Award Title: NIHR Applied Research Collaboration West
Funder: Department of Health and Social Care

Abstract: The overall aim of NIHR ARC West is to engage its partners, and public contributors, in the conduct of collaborative applied health and care research to facilitate the implementation of research evidence and thus improve health and care outcomes. Its ethos is to focus on research and implementation that is equitable (fair), appropriate (providing optimal care at the right time and place for prevention or care), and sustainable (taking account of resource-use and future continuation). This will be delivered in ARC West by focussing on four key research themes identified as of crucial importance for the population in the West and nationally, and reflecting local health and care system priorities and substantive research strengths: Public health and prevention, Mental health, Integrated and optimal care, and Healthier childhoods. Each theme is led by a practising clinician or public health practitioner with strong research interests and clear understanding of the pressures of working in front-line clinical, public health and social care practice.     Research and implementation projects in the four research themes will be delivered by ARC research staff, working closely with health and care practitioners and supported by academics with strong methodological expertise and experience of implementation and multidisciplinary applied health and care research in four cross-cutting methodological themes: Behavioural and qualitative science, Applied data science, Health economics, and Evidence. The cross-cutting themes will ensure the conduct of high quality research and employment of robust methods for implementation and evaluation.     The identification of appropriate topics and delivery of outputs and impacts are enabled by the inclusion of Health Integration Teams (HITs) – a model unique to the West, developed by Bristol Health Partners and CLAHRC West to promote integrated care by bringing together all relevant stakeholders (see attached summary). HITs have worked across system boundaries to develop new patient pathways, introduce and evaluate service changes (e.g. increasing liaison psychiatry hours, teleclinics for kidney transplant follow-up), coordinate services in particular areas (e.g. dementia, sexual health), improve aspects of public health (e.g. increasing activity in older people, preventing child injury, improving neighbourhood environments), and support vulnerable groups (e.g. problem drug users, children with multiple adverse experiences).      ARC West will employ this strategy to address the following objectives:     Short-term objectives (1-2 years) are to:       Work with our partners in the local health and care system, particularly STPs, ICS and WEAHSN, to implement evidence-based interventions, innovations and service changes in collaboration with HITs, and evaluate promising developments of local relevance scalable for national impact  Participate in nationally-relevant evaluations of interventions with the AHSN national network to improve outcomes for patients and the public  Increase public involvement in research and implementation, and collaborate with communities to better reflect the diversity of our population and its needs in our work  Encourage the inclusion of quantitative, qualitative and economic evaluation whenever interventions are introduced in local health and social care settings  Identify shared interests with other ARCs to plan collaborative research  Ensure that existing evidence is reviewed and considered before ARC projects are initiated or implementation occurs  Increase the understanding and use of research evidence in health and care practice, with additional support for allied health professionals      Medium-term objectives (3-4 years) are to:       Develop methods to integrate health and social care data to facilitate embedded evaluation of service changes and evidence implementation  Develop methodological innovations to evaluate promising interventions for effectiveness and efficiency, and optimise health outcomes  Develop understandings of the process of implementation and insights into how to make interventions more efficient through application of innovative methods  Develop mixed methods evaluations for local or national implementation of digital platforms across our research themes in collaboration with the WEAHSN, other ARCs and HITs.  Develop and evaluate effective and acceptable methods for de-implementation      Long-term objectives (5+ years) are to:       Develop the potential of integrated data from health and social care through linkage and triangulation resulting in more rigorous evaluation approaches, routine policy monitoring and improved patient outcomes.   Participate in nationally-relevant evaluations of interventions and service changes with improved outcomes for patients and the public  Ensure sustained implementation of effective and efficient interventions and services by working in partnership with local and national commissioners and service-providers      The ARC research themes were chosen to reflect the needs of the population and health and care system priorities:     Public health and prevention: to respond to the prevention agenda in STPs and to focus on areas of importance to public health practitioners     Mental health: to address local concerns about high rates of suicide/self-harm and common mental disorders     Integrated and optimal care: to reflect the requirements of the STPs/ICS in our area for service/pathway integration, increased efficiency and sustainability, better inclusion of social care, and to develop person-centre care for those with multi-morbidity     Healthier childhoods theme: to prevent and reduce the impact of adverse childhood experience and to reduce the burden of and inequalities in common childhood illness     We will monitor progress and measure success in relation to outputs, outcomes and impacts. Outputs will include publications, successful funding applications, wider adoption and roll-out, delivery and uptake of training, and number of co-funded collaborations. Outcomes will include number of successfully implemented interventions and/or evaluations, and value of co-funding for ARC research projects. We will measure impact as evidence of adoption of effective interventions (or de-implementation for ineffective interventions), inclusion in national guidance and attributable health improvement in patients and the population.     The translation of research findings into improved health and care practice will be facilitated by the presence of practising practitioners as director, implementation lead, and research theme leads and the involvement of HITs that are fully embedded in the local health and care system. The successful implementation of effective and cost-effective prevention and care, more effective implementation of evidence-based guidelines, and the development of interventions to accelerate the uptake of robust evidence are ARC West s proposed methods for improving the sustainability of the health and care system and patient and the public outcomes.

