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

Abstract: Building on CLAHRC-NWC s legacy, ARC-NWC focuses on addressing the considerable health inequalities across our region. This requires inter-disciplinarity with wide engagement of residents working alongside the professionals planning and providing health and social care, and academics. Therefore we have further expanded our consortium of Universities, Health and Social Care providers, Public/Community Advisers, Charities, and Commissioners, enhancing responsiveness to diverse needs, to achieve step-changes in delivering evidence-based improvements in health and social care that address regional and national priorities and effectively reduce health inequalities. Initially we shall always systematically interrogate existing evidence, identifying areas of uncertainty or conflict, before undertaking new applied research or proactively implementing relevant research. ARC-NWC s infrastructure embeds co-production with Partners and full public participation within communities of learning and practice, supported by our academic resources. ARC-NWC will deliver high-quality applied research and implementation projects, strategically aligned through our Research Development, Delivery and Implementation Pipelines (diagrams 2&3), encompassing robust systems for co-conception/production/delivery and Partner prioritisation, mainstreaming health inequalities. This ensures our programmes are attuned to Partners  priorities and the needs of the varied communities they serve, adapting to the challenges posed by structural change within the 10-year plan including Integrated Care Systems, Universal Personalised Care, the new GP contract and associated reorganisation. To ensure sustainable excellent innovation, we will concentrate on supporting small to medium-sized self-contained studies, cross-ARC programmes and pump-priming competitive collaborative applications for external funding. Our research themes have been co-produced with Partner and Public/Community Adviser involvement, and are supported by clear simple structures co-designed to facilitate involvement. Our themes address key challenges for health and care:  personalised care complexity, population health, and place-based health systems. Cross-cutting themes have been chosen to apply academic excellence to support programme-wide activity. Our Implementation and Capacity-building team will ensure research findings inform changes to practice and policy to maximise health and care outcomes. Supported by the Innovation Agency, we will work with industry to drive regional economic growth. Objectives: Short-term We have widened our collaboration to include primary, social care and third sector providers, STP/ICSs and charities. This is occurring incrementally as new NHS and LA structures emerge and we target specific areas for increasing engagement, particularly in social care; it ensures we work with areas of greatest need, and builds on the expanding CLAHRC-NWC collaborations. We shall use the number of new collaborators (e.g. project participation and leadership, committee participation) and the development of a community of implementation champions across NHS and Local Authority Partners as measures of success. Refreshed governance arrangements and policies will be implemented from the outset.  Theme Management Groups will be established, co-developing theme programmes prioritised according to standard criteria agreed across wider collaborations through the Public and Partner Fora. We will co-develop outlines for new partner-initiated projects through 2019 ready for ARC-NWC, as well as identifying CLAHRC-NWC work to continue, using our cross-cutting theme resources (see Themes Organogram). Integration of Public/Community Advisers from the outset, working with relevant ARC-NWC Partner staff and supported by core ARC-NWC academics, will ensure co-production. Prioritised outlines will be co-developed into full proposals, then reassessed including external peer-review (see Pipelines, diagrams 2&3). We will facilitate integration of equity across all of our work through the universal application of our co-developed health-inequalities toolkit (www.hiat.org.uk). Theme Management Groups will collate data on progress, successes, outcomes and impacts in their areas, and monitor co-production, Public and Community Involvement (P&CIEP). We will refresh Theme objectives annually. Building research skills within Partners, Public and Community Advisers is a key aspect of ARC-NWC s strategy. We will offer 25+ PhD and Masters Studentships, to be recruited from year 1; as will recruitment for our rolling programme of knowledge mobilisation internships (over 70 completed in CLAHRC-NWC). Progress measures will include the numbers and diversity of backgrounds of recruits, completion rates, policy/service impacts, publications where applicable, professional destinations, and in the case of the research interns, projects they then conduct within their employing organisations or communities. Prioritised implementation projects (see Implementation Pipeline diagram) will be supported through our evidence-based IMPACT programme, aligned to Innovation Agency and other health and care quality improvement structures. More detail is provided in our Implementation Strategy outlined below. We will collaborate with other ARCs from the outset to maximise synergies. We shall measure progress in joint working with other ARCs by the number of joint projects, grant proposals, associated activity, grant income and co-authored publications, BITEs and other outputs. Medium-term By year three we anticipate consistent Pipelines of co-produced research and implementation initiatives across all Themes. We will evaluate our processes and outcomes using our CLAHRC-NWC evaluation systems adapted in consultation with Partners and Public/Community Advisers. With the large variety of Partners and activities, ARC-NWC cannot be evaluated using traditional academic metrics alone. Some aspects of success can be captured by publications metrics arising from the collaboration, but that would fail to capture much of what ARC-NWC is trying to achieve– empowering our Partners and Communities to co-produce research and implementations far beyond academia. Therefore, in addition the Themes will also be evaluated by, for example, grant applications, BITEs, the flow-through to implementation and impacts, integration of co-production, P&CIEP, and Health Inequalities embedding. We plan a steady flow of external grant applications, awards and outputs arising from theme programmes Longer-term For sustainability we intend that ARC-NWC is engaged in a robust programme of increasingly externally-funded research with established Pipelines to widespread implementation. We will ensure Partner links with NIHR and regional infrastructures to support applied health research are sustainable through collaborative networking developed through ARC-NWC. Our aim is that rolling Research, Evaluation and Implementation cycles will be embedded within our Partners  core expectations to ensure collaborative applied research and implementation is sustainable. The legacy of ARC-NWC will be not just the completed projects, associated outcome benefits and publications, but a co-ordinated, well-connected network of empowered organisations and communities, sustaining Organisational Excellence, with the skills and confidence to continue to co-produce externally-funded work relevant to local needs, targeting health and care inequalities delivering real, lasting change through applied research and implementation.

