A Regional Account for Clinical Researchers in Northern Ireland (RACR-NI): flexible support to enhance research capacity.

Context and regional partnership: Northern Ireland faces a critical gap in clinical academic capacity, with one of the lowest per-capita investments in the UK and significant health inequalities. Our proposed Regional Account for Clinical Researchers (RACR-NI) brings together Queen’s University Belfast, Ulster University, Health and Social Care (HSCNI) Trusts and HSCNI Research & Development. We will work with strategic partners including the Future Medicines Institute and the Health Innovation Research Alliance (HIRANI). Working collectively, this partnership will pool expertise, infrastructure, and resources to deliver coordinated, flexible support that directly addresses these gaps and strengthens the clinical research pipeline across Northern Ireland.
Our clinical researchers lead transformative discovery science and translational research, linked to clinical trials and cohorts e.g. in acute respiratory failure, bronchiectasis and cancer. An example is the PANTHER trial in acute respiratory failure. The predecessor trial (HARP2) tested a statin (Simvastatin) for these patients and showed no benefit. However, our researchers showed that patients divide into high and low inflammation groups. The high inflammation group did better with statin treatment in HARP2. We developed and validated a precision medicine assay to identify these groups at the bedside, with our industry partner (Randox). This assay is used in the PANTHER trial, allowing prospective evaluation of Simvastatin for this indication. Our recently published CLEAR trial of mucoactive agents in bronchiectasis has allowed our researchers to conduct studies of how these agents work. Our translational researchers in cancer have developed radiotherapy biomarkers of toxicity risk. These have been used in an international phase 3 trial, co-led from QUB (PACE NODES). We have also conducted the first phase 2 trial of adding the bone-seeking radionuclide, Radium-223 to radiotherapy, in prostate cancer with bony metastases. These achievements illustrate the region’s potential to deliver high-impact research if career pathways are strengthened.
The challenge: Northern Ireland has fewer clinical academic trainees, pro-rata, than anywhere else in the UK (12 in training). For equivalence with England, we would require 65 additional trainees. We have high levels of rural and urban deprivation; 40% of the population falls into the lowest UK quintile. This is associated with reduced life expectancy, increased multimorbidity and high levels of health-related economic inactivity.
Expected impacts and benefits to clinical researchers: RACR-NI will support post-PhD trainees to achieve research independence. It will also provide a pathway for clinical researchers who have left academia to re-engage (with mentoring and support) and build a competitive research programme. Both approaches will improve recruitment, retention and capacity. These clinical researchers are the future leaders in our health system and will deliver improved health outcomes and economic benefits. We will support both groups to apply for funding such as post-doctoral advanced fellowships, industry collaborations, project and programme grants. The over-arching theme is to enhance the value of clinical trials and cohorts, through in-built mechanistic and precision medicine studies, identifying those most likely to benefit.
Award Management and best practice: QUB will hold the budget, with subcontracts between QUB and UU, BHSCT, WHSCT and HSCNI R&D. The award will be managed by an Oversight Committee, with representation from all partners, supported by a RACR Coordinator. Best practice will be shared through an Annual Partnership Event, cross-consortium learning sessions and contributions to national MRC forums, ensuring that insights from RACR-NI inform future capacity-building strategies across the UK.