Research Strategy:

Transcription

1 Research Strategy:

2 Mission 1 BACK To improve patient health through our excellence in world class translational and applied health services research and our culture of innovation Context 2 National Context BACK The way applied health services and translational research is funded in NHS trusts and universities in the UK have radically changed over the last five years. The previous Government s research strategy, Best Research for Best Health (BRfBH), was launched in January 2006 with the goal of securing and encouraging the pursuit of clinical (defined as near patient and near service) research. The strategy explicitly identified health services research and clinical trials as priorities, since they offer the prospect of a more immediate impact on clinical care, and culminated in the establishment of The National Institute for Health Research (NIHR). In essence, BRfBH changed Department of Health funded research from being a supportive funding stream (which covered mainly the NHS costs of hosting externally funded non commercial activity and provided for some own account research), to a directed and commissioned research programme with an explicit emphasis on research excellence. These commissioned and response mode research funding streams are co ordinated and managed by the NIHR Central Commissioning Facility (CCF) and the NIHR Evaluation, Trials and Studies Coordinating Centre (NETSCC). As part of the changes to the way research funds are distributed by the NIHR, the previous block R&D Support Funding Allocation (also referred to as Culyer funding) has ceased and trusts are now funded on the basis of the quality and volume of the research they actually undertake. One of the aims of transforming the mechanism of funding to support research is to make research activities far more transparent and to stop research funds being used to subsidise direct clinical service provision in a trust. The NIHR has also managed a series of initiatives including awarding a number of trust and university partnerships with additional funding for biomedical research centre and units status; and the establishment of comprehensive and disease specific local research networks as part of the UK Clinical Research Network programme. More recently, five major academic/nhs collaborations in England have been designated by the NIHR as Academic Health Science Centres (AHSCs). The aims of the AHSCs are to integrate some or all of the activities of their associated health care and higher education institutions, thereby strongly enhancing their ability to achieve their strategic goals (individual and 2

3 collective). By integrating their clinical service, research and teaching strategically and operationally, AHSCs deliver a whole which is greater than the sum of the parts. In parallel with the above changes in the way applied health services research is funded in NHS trusts, funding for basic science and translational research (see glossary for definitions of translational and applied health services research) also changed, driven by the 2006 Cooksey Review. The Review endorsed BRfBH and strongly recommended an increase in inward investment in R&D and supported a research driven healthcare system. The UK Government accepted these recommendations and most significantly greatly expanded the DH R&D and Medical Research Council (MRC) budgets, and established a new Office for Strategic Coordination of Health Research (OSCHR) to take a strategic overview of the budgetary division and research strategy of both the MRC and NIHR. In parallel the Wellcome Trust has also focused its very considerable funding on translational research and more recently has decided to allocate the majority of its funds for investigator awards rather than on specific projects. The need for the NHS to work better with industry and business has also been recognised widely by all UK funding bodies. All of the changes in funding have encouraged and facilitated academics and NHS researchers to work closely together in larger multi disciplinary teams. This integration and the focus on translational and applied health services research has attracted additional infrastructural and programme grant funding and has also highlighted the need to promote the clinical research skill base in professions other than medicine. A number of recent initiatives reflect efforts by funding bodies to ensure opportunities are provided to prepare both medical and non medical professionals to undertake and lead research, often in previously under researched and neglected areas of significant NHS activity. Local Context The response by the Bristol healthcare research community over the last two years to the above changes in the national applied health services and biomedical research agenda has been transformational. NBT has worked with its partner universities and NHS trusts in the region to form a novel collaboration called the Bristol Research and Innovation Group for Health (BRIG H). The six BRIG H partner organisations have developed a shared research strategy, joint enabling infrastructure (e.g. the new Clinical Research and Imaging Centre [CRIC] and the Specialist Methodological and Analytic Research and Training Unit, [SMART]) and agreed common goals for translational and applied health services research. It has been agreed by the BRIG H Leadership Executive that the next step in the evolution of the partnership is a more formal collaboration leading to the formation of a Bristol Academic Health Science Centre (AHSC). In order to respond strategically to the changes in biomedical and health research funding and as part of the development of an AHSC it is clear that we must build on our research strengths at NBT. Further, the new hospital and the Foundation Trust application provide a unique opportunity to better integrate research and clinical activity. A re examination of, and update to, the NBT research strategy is therefore timely and emphasises the importance of working with our BRIG H and regional partners to align our research and clinical service strengths leading to the establishment of a Bristol AHSC. Critical 3

