Published: 20 August 2020
The UK’s four Chief Medical Officers and NHS England and Improvements’ National Medical Director have written a joint letter to every NHS trust in the country urging them to continue to recruit high numbers of COVID-19 patients into the RECOVERY trial.
The letter states that now there is less workforce pressure, it should be the default position that every eligible patient is offered enrolment into a trial and that hospitals should be aiming to recruit 60% of these eligible patients.
The five senior doctors - including NIHR co-lead and Chief Medical Officer for England Prof. Chris Whitty - begin the letter by thanking NHS trust staff for their hard work in providing clinical care for COVID-19 patients and supporting research into COVID-19.
The letter highlights the finding from the RECOVERY trial that dexamethasone reduces deaths by one-third in patients receiving invasive mechanical ventilation and by one-fifth in patients receiving oxygen. The CMOs write that “this finding has informed clinical practice worldwide and was down to your efforts in facilitating research in the NHS.”
The letter then goes on to explain some changes which will strengthen the UK’s research and trial systems so that they are ready to increase recruitment if the number of COVID-19 cases increases.
Due to its national coverage and recruitment success, RECOVERY will continue to be supported as the national clinical trial platform for COVID-19 phase III therapeutics and will now be extended to include phase II trials.
A streamlined treatments prioritisation process will be used to identify candidate therapeutics for phase II trials, carried out by an independent and expert UK COVID-19 Therapeutics Advisory Panel (UKCTAP).
Existing phase II trials - such as the arms of ACCORD, CATALYST, TACTIC and DEFINE - will retain their urgent public health status and can continue. However, they are being encouraged to transition their proposed treatments to RECOVERY through the UKCTAP.
The CMOs state that “this is a positive step forward and a move to a more holistic and nationally coordinated approach.”
Finally, the letter explains that the COVID-19 research response is now moving into the next phase, which includes preparation to support a number of large-scale COVID-19 vaccine studies and driving forward the studies on convalescent plasma.
There is also an increasing need for paused research to restart and with this in mind, the CMOs encourage research delivery staff and clinical academics to return from frontline and other duties to resume their research.