Title: NIHR Applied Research Collaboration East of England
Funder: Department of Health and Social Care

Abstract: Our overall strategy focuses on fulfilling the NIHR vision and achieving the linked aims of the ARC scheme in the East of England (EoE). We have learnt from the predecessor CLAHRC EoE but will not simply replicate that approach. Our research strategy is to work locally and regionally on nationally and internationally important questions in health and social care (HSC), and to create a vibrant, inclusive infrastructure for applied health and social care research, implementing evidence to benefit citizens and communities. Our values are inclusivity, diversity, engagement, co-production, sustainability and excellence. Guided by national policies and a public health approach, our research themes arise from inclusive, priority-setting events involving the public, PHE, providers, charities, industry, the Eastern AHSN and researchers. Together, we identified important gaps in HSC evidence, matching these to our research strengths. Our research themes are designed to achieve cross-linkages and synergies: Inclusive Involvement in Research for Practice-Led HSC (IIRP) Population Evidence and Data Science Health Economics and Prioritisation in HSC Palliative and End-of-Life Care Mental Health over the Life Course Ageing and Multi-Morbidity Prevention and Early Detection in HSC The danger of spreading our resources too thinly is offset by strong partner support and by sticking to our strategy of using NIHR funds to leverage large-scale, additional research funds from government, industry, the third sector, and other NIHR schemes. The ARC EoE will be a multiplier. We embed public and community involvement, engagement and participation (PCIEP) into everything, as reflected by collaborations with other NIHR infrastructure, and the IIRP theme. We shall deepen our citizen and community engagement, and take a fresh approach to working with industry and the third-sector supported by the Eastern AHSN. Our research capacity building and implementation strategies are supported by our leaders who span organisational boundaries, and by developing communities of practice. Focusing resources on areas with high health need but few opportunities for applied research The East of England population is diverse and socially unequal. It includes dispersed, poor, rural areas such as Fenland; the ethnically diverse city of Peterborough; Britain s first post-war new town , Stevenage, with the settler cohort ageing in increasingly decrepit surroundings; and end-of-the-train-line' coastal towns such as Great Yarmouth with isolated, elderly people, socioeconomically disadvantaged adults, and disrupted families. Even thriving areas such as Cambridge contain individual wards amongst the UK s poorest. Our population strategy is threefold: First, focusing our resources particularly (but not exclusively) on engaging closely with people in four 'populations-in-focus', together comprising around 750,000 people. This will promote inclusivity, diversity, co-production and sustainability, as well as creating a nationally valuable population laboratory and test-bed for innovation and implementation. Endorsed by Directors of Public Health (see letter of support) these populations-in-focus are: City of Peterborough and Fenland; Great Yarmouth and Waveney; Stevenage; Thurrock Each is socioeconomically distinct with particular health needs for children, families and older people. With NIHR Clinical Research Network (CRN) Eastern, we shall concentrate research infrastructure and opportunities in this population laboratory . Second, we shall extend the population demographic through arrangements with NIHR ARC South London, systematically and reciprocally extending projects into the other region, where appropriate. Third, we collaborate widely. With ARC South London, we propose leadership of two national research collaborations: mental health where ARC North West Coast and ARC East Midlands will join us first as we extend this; and Palliative and End of Life Care, also with ARCs South London, North West London and North East and West Cumbria. There are many other examples. Objectives Pre-October 2019: our CLAHRC EoE extension supports completion of current work and preparation for ARC EoE. We are currently piloting our proposed implementation strategy. The ARC Board and other management groups will convene in Q1 2019; we will continue building our community engagement. Prioritisation of initial projects, governance and ethical approvals will be completed. Years 1-2 Create and nurture new networks between partners and our populations-in-focus to found the population laboratory concept; discuss medium and long-term goals. Prompt initiation of prioritised research projects in Q4 2019. Implementation strategy increasingly embedded through communities of practice (CoPs); board-level champions in each partner. Dissemination strategy implemented, linked to existing and new evidence. Develop applications, additional external research funds, guided by ARC priorities. Industry and Third Sector Liaison Group ensuring increasing engagement in these domains. Capacity development encompassing informatics, data science for practitioners, and implementation methods. National themes established, pending NIHR decisions. Focus on novel measures of success and progress developed, as below, with stretching targets agreed within the ARC. Develop and submit PCIEP strategy Years 3-4 Implementation strategy and leadership now routine business, demonstrably influencing practice and routine decisions about care. Themes co-producing first round and second phase projects and implementation plans. New applied research career pathways, involving academia, service and industry. Industry and third-sector collaborations increasing. External research funding enhancing the ARC, aligned with partner priorities. Evidence-led, novel HSC developments at local and national levels. Plans for next five years drawn-up. Long-term (5+years) To achieve a nationally impactful, self-sustaining culture of collaborative applied health research embedded in the region, enhanced capacity and embedded implementation practice. Deep and sustainable engagement spreading from populations-in-focus, measurable improvements in health, established mechanisms for routine evaluation beyond the ARC. Mechanisms for natural experiments and routine evaluations of policy and service developments are the norm in HSC. Measuring success The ARC will collect key performance indicators including the extent and diversity of funding sources; collaborations; research outputs; implementation and impact; effects on HSC policy and decisions; and economic benefit. We will adapt the CLAHRC measurement platform (https://clahrceoe.switchstancehq.com/login.php) and input metrics routinely. Our population evidence and data science theme will enhance public health intelligence. Our preference is for independent evaluation, as achieved for our CLAHRC Fellowship scheme (http://www.clahrc-eoe.nihr.ac.uk/wp-content/uploads/2018/05/CLAHRC-EoE-Fellowship-Full-Report-Final-Feb2018-v3.1-Compressed.pdf) through partner and NIHR views. ARC EoE will also develop new approaches to reflect our collaborations with citizens, and our emphasis on implementation. We shall use our CoPs and adapt existing evaluation models and a social impact framework to track the ARC s impact from process to benefits valued by people and communities.

