1. Unpacking the NIHR Development, engagement, effect and opportunities
Ben Morgan | Research for Patient Benefit (RfPB) funding scheme
NIHR Central Coordinating Facility
Helen Harris-Joseph
NIHR Training Programme
Kay Lakin
NIHR Evaluation, Trials and Studies Coordinating Centre
Saima Nayab | Invention for Innovation (i4i) funding scheme
Julie Bayley (chair) | ARMA Impact Special Interest Group
Coventry University
Unpacking the NIHR: Development, engagement, effect and opportunities.

2. Session
About NIHR
The view from ‘within NIHR’: scope, opportunities and challenges
Development | academic and clinician professional skills and careers
Example: the NIHR Training Programme
Engagement | of patients, industry and beneficiaries
Example: the Research for Patient Benefit (RfPB) scheme
Effect | benefits and impact on health, wealth and wider practice
Examples: NIHR Evaluation, Trials and Studies Coordinating Centre; and the Invention for Innovation (i4i) scheme
Group discussion and panel reflections
NB schemes don’t fit neatly like this, but need a way to structure it!!

3. About NIHR VISION MISSION
To improve the health and wealth of the nation through research.
MISSION
To provide 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.
The research arm of the NHS
“Improving the health and wealth of the nation through research”
Budget of ~£1bn
The National Institute for Health Research (NIHR) is funded through the Department of Health to improve the health and wealth of the nation through research. It is a large, multi-faceted and nationally distributed organisation. Together, NIHR people, facilities and systems represent the most integrated clinical research system in the world, driving research from bench to bedside for the benefit of patients and the economy.
Since its establishment in April 2006, the NIHR has transformed research in the NHS. It has increased the volume of applied health research for the benefit of patients and the public, driven faster translation of basic science discoveries into tangible benefits for patients and the economy, and developed and supported the people who conduct and contribute to applied health research.

4. NIHR Health Research System
NIHR is a whole health research system designed to:
fund leading-edge scientific research
drive faster translation of science into tangible benefits for patients
create conditions for inward investment by the life-sciences sector
The research arm of the NHS
“Improving the health and wealth of the nation through research”
Budget of ~£1bn
The National Institute for Health Research (NIHR) is funded through the Department of Health to improve the health and wealth of the nation through research. It is a large, multi-faceted and nationally distributed organisation. Together, NIHR people, facilities and systems represent the most integrated clinical research system in the world, driving research from bench to bedside for the benefit of patients and the economy.
Since its establishment in April 2006, the NIHR has transformed research in the NHS. It has increased the volume of applied health research for the benefit of patients and the public, driven faster translation of basic science discoveries into tangible benefits for patients and the economy, and developed and supported the people who conduct and contribute to applied health research.

5. The Innovation Pathway
NB TRAINING NOT HIGHLIGHTED ON THIS DIAGRAM
Here you can see the areas we manage in the NIHR Innovation pathway. One of the main areas of focus is pull-through of research across the pathway from invention to diffussion.
Academic Health Science Centres

6. The Innovation Pathway
INVENTION
EVALUATION
ADOPTION
Creation
new things
new ideas
new techniques
new approaches
Assessment
Uptake
DIFFUSION
Spread
Basic Research
Applied Research
Commissioning
Patient Care
Better Quality - Better Value
NIHR
CCGs
MRC
NHS Providers

7. The Innovation Pathway
INVENTION
EVALUATION
ADOPTION
Creation
Assessment
Uptake
DIFFUSION
total hip replacement invented
evidence that hip replacement is clinically and cost effective
Effectiveness of hip prostheses in primary total hip replacement: a critical review of evidence and an economic model
NICE guidance on hip replacement
Basic Research
Applied Research
Commissioning
Spread
97,000 hip replacements performed in England in 2007/08
Patient Care

8. Research for Patient Benefit (RfPB) Programme
Ben Morgan
Assistant Director

9. The RfPB Programme Response mode funding programme
Supports high quality investigator-led research projects that address issues of importance to the NHS
Grants may be:
Costed up to £350,000
Feasibility applications costed up to £250k
More upstream studies costed up to £150k
Three funding competitions per year
Eight Regional Advisory Panels
> 750 awards made to date totalling nearly £172m
Success rate of ~22% (peer reviewed applications) 9

10. Ongoing Reviews Review of 125 definitive trials
Review of trajectory of feasibility studies
Review of tier 3 developmental/innovative research

11. Feasibility Studies Why look into an established research pathway?
Push the Pace
Add value in research
Reduce waste
Time taken for feasibility studies to progress into definitive trials appeared longer than expected (but no benchmark to compare to)
What can we do to speed pathway up and increase progression rates?
Note for Ben: ‘Push the Pace’ – is this well-known enough to be a standalone thing? Might be better to explain purpose – as per second and third bullets – and give the name of the project as part of commentary?

