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Ethical research

D38

You must make the care and safety of the patient your first and continuing concern. All research should be conducted: 

  1. lawfully, 
  2. with honesty and integrity, 
  3. under appropriate clinical governance arrangements, 
  4. in accordance with codes of good practice.311 
D39

If you undertake research on people or animals, you must: 

  1. ensure it is based on a protocol:  
    1. that minimises any foreseeable risk
    2. where the anticipated benefits outweigh the foreseeable risks
    3. that is free from discrimination at all stages of research, particularly for recruitment
    4. developed in accordance with good practice guidance from relevant research organisations, professional bodies and government
  2. seek ethical approval, where appropriate, using the relevant research ethics approval process before conducting research
  3. make sure the safety, dignity and well-being of the participants take precedence over all study aims 
  4. make and keep clear, accurate and legible records.
D40
In the UK, the routes to ethical approval are:
  1. university ethics committees
  2. The Research Ethics Service, which is part of the Health Research Authority.312
D41

If your research involves even one NHS patient or record, you should apply for ethical approval using the appropriate NHS approval system:

  1. Research involving NHS patients in England or Wales should be approved using the HRA Approval system
  2. Research involving NHS patients in Scotland and Northern Ireland should be approved using the appropriate NHS/HSC permissions process for that nation.
D42
University research will be subject to the ethics processes in place at the individual institution.
D43
You must work within the relevant legislation; see Useful information and links section below.
D44

You must get consent from the research participants before involving them in any research project. For people who are unable to consent, you will need to make an additional application. However, there may be specific circumstances where you do not need to obtain consent to use health data for research:

  1. using anonymised health information 
    1. you may render confidential information anonymous without breaching duty of confidentiality 
    2. anonymised information refers to data without any patient identifiers (de-identified data) 
    3. you should ensure that the practice data usage policy includes reference to processing personal information for research purposes to comply with data protection legislation 
    4. patients must be given a choice as to whether or not their anonymised information is used for research and planning. 
  2. anonymous information can then be used in health research. There are two main scenarios where this is likely to apply: 
    1. adding anonymous information into a database to support public health surveillance and clinical decision making. The establishment of this database does not need ethical approval but should be managed under local clinical governance arrangements. Any research using this database does not need ethical approval. This data would be anonymous to a researcher, and can be used for research without ethical approval 
    2. adding anonymous information into a study specific database for an individual research project. The establishment of this database requires ethical approval, even though the data is anonymous to the researcher.  
  3. where patient information is being used for research, this should be included in your data protection policy.  
    1. how patient information is used should be visible in the practice. This may be through leaflets, posters or websites, but proportionate and appropriate to the circumstances 
    2. your data protection policy should be available upon request 

See Health Research Authority. Guidance for using patient data [Accessed 1 Nov 2023] 

D45
You must maintain confidentiality.
D46
You must act with honesty and integrity when designing, supervising or carrying out research and when publishing any data or reports.