This site is optimised for modern browsers. For the best experience, please use Google Chrome, Mozilla Firefox, or Microsoft Edge.

Feedback

We welcome your feedback, which will help improve this site.

Feedback form

20/14 Study into the potential mental health and wellbeing effects of HS2

 

Contents

Deadline for Stage 1 applications – 1pm, 22 May 2020

Introduction

High Speed Two (HS2) is a new high speed railway proposed by the Government to connect major cities in Britain. It will be built in phases. Phase One comprises the first section of the HS2 rail network of approximately 230 kilometres (km) (143 miles) between London and the West Midlands.

The High Speed Rail (London – West Midlands) Act received Royal Assent in February 2017 and works have commenced. Phase Two of HS2 would extend the line to the north-west and north-east: to Manchester and Leeds completing what is known as the ‘Y network’.

In response to the request in the House of Commons Select Committee Second Special Report of the 2017-19 session (para 125-134), HS2 Ltd wish to commission research to assess the potential mental health and wellbeing effects of the HS2 development. https://www.hs2.org.uk/

In the context of this study the definition of wellbeing being used is as defined by the WHO as a; “state of well-being in which every individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.”

According to this definition, a healthy state is not merely the absence of diseases but it also a sense of fulfilment, life satisfaction and motivation. Whilst the terms mental health and wellbeing are often used together, mental health typically refers to the presence of psychological or psychiatric illness or symptoms, whereas wellbeing refers to positive psychological health. Quality of life is included in this definition.

It is anticipated that a single piece of research will be funded in response to this opportunity but HS2 Ltd are open to considering a joint-venture approach if your preference would be to bid to undertake only one aspect of the research described in the scope.

It should be noted that the workpackages set out below are intended to be a guide only. If applicants wish to suggest changes to the workpackages or use other methodologies this is acceptable. Applicants can also suggest additional datasets for use in this study, if appropriate. It should be noted that it is beyond the remit of this Scope to consider physical health, per se. HS2 Ltd have already conducted literature reviews of the field  and it is not foreseen that further reviews will be undertaken as part of this Scope.

HS2 Ltd have sought the expertise of NIHR to ensure that the study is seen as independent and impartial. HS2 Ltd have been involved in the design of the scope to ensure it fulfils the ask of the Select Committee but once the study commences HS2 will be advised through NIHR on progress and will not seek to influence the outcomes of the study.

The value of the contract is up to £2,000,000 over 10 years. Studies will be commissioned with a break point at year 5 to review progress which would be conditional upon the release of further funding.

To support applicants in the development of proposals in response to this funding opportunity HS2 Ltd and NIHR will be hosting a Writing Workshop on 22nd April 2020. This is scheduled to take place in London but it may now be held virtually. If you are interested in attending the workshop, please email the PHR team at phr@nihr.ac.uk by 24 March with your name, the names of two of your team and details of your job titles and host institutions. As places are limited, we will then ask those who have expressed an interest to submit a one page summary of their proposed research by 3 April, with places confirmed by 8 April. The intention is for the one page summary to provide a basis for discussion at the workshop. Please note that there is no guarantee of funding by attending the writing workshop; the purpose of the workshop is to offer assistance and advice for potential applicants.

This document sets out three workpackages that will need to be employed to assess the potential mental health and wellbeing effects of HS2.

  •  Workpackage 1 Qualitative interview and focus group study;
  •  Workpackage 2 Quantitative study of existing mental health and wellbeing data; and
  •  Workpackage 3 Longitudinal epidemiological study of the potential effect of HS2 on mental health and wellbeing.

These workpackages cover a range of methodologies, to provide a broad assessment of the potential mental health and wellbeing effects on communities along the route – assessing effects at different stages of the Scheme  (e.g. planning, construction, operation) and for different types of residents (e.g. vulnerable groups, general population), using different  types of data (e.g. self-reported individual level versus readily available area-level data). The study will focus on Phase 2a but study locations should be chosen along the whole line to route including Phase One and Phase 2b to ensure that all stages of the Scheme can be assessed.

