Proxemis & O’Shaughnessy

Research Reimagined Supporting the recommendations of the 2023 Lord O’Shaughnessy review

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Revolutionising research The Lord O’Shaughnessy review

In line with the findings of this report, Proxemis can support you to:

We welcomed the thoughtful and insightful independent report published 26 May 2023: Commercial clinical trials in the UK: the Lord O’Shaughnessy review. This review examines commercial clinical trials, their impact, and the challenges they face. The report emphasises the importance of patient-centricity, proposing improved communication with, and involvement of patients in trial design. Streamlining regulatory processes and creating a centralised database for patient-trial matching are recommended to address recruitment challenges. Enhancing transparency and data sharing is also highlighted, with suggestions including a comprehensive database of commercial trials and the publication of all trial results. Calling out the UK’s 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.

Unlock the potential of primary care

Recruit high-potential candidates at speed and scale

Improve representation through trial participant diversity

Enhance patient access into clinical trials

Embed clinical research into day-to-day healthcare

Deliver financial incentives for primary care

Embrace decentralised and innovative trial approaches

Enable community pharmacies to support clinical trials

Implement research findings into healthcare systems 3

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The challenge

The opportunity

“Primary care is a negligible provider of clinical trial activity, despite the opportunities it provides for delivering population scale trials, and there is too much reliance on hospital settings for the delivery of trials.” Despite 95% of all patient contacts with the NHS occurring in primary care, it has unacceptably poor representation in clinical trials. O’Shaughnessy elaborates that “only around 10% of clinical research activity (as measured by the number of participants) takes place in primary care despite the potential of this area, and around 4% of practices are recruiting patients to commercial trials”. He continues to outline how primary care professionals express a strong interest in participating in research, but identify administrative burdens, limited time, and insufficient funding as significant obstacles. We understand the potential of primary care to transform clinical trial recruitment, and drive research that is representative of, and beneficial to, the whole of the UK population.

Primary care data is incredibly rich, supporting the identification of more diverse, high-potential candidates for clinical trials. Moreover, primary care organisations cover the breadth of the UK, serving all communities regardless of background, ethnicity, gender, culture, geography or socioeconomic status. This enables two significant advantages – connecting more citizens with an avenue to get involved in clinical trials, and supporting research that benefits everyone in our diverse population. “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. This works to our benefit, too, because the groups who gain most from taking part in more diverse research cohorts are precisely those people whose health needs are greatest and who are therefore of most interest to researchers.” Bringing together the unique combination of our reach into primary care communities and systems, alongside 20+ years’ experience conducting clinical trials in primary care, Proxemis is ideally positioned to transform the UK’s approach to primary care research.

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Our solutions Patient recruitment

In line with recommendation 22 from the O’Shaughnessy review, this solution also ensures that primary care teams are remunerated for the time they spend supporting clinical research. On a quarterly basis, practices are paid in line with the number of consented patients they have helped to identify using this tool. “Recommendation 22: financial incentives should be introduced for GPs to take part in commercial trials” Via patient applications We also offer a direct patient recruitment channel via Patient Access, the UK’s leading independent patient services app. With inbuilt ‘Research Manager’ functionality, users can browse recruiting clinical trials and consent to share their contact information directly from the app. Over 9 million tethered users are eligible to use this feature, whose personal health record has been linked to their account. Studies are suggested based on this information, enabling a targeted approach to potentially eligible participants.

Via primary care By leveraging technology within the UK’s market-leading primary care clinical system, we can identify high-potential candidates for clinical trial randomisation using trusted electronic health record data. By embedding a free clinical trial recruitment tool within GP systems, we’re making it simple for primary care teams to support clinical research without adding significant administrative burden. With the unique ability to tap into a vast network of GPs across the country, we can enable primary care teams to play a more active role in embedding research delivery into day-to-day care, allowing them to reach out to patients and give them the opportunity to be involved. There’s also functionality to allow engagement activity to be conducted at a higher level – allowing federated organisations such as Integrated Care Systems (ICS) or Research Development Networks (RDN) to lead this work.

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Improving access

ProScript Connect is the market leading PMR software, used in over 5,300 pharmacies across the UK. We intend to explore the opportunities to work with community pharmacies to provide recruitment and screening services, dispensing of medicines, and where appropriate, the option to act as a trial site for clinical research studies.

In our digital-first world, we understand the opportunities to approach clinical trials differently, and leverage new approaches and technologies to make clinical research more accessible. We have the capabilities to support decentralised trial solutions, and bring research opportunities to patients where they are. We can facilitate remote or virtual patient consultations, support home visits, and incorporate wearable tech solutions for remote monitoring. “The UK regulators should work with industry, academia and other experts to develop central guidance by the end of 2023 on carrying out decentralised trials, covering the approvals and set up processes and which settings, such as, homes or pharmacies, as well as more traditional locations, can be included as trial sites, to promote decentralised and innovative trials.” We’re also exploring how we can leverage the our reach into community pharmacy settings to conduct clinical research activities in new ways. With access to electronic health records, experience in patient consultations and medication dispensing, as well as their potentially under-utilised capacity, community pharmacies are ideally positioned to provide clinical research services in the UK.

Clinical implementation

We’re committed to driving the real-world impact of research. That’s why we offer a range of services to help research teams implement their findings back into healthcare systems. By leveraging market-leading clinical systems such as EMISWeb, PharmOutcomes and ProScript Connect, we can deploy alerts to guide decision making at the point of care and optimise care delivery. With the Pathway solution from EMIS, we can also help healthcare providers to deliver proactive interventions by supporting the identification of at-risk patient cohorts and facilitating seamless information sharing. When it comes to communicating with patients, we can help to get research in front of the over 1 million Patient Access users who have opted-in to receive tailored information and guidance based on their medications and health conditions. We can also support with education for healthcare professionals via FourteenFish – a learning platform used by over 125,000 healthcare professionals, and the preferred appraisal toolkit partner for the Royal College of GPs (RCGP).

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Introducing Proxemis Tailored clinical trial delivery

A long-established partnership Proxemis is a joint venture, leveraging the world-renowned expertise of the University of Oxford’s Department of Primary Health Care Sciences alongside the reach and capabilities of EMIS, the UK leader in connected healthcare software and systems. Emerging from a strong and long-established partnership, both organisations have a rich history of supporting clinical research. Together, our collaborative efforts over the years have showcased the potential of combining research and data expertise. Established in 2003, our co-owned not-for-profit, QResearch is one of the world’s largest databases of primary care records used for anonymised healthcare research. This database was subsequently used in the development of the QCovid risk assessment tool to identify 1.7 million vulnerable people during the pandemic. In 2021, QCovid was recognised as the winner of both the John Perry Prize for computing innovation in primary care, and the Florence Nightingale Award.

Proxemis offers a tailored experience for clinical trial delivery, specialising in primary and community care. We aim to make it easier for both patients and clinicians to participate in research, help find better treatments for long-term conditions and deliver research that is truly representative of the UK population. With years of industry expertise and our innovative technology solutions, we’re supporting researchers to deliver successful trials, and ultimately accelerate the development of ground-breaking treatments. We’re supporting UK researchers with:

Statistical design and analysis

Patient recruitment solutions

Investigator and site management services

Medical writing and publishing

Decentralised trial solutions

Dedicated sites service

Clinical implementation solutions

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EMIS

Oxford

As one half of our joint venture, EMIS is the UK leader in connected healthcare software and systems, with technology at the fingertips of clinicians in all major healthcare settings on a daily basis. EMIS point of care systems feed valuable data into EMIS-X Analytics, a cloud-based application that houses 55 billion clinical observations and 1.5 trillion data items for secure and ethical research. Amongst other areas, EMIS is:

The University of Oxford’s Nuffield Department of Primary Health Care Sciences makes up the other half of this joint venture. As one of the world’s most important academic centres for primary care, they have been delivering research for over 20 years, with a particular focus on the prevention, early diagnosis and management of common illness. The department boasts:

600+ staff and students working to develop new evidence and innovations in primary care​. 1,100+ research publications​ 200 GP practices

#1 in primary care with 58%market share, used by 4,600 GP practices serving 38 million patients. #1 in community pharmacy with 39%market share, used by 5,300 pharmacies. #1 independent patient services app with 16 million registered users of Patient Access, and 2 million monthly users.

taking 4-6 medical students on their GP attachment​. 250+ patient and public representatives involved in shaping projects​. 10 primary care research themes

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Let’s work together We’d love the opportunity to demonstrate in more detail how Proxemis is reimagining research in the UK. Please get in touch via the email below to set up a call and find out how we can support your goals.

Alex Eavis Director, Proxemis Chief Product Officer - Digital & Analytical, EMIS

Bernard Taylor Director, Proxemis Deputy Steward, Univeristy of Oxford

Email: info@proxemis.com

Linda Naughton Director, Proxemis Divisional Financial Controller - Medical Sciences, Univeristy of Oxford Professor Richard Hobbs Director, Proxemis Head of Primary Care Health Sciences, Univeristy of Oxford

John McCormack Director, Proxemis Executive Director - Research & Life Sciences, EMIS

www.proxemis.com

Dr Lucy Mackillop Director, Proxemis Chief Medical Officer - Data & Research, EMIS

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