhance training for resident doctors, and job satisfaction for NHS consultants.
“As Lord Darzi highlighted in his report on the state of the NHS in England, the declining number of clinical academics is a worrying trend. Clinical academics play a crucial role in bridging the gap between research and clinical practice, ensuring that research addresses the greatest needs and that patients benefit from breakthroughs faster.
“The NHS 10-year plan is an opportunity to address this, by supporting the changes needed to embed research into clinical practice and ensuring dedicated and protected time for NHS doctors to pursue research in their job plans. Additional steps are needed to boost clinical academic careers. If we want the NHS to remain at the forefront of global developments, it is essential that Trusts, NHS England, regulators, and funders act decisively. To keep research at the heart of the NHS.”
Professor Andrew Elder, president of the Royal College of Physicians of Edinburgh, said: “This survey confirms yet again that time constraints in doctors’ clinical work are the biggest factor in preventing them from undertaking clinical research, even when many are extremely keen to do so. This is an untenable position.
“The importance of doctors being able to conduct clinical research cannot be overstated. Research by doctors can lead to transformative new procedures and treatments for patients but in addition it is often highly beneficial to the professional development of clinicians.
“The Royal College of Physicians of Edinburgh is pleased to unite with our colleagues in London and Glasgow to call for protected, ringfenced time for research. This should be a fundamental part of doctors’ job plans at all career stages and across all specialties. We consider that this could also play a role in helping to tackle some of the workforce challenges in our NHS by making these careers more attractive.”
Mr Mike McKirdy, president of the Royal College of Physicians and Surgeons of Glasgow, said: “As a College we understand the value of continuous learning, research and development to the advancement of medicine. Today, new medical innovations are emerging at a speed never before seen in history and the power of clinical research has never been more important to our NHS.
“However, with the persistent strain on doctors, these figures reflect a troubling reality that is preventing our clinicians from engaging in a core aspect of their profession. There is a clear desire to take part in this vital research, as well as tangible benefits for patients and professionals in doing so. To ensure that our NHS remains a hub for innovators, we must prioritise protected time for clinicians in all specialities to engage in clinical research and encourage this at every career stage.”
About the census
The Medical Workforce Unit (MWU) of the Royal College of Physicians (RCP) conducts an annual consultant physician census on behalf of the RCP, the Royal College of Physicians of Edinburgh (RCPE) and the Royal College of Physicians and Surgeons of Glasgow (RCPSG).
The RCP sent the census survey to all the consultant and SAS physicians that it was able to contact via email between November 2023 and January 2024. In total, 22,253 physicians were contacted, with a total of 2,992 consultant physician responses to the section on clinical research activity.
Definition of a physician
A physician is a medical doctor, normally based in a hospital, who usually focuses on the non-surgical treatment of patients’ conditions, such as outpatient care and diagnostic investigation. A consultant physician is the most senior physician. Physicians are currently at the forefront of bringing down waiting lists, including diagnostic waiting lists. There are over 30 medical physician specialties from cardiology, acute medicine and gastroenterology to infectious disease, palliative medicine and stroke medicine.