12. Feasibility Studies
Join up parts of the commissioning process better, especially between programmes
Help applicants/managers navigate NIHR more effectively (which programme to apply to?)
Determine what evidence is needed at what stage

13. NIHR Training Programme
Helen Harris-Joseph
Senior Programme Manager

14. NIHR Training Programme
Research Capacity Development
NIHR provides training and career development awards in order to:
build a leading healthcare research faculty
develop research careers, research leaders and collaborators.
Training provided through
Awards programmes managed by Trainees Coordinating Centre
NIHR Infrastructure: Biomedical Research Centres, Collaborations for Leadership in Applied Health Research and Care etc.
Specific strategic initiatives: School for Primary Care Research
TCC is one part of that NIHR system, our remit is to ……….

15. NIHR Research Career Paths
Large range of awards for different levels and professional background.
Mix of institutional and personal awards – apply direct to us
Annual cycle of competitions

16. NIHR Training Programme
Research Capacity Development
NIHR provides training and career development awards in order to:
build a leading healthcare research faculty
develop research careers, research leaders and collaborators.
Training provided through
Awards programmes managed by Trainees Coordinating Centre
NIHR Infrastructure: Biomedical Research Centres, Collaborations for Leadership in Applied Health Research and Care etc.
Specific strategic initiatives: School for Primary Care Research

17. NIHR training awards: remit
People and patient based clinical, applied health or social care research
Patients, samples or data from patients, people who are not patients, populations, health technology assessment or health services research
No basic research or work involving animals and/or animal tissue
Biomarkers – clinical evaluation not discovery
Clearly demonstrate the potential to have an impact on the needs of patients and the public within 5 years of its completion
NIHR is also prepared to support research into medical education
All of the research that we fund has to meet these criteria and it is important to make it absolutely clear in any application you make to ensure it has demonstrable benefit for patients/public within 5 years. You can find out what research projects we have funded in the past by looking on the website, but if you have any queries about whether a project would be in scope or not – get in touch with the office. Team are happy to discuss.
Medical education: Whilst this area of research need not fulfil the criterion of having 'potential for benefiting patients and the public within 5 years of its completion', it is expected that the research will have the potential to have practical application.’

18. NIHR training awards @NIHR_trainees Funding covers:
Trainees have access to:
Salary
Networking and community events
Tuition fees (for PhD)
Programme of webinars
Research costs
Leadership programme
Full training and development programme
Mentorship programme for clinical academics
Senior Awards include Research Assistant support
Indirect costs for HEIs e.g. estates, facilities at 80%
Salary is in line with current clinical or academic scale at the moment.
Most awards hosted by NHS trust or HEI but others are eligible.
Annual cycle of competitions
HEI employers also receive indirect costs e.g. estates, facilities at 80%
@NIHR_trainees

19. NIHR Professorship
Prof Nadine Foster | Musculoskeletal Health in Primary Care
Professor Foster led a study which examined the implementation of stratified care in patients with low back pain - the IMPaCT Back study. In the UK, back pain accounts for 6-9% of consultations with a GP. The study’s results showed that stratified care led to a reduction in the number of sickness certificates issued for back pain patients, a halving in the number of days lost from work, and improved physical function for patients. It is estimated that use of the screening tool in general practice could potentially provide savings of more than £700 million if implemented.
Other
NIHR
KEY
NIHR Leadership Programme
RfPB (Co)
RfPB (Co)
RfPB (Co)
RfPB (Co)
RfPB (Lead)
2007
2010
2013
2014
NIHR Research Professorship
NCCRCD Primary Care Career Scientist
Senior Lectureship
Director of Clinical Trials Unit
Development of primary care screening tool for back pain reduces sickness certificates and saves money
Career history: Nadine studied undergraduate physiotherapy in Ulster and is a Chartered Physiotherapist. In 2007 she was awarded a Primary Care Career Scientist award from the National Coordinating Centre for Research Capacity Development (now NIHR). In 2012, Nadine was awarded an NIHR Research Professorship to support research into the development of treatments and services for common musculoskeletal problems in primary care. Nadine now leads a portfolio of research focused on clinical trials and intervention studies to test approaches for patients with common musculoskeletal problems and has been supported by a wide variety of NIHR awards and programmes throughout her career to date. In contribution to the ongoing management of NIHR schemes, Nadine has previously served on the EDaPT (HTA Programme) expert advisory panel, now Preventive Interventions TIDE panel at the HTA and is also Deputy Chair of the NIHR/HEE Integrated Clinical Academic programme for nurses, midwives, AHPs, pharmacists and clinical scientists (TCC).
Current Research: Professor Foster leads a large research theme focused on Musculoskeletal Health in Primary Care at the Arthritis Research UK Primary Care Centre in Keele.
Impact: (From Growth booklet):
Nadine Foster is an NIHR Research Professor and Chartered Physiotherapist who has successfully developed her career by means of NIHR funding. With the support of the NIHR Primary Care Research Network, Professor Foster led a study which examined the implementation of stratified care in patients with low back pain - the IMPaCT Back study. In the UK, back pain accounts for 6-9% of consultations with a GP. Many of these patients report pain and disability a year later. The study’s results showed that stratified care led to better results than standard care. Stratified care led to a reduction in the number of sickness certificates issued for back pain patients, a halving in the number of days lost from work, and improved physical function for patients. The cost-effectiveness analysis showed that stratified care is associated with an average saving of £34 per patient to the NHS. When taking into consideration the results on days lost from work, an average saving of £400 per employed patient to UK society was possible. Roll-out of stratified care has been significant, with many NHS services implementing the screening tool and matched treatment options. It is estimated that use of the screening tool in general practice could potentially provide savings of more than £700 million if implemented.
Nadine has reviewed and approved this slide and notes for use 08/11/15
NIHR Programme Grant (Co)
National School of Primary Care
NIHR Programme Grant (Chief)
MRC/EME (Co)
HTA (Chief)
HTA (Co)
HTA (Chief)