This document sets out study designs and methodologies that could be used, but leaves enough flexibility:

  • to enable applicants to further develop and fine tune the designs for the studies so that they can add their expertise, experience and have ownership of the final study designs; and
  • for HS2 to manage the budgets for the studies over a long-time frame (up to 10 years).

The initial time-frame for the funding will be five years.

Where possible, applicants should include a health economic analysis or indicate how economic data could be included in the study to assess a range of social and economic costs and benefits associated with the Scheme. 

Consultation and involvement from members of the public is expected for all NIHR-funded projects. The applicants should indicate how this is planned within the project in a way that will make an effective and meaningful contribution to the research.

Workpackage 1: Qualitative interview and focus group study

Aims and key research questions

The aim of this qualitative study is to understand the different ways in which individuals and communities in affected areas perceive and potentially experience the mental health and wellbeing effects of the HS2 scheme (both adverse and beneficial effects).

The study would assess the potential effect of the project at different time-points of HS2 including baseline (early phases of planning), during construction, and during operation and could also be used to evaluate the effect of changes in environmental exposures (e.g. increases in construction or operational noise) and mitigation measures associated with the Scheme on self-reported and perceived mental health and wellbeing.

Key questions could include:
 - the kinds of, and quality of, any mental health and wellbeing effects perceived and potentially experienced;
 - individual and community understandings of the pathways by which the HS2 scheme could influence the perceived and potentially experienced mental health and wellbeing effects;
 - how levels of concerns as well as opposition and support for the HS2 scheme could relate to perceptions and potentially experienced mental health and wellbeing effects;
 - perceptions on the appropriateness and effectiveness of current and ongoing mental health and wellbeing mitigation measures associated with the Scheme.

Methodology

Within a number of communities a series of focus groups and interviews could be undertaken. This could include the general population in affected areas, as well as interviews with individuals who have a greater understanding of the concerns and experiences of communities such as local health or social care professionals working within affected areas. The study design could be longitudinal, where relevant. Applicants should suggest a methodology for identifying the study areas (to capture different geographical, socio-demographic, vulnerability and health-related characteristics), which would need to be agreed in a written Protocol by HS2 and the Research team, at the outset of the study. HS2 Ltd’s involvement will be to assist in providing the researchers with the background they need with regards to the Environmental Assessments and the effects which are likely to be experienced in each area: they will not seek to unduly influence the methodology for choosing locations.

The research team would oversee the design of the semi-structured themes and questions to be used in the focus groups and interview protocols. It is envisaged that the research team would be led by an experienced qualitative researcher and would likely undertake the qualitative study in-house as the study will need researchers with a strong philosophical and practical foundation in qualitative research methods to ‘unpack’ the findings in a nuanced way.

The research team would be expected to obtain ethical consent for the study, pilot the themes and questions for the interviews and focus groups; undertake data documentation, collation and cleaning activities; to develop an analysis plan; and to undertake and write-up of the emerging themes: similarities, differences, unique findings, connections. The research team should also include a descriptive analysis of the demographic and socio-economic and cultural characteristics of the participants. All data would be handled in line with the Data Protection Act (2018) and all data would be anonymised. The dataset should be prepared and documented so it is suitable to be hosted on a publicly available platform such as the UK Data Archive. The research team will be expected to prepare peer-reviewed journal papers from their analyses.

Workpackage 2: Quantitative study of existing health data

Aims and key research questions

The aim of this study is to analyse existing mental health and wellbeing data reported by the government for residents living in communities potentially impacted by HS2, to quantitatively assess the potential effect of the Scheme on mental health and wellbeing outcomes over time.

The study would assess the effect of the project at different time-points of HS2 including baseline (prior to any knowledge of the Scheme being made public, though communities could know that one possible route option is sited near them), early planning, during construction, and during operation. The knowledge gained from this study would inform other large-infrastructure projects. 

