Title: NIHR Applied Research Collaboration North Thames
Funder: Department of Health and Social Care

Abstract: NIHR ARC North Thames will be a collaboration between six leading universities (UCL, LSHTM, QMUL, LSE, City, UEL (see List of Partner Acronyms)), our AHSN (UCLPartners), our region s NHS and local authority (LA) organisations and communities, industry and charities. Our vision is to achieve significant advances in tackling the major challenge of our times: how to reconfigure services (in response to the Five Year Forward View) to achieve sustainability and improve outcomes, within the context of austerity, widening inequalities, complicated digitisation and escalating demand driven by socio-demographic change, multi-morbidity and innovation. We will capitalise on opportunities presented by our socially and ethnically diverse population, varied service delivery models (which differ in maturity across six STPs); and world-leading research strengths and capacity. We will guide transformation through: (i) listening to and learning from all our stakeholders needs and perspectives; (ii) involving stakeholders throughout adaptive research/implementation processes; (iii) creativity stimulated by interdisciplinarity and methodological innovation; (iv) integration of applied health research (AHR) into the health and care system. Our approach will generate directly useful, outstanding research and support for evidence- based implementation, shaped locally and of national importance. We will establish infrastructure for: directly relevant research to promote sustainable health and care systems, improved outcomes and reduced inequalities; national research partnerships involving varied perspectives to increase impact at pace and scale; thriving public and community involvement; building new research leaders, expert in novel techniques to support the changing environment; attraction of significant additional funding. To achieve our goal, we will build on our current CLAHRC s strengths, notably the exceptional level of collaboration established between customarily competitive universities and across sectors with different priorities, pressures and perspectives. Our shared vision and track record in adhering to the approach described above, has allowed our collaboration to flourish. We will now expand to address NIHR s ARC remit by: including LSE s world leading social care/mental health economics research expertise and City s allied health professionals research strength; enhancing interdisciplinarity; training a new generation of researchers in cutting-edge methods; maximizing public and community involvement; better tailoring of outputs to meet diverse stakeholders needs. As well as forging links with other ARCs, we have established a Tri-ARC network with PenARC and YHARC to systematically embed national applicability into our work through collaboration from inception. We organise our work into four Research Themes (Mental Health; Multi-morbidity; Population Health and Social Care; Innovation and implementation Science) and one Cross&ndash;Cutting Theme (Health Economics and Data). These Themes and the studies they include were selected in response to extensive, multifaceted engagement with our service and user stakeholders. We will continue to responsively address emerging concerns, prioritised using our structured, transparent process (Figure) and leading to co-produced robust, implementable research or to pilot/modelling/systematic review to provide the case for further (external) grant funding. Both involve our service partners, leadership and multidisciplinary Research Partnership Team (RPT), key researchers and patients/communities. This approach achieved significant dividends in our CLAHRC. Our short term objectives are to: Refresh/strengthen governance, monitoring, engagement and dissemination arrangements, and Public and Community Involvement, Engagement and Participation (PCIEP) strategy, in view of our: transition from CLAHRC to ARC; inclusion of new partners; heightened focus on interdisciplinarity, population health and social care research; and support for AHSN/local priority programmes. Agree plans for delivery of Tri-ARC network goals and stronger links with other ARCs. Initiate Theme research and continue stakeholder engagement for generation of additional research proposals and to support evidence implementation. Continue to publish, disseminate, implement CLAHRC research and where appropriate, submit for further external funding. Establish our ARC Centre for Capacity and Capability Development (CCCD): deliver courses, mentoring scheme, PhD supervision. Establish/strengthen links with: regional digital infrastructure (One London, HSDRUK-London, UCLH-Turing Partnership, digitally enabled LAs); NIHR Policy Research Units; charities/non-NIHR research funders. Develop our National Leadership role. In the medium term we will: Increase research quantity, quality, relevance and range, through local/national engagement and external grant funding. Deliver Theme, Centre for Capacity and Capability Development (CCCD), Public and Community Involvement, Engagement and Participation (PCIEP) objectives. Disseminate outputs tailored to stakeholders needs. Begin to implement findings. In the long term we will have established thriving infrastructures across and beyond our region in: Interdisciplinary AHR partnerships in and with populations at most need. Support for implementation with demonstrable improvements in health, services and sustainability of the health and care system. Examples are planned to include: reduced inequalities in mental health service provision across the life-course; improved frailty detection and management; reduced inappropriate polypharmacy; use of data linkage (including across NHS/LAs) to inform commissioning of integrated health and care and to improve prevention; recommendations for LA action on social care, pollution, food environment, gambling addiction and knife crime; evaluations of costs, benefits and demand implications of digital innovation; economic evidence for decision making; implementation toolkit for diverse contexts and settings. Capacity/capability building: including supporting emergence of AHR leaders in novel methods. Public and Community Involvement, Engagement and Participation (PCIEP): including a Tri-ARC research platform. Tailored dissemination and engagement. AHR support for regional digital infrastructure. and Leveraging significant external research funding. Measuring success and and demonstrating progress Our success criteria are: PCIEP/partner co-produced improvements in health, inequalities and service outcomes; implementation of evidence based practice; better use of data; local evaluations that influence local decision making (funded eg by AHSN); peer reviewed publications; conference presentations; prestigious external grants (all with PCIEP authors/co-applicants); PhDs completed; competitively awarded allied health, clinical and researcher Fellowships/studentships; demand for and highly rated PCIEP co-delivered CCCD courses/mentoring schemes; CCCD alumni academic career progression. Progress will be demonstrated using tools developed by CLAHRC North Thames: our monthly monitoring tool provides transparent indicators of research progress; individualised quarterly bar charts compare chief investigator s publication outputs (total and with NIHR acknowledgement) with anonymised colleagues; Nuggets (interim findings of relevance to stakeholders, communicated in meaningful language to meet diverse partners needs. By providing this regular and highly valued feedback, we ensure productive, continual engagement). We will also monitor: research ideas from partners (and their progress); establishment, progress, outputs and outcomes of new networks/alliances (including from underserved communities).