20. NIHR Evaluation, Trials and Studies Coordinating Centre (NETSCC)
Dr Kay Lakin
Research Manager – Impact

21. NIHR NETSCC: remit NETSCC manages evaluation research programmes
Hosted by the Wessex Institute at the University of Southampton
Funding programmes:
Efficacy and Mechanism Evaluation (EME)
Health Technology Assessment (HTA)
Public Health Research (PHR)
Health Services and Delivery Research (HS&DR)
Systematic Reviews (SR)
Commissioned and researcher-led research
NETSCC – hosted by the Wessex Institute (Faculty of Medicine) at the University of Southampton
We manage evaluation research that is relevant to the NHS and public health sector
You may know that we manage five funding programmes:
Efficacy and Mechanism Evaluation (EME) which is joint funded with Medical Research Council
Health Technology Assessment (HTA) – the oldest and largest of our funding programmes
Public Health Research Programme (PHR) – research outside of the NHS setting
Health Services and Delivery Research (HS&DR)
Systematic reviews (SR)
All except Systematic Reviews have both a commissioned and researcher-led work stream
NIHR Dissemination Centre
James Lind Alliance
INVOLVE – the national advisory group that aims to bring together expertise, insight and experience in the field of public involvement in research, with the aim of advancing it as an essential part of the process by which research is identified, prioritised, designed, conducted and disseminated.
Southampton Health Technology Assessments Centre – undertaking technology appraisals that inform the NICE processes and other health research.
We also provide support to a number of schemes designed to stimulate excellence and support capacity building in health and social care research in Wales.

22. NIHR NETSCC: remit
NETSCC also manage or undertake a range of other activities:
NIHR Centre for Business Intelligence
Support for Clinical Trials Portfolio and Clinical Trials Units
Public Health Overview
Research on Research programme
Publish the NIHR Journals series:
Focus on adding value in research
As well as managing the five funding programmes, NETSCCs manage a range of other activities:
For example, we have small team that support management of the clinical trials portfolio and provide oversight into the NIHRs investments in public health research – the Public Health Overview. We also manage the NIHRs support for Clinical Trials Units.
We have an internal programme of research on research that aims to provide robust evidence in order to inform and improve research management and commissioning processes; to support the activities of the NIHR in areas of innovation, impact and adding value; and to build the skills, capacity and interest of the NIHR to improve the delivery of the research management function.
We manage the editorial process and publish the NIHRs journal series that are available via the NIHR Journals Library website; and all of our work has a focus on reducing waste and adding value in Research.

