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Embedding Research in NHS Trusts. What NIHR CRN staff need to know about supporting 'well led' and what is available to help.

Patients are at the centre of everything we do.....

This guide aims to provide some helpful tips, messages and tools to help you support NHS partners to further embed research activity in their organisations for patient benefit. You will find 'key messages' such as the message below throughout the guidance:

Clinical research is finding out what works best in patient care in specific areas through a ‘study’. A study aims to answer a question, in this case about patient care, using a carefully designed method.

'Well Led' as applied to research in the NHS is a term that arises from the incorporation of clinical research research markers in the CQC Well Led Framework since October 2018. As such it refers to how an NHS Trust embeds research activity through its governance, systems, operations and delivery for patient benefit. It focuses on the infrastructure that helps research happen at Trust level rather than the individual studies themselves. We could say that a Trust that embeds research in this way is 'Well Led' in respect of research.

The CQC now has a remit to assess how trusts are supporting and using clinical research to improve patient care.

A standard slide-set about the outputs of the CQC work can be found on the NIHR Hub and more on CQC related developments can be found on the NIHR website.

How do we communicate about 'Well Led' research? The term 'Well Led' is unlikely to mean anything to many non-research staff in the NHS, so we need to think about how to communicate about research in general. In a busy, stretched NHS, staff are focused on patient care and 'research' can seem like an 'extra' thing and not a priority. The first tip might be to start with what we have in common and talk about 'best patient care through research.' This immediately makes a link.

Another helpful approach may be to discuss and celebrate with NHS staff how they already use research, thus drawing attention to how important research is to best patient care:

Everyone providing care in the NHS uses research. But not everyone is aware of it. The core of all good training is that it is based on evidence which can be trusted.

The Frontline Research Staff Community is a key tool. It is designed to share what works in engaging non-research colleagues through:

  • Success stories to inspire frontline staff to promote research within their department or Trust and lead key initiatives to help to create a research culture
  • A toolkit of resources to introduce clinical staff to research and the
  • A self assessment quiz to enable staff to evaluate their own practice, in terms of embedding research within their role and promoting a research culture.
  • An interactive forum to enable staff to share success stories and key barriers/ challenges, and discuss core elements of research.

The community is being expanded all the time, not only in content updates but also as part of a developing active learning community, so its worth keeping an eye on it. Think about contributing success stories as well!

You can register with the community with an NHS related email address or those with NIHR Hub accounts can simply log in.

Research can help you identify effective and cost efficient treatments, processes and systems

Experience shows that it is important to demonstrate how research adds value to NHS care. There are perceptions that research costs more and is a burden to care whereas we know this is incorrect. There are some good research impact stories showing the value of research in the NHS on the NIHR website.

A growing body of evidence shows that trusts with high levels of clinical research activity have better patient outcomes (e.g. lower mortality rates)

It might be helpful to be familiar with some of this evidence when interacting with NHS staff and management at various levels. It will enable you to show another aspect of the value of research in the NHS:

Surveys show that patients and staff have very positive, empowering experiences of research studies.

In a 2018 survey of over 8,500 research participants 90% of respondents had a good experience of participating in studies in the NHS. Much of this was due to the excellence of research staff and the increased monitoring study participants generally have for their condition.

Other helpful 'tools'

There are a range of useful 'tools' available to the CRN that assist with engaging non research staff about research. Some of these have already been referenced in this guide but there are a few others to consider:

'Clinical Research is Everyone's Future' is a short video designed for very busy people and provides some of the basic information about clinical research:

'Be Part of Research' is a platform for both lay people and professionals that makes it easy to understand what research is and does and find current research studies in specific clinical areas on its database. Where patients are asking about research that may not be available in a particular Trust it can be useful. NHS staff can give patients a route into what they might be looking for, or simply and quickly check on the patients behalf for studies that may suit them.

RAND Europe 2018: 'Enabling NHS Staff to Contribute to Research' is an independent report about staff in NHS organisations being enabled to be research active. The report may be useful in influencing senior managers for example:

Royal College of Physicians: 'Research for All' is a strong statement which follows the work with the CQC, and endorsed by a range of Royal Colleges and related organisations including the NIHR. It includes that Trusts should:

  • ensure that research activity is integral to the work of the organisation and its staff and overseen at board meetings
  • use job planning to protect time for clinical research, including within the direct clinical care programmed activities

Well Led (research) Champions have also been established in every NIHR LCRN. Broadly their role is:

  • A link between local and national initiatives in the CRN
  • A catalyst within LCRN teams
  • Part of a CRN national ‘Well Led’ community of practice being built up
  • A conduit for feeding back to the national CRNCC NHS Engagement team any issues, suggestions, innovations, concerns, and perspectives from the LCRN.
  • Catalysing new positive ways of working with NHS R&D teams in the joint effort to embed research in NHS care.

What next?

The NIHR CRN's NHS Engagement Team continues to work closely with colleagues inside and outside the organisation to continuously improve how research is embedded in NHS care:

Contact:

Roger Steel, NHS Engagement Programme Manager. email: roger.steel@nihr.ac.uk