NIHR Blog

Catherine Lichten, Analyst, RAND Europe

How do BRCs impact their NHS partners? Findings from an evaluation in Oxford

Author:

Catherine Lichten, Analyst and Jon Sussex, Chief Economist, RAND Europe.

Date: 25 July 2017

The NIHR’s first Biomedical Research Centres were introduced in 2007 to transform high-quality basic and clinical research into improved care and outcomes for patients. Bringing together university researchers with NHS organisations, the BRCs represent a major NIHR investment. The BRCs attract substantial funding from sources beyond the NIHR such as from research councils, charities and industry. Given the scale of these investments and the potential patient benefits, it is important to understand the effects the BRCs are having on research, care and beyond.

During 2015 and 2016, we worked with the NIHR Oxford BRC to explore the impacts of its research activity, which spanned 14 different research themes. With activities ranging from a trial of an H1N1 vaccine for use in children, to development of genetic tests for characterising heart muscle conditions, and research to improve diagnostics for tuberculosis, the range of potential impacts from this BRC was vast.

Local impacts

To run a meaningful evaluation within the available time and resources, we chose to focus our work on local impacts to understand in greater depth how the presence of the BRC affected patient care in the immediate clinical environment. We sought to identify changes observed by staff working within the Oxford BRC’s NHS partner, Oxford University Hospitals NHS Foundation Trust (OUH), which could be linked to Oxford BRC research.

Previous work done by colleagues in 2008-09, 18 months after the BRCs first launched, showed that the BRCs had a role in building collaborative relationships between NHS and academic stakeholders. It was then too early to measure impacts on patients and care, but several years on, this is now possible.

The core of our qualitative study consisted of two sets of semi-structured interviews. First, we interviewed 17 leaders of Oxford BRC research streams and working groups to explore what impacts they expected their activity would have on patient care in local hospitals. Then, we interviewed 19 senior clinicians at Oxford’s acute hospitals to discover what impacts they had observed.

Direct and indirect impacts

The research, published in January 2017, confirmed the significant local impacts of the Oxford BRC on patient care. Though so-called ‘direct impacts’ from research - changes to care, like a new treatment or process for delivering care - are often emphasised, we found considerable ‘indirect impacts’ resulting from the presence of the BRC at OUH. We also found that indirect impacts could be felt earlier than impacts related to research outcomes, especially at the local level.

The indirect impacts on patient care locally that we observed from the research activity undertaken by Oxford BRC included: more formalisation of research roles enabling more clinical staff time for research, OUH staff becoming more aware of research developments (e.g. new treatments), better recruitment and retention of staff, greater willingness of staff to explore and use research findings, improved access to clinical infrastructure and earlier access to novel therapies for patients. While the majority of impacts were positive, challenges identified included increased pressure on physical space and some facilities in the hospital due to research activity, high-quality clinical staff moving to research-only positions, and difficulties planning staffing around individuals with part-time research roles.

Building a reputation

Our findings generally aligned with a framework of biomedical research impact mechanisms described in earlier work. However, we identified one additional impact mechanism that had not been included in that framework - reputation. The presence of the Oxford BRC was seen as enhancing the reputation of OUH, bringing about knock-on effects such as opportunities to attract funding to improve physical infrastructure and to recruit better staff.

We acknowledge limitations in our study but in spite of these the findings show that BRC-related research contributed to a wider growth in research activity at OUH and impacted local care in broadly positive ways. To build on this work, future studies could involve a wider range of staff that provide patient care, looking beyond the acute setting to identify impacts on local primary and community care.

Our research team, made up of researchers from the Office for Health Economics and RAND Europe, carried out this work as part of a wider evaluation of the NIHR Oxford BRC that also considered academic and industry impacts. The report of the wider evaluation is available here.

The views and opinions expressed in this blog are those of the authors and do not necessarily reflect those of the NIHR, NHS or the Department of Health.
  • Summary:
    Catherine Lichten and Jon Sussex from RAND Europe share findings from work that explored the impact of research activity from the NIHR Oxford Biomedical Research Centre.
  • Year:
    2017
  • Author:

    Catherine Lichten, Analyst and Jon Sussex, Chief Economist, RAND Europe.

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