Lay Abstract: The North West Coast region faces stark health inequalities. Average life expectancy can vary across Local Authority areas/wards by up to 12 years; for average healthy life expectancy this can be up to 27 years. Simultaneously, there are significant barriers to translating discoveries in academic health research into practice which improves lives (Cooksey, 2006). The Applied Research Collaboration North West Coast (ARC NWC) brings together health and social care providers, NHS commissioners, local authorities, universities, public advisers, the Innovation Agency (Academic Health Science Network) and more to address these problems. It will support the development, delivery and implementation of research into practice, enabling real and positive change for patients and the public, with an overarching focus on reducing health inequalities.  We build on the CLAHRCNWC legacy, a successful collaborative programme of applied health research and implementation which has run from 2014. CLAHRCNWC has established infrastructure, connections and novel methodologies to address major challenges in this area. ARC will be an evolution of CLAHRCNWC, strengthened by some of CLAHRCNWC s key outputs, and with a broadened consortium including Primary and Social Care, and the third sector.   Co-production  is key to ARC NWC; projects will involve and in some cases be driven by partners and the public throughout the research life-cycle. This ensures research is relevant to local communities  needs, practical, and shortens the delay between generating research findings and putting them into practice. Our established Neighbourhoods for Learning, a novel approach established by CLAHRCNWC for deep involvement of communities – will ensure co-production. Health Inequalities will remain a core focus of our work, aided by the CLAHRC-developed Health Inequalities Assessment Tool (HIAT) which integrates public involvement and assesses whether activities could potentially deliver a reduction in health inequalities.  The partnership has jointly chosen three research themes reflecting local needs. These are:  Person Centred Complex Care ,  Improving Population Health  and  Equitable Place-based Health and Care . ARC NWC s cross-cutting themes will provide expertise and guidance to support research theme activity:  Care and Health Informatics ,  Methodological Innovation Development Adaptation and Support  and  Health and Care across the Life-course .  NIHR s investment, combined with significant matched resources pledged by partners, will grow infrastructure to support a varied portfolio of projects across each theme to support our aims.  ARC NWC s aims are:    Engage and involve organisations which have a role in, or connection to, health and care service delivery, across social, primary, secondary care, public health and third sectors.  Embed public involvement and health inequalities in all our work, from idea generation to implementing findings.  Further develop partners  and local communities  research and implementation capacities and skills.  Develop a portfolio of high quality applied research which responds to health inequalities.  Support and evaluate implementation of research findings that address health priorities, to increase the sustainability and resilience of health and social care systems, locally and nationally.   Shorten delays between research needs being identified, studied, and findings implemented.  Ensure broader economic gains through increased research investment regionally.  Collaborate with other ARCs and NIHR infrastructure to address national priorities.

Research Activity Codes: 7.4 RESOURCES AND INFRASTRUCTURE (DISEASE MANAGEMENT);8.5 RESOURCES AND INFRASTRUCTURE (HEALTH SERVICES)
Health Categories: GENERIC HEALTH RELEVANCE