The care of patients undergoing major surgery is an area of substantial unmet need. More than 300 million patients undergo surgery worldwide each year. Assuming hospital mortality of 1%, non-cardiac surgery will be associated with 3 million deaths annually with complication rates up to ten times this figure.

Improvements in perioperative care will therefore have a substantial impact on public health. However, significant changes in healthcare policy require a robust evidence base, and large clinical effectiveness trials remain the primary source of the evidence which defines patient care.

In various medical specialties, national clinical trials groups have proved very effective in organising investigators to recruit patients into clinical trials. In any large collaborative trial, the essential skills and contributions of individual investigators vary widely.

The CTN will organise the many and varied contributors into effective collaborative teams. The resulting high rates of successful trial completion generate confidence amongst major funding organisations, both in terms of trial design and trial feasibility.

Over time, settled relationships with funders will lead to high rates of funding success whilst the sense of ownership amongst grassroots clinicians will promote speedy implementation of findings.