Lay Abstract: ARC West is a partnership between the organisations and individuals that provide, plan and support health and social care in the West of England alongside the public that use these services and four local Universities, each with a world leading reputation in research to support better health and social care services and improvements in patient and public health. The “ARC” West Applied Research Collaboration has evolved from the “CLAHRC” West Collaboration for Leadership in Applied Health Research and Care. ARC West aims to ensure that the health of our citizens is as good as the best anywhere, and that the care they need is provided fairly and at the right time and place.  We will support services that give value for money, are affordable in the local economy and effective in improving health and reducing health inequalities.     These aims are focused on four broad themes, chosen because they are particularly important for people in the West and we have an international reputation for carrying out research in these areas. We aim to improve sexual health, reduce problems related to addiction to tobacco, alcohol and illegal drugs, and promote healthier lifestyles through the Public health and prevention of ill health theme. An Integrated and optimal care theme aims to enable joined up and improved person-centered care for people with multiple health problems and to ensure frail and older people are better supported in the community, reducing their need for hospital care. We have a Mental health theme to improve services for people with common mental illness such as depression and anxiety and reduce levels of self-harm and suicide, particularly in people facing economic hardship. Crucially, we have a Healthier childhoods theme, to focus on improving care for the most troubled and vulnerable children and families and providing better care for the prevention and treatment of common childhood illness. ARC West will achieve these aims by conducting the most relevant health-related research and by making the best use of information collected by public services.     We will work with local  Health Integration Teams  (HITs). HITs include public health and NHS practitioners, scientists, and public contributors who decide which parts of health and healthcare systems need to be improved, and then carry out research to discover the changes that could make most difference to people s health and well-being. We will include public contributors in all our work and seek to attract new people to represent our local communities. There will be courses and other training provided to help health and care staff put research evidence into practice. At ARC West we have formed strong partnerships with health and social care leaders and decision-makers committed to using evidence effectively.  Together with patients and the public, we will improve and re-organise services locally providing a blueprint for national service improvement. High quality research provides the clearest opportunity to improve health and care.  We have developed the ARC West proposal to make best use of all our resources to improve health and well-being locally and nationally.

Research Activity Codes: 5.9 RESOURCES AND INFRASTRUCTURE (TREATMENT DEVELOPMENT);6.9 RESOURCES AND INFRASTRUCTURE (TREATMENT EVALUATION);7.4 RESOURCES AND INFRASTRUCTURE (DISEASE MANAGEMENT);8.4 RESEARCH DESIGN AND METHODOLOGIES (HEALTH SERVICES)
Health Categories: GENERIC HEALTH RELEVANCE;INFECTION