Methodology

A before and after study comparing mental health and wellbeing data (e.g. from Public Health England/Office for National Statistic/Department of Health and Social Care/Clinical Commissioning Groups/Local Authorities) for a selection of areas impacted by the Scheme is sought. For example, medication data and the prevalence of mental health disorders for the assessment areas could be compared to assess whether rates had increased since the publication of the HS2 routes. Data could be compared with control areas not impacted (‘unexposed’) by the Scheme, to compare any observed changes between impacted and non-impacted areas. Study areas should be matched on key factors that might also influence mental health and wellbeing, such as socioeconomic factors, albeit recognizing that this methodological approach would need to rely mostly on area-level data.

The applicants should set out an approach for scoping the study in terms of number of areas, which types of areas, and timing of follow-ups as well as the methodology for identifying the study areas. This approach would need to be agreed in a written Protocol by HS2 and the Research team, at the outset of the study.

Given the scope of the request from the Select Committee, the study could focus on PHE data to assess mental health and wellbeing, which includes the outcomes of ‘depression and anxiety prevalence’, ‘recorded incidence of depression’, ‘long-term mental health problems’, and ‘severe mental illness’. However, not all the data is updated every year, which limits its use for tracking changes in health over-time.

This would be a desk-based study of secondary data. The research team will be expected to obtain ethical consent for the study; develop a protocol for the geographical scope of the study; undertake data documentation, collation and cleaning activities; to develop an analysis plan; and to undertake and write-up advanced statistical multivariate analyses of the dataset. The research team will be expected to prepare peer-reviewed journal papers from analyses of the data.

Workpackage 3: Longitudinal epidemiological study of the effect of HS2 on mental health and wellbeing

Aim and key research questions

1.4.1 The aim of this study is to collect survey questionnaire data from residents living in communities impacted by HS2 and uncertainty associated with the Scheme, to quantitatively assess the potential effect of the Scheme on mental health and wellbeing over time.

1.4.2 The study will assess the potential effect of the project at different time-points of HS2 including baseline (early phases of planning), during construction, and during operation and could also be used to evaluate the effect of changes in environmental exposures (e.g. increases in noise) and mitigation measures associated with the Scheme on mental health and wellbeing. Such knowledge will inform other large-infrastructure projects. 

Methodology

A longitudinal epidemiological study of residents’ mental health and wellbeing is proposed, which would collect data from the same residents over-time at different survey waves. The timing and type of effects to be evaluated need to be agreed with HS2 and this scope is based on an oversimplified assumption of following up one construction period and one operational period (for a maximum of five years funding): in reality, multiple further follow-ups could be conducted, as needed. This study could also track residents who move out of the HS2 study area over-time. The applicants should suggest how they will scope the study in terms of number of areas, which types of areas, and the timing of follow-ups, recognising that this detail will need to be agreed with HS2. The initial study should include at least one follow-up survey. The involvement of HS2 Ltd is not intended to unduly influence the study, involvement is to ensure that the study continues to respond to the ask of the Phase 2a Select Committee.

Participants in the study will be randomly selected adults aged over 18 years. The participants in the study should be representative of the local areas, so that results can be generalized to the populations potentially impacted by the Scheme. Participants should be randomly selected using traditional address based approaches.

A number of ‘exposed’ study areas will be selected from along the route of the HS2 Scheme. These areas could be either selected randomly from across the Scheme or selected based on certain features of the Scheme (such as specific scheme features; levels of uncertainty; length of time of construction; mitigation measures to be employed etc.). The methodology for identifying the study areas should be agreed in a written Protocol by HS2 and the Research team, at the outset of the study. Each ‘exposed’ area should be matched to the ‘control’ area during selection on a range of socioeconomic and contextual factors such as financial, health and demographic factors (e.g. using Indices of Multiple Deprivation). Participants in the ‘control’ areas will be randomly selected to take part in the study and will provide the same questionnaire data as the participants from the ‘exposed’ areas.

Key outcomes to be assessed in the epidemiological study have been described as ‘community health and wellbeing’ by the Select Committee. This is interpreted as relating to mental health and wellbeing. The questionnaire survey should make use of established, standardized measures of mental health and wellbeing such as the Warwick Edinburgh Mental Wellbeing Scale (WEMWBS) ;  the SF36 (The Short-Form 36v2)  which assesses mental health, physical health, general health and vitality; and the HADs (Hospital Anxiety and Depression Scale)  which assesses clinically relevant depression and anxiety. Applicants should identify which standardized measures the study would use.

