Timetable and Budget
| Description | Deadline/Limit |
|---|---|
| Deadline for Stage 1 Applications | 11 July 2023 |
| Notification of outcome of Stage 1 Application | October 2023 |
| Project Start | within 2 months of outcome notification (subject to pre-contractnegotiations) |
| Project Duration | 9 Months |
| Budget | £150,000-£200,000 (for development phase) At this stage, applicants are required to submit their plans and costs for the development phase component of the research specified in this document. Since this initial study will inform the main stage (current estimate value between £200,000 - 350,000), we recognise that it will not be possible to set out full details of the main stage. However, applicants are required to describe how they will manage the follow-on phase, and their overall experience, capacity, capability and available resources to deliver the main stage of the study. |
Introduction
The National Institute for Health and Care Research (NIHR) Policy Research Programme (PRP) invites applications for a multi-phased research project. The project will aim to gain insight into how improvement happens in the social care sector and the impacts and outcomes from the national core improvement offer support provided to local authorities.
The multi-phased research project will consist of:
- a development phase which will focus on scoping, assessing the feasibility of and recommending possible approaches for evaluation;
- a main phase study which will take forward the evaluation approach identified during the development phase.
Funding is available for both phases of the research project. At this stage, we anticipate commissioning a development phase study (costing up to £200,000), that will inform a subsequent main study costing between £200,000 - £350,000. Given the complexity of the requirement, we may be able to increase the research budget, where applicants are able to demonstrate this is required.
Background
The Care Act places a duty on Local Authorities (LAs) to offer a meaningful choice of services, so that people have a range of high quality, appropriate care options to choose from and that they get the services that best meet their needs. LAs constantly strive to make care and support better, and the Department for Health and Social Care (DHSC) wants to make sure LAs and their partners have the support they need to do this.
DHSC currently provides funding to 5 partner organisations to deliver national improvement programmes offering improvement support to LAs and social care practitioners. This funding has been provided since 2012. The activities provided by these funded partners are the ‘National Core Improvement offer’.
The programmes delivered vary by each of the funded partners (see further details below). The activities funded aim to provide a coordinated approach to support LAs continue their own improvement journey, and ultimately improve the quality of social care, the experience of the workforce or putting finances on a more sustainable footing. The type of support provided varies from universal to bespoke and it is free to LAs at point of access.
We know that the resources, training, expert advice and support given to LAs and the wider sector, as well as the opportunities to collaborate through this offer, are valued by those who use them.
LAs and social care practitioners may also get improvement support outside of the National Core Improvement Offer, for example purchasing it from consultancies or through corporate-wide improvement activity across the council, through working with the NHS or through other means.
For financial year 23/24 the following support will be available to LAs and their partners through the National Core Improvement offer:
- Regional sector-led improvement, including networks and groups that help Directors of Adult Social Services to collaborate with peers to self-assess their own performance, identify improvement priorities, find solutions and share great practice. This is supported by the Local Government Association (LGA) and the Association of Directors of Adult Social Services (ADASS)
- Partners in Care and Health (PCH), delivered by the LGA and ADASS is a support programme for local authorities and their partners. PCH provides practical toolkits and tailored, expert support to LA leaders and managers to help local systems to deliver the best possible care for people with support and care needs. Support is available to health and social care systems at both a regional and local level and this includes support for: improving assessments; commissioning; safeguarding and social work practice; information advice and guidance; assessing and managing financial risks and efficiencies; digital transformation; and join up between health and care system leaders.
- Social Care Institute for Excellence (SCIE) identifies and disseminates best practice and provides associated training for social care practitioners.
- Think Local Act Personal (TLAP) set standards for personalisation – their Making It Real ‘I and We Statements’ are the cornerstone of CQC’s assessment framework. They provide resources, training, facilitate peer networks and can provide direct support to help local systems to adapt their services so that they can make personalisation a reality for people who draw on care and support.
The Department is currently reviewing its improvement and support offer and making decisions on what will be delivered in the financial year 24/25. Further to this we are continuing to review our improvement model beyond 24/25 to ensure that it is reflective of the needs of the sector, especially in the context of ongoing reform.
We are interested in understanding how LAs and social care practitioners engage in our improvement offer as well as other improvement activity in order to understand the impact of this spend and understand the outcomes and benefits. Evaluation of our current improvement programme as well as research into use and experience of wider improvement activities will help shape policy decisions on the Department’s improvement offer to the Adult Social Care sector from 2025. Depending on the scope of the main study, this could range from inputting on the content or delivery of the improvement offer to impacting on the overall model.
In 23/24 our national core improvement offer is being delivered in the context of a new duty on the Care Quality Commission (CQC) to assess LAs delivery of their Care Act 2014 duties and new SoS powers to intervene, where it found that an LA failing to deliver those duties which went live on the 01 April 2023. While we are interested in how these new elements of LA performance management may impact on LA engagement with our offer, this is not the main focus for this research.
