Table 2.

Actions required to fulfil a new vision for the joint future of clinical research and healthcare

Action	Rationale
Incorporate randomisation as part of routine care	Generation of reliable, conclusive results that benefit future patients through the delivery of standard NHS care. Engagement of clinicians and patients in continuously improving care.
Set-up small number of carefully selected perpetual large, simple randomised trials	Drive forward improvements in patient care for the most relevant healthcare challenges without prohibitive expense.
Collaboration at every level	Stakeholder buy-in at every level facilitating active engagement at every hospital. Coordination of effort and resources.
Prioritisation of clinical research	Reflect importance of clinical research in political, clinical, regulatory and academic leadership. Support initiative with adequate resources including funding, training and time for all healthcare staff.
Removal of barriers in research	Promote inclusivity and collaboration. Facilitate the generation of timely results to benefit patients. Make data transparent for use in bona fide research that benefits patients. Refocus regulation on quality.
Become a learning healthcare system	Position the NHS as the global leader in integrated clinical research that benefits patients worldwide.