4 to this will be to focus on and foster our priority areas of translational and applied health services research and innovation where we are, or have the potential to be world leading (Aim 1). In parallel, we must train, mentor and support research active staff to deliver high quality translational and applied health services research of direct patient benefit in our priority areas of research (Aim 2). These activities will develop a culture across NBT, in which research and innovation are embedded in and aligned with routine clinical services, leading to significant health gains and improvements in health services delivery (Aim 3). In support of the above strategic aims, we will increase the income from research and innovation and use that to maximise the translation of our priority research strengths into practice and service innovation for the benefit of patients and society (Aim 4). NOTE: Once this strategy has been approved by the Trust Board then a detailed implementation plan which will include actions against individuals/teams and time lines for delivery, will be developed by R&I and approved by Trust Research Committee. 4

5 Aims and Objectives 3 BACK Aim 1: Be World leading Actively participate in the establishment of a Bristol AHSC in which world class clinical services, research and innovation and teaching are strategically and operationally integrated. Objective 1.1: Work with our BRIG H/AHSC partners to focus on and foster our priority areas of translational and applied health services research and innovation where we are, or have the potential to be world leading. We will map our research into themes and ensure each has a coherent research strategy to deliver world leading translational and applied health services research and innovation We will ensure active involvement in the development and delivery of the Bristol AHSC takes place at all levels from Board to research team Objective 1.2: Align our research, teaching and clinical service strengths with those across the AHSC to generate significant health gain and improvement in service delivery for our patients. We will ensure that academic scrutiny provides the evidence to challenge conventional practice, maximises the dialogue between researchers and clinicians, identifies best practice and delivers a step change in clinical performance at NBT. Objective 1.3: Maximise the reputational benefits of being a member of the Bristol AHSC We will attract the very best clinicians and researchers to work across the new campus, maximising the dissemination of knowledge among staff and students, leading to better clinical delivery and health outcomes. We will ensure research and innovation is integrated with clinical delivery to make it easier to compete globally leading to much greater success in funding opportunities than could be obtained individually. 5

6 Aim 2: Deliver high quality research of direct patient benefit Support our staff to deliver high quality translational and applied health services research of direct patient benefit. Objective 2.1: Increase and diversify the participation in NIHR Portfolio studies We will ensure a balanced portfolio of studies take place at NBT from observational to complex interventional, supporting established teams and also teams that are yet to participate in NIHR Portfolio studies. Objective 2.2: Provide state of the art integrated clinical research facilities We will work with local and national charities to develop a separate and dedicated clinical research facility For all research where integration with clinical departments is preferable, we will ensure research facilities are embedded in clinical departments across the new campus We will explore opportunities to develop shared facilities and infrastructure with AHSC and other external partners. Objective 2.3: Provide support to ensure delivery targets for NIHR Portfolio studies are achieved We will monitor and provide support to enable teams to: navigate the necessary regulatory reviews in an efficient and proactive way, support assessment of study feasibility, reduce and streamline set up times, ensure research teams recruit to time and target. Objective 2.4: Provide skilled support and facilitation for the development of grant applications We will facilitate, support and advise at all stages of grant development which will include: mentoring, critical reading, reviewing outcomes from grant applications and feeding back to study teams provision of specialist support (e.g. project management, methodological) horizon scanning and promoting funding opportunities to researchers provision of appropriate costings to identify all resources required to deliver the research. 6

7 Objective 2.5: Provide protected time and pump priming funds for staff who are, or have the potential to be, research active We will actively manage the distribution and performance management of NIHR Flexibility and Sustainability funding and the NBT Small Grant Scheme We will report on the use of funds annually to the Department of Health and NBT Charitable funds Committee as required. Objective 2.6: Promote and develop patient/public involvement for all clinical studies We support both our researchers and our patients to meet this objective. We will provide support and advice on patient and public involvement in research at all stages of study development and delivery. We will actively increase public awareness of research at NBT and increase patient awareness of opportunities to be involved in research through our Take Part Be Involved campaign. We will continue to be an active partner in the People in Research South West initiative. Objective 2.7: Identify and support emerging talent and provide academic mentorship and training We will ensure all potentially research active staff are given the opportunity to participate in research We will provide appropriate academic mentorship and training for researchers to apply for appropriate training programmes. Objective 2.8: Support career and personal development pathways for researchers including succession planning We will ensure career pathways are actively managed and established for all research staff We will ensure established research teams have clear succession plans in place. 7