23. Impact assessment (NIHR-wide)
Mapping the non-academic impacts of public health
I’m a Research Manager – impact at NETSCC. As part of my role, I explore the impact of the research funded through NETSCC, as business demands.
Recently I’ve been involved in two concurring assessments looking at public health research funded through NIHR. The first was commissioned and funded by the Department of Health through PRiSM (Policy Research in Science and Medicine) and looks at NIHR-wide Public Health research. The second was commissioned through the Public Health Research programme focusing on impacts on policy and practice.
The aim of the first assessment is to understand and map the diversity of impacts from public health research. The Public Health Overview dataset, which is managed by NETSCC was the portfolio of research evaluated. The PHO data-set includes all NIHR-funded studies that have been classified as public health, under NIHR’s definition.
As an externally commissioned piece of work we needed to find a space where we (PRiSM and NETSCC) could work together while at the same time, maintaining the independent integrity of the work. In order to achieve this, PRiSM drove the overall planning and process for analysis, identifying broad trends and patterns in the data, providing the focus for the work. We (NETSCC) coordinated and managed access to requested data. Maintaining links in this way, offered the possibility to identify early on where there were overlaps in the case study work between the two impact assessments, and where there were, joining forces with case study collection.
Shows the potential to join up and maximize the value of interconnected activities each focusing on a different aspect of the NIHRs investments in public health research
The second piece is on Public Health Research programme, and is ongoing. This is being undertaken within NETSCC and is co-produced piece between impact and public health overview
Advocacy (and some analysis) with a lens on policy and practice
1. Portfolio analysis – 117 projects
2. Impact Statements: completed portfolio
currently applying to ethics at the university of Southampton
Forthcoming
3. Interviews with selected Principal Investigators
4. Impact Case studies
5. Impact assessment report
Information used by programme, shared with other funders, case studies to be used at conferences and at part of the 10th anniversary of the programme in 2018.

24. Invention for Innovation (i4i)
Saima Nayab
Senior Programme Manager

25. i4i i4i: Who we are, what we do NIHR translational funding scheme
Support collaborative R&D and clinical adoption
Focus on innovative medtech solution
i4i
De-risk projects for follow-on investment
Patient benefit
i4i is a translational funding scheme, supporting collaborative R&D projects of innovative healthcare technologies in the healthcare sector, with the aim of advancing their translation into the clinic for the benefit of patients.
We support collaborations between universities, companies, in particular SMEs, and NHS organisations.
The aim is to de-risk projects and make them attractive to follow-on funders and investors. We are keen to fund innovative technologies which are too early to be funded by venture capital or private equity.
The central focus is patient benefit.
Led by Programme Director, Martin Hunt
Supported by a team of Programme Managers

26. i4i monitoring process Contracting Monitoring Post-project monitoring
Due Diligence
Impact
Science scrutiny
IP & Commercial scrutiny
Financial scrutiny
Legal scrutiny
Periodic catch up
on advancement and generated impact
Contracting
Monitoring
Post-project monitoring
Enabling Delivery
We recognise that impact must be embedded in the research at the earliest stage as possible and we are aware that it does not happen right at the end of a project. For these reasons we have a monitoring approach which enable and support delivery of outcomes which in turn might lead to impact. In order to capture it, we plan periodic catch up with the team after the formal end of the project.
Progress and financial reports
Milestone-based payments
Site visits
Research Steering Group
Intellectual Property Management Group

27. 121 projects awarded >200 organisations ~ £90M invested £102M
i4i outcomes
121 projects awarded
>200 organisations
Since 2010, the programme has funded 121 projects investing £90m. We are supporting more than 200 organisations (HEIs, NHS Trusts, Research Institutes and SMEs), half of which are SMEs (which includes lead applicants, co-app and subcontractors) contributing to boost the economic growth and innovation pipeline of the UK. So far, £102m funding from Angel, VC and corporate capital, was leveraged as consequence of i4i support.
~ £90M invested
£102M
funding leveraged

28. Route to adoption & Commercialisation
Impact enablers
Innovation
Impact
enablers 1 2 3 4
Collaborations
Engagement with SMEs
We have recently commissioned a survey on what we refer to as i4i legacy projects, which include around 250 projects funded before 2010 which lead to the i4i Programme in its current form. The exercise will enable us to identify enablers of impact and ensure they are factored in at an early stage in our future processes.
The slide, from our experience, depicts few factors that play a key role in creating socio-economic and clinical (e.g. patient benefit) impact:
Innovation
Collaborations:
Engagement with SMEs
Clear route to adoption and commercialisation
Route to adoption & Commercialisation

29. Summary Development Engagement Effects Academic careers
Clinical professional skills and careers
Engagement
Patients & public
Industry
Clinicians
Allied Health Professionals
Beneficiaries
Researchers
Effects
Health and wellbeing
Service organisation and delivery

30. Activity: discuss…
Opportunities
Development
Engagement
Effect

31. Over to the panel…
Ben Morgan | Research for Patient Benefit (RfPB) funding scheme
NIHR Central Coordinating Facility
Helen Harris-Joseph
NIHR Training Programme
Kay Larkin
NIHR Evaluation, Trials and Studies Coordinating Centre
Saima Nayab | Invention for Innovation (i4i) funding scheme
Julie Bayley | ARMA Impact Special Interest Group
Coventry University