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18/149 Contractual Levers in Local Government



Please note: The Public Health Research (PHR) Programme would like to draw researchers’ attention to the commissioning brief below, which was first advertised in Autumn 2018. This is a brief that we have previously advertised as a commissioned funding opportunity. We are still interested in receiving applications in this research area, as it remains a priority in our portfolio. However, please note that the commissioning brief, along with the underpinning literature searches, has not been updated since originally written.

Research Question(s)

  • What are the impacts on health, health inequalities and related outcomes of implementing or changing contractual levers in services commissioned by local government?

Local government has the potential to improve health and health inequalities by supporting behaviours that can help populations maintain a healthy life. Local authorities hold many types of contracts with a range of providers. Changing these contracts could offer levers to shape local conditions and environments.

Adding clauses to contracts held by local authorities could impact health and health inequalities in a range of ways. Examples that are of interest include (but are not limited to):

  • Requiring providers to pay the Living Wage to contracted staff (e.g. social care workers, refuse collectors)
  • Workplace health requirements (e.g. requirement for a healthy food policy, enabling active travel to work) inserted into local authority contracts
  • Local advertising contracts limiting the advertising of foods that are high in fat/salt/sugar, alcoholic drinks, gambling or other potential harms to health
  • School catering contracts (where provision is external) influencing the diets of school children and staff (e.g. going beyond mandated standards).
  • Contracts influencing catering offered to council workers and visitors
  • Contracts for the upkeep of public open spaces in deprived areas to increase physical activity
  • Contracts creating or supporting spaces for community food growing
  • Contracts ensuring wide accessibility to cultural and social events for vulnerable groups
  • The local impact of the Public Services (Social Value) Act (2013), which aims to add social value to public procurement of services

Outcomes could include (but are not limited to):

  • Fruit and vegetable intake in workforces/school pupils with changes to catering contractors
  • Anxiety levels and/or healthy behaviours in workers’ households before and after the introduction of the living wage
  • Residents perceptions of their environment and wellbeing in relation to targeting of environmental services

While interested in contractual levers available to local government, the programme would consider applications looking at the use of contractual levers by other large local employers or organisations, including the NHS’s non-patient care contracts.

A range of study designs and outcome measures could be used for different issues/contract changes examined. The structures, processes of development and outcomes of these contracts are of interest, as is their use in a Health in All Policies approach. The nature of the impacts of such policy changes may make such interventions particularly suitable for evaluation as events within complex adaptive systems. Researchers will need to identify and justify the most suitable methodological approach.

Researchers should also specify and justify their choice of intervention and its relevance to the population being studied. Researchers should demonstrate the relevance of their proposed research to evidence-users.

Additional notes

Studies should generate evidence to inform the implementation of single or multi-component interventions. Studies may include evidence syntheses, studies evaluating interventions, including trials, quasi- and natural experimental evaluations, and feasibility and pilot studies for these. We welcome applications for linked studies (e.g. pilot + main evaluation). Secondary analyses of existing epidemiological data and/or impact modelling studies may also be funded. We encourage the adoption of a systems perspective where appropriate to the study context. In all cases a strong justification for the chosen design and methods must be made.

The primary outcome measure of the research, if not necessarily the intervention itself, must be health-related. The positive or negative impacts of the intervention, including inequitable outcomes should be considered.  Researchers are asked to indicate how long-term impacts will be assessed. All applications should identify underlying theory and include a logic model (or equivalent) to help explain underlying context, theory and mechanisms. Proposals should ensure adequate public involvement in the research.

The impacts of public health interventions are often complex and wide-reaching. Studies should acknowledge this by adopting a broad perspective, taking account of costs and benefits to all relevant sectors of society. An appropriate health economic analysis to inform cost effectiveness, affordability or return on investment should be included where appropriate.

For all proposals, applicants should clearly state the public health utility of the outcomes and the mechanisms by which they will inform future public health policy and practice. Details about the potential pathway to impact and scalability of interventions, if shown to have an effect, should be provided, including an indication of which organisation(s) might fund the relevant intervention(s) if widely implemented.

Remit of Call

All proposals submitted under this call must fall within the remit of the NIHR Public Health Research (PHR) programme. For the evaluation of time sensitive, policy driven, interventions applicants may wish to consider the fast-track work stream.

Notes about NIHR and the PHR Programme

The PHR Programme funds research to generate evidence to inform the delivery of non-NHS interventions intended to improve the health of the public and reduce inequalities in health. Our scope is multi-disciplinary and broad, covering a wide range of interventions that improve public health.

The primary aim of the programme is the evaluation of practical interventions. We will fund both primary research (mainly evaluative, but also some preparatory research) and secondary research (evidence synthesis); precise methods will need to be appropriate to the question being asked and the feasibility of the research.

Our research serves a variety of key stakeholders including: decision-makers in local government; primary care organisations and other local public services; third sector organisations; relevant national agencies (e.g. NICE) concerned with improving public health and reducing health inequalities; researchers; public health practitioners and the public.

Applicants should consider how their findings will impact upon decision making in public health practice, whether results are generalisable to other populations and affordable, setting out a clear pathway to impact. The NIHR PHR programme recognises that there is a need for an evidence base for disinvestment and that the removal of an intervention from a population can be worthy of evaluation.

The affordability of the intervention, and at least an indication of the stakeholder(s) willing to fund the intervention, should be referenced within the stage 1 application. At the stage 2 application point, statements of support confirming stakeholder commitments to funding will be required. Applicants should be aware that the NIHR PHR programme is unable to fund intervention costs.

The NIHR PHR programme is open to the joint funding of research projects with other organisations such as those in the third sector. If you would like to explore the potential for joint funding, please contact us at with details of your proposal and the other funder prior to submission.

All of our funded projects are eligible for publication in the NIHR Journals Library. This open access resource is freely available online, and provides a full and permanent record of NIHR-funded research.

Notes to Applicants

The NIHR PHR programme is funded by the NIHR, with contributions from the CSO in Scotland, Health and Care Research Wales, and HSC R&D, Public Health Agency, Northern Ireland. Researchers in England, Scotland, Wales and Northern Ireland are eligible to apply for funding under this programme.

Applicants are recommended to seek advice from suitable methodological support services, at an early stage in the development of their research idea and application. The NIHR Research Design Service can advise on appropriate NIHR programme choice, and developing and designing high quality research grant applications.

The NIHR Clinical Research Network (CRN) supports health and social care research taking place in NHS and non-NHS settings. The CRN provides expert advice and support to plan, set up and deliver research efficiently.

Clinical Trials Units are regarded as an important component of many trial applications however, they are not essential for all types of studies to the PHR programme. The CTUs can advise and participate throughout the process from initial idea development through to project delivery and reporting. NIHR CTU Support Funding provides information on units receiving funding from the NIHR to collaborate on research applications to NIHR programmes and funded projects. In addition, the UKCRC CTU Network provides a searchable information resource on all registered units in the UK, and lists key interest areas and contact information.

Transparency agenda

In line with the government’s transparency agenda, any contract resulting from this tender may be published in its entirety to the general public. Further information on the transparency agenda is at: