An Introduction to the NIHR & the Public Health Research Programme Phil Taverner, Assistant Director, PHR programme 2 May 2014

Overview Introduction to the NIHR programmes Introduction to NIHR Themed calls The PHR programme What makes a good application

An introduction to the NIHR www.nihr.ac.uk

What is the NIHR? The National Institute for Health Research (NIHR) aims to ‘improve the health and wealth of the nation through research’ Commissions and funds NHS, social care and public health research to develop the research evidence to support decision making by professionals, policy makers and patients. Large, multi-faceted organisation encompassing faculty, research, infrastructure and systems

Faculty Infrastructure Research Systems Investigators & Senior Investigators Associates Trainees Universities Infrastructure Research Clinical Research Networks NHS Trusts Research Projects & Programmes Patients & Public Clinical Research Facilities, Centres & Units Research Schools Research Governance Systems Research Information Systems Systems

The central role of NIHR research in the innovation pathway INVENTION EVALUATION ADOPTION DIFFUSION Basic Research Medical Research Council Development Pathway Funding Efficacy & Mechanism Evaluation Invention for Innovation Biomedical Research Centres Biomedical Research Units This pathway covers the full range of interventions - pharmaceuticals, biologicals, biotechnologies, procedures, therapies and practices - for the full range of health and health care delivery - prevention, detection, diagnosis, prognosis, treatment, care. Experimental Cancer Medicine Centres Clinical Research Facilities Patient Safety Translational Research Centres Healthcare Technology Co-operatives Horizon Scanning Centre Research Schools National Institute for Health Research Research for Patient Benefit Public Health Research Programme Grants for Applied Research Health Services and Delivery Research Health Technology Assessment Centre for Surgical Reconstruction & Microbiology Collaborations for Leadership in Applied Health Research and Care Centre for Reviews & Dissemination, Cochrane, TARs NHS Supply Chain Support for Procurement National Institute for Health & Clinical Excellence Guidance on Health & Healthcare NHS Evidence Access to Evidence Academic Health Science Networks Innovation NHS Commissioning Board and Clinical Commissioning Groups Commissioning Providers of NHS Services Patient Care

What is applied research? Research with the capacity to improve patient and public outcomes and NHS services Multiple methodologies - not only trials Not Discovery science Work involving animals or animal tissue

Which programme should I chose?

Which NIHR programme? EME – exploratory trials, less pragmatic, phase 2-3, efficacy, mechanisms if possible HTA – systematic reviews, large multicentre pragmatic trials or other studies (phase 3-4), effectiveness in the NHS HS&DR – organisational, patient experience, qualitative or other i4i - translational R&D projects aimed at cultivating new techniques or technologies into innovative interventions to address healthcare needs  PHR – effectiveness and cost effectiveness of non-NHS interventions to improve public health PGfAR- Up to 5 years, awards made to NHS bodies RfPB – max £350k for up to 36 months. Encourages proposals for projects covering a wide range of health service issues and challenges which translate into patient benefit locally and for the wider NHS. Fellowships – doctoral, postdoctoral and senior fellowships

What do NIHR do in relation to public health? EME: preventative and screening services HS&DR: research into public health/preventative services and workforce issues HTA: screening programmes or components of screening programmes in a population context, disease prevention or health promotion programmes PHR: evaluation of interventions outside of the NHS PGfAR: support priority NHS research that will deliver findings with practical application, typically through improved healthcare, better healthcare delivery, promotion of health and prevention of ill health, within three to five years of a programme’s end. NIHR School for Public Health Research (http://sphr.nihr.ac.uk/) http://www.nihr.ac.uk/files/pdfs/NIHR%20public%20health_web.pdf

Which funding programme? http://www.nihr.ac.uk/publications/Pages/default.aspx

What are NIHR Themed Calls? www.themedcalls.nihr.ac.uk

What is an NIHR themed call? NIHR themed calls are issued to meet an identified health challenge or government priority Calls are generally issued once a year Cross NIHR initiative involving all NIHR research programmes Previous calls have focused on: Dementia Surgery Primary Care Interventions Very Rare Diseases

Current Themed Calls Long-term conditions in Children and Young People Antimicrobial Resistance

www.themedcalls.nihr.ac.uk

Applying to Themed Calls Applications should meet the remit of the specification document and one of the participating programmes Provides opportunities to evaluate interventions which cross NIHR programme boundaries and applications which span the remit of one or more NIHR programme will be considered Engage collaborators, CTUs, RDS as soon as you can Process steps – timing varies between programmes However, the programmes will continue to welcome applications in this area after the call has closed www.themedcalls.nihr.ac.uk

