Timetable and Budget
| Description | Deadline/Limit |
|---|---|
| Deadline for Stage 1 applications | 14 February 2023, 1pm |
| Notification of outcome of Stage 1 application | April 2023 |
| Project start | within 2 months of outcome notification (subject to pre-contract negotiations) |
| Project duration | 6 - 9 months |
| Budget | £150,000* (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.
Applications for this development phase project will be assessed through a fast-track single stage Committee assessment process, based on information provided in the outline stage 1 application form. Successful applicants will be invited to respond to Committee feedback in an expanded form and will directly proceed to contracting and project start-up.
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 evaluate the implementation, impact and value for money of the strands of the national core improvement offer support provided to local authorities, and to explore how best to shape improvement support in the long-run.
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, as well as additional research to inform the future of improvement support.
Funding is available for both phases of the research project. At this stage, we anticipate commissioning a development phase study (costing up to £150,000), that will inform a subsequent main study will cost between £200,000 and £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 Department for Health and Social Care has funded sector partners to deliver national improvement programmes including Sector Led Improvement (SLI) since 2012. The type of activities funded as part of the improvement package aims to address information and coordination failures, as inefficiencies or variation in quality might arise from local authorities (LAs) not being aware of what works best and not coordinating to identify best practice without government intervention. 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 providers, as well as the opportunities to collaborate through this offer, are valued by those who use them. Central government funding for this improvement activity has typically stood at ~£10m per annum.
The core principles of SLI have been set out by the Local Government Association as:
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Councils are responsible for their own performance and improvement
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Councils are democratically accountable primarily to their own local communities
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Councils have a collective responsibility for the performance of the sector as a whole
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The relevant sector has key skills, experience and understanding that can support improvement at marginal extra cost
The Department is currently reviewing its improvement and support offer, with new aspects of the improvement programme to be phased in over the period between April 2023 and March 2025. Further to this we are continuing to review our improvement model to ensure that it is reflective of the needs of the sector, especially in the context of ongoing reform. Evaluation of our current improvement programme as well as additional research will help shape our improvement offer to the Adult Social Care sector post 2025.
Research priorities
The overall objective of the project is to evaluate the implementation, impact of the different elements of SLI support implemented from April 2023, and to carry out additional research to explore how best to shape the offer in the future.
On evaluation, the indicative research questions we expect the project to focus on are the following:
- What is the impact of the different elements (e.g. universally available improvement toolkits, bespoke improvement activity with LAs and providers, etc) of the improvement package on outcomes? Does that differ based on LAs performance status?
- Have elements of the improvement offer been taken up by and used by the LAs that need it the most (i.e those with lower performance status)?
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Are the different elements of the improvement package being implemented as intended? If not, what are the facilitators and barriers to implementation?
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Are the different elements of the improvement package value for money? Does this vary according to type of improvement activity?
On additional research, we are aware that there is limited evidence for how to support continuous improvement in adult social care, and we are keen to carry out more research to see what can be learned to shape the offer in the future. This might include:
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Considering how the improvement offer and SLI support are likely to interact with other policy interventions (e.g. interventions on LA assurance)
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Assessing best practice across ASC or other sectors in terms of implementing improvement activities and understanding how they enable robust assessment of their impact
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The development phase will be focused on scoping the evaluation for the main study. Specific questions for the additional research will be developed and agreed at the main stage, taking into account the outcome of the development stage as well as findings from latest evidence published in the King’s Fund (2022) Building capacity and capability for improvement in adult social care.
The primary objective of the development phase is to assess the feasibility of evaluating the implementation, impact and value for money of the different elements of the improvement offer including SLI support. This should include (but not be limited to):
- development of a detailed theory 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 SLI support;
- 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 wide range of approaches suitable for evaluation of process, impact and value for money of the different elements of the improvement offer and SLI 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. For illustrative purposes, the following elements are likely to feature – but please do not limit your application to these suggestions alone:
Development of a theory of change of SLI interventions
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Map out the typologies of activities offered as part of the improvement offer and SLI support.
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Outline the outputs, outcomes, and longer-term impacts for each strand of the improvement offer and SLI support.
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Indicate whether any of the causal links between inputs, outputs, outcomes, and impacts are already well evidenced
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Based on conversation with DHSC, determine which sections of the theory of change should be the focus of the evaluation, based on assessment of priority and feasibility.
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Produce a refined list of research questions for evaluation based on the theory of change that has been developed.
Review of available data and evidence
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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
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Advise on whether additional data would need to be collected to enable quantitative evaluation of the impact of the different elements of the SLI offer.
Assessment of causality for the evaluation
The development phase should put forward a proposal for the most robust feasible methodology to answer the evaluation questions. This should include any proposal for qualitative approaches that might support assessment of causality.
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 will now assess 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.
When exploring inequalities, we would like researchers to focus on collecting responses from individuals with a range of characteristics. Characteristics to consider are: sex and/or gender, region, 5 ONS Ethnic groups, and the 5 IMD quintile groups. These characteristics are considered an ideal, but we understand that these are subject to change depending on the sample population and research design.
A recording of the Health Inequalities in NIHR PRP Research Q&A Event which was held on 19 September 2022 is available to view on Youtube, this may be useful to refer to as it provides additional information.
Further details about this new request can be found in Appendix A.
Expertise required
Applicants should be able to demonstrate the following:
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A strong understanding of the adult social care sector in England
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Expertise in evaluation of national policy programmes
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Expertise in conducting quantitative and qualitative research and analysis
Outputs
Key outputs from the development phase should include:
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An end-of development phase workshop.
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A theory of change for the elements of the Improvement Offer.
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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. It doesn’t need to go in public outputs, but DHSC would like information on the cost implications of different design options.
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 £150,000. Our current assumption is that a subsequent main study will cost between £200,000 and £350,000.
For current planning purposes, we expect the development phase to take between 6-9 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. We estimate that the main study could take up to an additional 18 months. This timetable is not fixed; applicants are asked to set out their own indicative estimates for the timing and costs anticipated across the different phases of the project (this information can be included within the narrative research plan section of the application), based on their specific proposals.
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:
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Provide regular feedback on progress
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Produce timely reports to the advisory group
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Produce a final report for sign off
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.
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. For other methodologies, variable vs number of observations may be more appropriate to record participant data). This table is for an example only. It does not contain sub variables and does not illustrate any preference for certain variables, as these will be dependent on the proposed research.
| 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 | - | - | - |
| Sex | - | - | - |
| Gender | - | - | - |
| Disability | - | - | - |
| Ethnic Group | - | - | - |
| IMD Group | - | - | - |
| Region | - | - | - |