“I grew up in regional Victoria and the long term plan was always to work regionally, but, realistically if I wanted to specialise in clinical trials, I knew I’d have to relocate to the city.”
THESE are the words of Dr Chloe Georgiou, an up-and-coming oncologist at Bendigo Health in central Victoria.
As a regional Victorian myself, and with 30 years in oncology and clinical trials under my belt, I have seen the disparity between regional/rural and metropolitan health care opportunities for staff and access for patients. I had to either relocate to Melbourne or travel long daily commutes when I decided to specialise in clinical trials in the 1990s.
But that is changing. I now lead an Australian-first, federally funded, pilot program: TrialHub. A metropolitan hospital with a large clinical trial portfolio, Alfred Health in Melbourne, has partnered with regional and rural hospitals to improve or establish their own independent and sustainable clinical trial units.
We have now partnered with four Victorian hospitals — Latrobe Regional Hospital, Bendigo Health, Rosebud Hospital and Northern Health — with more to come onboard this year. The end goal is that every regional and rural hospital in the country will be able to provide their patients with clinical trials. While improved access for regional patients to potentially life-saving treatment is a priority, so is providing regional staff with new opportunities and career pathways; thus, those who want to, like Chloe and myself, can continue to work in the regional communities we love.
An initial focus for TrialHub is to develop the clinical trials workforce, meaning trials will be delivered safely by expert staff. We provide training and mentoring for regional staff interested in building and formalising their expertise in clinical trials without relocating to a city hospital.
The hospitals we partner with are at varying levels of clinical trial delivery maturity, so we provide support at the level they require.
Leveraging Alfred Health’s clinical trials excellence, we are providing a range of education and training opportunities for regional staff to upskill, or fill in gaps, in a range of clinical trial areas of expertise.
By offering clinical trials as a career pathway, staff are able to stay regional and hospitals can retain their staff.
For the first time, regional and rural pharmacists can specialise in clinical trials, or formalise their knowledge, through our Australian-first credentialing program. Oncologists and haematologists can specialise in clinical trials through our fellowship program. Research managers and study coordinators can formalise their training and can contribute to their community’s long term research and care through our university-accredited education and quality programs.
And GPs will be able to refer into their local hospital for advanced treatment options.
The teletrial program has been developed to enable trials to get up sooner, and seven trials have now been accepted for activation, with three teletrials open and actively recruiting. We have also supported the opening of a melanoma imaging clinical trial.
We continue to identify potential trials to be delivered either by teletrial or onsite, and these are all focused on cancer (prostate, rare cancer and melanoma), but we will be expanding outside of cancer very soon.
To embed clinical trials into any hospital, it’s vital you have the buy-in and endorsement of the Chief Executive Officer and Executive team. The key to TrialHub’s success has been working closely with them as partners, recognising their local needs, and having a good understanding of their resources and capabilities. From there, we have been able to build on their foundations and tailored our support accordingly.
Everything we do is being internally and independently monitored and evaluated to ensure the program is meeting the needs of each regional and rural hospital and a health economic evaluation will start this year.
The aim is that this program will be rolled into other States from 2025.
TrialHub isn’t about growing Alfred Health’s footprint in clinical trials, it’s about providing guidance and support to our partner hospitals and leveraging the expertise.
Our goal is that these hospitals, one day, attract big clinical trials and ask a major hospital to join them as a secondary site. Read more about TrialHub here.
Anne Woollett, TrialHub Director.
The statements or opinions expressed in this article reflect the views of the authors and do not represent the official policy of the AMA, the MJA or InSight+ unless so stated.
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