Research priorities
The overarching objective of this research (both the development and main stage) is to understand the impact of the spending on the National Core Improvement Offer. Given the complexity of the topic and the National Core Improvement Offer, we appreciate that an impact evaluation will not be feasible. To support further scoping and understand what is feasible we are commissioning a development phase, which will then be followed by a separate main phase informed by the findings from the development phase.
This research request builds on findings from a rapid research project undertaken by the Kings Fund (2022) Building capacity and capability for improvement in adult social care. This project found that whilst senior leaders in the case study sites were benefitting from the improvement programme, people sometimes struggled to articulate the different components of improvement, or know if the support they were benefiting from was part of the improvement programme.
Development phase
The development phase will be focused on scoping work to inform the main study.
The primary objective of the development phase is to assess the feasibility of evaluating the different government funded elements of the improvement offer (outlined above) as well as, where relevant, understanding LA and/or social care practitioner engagement with and experience of wider improvement activity that is happening in the sector.
As mentioned, we are aware that a quantitative impact assessment of the whole improvement offer is unlikely to be feasible. Therefore, the development phase should include activities to help us identify what it might be feasible to evaluate, and to explore different potential methods for undertaking a proportionate evaluation. This could include consideration of theory-based evaluation methods or qualitative impact evaluation methods as well as consideration of whether there are options for focusing a more quantitative impact evaluation, for example on specific partners or activities or LAs, to make it feasible.
As part of the development phase, we will want to understand the limitations of any proposed approaches to the main stage, as well as the benefits. The development phase may also include activities to help prepare for further research that will be conducted as part of the main stage.
This should include (but not be limited to):
- development of detailed theories of change to map the typology of activities and outline the intended outputs, outcomes and impacts of the different strands of the improvement offer and wider improvement support activity;
- review of the current data landscape to identify already existing data that could be used for evaluation purposes as well as advising on improvements to data currently collected;
- review of a range of approaches suitable for evaluation of the different elements of the improvement offer and wider improvement support.
Main phase
The overall objective of the project, which will be addressed in the main phase, is to evaluate the impact of the spending on the National Core Improvement offer. As outlined above, given the challenges anticipated in measuring and quantifying impact, this may need to focus on the implementation of and engagement with improvement support by LAs and social care practitioners, and understanding (qualitative or quantitatively) the benefits, outputs and expected, perceived or anticipated impacts.
We are also interested in what can be learned from LA and/or social care practitioner engagement with and experience of wider improvement activities, to consider how this could help shape any future improvement offer post 2025 (and beyond).
The research questions and approach for the mainstage will be informed by the development phase and what is feasible, but some indicative research questions include:
- What drives LA decisions to engage with (or not) the National Improvement Offer or alternative improvement activities?
- What aspects of improvement support (e.g. universally available improvement toolkits, bespoke improvement activity with LAs, government funded and wider) do LAs and social care practitioners engage with the most? How does this vary across different areas? What are the perceived or actual outputs and benefits?
- What have LAs or social care practitioners done differently following engagement with the national core improvement offer or alternative improvement activities. How has engagement influenced the delivery or quality of ASC services? Have different aspects/activities been more or less useful in generating improvement?
- What other improvement support are LAs engaging with? And what is driving that decision?
- What are the best approaches to local quality improvement?
- What can we learn about the implementation of the National Improvement Support? What are the barriers or facilitators to providing and accessing support?
Design and methodology
At this stage, applicants are required to submit their plans and costs for the development phase component. Since this initial study will inform the main stage, we recognise that it will not be possible to set out full details of the main stage. However, applicants are required to describe how they will manage this phase, and their overall experience, capacity, capability and available resources to deliver the main stage of the study.
Applicants will need to demonstrate their plans for conducting this development phase. We anticipate that this will be mainly qualitative, involving document review and stakeholder engagement. But welcome alternative suggestions from applicants. For illustrative purposes, the following elements are likely to feature – but please do not limit your application to these suggestions alone:
Development of theories of change of improvement activity
- Map out the typologies of activities offered as part of the improvement offer and alternative improvement support.
- Outline the intended outputs, outcomes, and longer-term impacts for each strand of the improvement offer and alternative improvement support.
- Indicate whether any of the causal links between inputs, outputs, outcomes, and impacts are already well evidenced
- In consultation with DHSC, determine which sections of the theories of change should be the focus of the evaluation, based on assessment of priority and feasibility.
DHSC will work with the successful applicant to discuss and agree the number/scope of any theories of change, logic or programme modelling.