The questionnaire should also assess a range of potential covariates and confounding factors (factors that could be associated either with exposure to HS2 and/or the mental health and wellbeing outcomes) as well as a range of socioeconomic factors.  These factors should also be assessed using measures comparable to those used in other national surveys.

Procedure

The research team will oversee the design of the questionnaire survey to be employed for the baseline survey. The questionnaire survey will include a core set of questions that can be repeated at subsequent survey waves. The research team will also be responsible for designing the geographical scope of the study, working alongside HS2.

It is envisaged that the research team could sub-contract a market research team to undertake the data collection for each wave of the study. Alternatively, the research team may feel qualified to conduct the questionnaire survey in-house.

The research team will be expected to obtain ethical consent for the survey; pilot the survey questionnaire; undertake data documentation, collation and cleaning activities; to develop an analysis plan; and to undertake and write-up advanced statistical multivariate analyses of the dataset. The research team should also include an assessment of representativeness of the participants in each of the study areas compared to Census 2011 data. The dataset should be prepared and documented so it is suitable to be hosted on publicly available platform such as the UK Data Archive. The research team will be expected to prepare peer-reviewed journal papers from analyses of the baseline data. 

Frequently asked questions (FAQs)

Remit of the call

Q1. How can I find out more information about the call and its remit?

You can find further information about this call in the specification document on this website.

Q2. When will the call open?

The call will open on 17 March 2020. From this date you will be able to access application forms.

Q3. What is the deadline for proposals?

The deadline for Stage 1 proposals is 1pm, 22 May 2020.  Applications received after the deadline will not be considered. 

Background

Q4. Why has this study been commissioned?

In Select Committee's Second Special Report of Session 2017-19 the Committee directed HS2 to commission an ongoing epidemiological report to address mental health and wellbeing. Not only to provide the Phase 2b Committee with a clearer overview of these potential effects but also inform the development of major infrastructure projects in the future.

HS2 Ltd have therefore committed to the scoping and commissioning of an epidemiological quantitative analysis of the impact of Phase 2a on mental health and wellbeing, which would also look at international best practice in the field. Whilst initial base-lining data would need to be captured now, the study will be long term.
Although the main geographical scope for the study will be the Phase 2a route, the study should look at study areas along both Phase One and Phase 2b of the proposed scheme in order to collect data from areas where development is at different stages.

Q5. What are the overall objectives of the study?

To understand the different ways in which individuals and communities in affected areas perceive and potentially experience the mental health and wellbeing effects of the HS2 scheme (both adverse and beneficial effects);

To analyse existing mental health and wellbeing data reported by the government for residents living in communities potentially impacted by HS2, to quantitatively assess the potential effect of the Scheme on mental health and wellbeing outcomes over time;

To collect survey questionnaire data from residents living in communities impacted by HS2 and uncertainty associated with the Scheme, to quantitatively assess the potential effect of the Scheme on mental health and wellbeing over time.

Q6. What will happen to the research findings i.e. what will happen if the research shows a negative impact on mental health and well-being?

The research findings published at the end of the study will be shared with DfT to be used to inform the development of major infrastructure projects in the future.

Management and governance

Q7: Who is paying for the research, is it coming from the NIHR budget?

No. The total research costs (up to £2M) will be covered from the budget of HS2 Ltd. The NIHR will not support any research costs in this instance.

Q8: Why are NIHR working with HS2 Ltd?

The remit of the NIHR is to improve the health and wealth of the nation through research. In response to the request in the House of Commons Select Committee Second Special Report of the 2017-19 session (para 125-134), NIHR are working closely with HS2 Ltd to support the commissioning of research to assess the potential mental health and wellbeing impacts of the HS2 development.  The research project will be commissioned through the NIHR Public Health Research (PHR) Programme.

HS2 Ltd have sought the expertise of NIHR to ensure that the study is seen as independent and impartial. HS2 Ltd have been involved in the design of the scope to ensure it fulfils the ask of the Select Committee but once the study commences HS2 will be advised through NIHR on progress and will not seek to influence the outcomes of the study.