Lay abstract: For 10 years, the East of England has had a Collaboration for Leadership in Applied Health Research and Care (CLAHRC East of England). Experts in health and social care research from three universities 'collaborated' with the public and health and social care professionals from across the East of England. Together, they carried out 'applied' research with results that have made a real difference to health services and social care. We are applying for funding to have an Applied Research Collaborative (ARC) in the East of England (EoE). This will be a partnership of four universities and providers of health and social care services in the East of England. It will build upon the good work and successes of CLAHRC EoE. We will work together to plan and carry out health and social care research in the best possible ways. The ARC will cover Cambridgeshire and Peterborough; Norfolk; Suffolk; Hertfordshire; Essex; and parts of Bedfordshire. We will concentrate our research on four 'populations-in-focus', communities where people have high health needs. This may be due to being poor; lacking opportunities; having many different illnesses; or difficulty getting the care they need. Our research areas will include mental health; ageing; dementia; learning disabilities; end of life care; and managing multiple conditions. We will span different age groups from young children to the oldest old. Our health economics research will look at the cost-effectiveness of care and treatments. We will develop the best ways to involve the public (including patients and carers) in our research to make sure our research is sensible and relevant. ARC EoE will fund research training for health and social care professionals, and help front-line staff learn how to change their practice using research. Our Boards and Committees will steer ARC work and manage budgets and activities. These groups will include public members to make sure we act in our communities best interests. We will also work closely with other organisations that fund health and social care research to help us achieve our aims. Short-term: We will set-up new research projects in our different research areas. We will use new ways of working between universities and services that will help put our findings into practice. We will develop our training programmes and explore other ways to support career development. Medium-term: Our research will produce results which we will share widely. We will run a strong and varied programme of training, nurturing staff confidence to carry out health and social care research. Processes will be in place to start putting our findings into practice in meaningful ways. Long-term: Our research will be making improvements to health and social care services. Our training programmes will have built a workforce of research-active staff. We will have established new ways to meaningfully involve the public. We will have strong links across our communities and with top-decision makers to share our good work. Overall, we will be making a difference regionally and throughout the country that will last into the future.

Research activity codes: 7.4 RESOURCES AND INFRASTRUCTURE (DISEASE MANAGEMENT);8.5 RESOURCES AND INFRASTRUCTURE (HEALTH SERVICES);6.9 RESOURCES AND INFRASTRUCTURE (TREATMENT EVALUATION)
Health categories: GENERIC HEALTH RELEVANCE;NEUROLOGICAL