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

Abstract: In April 2016, Greater Manchester (GM) took control of the £6 billion health and social care budget for its 2.8 million inhabitants. This new system, led by the GM Health and Social Care Partnership (GMHSCP), brings together the NHS, local authorities, charities, voluntary and community groups to transform the way public health and care services are designed, commissioned and delivered. These partners are our partners for NIHR ARC-GM. Health and care services are being redesigned around local communities, with greater emphasis on prevention, on closer integration, and on public health through greater alignment with other public sector services such as transport, housing, community development, and education.  The population of GM has substantially worse health than most areas of England; for example the highest avoidable mortality rate, poorer healthy life expectancy, lower employment, and higher rates of smoking, long-term conditions and mental health conditions. GM also has a rapidly changing health and care landscape in which the devolved health and social care budget presents many opportunities for research. The health and care system faces significant financial challenges and research is needed to inform resourcing strategies and decisions. We have built our NIHR ARC-GM around these themes. Our strategy reflects this GM context and the priorities identified by GMHSCP from extensive engagement with the health and care system and with our diverse communities (via the GM Engagement Framework).  The NIHR ARC-GM will be part of the GM health and care ecosystem, ensuring that its work is directly informed by the needs of both the local population and the health and care system. We will be hosted by Health Innovation Manchester (HInM), whose Board represents the GMHSCP, the GM Provider Federation, the GM Joint Commissioning Board, Local Authorities, universities and industry. These stakeholders also co-fund HInM and HInM works with them to create one integrated system which both supplies and demands innovation. The role of HInM is to accelerate innovations through evaluation and support the rapid implementation of those that are cost-effective and likely to contribute to wider economic gain (Figure 1).    Our over-arching goal is to improve the health of the GM population and the quality and sustainability of the health and social care they receive. We will achieve this by co-producing excellent research in areas prioritised by the system and by enhancing its impact through supported implementation into policy and practice. Our broad research themes reflect the specific priorities of GM and resonate nationally; they will have enduring relevance and they reflect where GM has research expertise committed to making a difference in GM.  Our research themes of Organising Care, Economic Sustainability, Mental Health, Healthy Ageing and Digital Health are complemented by cross-cutting themes of evaluation methodology and implementation science. We will ensure cross-fertilisation and synergy by ensuring each project connects a minimum of one research theme and one cross-cutting theme.  In moving from CLAHRC to ARC we have moved from  doing  implementation towards  supporting and researching  implementation in order to enhance the embeddedness and sustainability of evidence-informed change within the local health and care system.  Co-production is at the heart of our approach; that is researchers, practitioners and the public working together throughout the entire research process, because we know that this makes the uptake and impact of research more likely. We will work with our partners to translate their strategic priorities into answerable research questions, ensuring that co-produced research is relevant, useful and applicable to local service needs and achieves impact on policy and practice within GM and beyond.  Within 6 months we will:    Embed within HInM; establish our core infrastructure, monitoring procedures and governance structures; inform HInM s implementation strategy.  Develop ways of working with partners, the public and communities across GM; establish ARC-GM s position within GMHSCP and HInM consultation and prioritisation processes.  Deliverables: joined-up systems; co-development of a theoretically- informed, evidence-based implementation strategy for HInM.      Short-term objectives (0-2 years):    Establish our public and community involvement, engagement and participation (PCIE) panel and co-produce terms of reference and a full PCIE strategy; ensure research themes have meaningful and appropriate plans for PCIE. Deliverables: an effective PCIE strategy with PCIE embedded in each theme;  Establish our five research themes with engagement of local organisations and communities; co-produce excellent, relevant research. Deliverables: research and outputs progressing against milestones; demonstrable involvement and engagement in shaping the research; undertaking planned dissemination;  Establish research capacity building. Deliverables: Five PhD students competitively recruited and integrated into research themes; a comprehensive GM NIHR Academy Members' and Associates' Network of pre-doctoral, doctoral and post-doctoral students and early career researchers;  Begin collaborative research with other NIHR ARCs in areas of ageing and frailty, mental and physical multimorbidity, health economics and knowledge mobilisation. Deliverables: Joint projects underway; an area of national ARC leadership established;  Work with the GMHSCP to develop the evidence to support the case for further devolution from 2021. Deliverable: research evidence integral to the case and wider learning for ICSs with embedded innovation systems.      Medium-term objectives (3-4 years):    ARC-GM will be a high-performing research and implementation partner in GM, with a reputation for providing relevant, actionable research in high priority areas;  Co-produced research will have produced knowledge being actively implemented;  Our implementation science expertise will have influenced the roll out of innovation in GM;  Ensure added-value by each research theme securing external funding for at least two new research projects;  The work of NIHR ARCs nationally will be visible and influencing policy.      Long-term objectives (5 years+):    GM will be known internationally for integration of excellent research into the health and care ecosystem, and for the difference the research has made to NHS and social care planning, delivery and health outcomes;  NIHR ARC-GM will have an effective implementation strategy adopted in GM and beyond;  Sustainable funding of NIHR ARC-GM by GM partners, NIHR and other research funders;  Research capacity increased including a minimum of five doctoral graduates with supported transition to postdoctoral status;  Career advancement opportunities for NIHR ARC-GM early career researchers.  Greater capacity in the health and care ecosystem to evaluate and implement sustainable innovations.

