Research for Patient Benefit Overview of the programme in the West Midlands RDS West Midlands Exploring Research Funding Day 9 October 2013 Professor Scott Weich Chair, West Midlands Regional Advisory Committee Bob Scott West Midlands Programme Manager

Background on NIHR and RfPB RfPB in the West Midlands Regional statistics update The application process Tips for applying and common areas of feedback to applicants Today’s presentation

NIHR Remit Aims to create a health research system in which the NHS supports outstanding individuals, working in world class facilities, conducting leading edge research focused on the needs of patients and the public A range of programmes with a broad range of health priorities Funding is based on the quality and relevance of the research to the NHS and personal social services Demonstrate the potential to have an impact on the needs of patients and the public within 5 years of its completion The NIHR does not fund basic research or work involving animals and/or animal tissue

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

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

The RfPB Programme Response mode funding programme Budget of up to £25 million per year Grants may be: –Costed up to £350,000 –Feasibility applications costed up to £250k –Up to 36 months in duration Three funding competitions per year Ten Regional Advisory Committees > 540 awards made to date totalling nearly £120m

Aims of Programme The research projects will use quantitative or qualitative methods to: –Study the way NHS services are provided and used –Evaluate whether interventions are effective and provide value for money –Examine whether alternative means for providing healthcare would be more effective –Formally assess innovations and developments in healthcare –Pilot or assess feasibility of projects requiring major applications to other funders

Aims of Programme Intends to support research which is related to the day- to-day practice of health service staff and is concerned with having an impact on the health of users of the NHS Funded research projects are likely to fall into the areas of health service research and public health research, although other areas are not excluded from the programme Applications which have emerged from interaction with patients and the public, which relate to patient and service user experience and which have been drawn up in association with a relevant group of service users will be particularly welcome

Research for Patient Benefit Spend across health category ( ) Generic Health Relevance 9% Reproductive 4.5% Mental Health 23% Oral and Gastrointestinal 4.5% Neurological 7.5% Stroke 8% Cancer 10% Musculoskeletal 4% Metabolic and Endocrine 5% Renal and Urogenital 5% Cardiovascular 6% Injuries and Accidents 3%

60 projects funded by RfPB of 398 applications received 71% of applications successful at preliminary scrutiny/scoping stage (69% national average) 21% of peer reviewed applications successful for funding (23% national average) Regional Panel Chair – Professor Scott Weich (from Jan 2013) Programme Manager – Bob Scott RfPB in the West Midlands

Preliminary Scrutiny

Recommended for Funding

Overall Success Rate

Application Process Once registered on the Research Management System portal, applicants have access to all CCF programmes Application form supports full formatting Edit options allow work to be saved and returned to at a later time Invited co-applicants can also edit the form All co-applicants must confirm their involvement and approve the application prior to submission Only the lead applicant can submit the application Declarations and signatures are due within a week and must be signed by contracting NHS body All applications are validated by CCF

Preliminary Scrutiny Reduction in the number of submitted applications over recent competitions Appreciation of the effort and resource involved in preparing an application Alternative process to be piloted for Competition 22 A ‘light-touch’ preliminary scrutiny process to be carried out on the basis of programme scope Fewer applications rejected on the basis of methodology Increased percentage of applications assessed by peer review and Committee

Peer Review A key part of the assessment process and integral to Committee recommendations At least three expert reviews and one public review per application Includes opinion on: –Relevance of the research –Quality of the design and work plan –Strength of the research team –Potential impact of the study –Value for money –Involvement of patients and the public Anonymised and redacted reviews provided to applicants with Committee feedback at outcome

Committee Assessment West Midlands Committee comprises 16 academic members and 3 public members Members of the RDS with methodological expertise sit on committees in neighbouring regions Committee meetings held three times a year, with a maximum of 15 applications at each meeting Conflicts are minimised by the re-allocation of applications to other regions if required. All applications are presented to the Committee by two expert lead assessors and one public member assessor Feedback provided to all applicants

Methodology lacking or design questions Overall lack of clarity and focus of the application Inappropriate outcome measures Expertise lacking in the research team Insufficient quality of the patient and public involvement Justification or detail of the intervention lacking Insufficient detail in background information Inappropriate statistics or health economics analysis Concerns about recruitment, sampling or feasibility Project impact, timescales, generalisability or dissemination Common areas for feedback

Feedback to applicants

What makes a successful RfPB application? Important question and clear aims Do your homework & don’t overlook key references Strong team with appropriate expertise & balance Convincing research design inc sample size Explaining how the evidence will benefit patients Evidence of meaningful patient and public involvement Justify outcomes & ensure these match aims Seeking & listening to advice from the RDS Value for money If feasibility study, will the full trial be fundable?

Other things to keep in mind All project costs are scrutinised by CCF – particular attention should be paid to NHS service support, treatment and excess treatment costs Patient and public involvement must be adequately thought through and costed Plain English Summary should be reviewed by a public contributor Relevance to patients and NHS is important Read the guidance and website resources All deadlines are at 1pm exactly so don’t leave it to the last minute

Research Costs are the costs of the R&D itself; data collection, analysis and other activities needed to answer the research questions. Research Costs will be met by the research funder (i.e. RfPB) NHS Support Costs include the additional patient-related care costs associated with the research, which would end once the R&D activity in question had stopped, even if the patient care service involved continued to be provided. NHS Support Costs will be met by NHS R&D Support Funding (i.e. Networks) Treatment Costs are the patient care costs which would continue to be incurred if the patient care service in question continued to be provided after the R&D activity had stopped. Excess Treatment cost is the difference between the total Treatment Costs and the costs of the standard treatment currently provided. NHS Treatment Costs will be met through commissioning arrangements for patient care (i.e. NHS/contracting organisation) Guidance: Attributing the costs of health and social care Research & Development (AcoRD) – updated 4 May 2012 The costs of R&D in the NHS

Tips for applicants Read the Guidance for applicants and FAQs (RfPB website) Ensure originality – thorough literature review Assemble the right team for the task Write clearly and for a broad audience Describe clearly how the research will benefit patients Don’t be over-ambitious –Can you recruit in the time available? –Are recruitment estimates realistic? Don’t forget to allow time for gaining ethical approval Have you left enough analysis and write-up time?

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