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

Abstract: Strategy and approach of ARC East Midlands ARC-EM will improve patient and service outcomes through the co-production of research of local relevance and international quality and through the implementation of high-quality evidence into everyday health and care. All projects and programmes in ARC-EM will use the complementary approaches of integrated knowledge translation (iKT) and end-of-grant knowledge translation advocated by the Canadian Institutes of Health Research. Intended knowledge users (health and care practitioners, managers, and commissioners as well as patients and the public) will be equal partners throughout the research journey, from project selection through to implementation and diffusion. This approach has been shown to lead to evidence that is more relevant to the intended audiences and more likely to be adopted to improve services and to deliver better population health and well-being. ARC-EM programmes will be delivered through six inter-related themes: (1) Managing multi-morbidity; (2) Mental health and wellbeing; (3) Building community resilience and enabling independence; (4) Data2health (cross-cutting); (5) Ethnicity and health inequalities (cross-cutting); (6) Translating and implementing sustainable service improvement (cross-cutting). These research and cross-cutting themes have been chosen, and their leads selected, to meet the highest priority regional and national challenges in health and care. ARC-EM will address regional and national priorities and generate actionable evidence for specified knowledge users (practitioners, policy makers, commissioners, health and care services, charities, patients, care regulators, and so on). All ARC-EM programmes will have strong commitment from senior service representatives and extensive engagement from broad multi-stakeholder teams with appropriate clinical, managerial, financial, experiential and academic expertise. ARC-EM will conduct pragmatic trials and other high-quality applied research designs to evaluate and implement evidence-informed treatments, therapies and health and care system improvements. Findings will be deployed through multiple knowledge translation strategies (see section 4: implementation strategy) to deliver better outcomes for patients and the public and to increase the efficiency, quality, accessibility and sustainability of services across the region and nationally. ARC-EM will also work with collaborators and other partners to increase capacity and capability for research appraisal, conduct and use (see section 7). It is anticipated that ARC-EM will invest between &pound;25,000 and &pound;250,000 in each of 50 or more research projects in collaboration with other ARCs, with many attracting additional external funding. To ensure sustainability, the economics of interventions will be considered from multiple perspectives and the impact on relevant components of the health and care system assessed. Additionally, and in partnership with other ARCs and research infrastructure groups, ARC-EM will lead national priority programmes, particularly relating to the management of complex multi-morbidity, the drivers of health inequalities and the capture and use of health and care data. ARC-EM has provisional agreements for collaboration with nine other ARCs (see section 5: national leadership role). Objectives for ARC East Midlands Building on the substantial track record of CLAHRC East Midlands and its predecessor pilot CLAHRCs, ARC-EM will be judged against delivery of a range of specific objectives: Objectives for years 1-2 All core and theme staff will have been appointed and all committees will have met All themes will have participated in one or more priority setting event Multistakeholder teams will have identified high-priority challenges areas and outline research proposals developed Themes and projects will have developed comprehensive knowledge translation strategies and implementation plans Firstwave research projects (20-25) will have been selected and projects commenced Educational programmes will have launched for ARC staff, employees of collaborator organisations and public contributors (including in public involvement, health research methods, accessing evidence, critical appraisal and knowledge translation) 12 or more people will have begun full or part-time doctoral studentships Proposals for national leadership will have been developed in at least three research areas in consultation with NIHR Specific objectives for years 3-4 Second and third-wave research projects (40-50) will have commenced Some firstwave research projects will have completed and, where positive findings are confirmed, end-of-grant knowledge translation activity will be underway Doctoral students will be have completed or be close to submission An independent external review will have assessed midstage progress of ARC-EM in knowledge translation and capacity development and key recommendations enacted Specific objectives for years 5 onwards All ARCEM supported doctoral students will have completed Findings from at least 12 ARCEM projects will be implemented by collaborator organisation to improve health and care practice and delivery Findings from at least 10 ARCEM research projects will be implemented to improve health and care practice in services outside East Midlands Research capacity in collaborator organisations will have increased demonstrably Positive improvements will be evident in the health and care challenges addressed by ARCEM Evaluating the success of ARC East Midlands The progress of the ARC-EM will be assessed at organisational, programme and project levels. For each project and programme, we will monitor progress against key milestones through completion of quarterly reports and associated risk registers. In addition, we will undertake quarterly monitoring of dissemination activities, engagement with end-users (collaborators and other partners, patients and the public, etc) and efforts to apply evidence in practice. In relation to post-implementation impact, we will continually evaluate the degree to which projects have positive benefits, such as whether they improve patient experiences, health or wellbeing; contribute to local/national policy or guidance; change organisational practice or service delivery; influence or change commissioning; improve the efficiency and costs of healthcare services or reduce demand; and/or reduce health disparities between population groups. To assess the ARC as a whole, a high-level independent external review will be commissioned between months 18 and 24 to assess strengths, limitations and areas for improvement. The review will consult with a broad range collaborators and other stakeholders to appraise the ARC-EM s strategy, processes and methods for achieving its objectives; governance procedures and monitoring arrangements; progress against objectives. Report recommendations will identify any changes necessary so that ARC-EM s objectives will be met.

Lay abstract: We will deliver research to improve outcomes for patients and the public and to increase the efficiency, quality, accessibility and sustainability of care services. All our research will be of the highest scientific quality and address the most important health and care challenges for communities across our region and nationally. Our research will be co-produced by highly skilled and motivated practitioners, health and care managers, patients, community representatives and world class academic researchers. These multi-skilled teams will steer research projects from initial idea through to the use of findings to improve health and wellbeing. The Managing Multimorbidity (MM) theme will carry out research to improve the health, care and safety of the growing number of people with more than one long-term condition. The Mental Health and Wellbeing (MHW) theme will carry out research to improve the mental health and wellbeing of our population and to increase access to effective therapies and treatments. The Building Community Resilience and Enabling Independence (BCREI) theme will undertake research to support independent living, improved care for stroke survivors and coordinated multi-service care, particularly for older people. The Data2Health (D2H) theme will carry out and support research that uses the most efficient designs and all appropriate sources of information about patients and services. It will develop new ways to understand this information for the benefit of patients and communities locally, regionally and nationally. The Ethnicity and Health Inequalities (EHI) theme will carry out research that considers health gaps between population groups, including those related to ethnicity, culture, wealth, disability, geography and education, so that our research is fully inclusive. The Translating and Implementing Sustainable Service Improvement (TISSI) theme will work to ensure that our research findings are widely shared with our public and partner organisations to improve health and social care. It will support education so that more of our collaborators have the skills necessary to do high quality research. Short- to mid-term aims Deliver 70 or more high-quality research studies in areas of high priority, including in multimorbidity, mental health, rehabilitation, ethnic health and health inequality. Greatly increase the number of people in our partner organisations who work together to carry out high-quality health and care research. Improve ways to share the findings from research so that patients benefit from better health and care services. Mid- to long-term achievements Widely shared high-quality evidence about the prevention, detection, management and treatment of a broad range of long-term health conditions; Evidence informed improvements to service planning, delivery, patient care and population health and well-being; Widespread improvements in the quality and safety of services and reductions in gaps in care across the East Midlands; An increase in the volume and value of health and care research carried out by organisations across the East Midlands; A real increase in number and diversity of patients and members of the public involved in all aspects and all stages of health research.

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