NIHR Support Available http://www.themedcalls.nihr.ac.uk/children/help-with-applying

What is the NIHR Public Health Research Programme www. nets. nihr. ac What is the NIHR Public Health Research Programme www.nets.nihr.ac.uk/programmes/phr

Commissioned and Researcher-led Workstreams www.nets.nihr.ac.uk

The PHR programme Funds the evaluation of non-NHS interventions intended to improve the health of the public and reduce inequalities in health Unable to fund intervention costs National programme open to researchers from across the UK Includes qualitative and quantitative research which evaluates the effectiveness and cost-effectiveness of public health interventions Primary outcome measure must be health related

Developmental studies PHR will fund studies with a developmental element to them. The MRC Public Health Intervention Development Scheme has been set up to support early stage development of public health interventions http://www.mrc.ac.uk/Fundingopportunities/Grants/PublicHealthInterventionDevelopmentScheme/MRC009274 www.nets.nihr.ac.uk

Opportunities Public Health England – new research priorities Local authority focus – wider determinants of health, community engagement, new partnerships and approaches UK-wide research programme – shared and different priorities and opportunities Significant growth in funding for public health research in recent years

Challenges Research disruption - evolving new organisations, functions and roles Research context – changing budgets, services spread across sectors, culture of evidence-based practice, research priority, divergence between UK administrations Research capacity – workforce dispersal, supporting functions, training and capacity building

What Public Health Research Adds: Evidence for Education Teacher training and school environment to promote health Building social and emotional wellbeing Promoting physical activity and healthy diet Preventing smoking, alcohol and substance misuse

What Public Health Research Adds: Evidence for Local Decisions Urban regeneration and health Community engagement and disadvantaged communities Alcohol environment

What Public Health Research Adds: Evidence for Environmental Health Transport – urban motorway, free bus travel, active and sustainable travel Housing quality and energy efficiency Effect of reducing street lighting on crime and road accidents

Priorities for the Public Health Research Programme Maintaining support and funding for high quality public health intervention research across the UK Building partnerships with new organisations Understanding and responding to emerging needs for evidence and knowledge Reaching out to new audiences across sectors http://www.nets.nihr.ac.uk/programmes/phr

What have we funded? http://www.nets.nihr.ac.uk/projects Health impacts of the Cambridgeshire Guided Busway (Dr David Ogilvie, Cambridge University) Health impact, and economic value, of meeting housing quality standards (Professor Ronan Lyons, Swansea University) A feasibility trial of screening and brief alcohol intervention to prevent hazardous drinking in young people aged 14-15 in a high school setting (Dr Dorothy Newbury-Birch, Newcastle University) http://www.nets.nihr.ac.uk/projects

What makes a good application?

The Application Process Two-stage application process (outline & full) External peer and public review (full) Assessment by Programme Advisory Board (PAB) and Research Funding Board (RFB) PAB: considers public health importance RFB: consider scientific quality, feasibility & value for money ‘Needs-led, Science-Added’

Process for Assessment of Applications Screening assessment: remit Programme Advisory Board: public health importance Research Funding Board: scientific quality feasibility value for money www.nets.nihr.ac.uk

Is the research question in remit? Is the research question within the remit of the PHR programme? Is there an intervention? Are the intervention costs funded? Is it delivered outside of the NHS? Is the primary outcome measure health related? Does it meet the commissioning brief? Talk to programme staff or consult the NETSCC web pages: www.nets.nihr.ac.uk for advice 32

Is the question important? The need for the research Public health ‘need’ should be explicitly stated Will the research provide the evidence needed by decision makers on a prominent public health issue? How will the results reduce inequalities in health? Will the findings be generalisable and transferable? Has the research question been explained clearly and the importance of topic made? 33

Finding existing research PHR portfolio: http://goo.gl/jLrJaH NIHR Journalshttp://www.journalslibrary.nihr.ac.uk/

Is the research feasible? Ambitious but realistic Is the presentation and/or methods appropriate for the research question? Design complexity Justify recruitment methods and assumptions Explain and justify the sample size calculations Experience, track record of research team and appropriate partners 35

The science Use headings Clear, simple, succinct, logical Cover all the essential elements relevant to the design e.g. Participants Intervention Control Setting Outcomes Sample size and power Analysis 36

Feasibility & Pilot Studies Feasibility included or done already? PHR funds feasibility and pilot studies but likes to have sight of the full trial lying behind it including the statistical analysis plan and progression criteria. Pilot data – include in application. 37

Picking your team Involvement of CTU or RDS from the beginning Comment on the track record and experience of the team Roles and responsibilities in relation to the project Make sure enough statistical support is in place i.e. a statistician as a co-applicant Some team members are specific to the methodology eg health economist & qualitative researchers. Other committees eg steering group; IDMC; patient advisory group.

