The correlation between National Health Service trusts' clinical trial activity and both mortality rates and care quality commission ratings: a retrospective cross-sectional study

Public Health. 2018 Apr:157:1-6. doi: 10.1016/j.puhe.2017.12.022. Epub 2018 Feb 10.


Objectives: Evidence supporting the notion that clinical research activity in itself is of benefit to organisations as a whole is inconclusive. In the recent past, a positive association between research activity and reduced mortality has been shown. This study aimed to ascertain if clinical research activity is associated with established organisational outcome measures.

Study design: Retrospective cross-sectional study.

Methods: For 129 English National Health Service hospital Trusts, National Institute for Health Research study activity data, Summary Hospital-level Mortality Indicator (SHMI) scores and Care Quality Commission (CQC) ratings were collected. Research activity was controlled for Trust size by dividing it by clinical staffing levels. Multiple linear regression and Spearman correlation analyses were performed.

Results: Although there is a significant association between the number of studies and participants with both SHMI score and CQC rating, one particular variable is correlated more significantly than others: the number of participants recruited into interventional studies. It shows a significant correlation with better CQC ratings (standardised coefficient beta 0.26, P-value 0.003) and lower SHMI scores (standardised coefficient beta -0.50, P-value 0.001).

Conclusions: The mortality-related results corroborate with other published data showing a correlation between increased research and reduced deaths. Furthermore, there is also a statistically significant association between clinical trials activity and improved CQC ratings. However, these tie-ins are predominantly driven by the number of participants in interventional research rather than observational research activity.

Keywords: Care Quality Commission; Clinical trials; Interventional research; National Health Service; National Institute for Health Research; Summary Hospital-level Mortality Indicator.

MeSH terms

  • Clinical Trials as Topic / statistics & numerical data*
  • Cross-Sectional Studies
  • England / epidemiology
  • Hospital Mortality / trends*
  • Hospitals, State / statistics & numerical data*
  • Humans
  • Outcome Assessment, Health Care
  • Quality of Health Care / statistics & numerical data*
  • Retrospective Studies
  • State Medicine / organization & administration*