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Injuries, accidents and urgent and emergency care themed call - Commissioning brief

 

Contents

This themed call seeks applications for research into the prevention, management and treatment of accidents and injuries and other conditions needing urgent and emergency care. 

The call includes the organisation, staffing and delivery of urgent and emergency care services wherever delivered, at an incident, in the community, or in primary or secondary care settings.

Applicants may propose primary research or research using methods for evidence synthesis and investigate interventions for individual patients, delivery of services, health systems or for population groups.

The call can accept a broad range of preventive, social care or clinical interventions, including services and interventions for people needing urgent or emergency care due to mental or physical health issues.

This call supports the intentions for urgent and emergency care set out in the NHS Long Term Plan (2019) and is complementary to the recent NIHR Emergency Response and Preparedness call.

We recognise there is a significant global burden of mortality and morbidity due to injuries, accidents and conditions requiring emergency care. We will provide separate scope and guidance around research to tackle these themes through the NIHR Global Health Research programme.

The inclusion of patient, service user, carer and public views and experiences are considered important by each participating programme.  NIHR is committed to inclusiveness in its research and applications are preferred that include geographic populations with high disease burden and socio-demographic groups that have been historically under-served by NIHR research activity.

The issue of health inequalities in relation to injury, accidents and urgent and emergency care are of particular interest.

Research following patient need

Please note that the enclosed maps are provided to illustrate one example of the mismatch between research and burden of disease. The data in Figure A is derived from the NIHR Clinical Research Network (CRN) in England. The CRN does not have access to equivalent data from the Devolved Administrations, however, the NIHR is keen to ensure that research is conducted in the areas where health needs are greatest across the whole of the UK and all applicants whether from England or the Devolved Administrations will be expected to justify their choice of recruitment sites.

Figure A shows CRN-supported research activity in England from 2010/11 onwards in the specialty of ‘Trauma and Emergency Care’. The shading represents the number of studies that have recruited participants in each Clinical Commissioning Group (CCG) area. Secondary care recruitment has been matched to CCG area.

Figure B shows the geographical variation across England in the standardised mortality rate from injuries for people under the age of 75 years as defined by district and unitary authority boundaries.

 

 

 

 

 

 

 

 

 

 

 

Figure A: Number of recruiting NIHR CRN-supported research studies categorised as ‘Trauma and Emergency Care'. Open Data Platform Research Targeting Tool, NIHR CRN, accessed 17 December 2019. Data source: NIHR CRN Central Portfolio Management System.


Figure B: Under 75 mortality rate from injuries. Directly standardised rate – per 100,000 (2015-2017). England benchmark 12.8 per 100,000. (Public Health England (based on ONS source data), data last updated Nov 2018).

How to apply

Research proposals must be within the remit of at least one participating NIHR programme. Applications that span the remit of one or more NIHR programme will be welcomed. In these cases, proposals should be submitted to the programme within whose remit the major part of the work lies.

Applicants who are unsure which programme to apply to may wish to send a short summary (maximum 1 page) of their research proposal to themedcalls@nihr.ac.uk

Applicants from England may wish to contact their local RDS to discuss their application.

 All applicants should take note of:

  • the remit of each of the participating programmes (see list below)
  • the existing NIHR portfolio of published and funded projects in these areas to avoid duplication of research
  • that after the initial call close dates, this topic will remain an NIHR priority for  participating programmes.  

Participating programmes

The following NIHR managed research programmes are participating in the NIHR Themed Call.  Please see the individual programmes for information about the scope of each programme. For information on areas of specific interest to this call please see the text below.  For information on call open and close dates of the participating programmes please see the NIHR Themed Calls webpage.

Efficacy and Mechanism Evaluation (EME)

Applications to the EME Programme may test interventions for the prevention or treatment of injuries, accidents and conditions requiring urgent and emergency care. Applications should examine the efficacy of interventions, and may explore the mechanisms underlying possible efficacy. Particular areas of interest include the use of personalised or stratified approaches and digital innovations.

Applications may investigate novel or repurposed interventions and technologies, but studies of incremental or minor improvements to existing technologies or the discovery of new biomarkers are not within the remit of the EME Programme.

The programme would like to encourage applications that utilise novel or efficient study designs where appropriate to the study question, for example the evaluation of a single intervention across multiple diseases, or multiple interventions in one disease. Innovative trial designs are encouraged but not essential.  Applicants will need to fully justify their choice of study design.  Applicants may wish to reference the HTA UK-REBOA study as an example of the use of an innovative study design.