8 Aim 3: Embed a research culture in clinical service delivery Develop a culture across NBT in which research and innovation are embedded in and aligned with routine clinical services, leading to significant health gains and efficiency improvements in health services delivery Objective 3.1: Promote and increase the understanding of all staff at NBT of the role of research and innovation in high quality clinical care We will work with Directorate research leads to raise awareness of all staff of the value and contribution research makes to practice Objective 3.2: Work with staff at all levels to ensure quicker pull through of new techniques and therapies and that patients have better access to the latest treatments and interventions We will work closely with the clinical effectiveness committee and the business development unit to ensure that our cutting edge research is rapidly translated through into measurable improvements in patient outcomes, experiences, safety and potentially cost effectiveness Objective 3.3: Provide Directorates with appropriate performance and financial information and resources to deliver NBT research objectives We will provide quarterly performance information to Directorates or more frequently as required We will ensure Directorate research plans respond to performance information We will provide transparent costings and financial management of research at Directorate level Aim 4: Increase research income Increase the income from research and innovation and use that income in support of our strategic aims. Objective 3.1: Work with our BRIG H/AHSC partners to maximise external income (NIHR grants, WCLRN support and commercial income) We will work collaboratively with partner organisations to ensure we maximise the chances of successful grant applications We will support the work of the WCLRN as an active member organisation Objective 3.2: Ensure transparency in financial costings, management and resource allocation to Directorates 8

9 We will provide transparent costings and financial management of research at Directorate level We will ensure all commercial research is costed in line with the national costing template Objective 3.3: Focus available income on our priority areas of research and innovation, maximising the translation of our research strengths into practice and service innovation for the benefit of patients and society We will distribute NIHR Flexibility and Sustainability funding and the NBT Small Grant scheme to give priority to: our priority research themes projects that have an impact on the NHS projects that have direct patient benefit 9

10 Glossary 4 BACK AHSC Academic Health Science Centre/Cluster aim to integrate some or all of the activities of their associated health care and higher education institutions, thereby strongly enhancing their ability to achieve their strategic goals (individual and collective). By integrating their clinical service, research and teaching strategically and operationally AHSCs deliver a whole which is greater than the sum of the parts. AHSC collaborations now apply to many of the most successful hospitals and medical schools nationally and internationally. BRIG H Bristol Research and Innovation Group for Health is a vibrant and ambitious Bristol wide strategic research and innovation partnership. It is dedicated to fostering excellence in people and infrastructure to realise the full potential of research and innovation to benefit patient health. BRIG H partners are North Bristol NHS Trust, United Hospitals Bristol Foundation NHS Trust, Avon and Wiltshire Mental Health Partnership NHS Trust, NHS Bristol, University of Bristol and University of the West of England Innovation relates to The adoption of new to the organisation or new to the NHS technology products and/or service delivery processes, comprising step or incremental change, and resulting in a significant improvement in patient outcomes, experiences, safety and potentially cost effectiveness. An implication of this definition is that the benefits of the introduction of the technology/service delivery processes are proven. (National Innovation Centre 2008) Translational and Applied Health Services Research leads to benefits in the care provided for patients and encompasses a range of activities that include research going: (a) from bench to bedside, where theories emerging from pre clinical experimentation are tested on patients, and (b) from paper into practice, whereby a better understanding and then evaluation of health services results in an improvement in outcomes. Trust Research Staff or Researchers are used throughout this document to encompass all clinical researchers and includes the following professional groups: Medical, Nursing, Midwifery, AHPs, Clinical Scientists, Pharmacists and research administrators. R&D Approval relates to the process of reviewing and checking applications for research to take place within an NHS organisation, prior to giving written permission. It is also frequently referred to as NHS 10

11 Permission or R&D Management Approval. In most NHS organisations, an R&D office is responsible for carrying out these checks before permission is given by the Chief Executive or a delegated senior person. In North Bristol NHS Trust (NBT), the R&D department is called the Research & Innovation (R&I) office. 11