Bypassing bureaucracy to answer important questions quickly

Sometimes there is a need to answer important clinical questions quickly. Bureaucracy can erect an insurmountable barrier. The Research Governance Framework (RGF) for Health and Social Care was introduced in England in 2005 aiming to improve the efficiency and quality of research in the NHS, but has unwittingly introduced a new layer of bureaucracy which is preventing some important questions being answered. We attempted to survey prescribing practices among UK psychiatrists in response to an urgent need for this information. There was huge variation between the responses of Research and Development (R and D) offices and our capacity to address the requirements of each office was overwhelmed. R and D approval can now be impossible to obtain. This implies the need for a radical rethink of the system. Scotland is now leading the way in the development of the first UK Multicentre R and D committee which aims to create a standardised and more simple system.