Lay Abstract: Although Greater Manchester has many strengths, people here have poorer health and die earlier. These are particular problems for disadvantaged groups.     The organisations in Manchester have come together in the Greater Manchester Health and Social Care Partnership to tackle these challenges. In 2016, we became the first area to take charge of its £6bn annual budget for health and social care, taking control to better support local people.     To make the right decisions, the Partnership needs accurate information at the right time and research can provide this information. Even more importantly, we must ensure this research is used.     Our Applied Research Collaboration (ARC) will bring together researchers and health and care providers to do great research which can be used to improve health.     The Partnership has created a new organisation called  Health Innovation Manchester  (HInM) which joins together researchers, the health and care system and other partners, such as industry.  HInM discovers new ways of delivering care and getting them into practice.     The Greater Manchester ARC will be part of HInM, to help meet this goal.        What will our new ARC do?       First, everything we do will involve working closely with patients, the public, professionals, charities and industry, to ask the right questions and give useful answers.     Second, we will draw on the wide range of expertise available locally to understand and address health problems and needs.     Third, we will focus on doing high quality research around the needs of local people, and helping services make changes to care.     We will focus on five themes, which we know are important in Greater Manchester:     1. How can we help older people stay healthy and happy for longer?  2. How can we organise services to better meet people s needs?  3. How can we prevent mental health problems and help people get and stay well?  4. How can we ensure that local services remain affordable in the long-term?  5. How can we use the latest technology to help achieve all this?     All these questions are also relevant nationally. We will work with other ARCs on research and on spreading good ideas widely.     We also have two themes to support all our work, exploring new ways to do high quality research, and developing new methods to help people put ideas into practice.        What do we aim to achieve?     In the first 1-2 years, we will work with all our partners, and with the public, patients and carers, to start the right research to solve local and national problems.     Within 3-4 years, we will make a big difference to helping HInM achieve its goals, by doing high quality research and making sure the results are used, as well as supporting others to do the same.     Within 5 years, we will be known as a leader in research that makes a difference to people s lives locally and more widely.     Devolution means Greater Manchester is in a unique position to make a difference locally and nationally. Our ARC will be a major contribution to making that happen.

Research Activity Codes: 7.4 RESOURCES AND INFRASTRUCTURE (DISEASE MANAGEMENT);6.9 RESOURCES AND INFRASTRUCTURE (TREATMENT EVALUATION)
Health Categories: MENTAL HEALTH