Award Title: NIHR Applied Research Collaboration - North East and North Cumbria (ARC NENC)
Funder: Department of Health and Social Care

Abstract: Over the last nine months, we have embarked on an extensive and transparent process of stakeholder engagement, Care System mapping and research prioritisation work. This was informed by our pre-existing detailed regional knowledge of unmet health and care needs and related national policy. Over 300 individuals contributed views including CEOs, practitioners delivering health and social care, commissioners, academics, and adult and youth members of the wider public. Notes were collated and analysed via Word-cloud software and thematic mapping, to identify eight research priorities. These priorities were fed back to a large meeting of over 100 stakeholders (13/06/18). We also ran three Public Engagement events to discuss our process and findings – these were with two adult panels (in Newcastle and Teesside) linked to Voice, our PPI/PPE network, and a Young People s Advisory Group workshop (YPAG). At all events, we sought views on our vision, aims and objectives, priorities and planned mode of working. Finally, our priorities were discussed with the CEO of our emerging Integrated Care System (ICS) and the Medical Director of NHS England (NHSE) (Cumbria and North East) which confirmed that they aligned with regional priorities. Thus, we are confident that our strategy is based upon the needs of our population and Care System, and aligned with the region-wide whole system research strategy recently launched by AHSN NENC (http://www.ahsn-nenc.org.uk/wp-content/uploads/2018/08/RESEARCH-STRATEGY-FOR-NENC.pdf).     Our vision is to achieve:  Better, fairer health and care at all ages and in all places .     We aim to develop and sustain a regionally engaged and responsive network of clinicians, public health and social care practitioners, policy makers, commissioners, VCS providers, lay members and researchers who are all focused on applied research and innovation to prevent illness, improve care and sustainability, promote population health and reduce health inequalities.     Our objectives are to:       Develop region-wide principles of research, co-production and evidence sharing  Promote intersectoral work across all our research infrastructures  Build capacity in evidence generation and knowledge mobilisation  Enhance capability via skill-building and access to experts in evaluation methods  Enable public and patient partners to shape evidence generation and translation  Conduct high quality applied research and implementation for priority health and social care issues  Mobilise evidence to shape innovation with embedded process and outcome evaluation      All research, knowledge exchange and implementation will be focused on our priority Research and Cross-cutting themes. Whilst these were developed through extensive consultation, they are not set in stone. Thus we will review priorities as work progresses and also as our Care System and local populations evolve. We have worked with partners in the Combined Sustainability and Transformation Partnership (STP) for the North East and North Cumbria under the leadership of CEO Alan Foster, which is an aspiring Integrated Care System (ICS), awaiting approval to proceed as an ICS in shadow form (estimated) springtime 2019.     Our Research themes are:    Multimorbidity, Ageing and Frailty (Multimorbidity)  Supporting Children and Families (Families)  Prevention, Early Intervention and Behaviour Change (Prevention)  Integrating Physical, Mental Health and Social Care (Integration)        Our Cross-cutting themes are:    Inequalities and Marginalised Communities (Inequalities)  Assistive Technologies/Data Linkage (Technology)  Evaluating Change with Pace and Scale (Evaluation)  Knowledge Mobilisation/Implementation Science (Mobilisation)     We also have three enabling structures: a Public and Patient (PPI) strategy group; Implementation Advisory Group (IAG); and Training Network.   Research Strategy   Short (1-2 years)      Recruit key administrative posts to successfully manage and deliver ARC NENC  Finalise PPI strategy for the ARC in collaboration with the PPI strategy group  Recruit 11 ARC fellows (one per theme; one each in partner university not leading themes)  Recruit 22 PhD students linked to the Research Themes/Cross-cutting Themes  Conduct work implementing 4 care pathways (Frailty, Back pain, Deteriorating Patient, Child Allergy)  Run the first open funding call for research across the ARC  Appoint 4 Knowledge Mobilisation Fellows through open competition across the care system  Appoint an embedded Knowledge Mobilisation Fellow to specifically support national lead topic work  Appoint 1 ARC/CRN posts to lead applied research delivery across NENC  Plan a multi-modal communications strategy within and across the ARC  Work with other ARCs on areas of mutual interest and/or complementary skills.      Medium (3-4 years)       Deliver early research projects to time and within allocated resource  Refine knowledge brokerage activity and knowledge exchange resources  Disseminate early findings through a range of media, including specific social media channels  Run stakeholder workshops to re-assess research priorities  Hold two more open funding calls for research across the ARC  Develop further care pathways in conjunction with AHSN for roll out/implementation  Review theme network membership against regional priorities and ongoing Care sector co-funding  Implement the ARC PPI strategy and promote co-creation within themes  Host a national conference on our proposed lead topic(s)         Long term (5+ years)       Review success to date with the emerging ICS, AHSN and ARC Stakeholder Boards  Establish ongoing implementation plans to maintain sustainability of research implementation  Produce a best-practice model of how to mobilise and implement evidence in local practice and policy  Prepare for successor funding (and/or develop an ARC Sustainability plan)  Continue disseminating emerging early findings through a range of media, including social media  Lead an international conference/workshop on key areas of cross-ARC research and implementation  Share via relevant networks new learning on applied research methodologies, data capture and implementation  Partner with AHSN NENC in leading a whole-system review of our integrated regional research strategy  Sustain capacity built in the care system (ARC Fellows, PhDs and internships/ training) through securing external research funding and permanent contracts within partner organisations.      Measuring success     During the first three months, Theme leads and the Executive Board will confirm measures of success and risk against their PPI-supported objectives and NIHR requirements: a framework of Care Outcomes including economic indicators; Care Delivery Indicators including economic indicators; Research Excellence including external grants; Public Involvement; Sustainability including capacity building; and Value including co-funding. This will be reviewed at all Executive and Stakeholder meetings. Progress across the ARC will also be reported on: Communication / Dissemination, Cross-ARC Collaboration and progress on care sector plans for Implementation. Metrics for a national role will be determined in conjunction with other ARCs and relevant national bodies.

