Case study: Collaborating to boost musculoskeletal research
The NIHR collaborates with charities on high quality research in areas of shared interest, to drive alignment in the health and care research ecosystem and make best use of resources and expertise.
Supporting people with arthritis
Versus Arthritis is the UK's largest charity dedicated to supporting people with arthritis. The charity funds research to develop new treatments for arthritis, as well as campaigns for arthritis to be a priority in government and the health and care system, and provides information, advice and support for people with arthritis.
Versus Arthritis funds invests approximately £20 million into health and care research each year, adding to its portfolio of £130 million worth of active research projects.
Versus Arthritis has a long history of collaborating with NIHR, dating back to 2002 and encompassing a number of the different ways that research charities can collaborate with the NIHR.
Understanding the research landscape
Versus Arthritis is currently reviewing its research strategy and considering how it can best deliver impact from its funding. As part of this, the charity has been analysing the additional sums leveraged by its researchers from other funders, to see to what extent funding leveraged boosts the impact of Versus Arthritis funding.
Versus Arthritis were able to estimate approximately how much additional funding each pound of their funding generated. “The challenge then was to understand how significant this figure was in a broader context,” said Tammy Cheng, Research Evaluation Manager at Versus Arthritis.
As the national health and social care research funder, the NIHR has a unique overview of the national health and care research landscape. In this case, the NIHR shared information with Versus Arthritis about the arthritis research on the NIHR portfolio, to help with benchmarking. By combining this with information submitted to Researchfish, the NIHR could provide a rough estimate of how much additional funding is leveraged from its arthritis portfolio, to assist Versus Arthritis in benchmarking its figure.
“Previously we had no idea whether our figure for funding leveraged was good or bad, so it’s been really valuable to know that the leveraged power of NIHR is twice greater than us based on 2018 award data,” said Tammy. “This intelligence has fed into our ongoing discussions about our research funding strategy and how we can maximise the impact of our spend.”
Versus Arthritis’ first steps to co-funding with the NIHR were driven by Professor Elaine Hay, Programme Director of NIHR Programme Grants for Applied Research (PGfAR). Alongside her NIHR role, Elaine is Professor of Community Rheumatology and the Director of the Primary Care Centre Versus Arthritis at Keele University.
Both Versus Arthritis and NIHR had an ambition to fund more research in pain, with Versus Arthritis developing a pain roadmap to guide their research investment and NIHR running an ongoing themed call in chronic pain.
“Collaborating with Versus Arthritis has shone a spotlight on the mutual benefits of NIHR and the charity working together to fund research that tackles issues that have been prioritised by patients and hence has the potential to make a real difference to the lives of patients and the public,” said Professor Hay.
Versus Arthritis was interested in collaborating with the NIHR because of its focus on patient benefit, said Anna Durrans, Research Programme Manager at Versus Arthritis. “Following the merger of Arthritis Research UK and Arthritis Care, Versus Arthritis has a much bigger ambition around bringing research to people faster,” she said. “There aren’t many organisations who are funding research at the applied end of the spectrum, so NIHR was an obvious partner.”
Another factor that drew Versus Arthritis towards collaborating with the NIHR is the nature of pain, which crosses many conditions though musculoskeletal diseases and beyond. “The NIHR has a large reach across a broad range of disciplines and expertise, so working with NIHR helped us to encourage researchers from other backgrounds into the field and broaden our research community,” said Anna.
This benefit works two ways, said Rajinder Flora, Assistant Director of PGfAR. “The NIHR can use this collaboration to galvanise the Versus Arthritis research community, reaching a different group of people for our researcher-led programmes and generating high quality research applications in pain.”
Versus Arthritis initially joined forces with PGfAR in 2017 to co-fund a £2.7 million programme of research to personalise care for people with shoulder pain - the PANDA-S study.
Following this co-funding of a single research project, the partnership between Versus Arthritis and NIHR evolved to co-funding whole research calls on understanding, treating and managing pain. Versus Arthritis co-funded all three funding calls in 2019 with PGfAR, with plans for potential ongoing activity in the works for 2020.
“Collaborating with NIHR wasn’t just about money and leveraging funds,” said Keith Pugh, Research Programme Manager at Versus Arthritis. “The collaboration between Versus Arthritis and the PGfAR scheme has increased the profile of research into arthritis and musculoskeletal pain within the NIHR portfolio, highlighting with NIHR topics of mutual interest that are particularly close to our hearts.”
Versus Arthritis and the researchers it funds also benefit from free support that NIHR offers in planning, setting up and delivering research in the NHS or in public health or social care settings.
The NIHR Clinical Research Network (CRN) has been supporting Versus Arthritis studies since 2002, with a total of 396 studies supported to date. All 15 NIHR Local Clinical Research Networks have recruited patients to Versus Arthritis, with more than 250,000 patients recruited at 1,631 sites.
Versus Arthritis and the NIHR are also both leaders in funding and delivering early phase translational research into musculoskeletal diseases. The two organisations formally partnered in 2019 to offer this expertise to the life sciences industry, charities, researchers and other funders and partners - just one example of NIHR’s unique experience in setting up and supporting networks of experts.
The UK Musculoskeletal Translational Research Collaboration (UK MSK TRC) brings together the Versus Arthritis investment in Experimental Arthritis and Osteoarthritis Treatment Centres with the relevant NIHR infrastructure with expertise in musculoskeletal diseases, such as at the NIHR Biomedical Research Centres in Oxford and Manchester.
The collaboration offers the life sciences industry and other funders streamlined access to world leading academic clinicians and scientists in musculoskeletal diseases, who offer input and feedback on design of studies that use experimental medicine approaches, such as novel exploratory endpoints, biomarkers and stratification strategies.
The main aim of this collaboration is to drive cutting-edge translational research in musculoskeletal diseases in order to improve outcomes and develop cures for patients, said Shanae Dennis, Research Collaborations Manager at the NIHR Office for Clinical Research Infrastructure (NOCRI).
“From an NIHR perspective, it has allowed us to widen our focus to a greater range of musculoskeletal disease areas and proactively develop initiatives that create more translational research in these areas, such as pain, where Versus Arthritis has particular expertise,” she said. “Together with the charity we are also working to make sure MSK TRC research is taking place across the whole life course, so that paediatrics and ageing is considered for all projects.”
The added value of collaboration
Versus Arthritis has benefited from the sheer scale and breadth of NIHR’s involvement in research funding and delivery. “Given the size of our charity, we wouldn’t be able to achieve the impact we’re aiming for without collaborating with the NIHR,” said Anna.
The NIHR will also benefit from collaborating with Versus Arthritis, in particular their community of patients and carers with arthritis. “This partnership ensures the patient voice is heard clearly in our research programmes and has the potential to catalyse the implementation of research findings into everyday practice” said Professor Hay.
Professor Hay concluded: “We all need to work together to make sure that our research gains maximum impact for patients, carers and the public. These examples of how Versus Arthritis has worked with the NIHR exemplifies this approach, and will hopefully be a model that can be replicated with other charity partners.