Routinely embedding recruitment and retention interventions within randomised controlled trials

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There is a need to improve health care and wellbeing by developing and testing new treatments. The best way to test these new treatments is using a randomised controlled trial (RCT). In a RCT some patients get the new treatment and some do not. The results of the different groups are then compared to see if the treatment leads to better health. Many trials like this are run in the NHS but recruiting patients and keeping them engaged in these trials is often very difficult and takes longer than planned. The methods used to approach people generally have not been tested to see if they work, meaning research teams don't know how best to recruit and keep patients engaged. Because of this, research is often delayed and patients and professionals cannot benefit from knowing which treatments work best.Recently, there has been an interest in testing different ways of recruiting and keeping patients engaged in RCTs that are taking place in the NHS. The testing is done in studies set within a larger RCT. These studies are called 'Studies Within A Trial' or SWATs. The Medical Research Council previously funded members of our research team to find out whether it was possible to do SWATs across a range of different trials at the same time, and to design standards for doing them. With this funding we were able to design frameworks and standards for doing and reporting SWATs. Recently a database of SWATs has been set up. This database can be used by other researchers to share their ideas for SWATs and to encourage others to do these types of studies, so that findings might in future be combined to develop better evidence of what works. Our aim is to build on this earlier work by making SWATs standard practice across Clinical Trials Units, which are the leading centres for doing RCTs in the UK. We would like to support at least 25 SWATs, by giving teams doing SWATs advice and financial support of £5000 to cover the costs of doing each SWAT. We have set up a network of Clinical Trials Units who have committed to starting at least two SWATs that are focused on recruiting and keeping patients engaged. The ultimate aim is to make SWATs routine when doing a clinical trial. This will help the NHS to do better research which will lead to knowledge of how to improve the health and well-being of patients.