Lay Abstract: The North East and North Cumbria covers a large geographical area but has a small population of under 3 million people. This region also has the highest rates of poverty (22%), unemployment (12%), poor health and early death in England. For example, premature cancer death rates are 25% higher in the North East than the South East, with particular hotspots in Middlesbrough and South Tyneside. Over 70% of our adults are obese or overweight, particularly in North and South Tyneside. For very young children, the highest rates of obesity are found in rural places like Cumbria. A third of people in the North East do no exercise, compared to a quarter in South East England and we have the highest levels of heavy alcohol use in the country.     It is clear that we have much to do to improve the health of our population and provide care that helps people in this region have the same health outcomes as people in other parts of England. Despite this challenge, the North East and North Cumbria is one of just two areas in England without the earlier version of an Applied Research Collaboration (which have had £5-10 million over the last decade). We prepared for our new ARC by meeting with over 300 people in large workshops, smaller groups and individually. These conversations have taken place since November 2017, and have included a wide range of clinicians and other practitioners leading or delivering health and social care, as well as prevention experts, researchers, commissioners, volunteers, patients, carers and young people s groups.     Key short and medium term priorities stood out during these discussions and have been included as themes in our proposal: care for vulnerable people, especially older individuals with more than one health condition (Multimorbidity); supporting children in early life (Families); keeping people well, rather than waiting to treat complicated health problems (Prevention); and tackling linked mental, physical and social problems together across organisations and near to where people live (Integration). There was particular concern for people living in deprived communities, including those living a long way from hospitals and health centres (Inequality). Many felt that new tools could be developed to help deliver better health and social care, including electronic or digital devices that produce information about people s state of health or their recovery (Technology). Lastly, many people felt that new treatments or ways to support people to remain healthy take too long to become available; they were keen for research to  speed up  (Evaluation) and for evidence to be used by those delivering care (Mobilisation).       These eight research priorities form the basis of our plans going forward. We have assembled teams of researchers and practitioners who wish to work together with lay people to design, deliver and implement research that supports a long term aim of  better, fairer health and care at all ages and in all places  so as to minimise illness and reduce avoidable costs of care in our region.

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