Review of available data and evidence
- Review publicly available data and evidence as well as data that can be obtained by the Department (including, for example, data collection through delivery partners to build a picture of LAs participation in the different elements of the offer and understand variation in take-up) to assess their potential to evaluate the impact and value for money of the different elements of the improvement offer and SLI support through secondary data analysis
- Engagement with stakeholders, including DHSC, National Core Improvement Offer providers, LAs and providers, as well as those using social care to help shape the objectives and review feasibility of the mainstage proposal.
Development of options proposal for the main stage research project
- The development phase should produce a suggested approach and refined list of research questions, informed by the work conducted during the phase.
- A proposal for the most robust feasible methodology to answer the evaluation questions should also be produced. This should include any proposal for qualitative approaches that might support assessment of causality.
Expertise required
Applicants should be able to demonstrate the following:
- A strong understanding of the adult social care sector in England
- Expertise in evaluation of complex national policy programmes, using a broad range of methodologies
Outputs
Key outputs from the development phase should include:
- A theory (or theories of change for the elements of the Improvement Offer.
- An end-of-development phase meeting with DHSC to discuss the findings of the development phase and approach to the main stage evaluation.
- An end-of development phase report detailing the recommended approach for the design of the main evaluation or options for the design of the main evaluation, as well as the recommended approach for the main study to address the additional research questions. DHSC would like information on the cost implications of different design options - but this does not need to go into public facing outputs .
Applicants are asked to consider the timing and nature of deliverables in their proposals. Policymakers will need research evidence to meet key policy decisions and timescales, so project resources need to be flexible to meet these requirements. A meeting to discuss policy needs with DHSC officials will be convened as a matter of priority following contracting.
Budget and duration
Funding is available for both phases of research set out in this document. At this stage, we anticipate commissioning a development phase study of £200,000. Our current assumption is that a subsequent main study will cost between £200,000 - £350,000.
For current planning purposes, we expect the development phase to take approximately 9 months. Applicants are asked to describe the work anticipated in the development phase in detail, providing an accurate estimate of the cost for delivering this development phase specifically. This figure should be entered in the application as the estimated research cost.
The duration of the main study will need to be considered in light of the development phase.
Costings can include up to 100% full economic costing (FEC) but should exclude output VAT. Applicants are advised that value for money is one of the key criteria that peer reviewers and commissioning panel members will assess applications against.
Management arrangements
A research advisory group including, but not limited to, representatives of DHSC, other stakeholders and the successful applicants for the research should be established. The advisory group will provide guidance, meeting regularly over the lifetime of the research. The successful applicants should be prepared to review research objectives with the advisory group, and to share emerging findings on an ongoing basis. They will be expected to:
- Provide regular feedback on progress
- Produce timely reports to the advisory group
Research contractors will be expected to work with nominated officials in DHSC, its partners and the NIHR. Key documents including, for example, research protocols, research instruments, reports and publications must be provided to DHSC in draft form allowing sufficient time for review.
Commissioning process
We invite proposals using the NIHR PRP Stage 1 form specific to this call. At this stage, applicants are required to submit their plans and costs for the development phase of the project. Since this will inform the main study, we recognise that it will not be possible to set out full details of the main study. However, applicants are required to describe how they will manage and deliver the main study.
The development phase study will be commissioned via a one-stage assessment process. The funding decision will be informed by advice from the NIHR Policy Research Programme funding committee.
On completion of the development phase, applicants will be required to set out a plan for the main study and an indicative budget. This plan will be assessed by independent experts and a judgement will be made regarding the next stages of research and whether to proceed.It is possible that the development phase of research will conclude that a main study is not possible or deliverable within the available research budget. The decision to progress will be subject to independent expert assessment of the development phase, including the proposed approach to the main study, and budget approval.
Should the development phase conclude that a main study as proposed is not feasible, an output of the development phase could be an alternative proposal achieving the aims set out here for the main study. Any such alternative proposals will similarly be subject to assessment by independent experts and DHSC officials, on whether and how to proceed.
New Guidance on Health Inequalities data collection within NIHR PRP Research
Inequities and inequalities in the provision, access to and experience of health and care services is a high priority area within the Department of Health and Social Care and the NIHR and is present in the majority of funded projects. We are now assessing all NIHR research proposals in relation to health and care inequalities. NIHR asks researchers to explore issues of inequality and inequity in the research being proposed.
Our goal is also to facilitate more widespread and consistent reporting of data on health and care inequalities relating to the primary outcomes of NIHR funded research. Applicants should, if feasible, collect or analyse data related to health and/or care inequalities, we request that this stated in the proposal. This is a new request from the NIHR PRP and we will be continuing to monitor queries and make any necessary clarifications, as needed.
We understand that research projects may employ different methodologies, and focus on different populations. We ask that you please clearly identify in the research plan section of the application whether your application has a health and care inequalities component. If the project uses quantitative methods, please include detail of the core set of data that will be collected or analysed. Submission of the data collection will be a condition of final reporting that will need to be submitted to NIHR PRP when the grant has finished. If a health and/or care inequalities component is not included, please explain clearly why this does not fit within your research.
