NHS evaluations: Bringing research to bear on major initiatives arising in and from the NHS Hugh Ross and Kieran Walshe hugh.ross@cardiffandvale.wales.nhs.uk kieran.walshe@mbs.ac.uk
Overview ► Background and context for the NIHR SDO research programme ► Aims and purpose of the NHS evaluations workstream ► Examples of projects commissioned so far ► Arrangements for our forthcoming call for proposals
Our mission The NIHR Service Delivery and Organisation (SDO) programme improves health outcomes for people by: ► Commissioning research and producing evidence that improves practice in relation to the organisation and delivery of health care, and ► Building research capability and capacity amongst those who manage, organise and deliver services – improving their understanding of the research literature and how to use research evidence
Background and overview ► Established in 1999, and is a part of the National Institute for Health Research which brings together DH/NHS investment in health research ► In April 2009 the NIHR Evaluation, Trials and Studies Coordinating Centre (NETSCC), based at the University of Southampton, took on the management of the SDO programme. ► Focused on serving the research needs of the NHS management and leadership community, and building capacity to use research in decision making ► Has funded over 230 projects to date – spent around £9.2m in 2008/09 – planned to rise to £11m pa by 2011/12 ► Website at www.sdo.nihr.ac.uk contains all our research, publications and lots more
Programme structure SDO Programme Executive Group Kieran Walshe Research KM/CB Priority Areas NHS Evaluations SDO Studies Commissioning Expert Advisory Panel Panel Panel Board Group David Steel Hugh Ross Lorna McKee Kieran Walshe Huw Davies NETSCC at University of Southampton SDO Network
Research production ► The annual budget is £11m in 2011/12 ► The SDO programme funds both commissioned and researcher-led funding streams through the Priority Areas, Evaluations, and SDO Studies panels. Types of Who defines Frequency Research the question? Per year Primary research Evidence synthesis SDO programme 4 calls Priority areas Priority areas Commissioned Commissioned Primary research NHS 2 calls Evidence synthesis SDO programme Evaluations Evaluations Researcher Researcher-led Researcher-led Primary research 2 calls SDO studies Evidence synthesis SDO studies Researcher
Knowledge mobilisation ► The annual budget is £1.2 million in 2010/11 ► Annual SDO/HSRN conference ► Chief executives’ forum and programme of SDO network events ► Knowledge interaction fund to support events and engagement between researchers and managers ► Knowledge synthesis and translation products – reports, summaries, monograph series, toolkits, guidance... ► Collaborative academic placements cosponsored with ESRC ► SDO management fellowships attached to research projects ► SDO involvement with the Harkness Fellowships programme
NHS evaluations workstream ► Established 2009, budget of about £3 million pa in steady state ► Aimed at funding research evaluations of promising innovations arising in/from the NHS with wider potential benefit ► Based on early discussions with SHAs, NHSI and others ► Model of partnership between NHS organisations with a research need, research teams with the capacity and expertise, and SDO programme with the funding ► Challenges – getting the timing right, finding issues that really matter to the NHS, matching NHS and academic agendas ► One call so far – but disappointing response, mostly researcher-led ideas with rather limited SHA engagement ► Trying again – call opens on 15 April, closes on 10 June
What are our criteria? ► Promising innovations in healthcare delivery which have a substantial potential benefit and could be applied more widely in the NHS. ► Being piloted, tested or implemented in a number of healthcare organisations ► Involving the application of ideas or technologies introduced or transferred from other countries, sectors or settings ► Not already been well explored and tested through research so knowledge is lacking on impact, effectiveness, optimal implementation or adaptation, relationship to organisational context and generalisability and sustainability in the NHS.
Example: evaluation of the North East Transformation System (NETS) ► Initiated by NHS North East ► Aims to evaluate the impact of NETS and other improvement initiatives on variation, waste, safety/quality, working arrangements and relationships ► Learning for the wider NHS on the successful implementation of lean management and related approaches to improvement and large scale organisational change ► Research commissioned from Universities of Durham and Newcastle, from 2009 to 2012
Example: evaluation of the Advancing Quality P4P programme ► Initiated by NHS North West and the Audit Commission ► Aims to understand the implementation and impact of AQP on hospitals, commissioners, patients and clinicians, assess cost- effectiveness. Identify barriers and facilitators ► Learning for the wider NHS on the design and implementation of P4P incentive systems to improve performance ► Evaluation commissioned from University of Manchester, from 2009 to 2013
Example: evaluation of NTAC technology adoption programme ► Initiated by NHS Technology Adoption Centre ► Aims to evaluate adoption processes and pathways for non- pharmaceutical technologies and impact of adoption pilots and resources initiated by NTAC ► Wider learning for the NHS on the barriers and facilitators to adoption of innovation ► Evaluation commissioned from University of Manchester from 2009 to 2013
Forthcoming call for proposals ► Advance notice sent out on 31 March via our mailing lists, advert in HSJ, etc ► Call for outline proposals opens on 15 April 2010 ► Briefing meeting for researchers and people from SHA or other NHS organisations in London on afternoon of 28 April ► Call for outline proposals closes on 10 June 2010 ► Panel will then shortlist, full proposals will be sought, and considered by the SDO Commissioning Board ► Call details now available on SDO website at http://www.sdo.nihr.ac.uk/fundingopportunities.html
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