Boost your practice income through commercial research

Non-clinical partner Ryan Smith outlines how your practice could increase revenue significantly through commercial research trials

Very few GP surgeries get involved in commercial research. Some assume there will be too much competition to host a study, others worry about the links to ‘Big Pharma’.

Having worked in this field for the past two years I can testify that any initial concerns around these issues have been allayed. The process has been simple, informative and great for patients and staff alike.

The extra income it can provide is significant – in some cases a study will bring in tens of thousands of pounds of revenue.

Historically it has only been feasible for large practices, of at least 10,000 patients. However, now we are almost all working in primary care networks of 30-50,000, this should no longer be a barrier – and it could be a unifying project on which practices can work together and share a common goal.

How to get involved

Here are some tips for getting started:

1. Don’t do it alone. There are several big companies that are experts in this field and will jump at the chance to work with GP practices. They also bring all of the contacts needed to bid for big studies and most of the time they have their own staff to carry out the clinic work. A good place to start would be to become accredited to deliver research by completing the RCGP Research Ready programme online. The National Institute of Health Research also provides support for participating in trials and details of companies involved.
2. Don’t just be a PIC (Patient Identification Centre) site. Companies will simply want you to search your practice list for suitable patients and pass them over to them. While it’s the easiest way of getting into research, you will not receive a huge amount of money doing this work and it won’t feel as rewarding to your patients or staff.
3. Obtain as much information as possible before you start. Clinical trials are mainly in three phases – Phase 1 being the first time a drug is tested in humans and Phase 3 being pre-approval to market. Obviously Phase 3 is the safest and most appropriate for practices to be involved in. There are also Phase 4 ‘post-marketing surveillance’ trials available to participate in, for example if a manufacturer has found ways they can improve a product slightly – such as reducing its side effects. I always ask for a full breakdown of the trial including the patient journey. If my partners or I are not comfortable with any part of the trial we do not go ahead. Only do what you feel sure is right for your patients and your practice.
4. Promote it to patients. Most trials involve some form of diagnostic testing, from simple observations to X-rays, MRIs and so on. These are generally done in private facilities. They also involve several consultations lasting from 20 mins up to 2 hours. Most patients benefit from having additional time and resources spent on their ailment, which in turn can benefit the practice though satisfaction ratings.
5. Ask for as much information to put back into your clinical system as possible. All blood pressure readings, blood tests and so on can be coded to be used for QOF, medicines management and a whole host of other benefits.

What remuneration to expect

There are a few income streams that come from working in this area:

1. Room rental. It is best if you have spare capacity for the research company to see your patients at your surgery or branch site. Dependent upon capacity, you could get £40-£80,000 per year based on 1-2 rooms per day at £20 per hour.

• Patient identification. As previously mentioned, this is the easiest way of getting into research and in most cases a set of criteria and clinical system search will be given to you. This would involve importing the search into your system and sending a pre-authorised text and/or letter to the included patients. Based upon the work involved you could receive from £100-£500 per study for this.

• Screening patients. This is a follow-on from identification whereby a clinician or high-level administrator would screen the included patients and hand-pick those that are most likely to be eligible for a particular trial, and to benefit from any improved intervention. At the same time they will need to remove patients that are not be suitable, for example those who are disengaged or housebound. This saves time for the researchers and the patients. For this you could receive up to £100 per patient per study.

• Record retrieval. Some studies only need a brief summary whilst others will need full medical records. You could receive £50-£80 per patient per study.

• Screening and/or randomisation. You can get payments for both screened and randomised patients or both in one payment. Depending on the study this could be between £500 and £5,000 per patient per study.

• In all instances Data Protection and adhering to GDPR guidance is key. Working with an established company will have the benefits of having links to an ethics board and if in any doubt always speak to your local data protection officer before embarking on any information gathering or marketing.

What are the other benefits, aside from boosting income?

For patients

– They get to play a more active role in their healthcare

– Gain access to research treatments before they become available, if ultimately approved

– Continue to receive medical care at their own practice during the trial

– Regular monitoring at trial visits and the results of any investigations such as X-Rays, MRIs, blood tests, etc being forwarded to their GP

– Feel good about future generations by contributing to medical research.

For practices

• Participation in research is encouraged by NHS
• It raises the profile of the practice
• Improves access to trials for suitable patients
• Generates QOF points from health screening and study activities

For the CCG/STP/Local Health Economy

• Pre-screening activities such as DEXA scans, spirometry interpretation, HbA1c levels give commissioners more data to introduce measures to, for example, help reduce disease incidence
• Assists with early identification of wider population health issues  
• Can assist with CCG targets        
• Participation in global studies to identify new treatments
• Can provide opportunities for other GPs and practices to get involved in research.

Ryan Smith is a non-clinical partner in Warwickshire