Health Services and Delivery Research (HS&DR)

The HS&DR Programme funds research to produce evidence on the quality, accessibility and organisation of health and social care services. Robust mixed methods studies, or evidence syntheses, are invited with a focus on the organisation and delivery of services, costs, quality, and patient, service user or carer experience. Proposals should be multicentre and aim to produce generalisable findings. Research may evaluate the impact on health, health service and social care outcomes.   

Although other topics may be proposed within the broad remit of this call, the following issues are of particular interest: models of service that involve social care in the urgent and emergency care system; the effects of different approaches to demand management in urgent and emergency care systems; models of interaction within or between emergency departments and other hospital departments, and care delivery settings. We would also be interested in research that addresses issues of service and care delivery at scale. 

Health Technology Assessment (HTA)

The HTA Programme invites applications to evaluate the clinical and cost effectiveness of a wide range of medical, surgical, mental health or social care interventions that have the potential to improve the outcomes of treatment for people needing urgent and emergency care.  The remit of the call includes interventions delivered in hospital or in the community, provided the main focus is on the condition leading to the need for urgent and emergency care services. The intervention needs to be ready for HTA evaluation, in terms of having a clear signal of efficacy and potential to be delivered across the NHS. The inclusion of social and occupational outcomes in addition to health outcomes is encouraged.

Invention for Innovation (i4i)

The NIHR i4i programme is a translational funding scheme which advances healthcare technologies and interventions for increased patient benefit in areas of existing or emerging clinical need. It supports research and development of medical devices, active implantable devices and in vitro diagnostic devices. Applications fitting the i4i programme remit are encouraged but not limited to technologies that address healthcare needs in urgent and emergency care. In particular, proposals focusing on the prevention, management and treatment of accidents and injuries are  welcomed.

Applicants are encouraged to contact the i4i secretariat before submitting an application. The i4i programme will not support basic research activities such as biomarker discovery

Programme Grants for Applied Research (PGfAR) and Programme Development Grants  (PDG)

The PGfAR scheme (inclusive of  PDGs) will support programmes of research which involves a number of interrelated and linked components, using a range of methodological approaches, to answer clinically important questions relevant to the research into the prevention, management and treatment of accidents and injuries and other conditions needing urgent and emergency care. 

Applications employing novel methodological approaches to demonstrate patient benefit at an individual or population level are encouraged.  Examples include development and testing of interventions (including links with industry); using observational data to demonstrate benefit; public health interventions; use of existing data from previous research, or routinely collected health care data. Applications which clearly demonstrate multidisciplinary approaches, and are conducted in geographical locations of high health care needs will be welcomed. Research may be carried out in community, primary or secondary care settings.

Public Health Research (PHR)

The PHR Programme evaluates non-NHS interventions intended to improve the health of the public and reduce inequalities in health. The programme will consider proposals that focus on the potential for population health gain from preventive interventions, and on environmental and social determinants of accidental injuries.

PHR has a particular concern with generating evidence to underpin scalable interventions that operate at a population or whole system level and/or across the life-course.

PHR is interested in population interventions aimed at reducing the impact of accidental injuries and preventing the need for urgent or emergency care and associated inequalities in outcomes. Where justified, proposals can focus on populations that are defined by social or environmental determinants, rather than by clinical conditions (e.g. injuries). Studies should generate data on the economic as well as health benefits of interventions, as well as wider social benefits. We recognise that interventions may be multi-component and that long term follow-up may be necessary to demonstrate effect.

  •   NB. Injuries can be accidental or intentional (including self-inflicted).

Research for Patient Benefit (RfPB)

Applications to the RfPB Programme should arise from daily practice in NHS and social care services, and must demonstrate a trajectory to patient, service user, and/or carer benefit. The programme supports applications which are regionally derived and are concerned with studying the provision and use of NHS and social care services, evaluating the effectiveness and cost effectiveness of new innovations and interventions, and developing and refining new interventions, scales or outcome measures. The programme also welcomes applications for feasibility studies, and applications exploring the potential for improving health and wellbeing through needs assessments, methods development, evidence synthesis, systematic reviews, and qualitative, mixed methods and exploratory studies.

Professorships/Fellowships/Integrated Clinical Academic Programmes

 All NIHR research training programmes are aimed at developing tomorrow’s research leaders and are available at a range of levels depending on the applicant’s background and experience. The new NIHR Fellowship programme, NIHR Research Professorships and HEE/NIHR Integrated Clinical Academic Programme will participate in this call, and further NIHR training awards will be potentially involved in the call at a later date.

Research and Innovation for Global Health Transformation (RIGHT)

The RIGHT programme is expecting to launch a thematic call on injuries, accidents and emergency care in low and middle-income countries in summer 2020. Scope and guidance will be produced ahead of the call.