Lay abstract: NIHR ARC North Thames will be a partnership of leading universities, the NHS, councils, patients, communities, charities and industry who share a commitment to improving health and social care services, and people s health. Working together, we can identify the health and care problems that most concern everyone, design innovative research in response and then rapidly put findings into practice across our region and beyond. We will join similar partnerships, for example in Yorkshire, and the South West, so that our findings are widely applicable and have a national impact. We will focus on five Themes: Mental Health: 25% of people are affected annually and many suffer from treatment inequalities. We will examine the causes and test better prevention and management approaches. This will increase fairness in provision and more effective, linked, efficient care for all ages, the socially excluded and ethnic minorities. Multi-morbidity: 54% of people over 65 have multiple health problems. This is projected to rise by 14% by 2035. We will examine socio-demographic differences in service use, experiences and outcomes; and test ways to reduce inappropriate prescribing, improve frailty detection, the quality of treatments within NHS settings and connections of services across settings. Population Health and Social Care: We will help councils decide how best to apply their powers and provide services to promote health and wellbeing. We will examine persistent problems (child health inequalities, impacts of multiple disadvantage, pollution, sustainable social care) and emerging issues (gambling, knife crime). Innovation and Implementation Science: We will evaluate new models of care, digital technologies, and approaches to improving health system performance. We want to improve implementation in diverse settings, provide frameworks and tools for practitioners, and reduce the delay between innovation and its inclusion into everyday practice. Health Economics and Data: This cross-cutting Theme supports the other Themes to make better use of advances, including data linkage for examining interventions and variations in outcomes due to multimorbidities; measuring value for money eg of new care models at the end of life; novel ways of combining data for policy-makers and providers. We will begin by building on existing processes, structures and networks that work well (eg involving everyone relevant in the entire research process, from national policy makers to local providers and users); embedding new partners; designing national collaboration into our core arrangements; and forging new links eg with digital specialists like One London. In the medium term, we will share findings and support partners to put them into practice; address emerging priorities; win additional grant funding and demonstrate the value of our teaching and training activities. After five years, we will have contributed to: higher quality, fairer, better linked services which address individual s complex needs, and improve their outcomes and experiences. We will have structures for: research involving different views to increase impact, supported by thriving public and community involvement and new research leaders, expert in cutting-edge skills. We will continue attracting funds for further research and implementation support, and adapt our findings for different audiences needs.

Research activity codes: 5.9 RESOURCES AND INFRASTRUCTURE (TREATMENT DEVELOPMENT);7.4 RESOURCES AND INFRASTRUCTURE (DISEASE MANAGEMENT)
Health categories: MENTAL HEALTH