Title: NIHR Applied Research Collaboration - Yorkshire and Humber ARC
Funder: Department of Health and Social Care

Abstract: The Yorkshire and Humber ARC is a collaboration between NHS, social care, third sector and industry organisations and leading universities in Yorkshire and the Humber. We aim to transform services and improve peoples health and wellbeing and reduce health inequalities through four strategically important core themes, which have ambitious and clearly defined deliverables, focused on the needs of the local community. Early life and Prevention Older people with Frailty Mental and Physical Multimorbidity Urgent and Emergency Care Cross-cutting research teams in improvement science , health economics, evaluation and equality and a core implementation team will generate reliable, real world evaluations, assessing , assessing the impact on inequalities and value for money and will stimulate service innovation and uptake (Figure 2). Our themes also align with NIHR priorities and key areas of future investment identified by the Rand Future of Health report and builds on and further develops internationally recognised research from CLAHRC YH. Vision The ARC will stimulate collaborative applied health and care research in Yorkshire and Humber and to improve services and outcomes by working with delivery agents to translate research and implement change, as well as contributing knowledge of international significance. Strategic Aims The YHARC will: Catalyse world leading, applied health and social care research, to advance knowledge and support change in strategically important areas relevant to local needs. Encourage high quality research collaborations across Yorkshire and Humber and between ARCs across the country. Engage deeply with policy makers, professionals, commissioners and providers of health and social care to develop the research agenda and to translate research findings in order to improve services and health outcomes and reduce health inequalities. Co-produce the development, conduct and translation of our research with the public and practitioners to ensure they focus on the needs of the local community. Develop and consolidate the use of innovative methods for applied health research for evaluation, including the equity impact of innovation and change and value for money. Build applied researcher and research user capacity in service delivery and university sectors. The YHARC will be characterised by: Interdisciplinarity &ndash; promoting cross discipline, profession/sector working and interaction; extracting value across what are often professional, disciplinary and service silos, building on and developing pan-Yorkshire and Humber strengths. Health economics, for example, will be embedded across the work programmes. Strong public, patient and other service user engagement &ndash; extend existing good practice and networks to engage effectively with the public and service users to promote genuine community and patient co-production of research and its translation. We will build on our record of engaging diverse groups &ndash; Born in Bradford birth cohorts (South Asian and deprived communities), older people with frailty and diverse ethnic backgrounds, mental health (serious mental illness). A policy and practice focus &ndash; serious service involvement in order to address relevant questions, promote use of findings and realise impact. This will be supported by experts from the cross-cutting theme in improvement science and support for change provided by the YH AHSN s Improvement Academy. A system wide approach - engaging with a wide range of health and social policy organisations across sectors which directly or indirectly influence the level and distribution of health and wellbeing. Each of the core themes will look across organisations and, where sensible, sectors reflecting service users whole journeys through place, organisation and age. A focus on reducing inequalities &ndash; the four core themes will each consider how their research can help reduce health inequalities. They will be supported by experts in the cross-cutting Health Economics, Evaluation and Equality theme. Exploit the power of population cohorts &ndash; we will use and extend the value of our world-class cohorts which include >100,000 people actively participating in our research themes: birth cohorts (Born in Bradford and Born in Bradford s Better Start); the Community Ageing Research 75+ (CARE75+) cohort, the Yorkshire Health Study, and the Health and Wellbeing cohort of people with severe mental illness. Harnessing the potential of routine data linkage - we will develop learning health and care systems through the efficient use of research-calibre routine data collection and linkage. This will build on our Connected Health Cities programme of whole system data linkage across primary, secondary and community care, education and social services (Connected Bradford; n=700,000) and our regional Urgent and Emergency Care database (n=5million). Capacity building emphasis &ndash; we will inspire and train the next generation of researchers and research users from different disciplines. We will harness local creativity and find ways of involving local staff in suggesting, developing and testing new approaches and innovations. Questions and projects emerging from engagement with public, service providers and policy makers and researchers will populate a portfolio of responsive and feasible applied research projects. System change will be promoted by pulling together and sharing learning from research and evaluations. Distributed and flexible &ndash; The YHARC will be non-bureaucratic, channeling most resource into research, implementation and capacity development. It will be managed so as to promote cross-theme working and the ability to take advantage of new opportunities and collaborations and follow new unexpected routes. Good governance A Partnership Strategy Board, representing stakeholders and an International Advisory Board will ensure relevance and research quality respectively. YHARC will have strong internal strategic and operational management at core and theme levels. Anticipated Outcomes The YHARC will be successful if over the next 5 years it has: Generated internationally recognised research output in areas of policy, service or care need and evaluation methods, Developed links with, and generated value to, health and care organisations as measured by attributable service change, policy development and improved public and patient outcomes, Built research capacity and receptivity and harnessed the creativity of health and care staff in the region wishing to use and/or do research, and to innovate, Established partnerships with other NIHR ARCs nationally, Provided local people with more opportunities to be involved in research, Secured additional research funding in order to increase the return on investment and ensure sustainability beyond the funding period.

Lay abstract: Yorkshire and Humber has a ten year record of a highly successful CLAHRC programme where we collaborated with partners including the NHS, Local Authorities, industry and charities, to conduct research in health and social care and public health to improve the lives of people regionally and beyond. We aim to build on these successes and are proposing an ambitious Yorkshire and the Humber Applied Research Collaboration (YHARC). We will work with existing partners and new partners, who will contribute to fund the work and ensure its relevance to the people of Yorkshire and the Humber, with some components addressing national priorities. At its core, YHARC will address inequality and include vulnerable and often hard to reach groups (e.g. with severe mental illness, or advanced frailty). Themes will work closely with patients and the public to set targets for their work programmes. The Early Life and Prevention theme will bring together policy makers, communities and charitable organisations to develop effective treatment and programmes to improve child health and reduce inequalities. Initially, we will conduct local/regional prioritisation exercises to develop objectives and test programmes. In the longer-term, we will undertake full-scale trials of community interventions and assess their cost-effectiveness. The Older People with Frailty programme brings together researchers from medicine, primary care, social care, nursing, physiotherapy and occupational therapy. It will develop approaches to improve healthcare for older people, particularly with frailty and including care homes residents. Firstly, priorities will be identified from community-dwelling older people with frailty and care home residents to develop treatments which can be tested in the longer-term. We aim to improve the methods to more efficiently test treatments and programmes with older people. The Mental and Physical Multimorbidity theme will address the challenges when physical health problems co-exist alongside mental disorders and people with physical illnesses (e.g. heart disease) who are more likely to experience depression and anxiety. Initially, we aim to better understand social, economic, lifestyle, and environmental causes of poor physical health, and health and social care use, amongst people with co-existing mental and physical illness. In the medium and longer-term, we will develop new treatments and service models to improve physical and mental health, so local and national NHS and Social Care services can better respond to the needs of people with mental and physical illness. The Urgent and Emergency Care theme will investigate and inform improvements in how patient demand and flow is addressed through the urgent and emergency care system. It will help reduce avoidable ambulance journeys to hospital and by reducing demand on emergency departments and acute admission by providing access to frailty care and solutions for care homes. In the medium and longer-term, we will develop a rapid responsive mode model for rapid testing, service innovation and system change. The themes have large, established cohorts (groups of people), and access to data, to test programmes, treatments and innovations. Themes will have access to world-leading expertise in improvement science and economic evaluation via our cross-cutting themes.

Research activity codes: 8.4 RESEARCH DESIGN AND METHODOLOGIES (HEALTH SERVICES)
Health categories: GENERIC HEALTH RELEVANCE