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Compound pressures commissioning brief


Published: 21 February 2023

Version: 1.1 October 2023

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The NIHR wants to generate high-quality research evidence into the evaluation of health and care interventions and services, to reduce compound pressures on the NHS and social care. This cross-programme call for research supports the recently published Department of Health and Social Care Areas of Research Interest, which calls for high quality evidence to support those who plan, commission, manage, deliver and use services across the health, public health and social care sector.

We welcome applications for both new primary research studies to establish the effectiveness of new, promising or existing interventions, and implementation science, evidence synthesis and policy research to support the translation of effective interventions into policy and practice. We anticipate that a range of projects in size and scope will be commissioned and that where possible, will be able to report meaningful intermediate data early in the contract period.

For the purposes of this NIHR themed call, compound pressures are defined as:

  1. pressures on the health and care system, including additional pressures in:
    • winter
    • during extreme heat and weather events
    • during epidemics or pandemics.
  2. the interaction with other pressures, including
    • increases in the cost of living
    • disease levels post-COVID
    • the operational pressures faced by the NHS and social care

For example, frontline services always experience challenges over winter as the demand for services increases significantly with the onset of cold weather and influenza. Typically, attention is focused on Accident and Emergency services, or discharge from hospital into social care or the community; however the impact of compound pressures is felt across the entire health and social care system and is not just seasonal.

Research is needed to identify, assess and evaluate how all parts of the health and care system (including initiatives in community and voluntary services, social care, primary and secondary care) can work effectively to reduce the impact of compound pressures and contribute to better outcomes and quality of life for people, reduce health inequalities and mortality, and improve access to and experience of services. We want to understand how to reduce the impact of compound pressures on the health and care system, how to enable routine care to be more efficient, effective and resilient during times of increased pressure, and to understand what is working for whom, where and why.

Specifically, applicants are encouraged to include geographic areas or populations which have been historically under served in order to ensure that NIHR research is conducted in the areas where health needs are greatest.

Applications should be co-produced, demonstrating an equal partnership with service commissioners, decision makers, providers, service users and community members in order to provide evidence and actionable findings of immediate utility in practice. Applicants may wish to consult the NIHR guidance on co-producing research.

Deadline for proposals

Please note that opening and submission dates vary. Completed forms must be submitted by the date specified by the relevant NIHR programme.

A list of programmes which are currently open to applications for the Compound Pressures Themed Call is available. This will be updated in due course as new funding rounds open.


High quality applications to address the following research questions are encouraged:

  1. How can the health and care system most effectively work together to plan for and respond to compound pressures?
  2. How can the health and well-being of vulnerable people be protected, and avoidable hospital admissions reduced?
  3. How can illnesses which cause excess burden in winter, during extreme heat or infections with pandemic potential be more effectively diagnosed and treated?
  4. How can routine health and care services best be structured and supported to enable them to continue during times of increased pressure, and to recover quickly afterwards?
  5. What works to reduce unnecessary hospital stay, promote smart discharge and reduce staff burden?

All research proposals should consider addressing the following cross-cutting themes:

  • reducing health inequalities, such as the impact on equity and vulnerable populations, including intersectional issues
  • promoting economic growth in the broadest sense, including by delivering a healthier workforce, a more efficient NHS, a higher skilled health and social care workforce, and through investment in the life sciences
  • accelerating speed and adoption of innovation to tackle compound pressures

The expectation is that research funded through this call leads to the development or evaluation of practical, real-world solutions to provide evidence and actionable findings for decision-makers in the short, medium and longer term. This would in turn help to deliver improved public, patient and service outcomes and reduced pressure across the health and care system. Economic evaluation, including health and sector costs, would also be informative to decision makers.

Further details of the scope of the call and specific areas of interest under each research question are available in the supporting information.

Contact information

Applicants should contact the relevant NIHR programme at an early stage if they require further guidance regarding eligibility.

How to apply

The following NIHR programmes are participating in this call for research:

Please note that:

  • proposals must be within the remit of at least one participating NIHR Programme
  • 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
  • applicants should consider the existing NIHR portfolio to support the development of their applications, particularly with respect to programme remit and how the research addresses an explicit evidence gap
  • applicants are encouraged to contact the NIHR Research Support Service or equivalent, and the NIHR Clinical Research Network for early support
  • this call represents an ongoing area of interest for the NIHR and following this opportunity, the NIHR research programmes would still be interested in receiving applications in this area to their researcher-led workstreams

Specific questions about the commissioning brief can be sent to