How much can I ask for? There is no maximum limit on the duration and costs of proposals to the programme, but….. Is the research realistically costed and does it offer value-for-money? Is the cost to address the disease / health issue in question justified, and does the topic clearly account for the cost requested?

Patient and public involvement is of key importance Researchers need to involve patients and the public during the development and delivery of the research project Patients and public will be involved at all stages of the assessment process (referees, board members) Funding boards will explicitly look for evidence of appropriate patient and public involvement 40

Useful PPI Resources INVOLVE http://www.invo.org.uk/ Involvement Cost Calculator http://www.invo.org.uk/resource-centre/involvement-cost-calculator/ “Were patients and the public actively involved in either identifying the research topic/prioritising the research question and/or preparing this application?”

How will your research really make a difference? Have an imaginative plan for dissemination How will your research really make a difference? How will people know about it? Plan and cost for dissemination at the outset. Think imaginatively

English for mixed audience Is it clear, logical and persuasive? English for mixed audience Methodologists, patients and the public etc Tell the story well for the non - expert Plain English summary Follow the guidance notes Visible headings (e.g. sample size, outcomes, technologies) White space – there should be some (use paragraphs) Flow diagrams PROOF-READ SUBMISSIONS CAREFULLY!

‘Feedback from funding boards’ Feedback from funding boards at all stages is meant to be helpful to the applicants Applicants should respond to all areas highlighted as necessary by the funding board

Inadequate detail given on the public health issue Common pitfalls Inadequate detail given on the public health issue Inadequate detail given on the intervention to be evaluated Application has not stuck to remit and/or the brief Application has not paid enough attention to board feedback between outline and full proposal Unrealistic / inaccurate costings (both under and over-costing) Submissions have not been proof-read

Inconsistent accounts of planned research Common pitfalls Inconsistent accounts of planned research Incorrect or inconsistent numbers e.g. sample size calculations Apparent lack of awareness of major or related work in train Insufficient detail, or muddled detail particularly in the methodology sections – even at full proposal Gaps in expertise on the research team – even after feedback from funding board

‘Where can I find help?’

NIHR Research Design Services “To increase the number and proportion of high quality applications for funding …” http://www.ccf.nihr.ac.uk/Pages/RDSMap.aspx 48

Submitted Outline Applications Submitted Full Applications RDS National Figures Year Projects Supported Submitted Outline Applications (% Shortlisted) Submitted Full Applications (% Funded) 2009/10 2335 217 (62%) 662 (35%) 2010/11 2328 311 (54%) 839 (37%) 2011/12 2405 418 (38%) 899 (35%) 2012/13 2492 379 (40%) 921 (37%)

Working with the RDS Booking an ‘early’ appointment with the RDS Summary of research idea/s http://www.ccf.nihr.ac.uk/Pages/RDSMap.aspx Face to face meeting First point of contact with a generalist

Initial meeting with the RDS Assessment Importance of the question Existing research Potential funding streams Study design – is it a trial Clinical area Feasibility of recruitment strategy Track record of team PPI Costs; research, treatment, excess treatment

Contacting the RDS http://www.ccf.nihr.ac.uk/Pages/RDSMap.aspx#tab8 22/09/2018

How can I get involved? Suggest research topics http://www.phr.nihr.ac.uk/suggest/0.asp Potential new referee http://www.phr.nihr.ac.uk/getinvolved/refereeing.asp Join our mailing list Email your contact details to info@phr.ac.uk

Where can I find help? For more information, visit: http://www.nets.nihr.ac.uk/programmes/phr Enquiries welcome: info@phr.ac.uk or +44 (0)23 8059 9697 (24 hour answer phone) Tips for success: http://www.nets.nihr.ac.uk/__data/assets/pdf_file/0011/67637/Final_Tips-for-success-PHR-Nov-13.pdf PHR webinars