19/106 Changes to the welfare system
Deadline for submission: 17 March 2020, 1pm
• What are the impacts on health, health inequalities and related outcomes of changes to the welfare system encompassing the implementation of Universal Credit?
There is a large body of evidence on socio-economic inequalities in health and wellbeing that suggests a positive relationship between access to sufficient financial resources and health status. In theory, access to sufficient financial resources provided by the social security system for people not in work or on a low wage could have positive impacts on health. The new Universal Credit payment provides help with living costs for those on a low income or out of work and replaces a previous system of six means-tested benefits. However, there is no specific research about how the implementation of Universal Credit impacts on health and health inequalities.
The implementation of Universal Credit could have an impact health and health inequalities in a range of ways. It is therefore important to evaluate the policy prior to full implementation. For some time, public health researchers have been arguing that the evaluation of new policies and interventions is more effective if it is planned and conducted prior to full‐scale implementation. Nevertheless, researchers are also aware that it is very difficult to control the timing of a policy intervention or prevent concurrent policy change from affecting populations under investigation.
Outcomes to be researched could include (but are not limited to): physical health, mental health, debt, food security, fuel security, diet and nutrition, and health and social care service use.
- We are interested in process and outcome evaluation studies and research areas of interest may include (but are not limited to): The causal linkages between Universal Credit implementation and health outcomes and inequalities.
- Effects on employment rates and related health impacts.
- Effects on housing tenure and related health impacts.
- Effects on people with disabilities.
- Health impacts on others in the household, including implications for family members.
- Effects on social relationships and social networks.
- Evaluation of Universal Credit implementation: effects of variations in the roll out of Universal Credit, how Universal Credit is delivered, the changes in benefit income received by individuals, families or specific population groups and the associated positive or negative impacts on health.
- Investigations on payment patterns including, for example, the minimum five week waiting/transition period for (i) new Universal Credit claimants and/or (ii) claimants of the previous system of six means-tested benefits moving to a single Universal Credit payment.
- Investigations on the experiences of claimants dealing with the ongoing claimant process for Universal Credit for example; in meeting the ’claimant commitment’, in responding to changes to the frequency of payments, in adapting to the online only application process, managing the online journal, experiences of sanctions, etc.
- Evaluations of the effectiveness and uptake of third sector support services or community initiatives on health among Universal Credit recipients before, during and after full or partial roll out of Universal Credit in a local area.
- Investigations on the effects of the full or partial roll out of Universal Credit on staff working with Universal Credit claimants.
- Researchers are encouraged to consider economic impacts across wider systems which may lead to further, indirect consequences for health (e.g. employment sector, demands for health and social care, police and criminal justice system).
A range of study designs and outcome measures could be used. Researchers will need to identify and justify the most suitable methodological approach(es). Researchers will also need to specify key outcome measures and specify how these will be measured in short, medium and long terms. Researchers may wish to consider evaluating natural experiments comparing the effects of different approaches in design and delivery of Universal Credit in any/all of the Devolved Administrations.
Relevant populations or sub-groups may be studied, based on factors such as ethnicity, socioeconomic status, gender, employment status or other social markers. Researchers are to specify and justify their choice and the relevance to the population being studied. Researchers should demonstrate the relevance of their proposed research to policy makers and other evidence-users. Collaborative, co-produced studies involving policy and practice partners are welcome.
The Department for Work and Pensions (DWP) has implemented an evaluation framework under which it will manage a significant programme of research and evaluation to understand the extent to which the policy change has achieved its aims and to understand how the design and delivery of Universal Credit can be improved. Researchers will be expected to be aware of the programme of research and ensure their proposed research is complementary.
We anticipate research teams will be inter-disciplinary bringing together scientists with multiple perspectives. We would welcome the involvement of subject matter experts from outside research, for example from government departments, local government and civil society organisations working in this area. We would also welcome meaningful involvement of people who are experts by experience. We will consider inclusion of experts as costed members of the research study team if appropriately justified.
Studies should generate evidence to inform the development or 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. Sustainability - health, economic and environmental - are also of interest.
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.
Representatives of policy or practice communities relevant to the project should be directly engaged or involved with the development and delivery of PHR research because this produces research that is more closely grounded in, and reflective of, their concerns and makes the subsequent uptake and application of research findings more likely. By policy or practice, we mean any organisation that is involved in shaping policy or delivering public health services relevant to the research, whether at local or national levels. This might include local authorities, charities, voluntary organisations, professional bodies, commercial organisations, governmental and arms-length bodies.
We welcome proposals in which appropriate professionals (e.g. a director of public health or chief executive of a charity) are formally part of the project team as a co-applicant, and in which they play a defined role in the project. Their contribution may be to facilitate or enable research access to organisations, to be directly involved in research fieldwork, to contribute to interpretation of emerging findings, and to be involved in dissemination activity. The time of policy or practice representatives as co-applicants can be costed into the proposal, as part of the Research Costs. As with all members of a project team, an individual's equipoise should be considered before they are proposed as co-applicant of a research project. Their involvement and associated costs should be fully justified, in the same way as for academic applicants.
There are other ways in which policy or practice representative support for the proposed research can be demonstrated, such as co-opting on to a project advisory or steering group, or the inclusion of a letter or statement of support from a senior policy or practice partner from relevant organisations.
Remit of call:
All proposals submitted under this call must fall within the remit of the NIHR Public Health Research (PHR) programme. Please go to http://www.nihr.ac.uk/phr for details. For the evaluation of time sensitive, policy driven, interventions applicants may wish to consider the fast-track work stream - http://www.nihr.ac.uk/phr
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 firstname.lastname@example.org 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, NISCHR in 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.
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