Report from our seminar at Almedalen

There are big differences between healthcare organisations when it comes to participation in clinical studies. How can we make clinical studies an integrated and natural part of health and medical care? This was the question raised before Tuesday’s well-attended seminar in Almedalen.

Participating in the seminar were: Anders Lönnberg, the Swedish Government’s National Life Science Coordinator; Jonas Appelberg, Director of Research and Development in Västernorrland; Jonas Andersson, Chairman healthcare committee, Västra Götaland; Hans Karlsson, Head of the Health and Social Care Division at the Swedish Association of Local Authorities and Regions and Håkan Billig, Chairman of the Committee for Clinical Studies, Swedish Research Council.

R&D leads to increased quality of healthcare

The seminar began with Håkan Billig presenting a number of PowerPoint slides that included recently compiled statistics1. The statistics show that the number of medical publications in Sweden have increased in recent years.
- I am often told that the number of clinical studies is decreasing. The fact is that the number of pharmaceutical trials is decreasing, but clinical studies are on their way up and quality is increasing. Nevertheless, there are big differences between the different healthcare regions when it comes to patients’ chances of participating in studies.
Håkan Billig also presented the results of two articles that highlight the importance of research to increased quality of healthcare.
- An article published in the BMJ2 has looked at 33 studies, with 28 of them showing that the quality of healthcare at the participating units had increased. Another study3 showed that mortality decreases in organisations that run clinical studies.

Jonas Appelberg commented that in his experience, organisations focusing on R&D and innovation have better skills provision and more effective activities on the whole; however, there is still great potential for improvement.
- We need to get rid of the mysteries surrounding R&D in day-to-day clinical practice and we need to make sure that the management makes inquiries about how to work with R&D at an operational level. We also need to continue the dialogue on R&D accounts to get the numbers on how R&D is conducted. It’s important that operations managers allow R&D work and find a way to support the individual clinical manager with this task.
Anders Lönnberg pointed out that there is a historical factor that is important to remember about why – despite everything – more research within healthcare is not conducted.
- Many have been given the idea that research is to be taken care of by someone else. The State does the research – not the county councils. There’s also the impression that it hasn’t been good to have pharmaceutical trials and dealings with the industry. This is starting to change, as people begin to realise that R&D is an important way of developing the activities that all healthcare personnel must be involved in. The management is often in agreement about this, but we need to get the middle managers on board. The new large biobanks will require more contributions and people with chronic illnesses are a large patient group that drives R&D.

New position paper as an engine to further development

In the spring, SALAR produced the position paper “Patients need clinical research to access the best possible healthcare – not just today, but tomorrow too4” [Patienter behöver klinisk forskning för att få tillgång till bästa möjliga vård – inte bara idag utan även imorgon]. The paper states clearly that research and development must be included as a natural part of health and medical care activities.
- It’s an important and challenging position paper that discusses the responsibilities of regions and county councils. Previously, we haven’t followed up on how county councils and municipalities are handling this task, but now we are going to do this at both a regional and national level. SALAR is reorganising its activities to be able to contribute to this work, comments Hans Karlsson.

Jonas Andersson emphasised the importance of the position paper to his role as a politician and orderer of health and medical care.
- The political sector has an important role to play in talking about how research provides better quality in healthcare. It’s part of the managerial task to plan for research and the executives will often be on top of things, but we need dialogue and discussions with the whole organisation. We need to make our demands and incentive structures more explicit. The SALAR paper will be an important tool to do this. As an employer, we also need to get better at the practical aspects, like training research nurses and creating room for development work.