Q9: What is the relationship between NIHR, DHSC, HS2 Ltd and the University of Southampton?

The NIHR Public Health Research (PHR) Programme is hosted by the Wessex Institute, University of Southampton. The NIHR is funded by and reports to the Department of Health and Social Care (DHSC). For the purposes of commissioning this study, University of Southampton will be working with HS2 Ltd to commission a study through the NIHR PHR programme, with a research contract being issued between HS2 Ltd and the successful host organisation (e.g. HEI) who will deliver the study.

Q10: How will you ensure independence of the research?

In line with standard practice, the specification document will be openly advertised on the NIHR website. Applications will be welcome from any host institution within the UK and will be assessed through the NIHR PHR Programme's decision making committees. The study will be monitored in line with the NIHR standard contracting and monitoring processes to ensure delivery against the objectives. In order to provide an important and permanent archive of research, a full and comprehensive account of the study findings will be published in the open access NIHR journal in order to comply with the NIHR guidance on research outputs and publications guidance: https://www.nihr.ac.uk/documents/nihr-research-outputs-and-publications-guidance/12250

The involvement of HS2 Ltd is not intended to unduly influence the study, involvement is to ensure that the study continues to respond to the ask of the Phase 2a Select Committee.

Planning and making an application

Q11. How much money can I request in my application?

The available funding is up to £2M over 10 years. Studies will be commissioned with a break point at year 5 to review progress which would be conditional upon the release of further funding.

Q12. Which type of costs can I request in my application?

Detailed guidance regarding the types of costs that can be requested in an application are available on the PHR Programme website.

Q13. Who can apply for funding?

The standard eligibility rules for the NIHR Public Health Research Programme apply.

Q14. Who is allowed to submit proposals - is it just universities?

Applicants should check the PHR programme website for further details on which organisations would be eligible to apply. 

Q15. Do I have to be affiliated to the NHS to submit a proposal?

Applicants should visit the individual programme website to check whether they or their organisation are eligible to apply before submitting an application. 

Q16. What type of research are you hoping to fund?

Please refer to the specification document for information on the three work packages.

Q17. How will my proposal be assessed?

Your proposal will be assessed against the criteria stated on the specification document.
Management and scientific assessment of the proposals will be by the PHR programmes decision making committees. Further information regarding the programmes assessment processes can be found on the website: https://www.nihr.ac.uk/documents/general-assessment-criteria/12097 

Q18. How many applications are you looking to fund?

Given the available budget it is likely that only one application will be funded against this particular call. However, HS2 Ltd are open to considering a joint-venture approach if your preference would be to bid to undertake only one aspect of the research described in the scope. Applications outside of the scope for this particular call but in remit for the PHR Programme could be considered through the researcher-led workstream.

Study development

Q19. Where can I get advice on how to develop my proposal?

The NIHR and HS2 Ltd will be hosting a writing workshop for potential applicants on 22 April 2020. Further details on how to apply to attend this event are available on the NIHR website.

For support developing applications, applicants are also encouraged to contact their local NIHR Research Design Service (RDS) or equivalent in the first instance: https://www.nihr.ac.uk/explore-nihr/support/research-design-service.htm

Q20. Should patients and the public be involved in my study and where can I find out further information?

The NIHR and HS2 Ltd will be hosting a writing workshop for potential applicants on 22 April 2020. Further details on how to apply to attend this event are available on the NIHR website.

For support developing applications, applicants are also encouraged to contact their local NIHR Research Design Service (RDS) or equivalent in the first instance: https://www.nihr.ac.uk/explore-nihr/support/research-design-service.htm

Q20. Should patients and the public be involved in my study and where can I find out further information?

Patient and public involvement must be included within the application and study design to ensure the research is relevant and appropriate to patients and the public.

INVOLVE and the Research Design Service have extensive resources to support you in the involvement of patients or other members of the public in your study. For further guidance, please refer to: https://www.invo.org.uk/

Q21. I have a question not answered here – what can I do next?

General questions about the call should be addressed to the following address: phr@nihr.ac.uk