Specifically for this project, it may be useful to consider whether any particular groups are particularly impacted by discharge delays, and whether interventions have any differential impact for different groups. This may include consideration of local / regional variation, deprivation or characteristics covered by the Equality Act.
A recording of the Health Inequalities in NIHR PRP Research Q&A Event which was held on 19 September 2022 is available online, this may be useful to refer to as it provides additional information.
Further details about this new request can be found in Appendix A
Relevant background documents
The King’s Fund, August 2022. Building capacity and capability for improvement in adult social care. [Accessed November 2022]
Appendix A: Further Detail on the New Guidance on Health Inequalities data collection within NIHR PRP Research
Health Inequalities is a high priority area within the Department of Health and Social Care and the NIHR and is often present in a majority of funded projects. We are now assessing all NIHR research proposals in relation to health inequalities. We are asking applicants to identify in their application whether or not there is a health inequalities component or theme and how this research hopes to impact health inequalities. We are also asking researchers to collect relevant data related to health inequalities, if appropriate for the research. Collecting specific information about health inequalities in research submitted to the programme will allow for categorisation of health inequalities research, curation of data to aid future health inequalities research and enable policymakers to better understand the implications of health inequalities within their policy areas. This is a new request from the NIHR PRP and we will be continuing to monitor queries and adapt the process as needed. If you have any feedback on this new request, please contact us at prp@nihr.ac.uk.
Our goal is to facilitate more widespread and consistent reporting of health inequality breakdown data relating to the primary outcomes of NIHR funded research. We would ideally like researchers to focus on the following equity-relevant variables: age, sex, gender, disability, region*, 5 ONS Ethnic groups**, and the 5 IMD quintile groups. These variables are considered an ideal, but we understand that these are subject to change depending on the sample population and specific research question.
For qualitative research projects, this can be purely baseline characteristics of the participants, for example, the number of participants in each ethnic group.
For quantitative research projects, if there are multiple outcomes/effects with your stakeholders, select a small number of main outcomes as appropriate to report equity breakdowns. We will not be prescriptive about the number of the outcomes, as it will depend on the number of study design types and the nature of the project aims. We are asking for one way cross tabulations of each primary outcome by these equity-relevant variables, if appropriate for your research, together with the number of observations in each cell. If more detailed cross tabulations are appropriate for your proposed research, please include these as well. This request applies to both primary data collection studies and secondary analysis of routine data, and to causal inference studies as well as descriptive studies; however, if this is not possible due to data limitations then please explain. Due to sample size and other data limitations there may be difficult scientific and/or data security*** judgement calls to make about which breakdowns to report and whether to merge categories to increase counts in particular cells; we ask you to make these judgments yourself, bearing in mind our data curation aim of enabling future evidence synthesis work in pooling results from different studies. We also ask that researchers report breakdowns for the unadjusted as well as adjusted outcomes/effects, as appropriate.
We understand that research projects may employ different methodologies, and focus on different populations. Please explain how the variables and data collection methods chosen are appropriate to the methodologies used.
We ask that you please clearly identify in the research plan section of the application whether your application has a health inequalities component or not and detail the core set of health inequality breakdown data that will be collected, if applicable. Submission of the data collection will be a condition of the final report for all research with relevant methodologies regardless of whether the research has a health inequalities component that will need to be submitted to NIHR PRP when the grant has finished. This should only take a few sentences within the research plan section.
* Table below uses the nine regions in England, further regions can be used if using the UK as the study population. Please report region breakdown for large samples in nationally representative descriptive studies. There is no need to report this for small sample studies, for sub-national studies, or for quasi-experimental studies where it would require time-consuming re-estimation.
** White, Mixed/ Multiple ethnic groups, Asian/ Asian British, Black/ African/ Caribbean/ Black British, Other ethnic group. If the sample size is small then it is fine to report only some of the requested equity breakdowns and to merge some of the sub-groups as appropriate.
*** For guidance on how to handle data security concerns in reporting of sensitive data please see ONS guidance.
Example data table for submission at the end of the funded research project
(N.B. If there is more than one main outcome then you will require more tables and if you adjust your outcome then you will need two tables for the adjusted outcome and unadjusted outcome):
| Variable | Outcome (an appropriate average for this subgroup, usually the mean) | Number of observations | Additional information about variation if appropriate, e.g. range, standard deviation |
|---|---|---|---|
| Age | 0 | 0 | Additional information |
| Sex | 0 | 0 | Additional information |
| Gender | 0 | 0 | Additional information |
| Disability | 0 | 0 | Additional information |
| Ethnic Group | 0 | 0 | Additional information |
| IMD Group | 0 | 0 | Additional information |
| Region | 0 | 0 | Additional information |