North London Cancer Research Network

Contact Information

Trusts in the Network

• UNIVERSITY COLLEGE LONDON HOSPITALS NHS TRUST
• BARNET & CHASE FARM HOSPITALS NHS TRUST (N London NW)
• NORTH MIDDLESEX HOSPITAL NHS TRUST
• ROYAL FREE HAMPSTEAD NHS TRUST
• WHITTINGTON HOSPITAL NHS TRUST
• GREAT ORMOND STREET HOSPITAL FOR SICK CHILDREN
• PRINCESS ALEXANDRA HOSPITAL NHS TRUST

Geographical coverage and Population

The total population estimate for Network who may access the research activities is 2 million. The hospitals providing care are the joint Cancer Centre of the Royal Free (Hampstead) and University College London Hospitals; Great Ormond Street Hospital for Children; the North Middlesex Hospital (Edmonton); Whittington Hospital (Archway) and Barnet/Chase Farm Hospitals (Barnet & Enfield) and the more recent addition of the Princess Alexandra Hospital (Harlow). The Princess Alexandra Hospital is a recent addition to the NLCRN following the recent (1st April 2004) transfer of services from the West Anglia to North London. The resident population, is just over 1.65 million but there are a significant cross boundary flows that can be attributed to:

• Network Oncologists holding outreach clinics at hospitals such as Ashford, West Middlesex, Stevenage and Welwyn Garden City and see patients who are treated in facilities within the Network
• Paediatric Oncology Services - the population base for GOS alone is 1.65 million and it is the largest unit in the UK for infant leukaemia and infant brain tumours
• Specialisation in services for the treatment of:
• Bone tumours and soft tissue sarcomas
• Transplantation Haematology
• Rare cancers
• Pancreatic and Hepatobiliary Cancers
• Neuro-oncology

For the above, the Royal Free and UCL Hospitals have a significant tertiary referral practice. Patients are referred from a large area of South England for the treatment of these conditions. Cancer Registration data available for 1997 from the Thames Cancer Registry shows that over 40% of cases came from outside the Network and UCLH saw significantly more cases from outside the Network than within it.

Structure and Activity

In 2000/01 local mapping of cancer research projects demonstrated considerable research activity in the Network. A substantial portfolio of research was in place across the Network with a particular focus of activity at the joint cancer centre of University College London Hospitals (UCLH) and the Royal Free Hospital. Research was carried out in many locations within the Network, and some hospitals had several Trials offices in different departments. In addition to these the Cancer Research UK and UCL Cancer Trials Centre, EMBT London Support Office and Palliative Care Research Unit at the Royal Free Hospital are national trials offices located in the geographical area covered by the Network. Shared with the Mount Vernon Network, North London also hosts one of the 10 NTRAC centres established to support translational research.

The research portfolio mapping exercise also demonstrated a broad spectrum of activity, supporting a large number of non-commercial projects as well as a relatively substantial portfolio of commercial activities. The non-commercial portfolio was well represented by NCRN approved, NTRAC registered, local academic studies as well as other national/international trials. The research portfolio was well represented across the 19 tumour boards have been convened covering disease-specific sites and broader therapy groups such as molecular genetics, chemotherapy, radiotherapy and palliative care. The Tumour Boards are locally charged with the strategic development of the integrated local trial portfolio, in conjunction with the local research offices and Research Network’s Offices, and a Network mechanism has been put in place to review the NCRN trials included in the portfolio. The NLCRN Offices have appointed a Clinical Trials Administrator who, in-conjunction with the Research Network Manager, administer this process and centrally deal with submissions for the local trust and ethical approval for NCRN projects.

NCRN funding has been used to help under-pin and establish research offices within the Network by the appointment of dedicated research support staff. The Network supports Research Nurses, Clinical Research Assistants, Data Managers and Pharmacy staff working across all of the Network’s constituent acute Trusts. There are currently 19 staff (13.4 whole Time Equivalents) appointed across the Network, who are integrated with non-NCRN funded staff and support the integrated portfolio of research.

A web-based tool, NOTIS (Network Oncology Trials Information System), has been adopted locally to monitor the trial portfolio and screening and accrual activity for all oncology-based clinical research projects. Currently only research-support staff working at UCLH, Royal Free, North Middlesex and Whittington Hospitals have access to this database, although the aim is to continue the role-out of this system across the Network. Access to the database to the wider clinical research community will be available once a dynamic link to the North London Cancer Network’s website has been developed.

Since the establishment of the NLCRN, North London has seen accrual to NCRN projects increase from 3.8% (2001/02) pa of incident cancers to 10.5% (2003/04). An overall broadening of the Network’s portfolio has helped to underpin this achievement, improving accrual in both the common and less common cancers. The NLCRN are committed to supporting high-quality research, including screening, prevention and genetic epidemiology studies as well as the classic randomised controlled trials across the common and rare tumour-types.

Future Plans

The overall aim is to achieve national targets by implementing a coherent network-wide strategy. In general this will be achieved through:

• the development of an infrastructure to support and co-ordinate research activity in the North London Network
• the development of effective working links with Tumour Boards
• the appointment of motivated research staff across the Network
• the development of training programmes for research personnel
• increasing the Network’s portfolio of NCRI approved trials

• North London Cancer Network
• North Central London Strategic Health Authority
• Clinical Research Network (CRN)
• UCL Department of Oncology
• CR UK & UCL Cancer Trials Centre
• MRC Clinical Trials Unit
• Thames Cancer Registry