Annual MACRO database maintenance fee.

Elsevier is the only supplier of the MACRO database it is their bespoke offering so we do not have the option of another supplier for this. We are beginning to move away our new study builds from MACRO and onto REDCAP but this is the annual maintenance fee for the supply of the system which we will have to continue to pay until such times as the old studies on this database are archived or we can migrate onto another database offering. This option is also being considered alongside what REDCAP can and can't offer us in the future.