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A new vision for Public Health Research - setting the scene

Published: 25 May 2021

Professor Brian Ferguson, Director of the NIHR Public Health Research (PHR) Programme outlines his strategic vision for the PHR programme and reflects on the challenges the research community must overcome.

When I was appointed to the role of Director of NIHR’s Public Health Research programme at the end of 2019, I could not have envisaged what lay ahead. With the onset of the pandemic, it was a privilege to continue to serve as Public Health England’s Chief Economist until the end of March this year and contribute to the country’s pandemic response. But taking on the NIHR role has only served to underscore the enormous challenges we face as a public health system over the coming months and years.

Pre-pandemic, I came into the role with a few key things in mind. The first was to try to ensure that the programme is as focused as possible on the most important population health issues. However complex, this has to include topics such as climate change and the growing gap between rich and poor in our society. Secondly, there is a need to identify and develop the next generation of public health research leaders. We are planning a new Population Health Career Scientist Award Scheme as one building block in a strategy that continues to drive research excellence across the field. This needs to embrace researchers from all disciplines, particularly where less conventional fields have much to offer - as in the case of climate change, for instance.

Our public health research leaders and wider community need to have strong influencing skills as well as understanding the translational challenges in helping to ensure that public health research makes a difference. Developing our knowledge of how things work, not just what things work, is critical in understanding how evidence and research can impact most effectively on policy and decision making. We are therefore planning an initiative aimed at developing research capacity and capability in local government in tandem with academic partners: the creation of Health Determinants Research Collaborations (HDRCs). As the name suggests, these will focus on the underlying drivers of health and well-being, and they will be true and equal partnerships between local government and higher education institutions. HDRCs will also be an opportunity to stimulate new research capacity in areas of disadvantage.

The intention is that the HDRC model will drive a research culture within local government, building not only on the skills and expertise of academics but also the experience of those working in local government. Many people employed in local government are highly qualified, with the added advantage of knowing how to operate in a political environment and to manage complexity on a daily basis. There is a tremendous opportunity for sharing skills and experience between sectors and successful HDRCs will need to be able to demonstrate this, including how they will enable effective knowledge mobilisation and sharing of lessons learned from the collaboration.

My final reflection is in relation to health inequalities, or more broadly the distributional issues that are frequently overlooked in evaluations of interventions. Excellent work in this area is already undertaken by the Public Health Policy Research Unit and we should build on this platform. There are data and other challenges to be overcome but this has to be a sustained long-term focus for public health research. The UK R&D Roadmap (July 2020) contained a whole chapter on ‘levelling up’, recognising the high degree of concentration of research activity and funding in certain parts of the UK. We have to challenge ourselves on this over the coming years as the public health research programme mirrors other R&D activity in this respect. The exam question is how do we ensure that research is relevant to the areas of the country and/or groups experiencing the most disadvantage, if we are serious about contributing towards reducing the gap between the best- and worst-off in our society.

Like everyone else, researchers have difficult work-life balances and have faced considerable uncertainties over the last year. It would be remiss of me not to acknowledge the very real and serious financial situation that is faced by our universities at the present time. It is impossible for researchers to be immune to these wider considerations. In our programme, as with the rest of NIHR, we will continue to view our work with the research community as a partnership where we try to face these challenges together. Finally, I want to extend my thanks to all of the researchers out there who have done an astonishing job over the last year in trying to keep research studies and wider public health activities going during the pandemic.

Professor Brian Ferguson, Director of the NIHR Public Health Research (PHR) Programme

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