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Policy Research Programme - Working Age Health call 4

Published

10 May 2022

Version

1.0 - May 2022

Contents

This document provides guidance on completing an application for stage 1 of the fourth NIHR Policy Research Programme (PRP) tcall for research on the relationship between health and work.

Timetable and budget

 Description Deadline/Limit
 Deadline for stage 1 applications:  14 June 2022, 1 PM
 Notification of outcome of stage 1 applications:  August 2022
 Deadline for stage 2 application:  28 September 2022, 1 PM
 Notification of outcome of stage 2 applications:  January 2023
 Project start:  January 2023
 Budget:  £250,000 to £750,000 per project

Introduction 

The NIHR Policy Research Programme (PRP) invites applications to undertake research to inform Government policy around working age health, and disability. 

Research projects funded by this call will provide evidence to inform policy for improving health and wellbeing and reducing health inequalities. Issues include the relationships between health and work, and effective interventions which enable people to work, with a focus on service rather than clinical issues. Funded projects will need to generate results to inform policy in the next three to five years.  

Proposed research studies will need to demonstrate relevance to the issues outlined in this specification and demonstrate the potential to:

  • Inform action from a range of stakeholders including. Department of Health and Social Care and Arm’s Length Bodies, Department of Work and Pensions, National Health Service England, Clinical Commissioning Groups, Primary Care Networks, local government, employers/industry).
  • Inform improvements to policy and practice with broad population impact. 
  • Support strategic improvements such as effective integration across health and employment systems, and investment decisions. 
  • Suggest interventions or policies that could be sustained medium to long term.
  • Improve societal and system preparedness for future health and wellbeing challenges.

This current call follows earlier calls announced in December 2020, June 2021 and January 2022. Details on the projects funded in these iterations will be made available on the PRP website.

This is a significant opportunity to inform policy in an important area for people and the economy. We are seeking projects with a high potential for impact and relevance across the working age population. Proposed studies should generate evidence that helps improve population health and helps reduce costs associated with ill health that prevents people working. Applications must state how proposed projects will deliver policy relevant findings and impact.

Policy context

There are around 13.7m working-age people in the UK with a long-term health condition, including 8.3m disabled people whose condition reduced their ability to carry out day-to-day activities (1). Only 5 in 10 disabled people of working age are in work compared to 8 in 10 non-disabled people. In 2019, 138m working days were lost to sickness absence, and 1.4m people had a sickness absence lasting 4+ weeks (2).  

Improving work and health outcomes amongst working-age people has the potential to deliver substantial economic and social benefits for individuals, employers and wider society. Individuals and their families benefit through improved employment, income, and health outcomes. Savings may occur through increased tax revenues, reduced benefits spend, and reduced use of health and care services.

In the Health is Everyone’s Business Consultation Response (3) the Government committed to supporting a sustainable occupational health (OH) workforce, recognising that immediate actions are required, alongside the development of a longer-term strategy, which acknowledges the cultural, behavioural and administrative changes required amongst organisations and stakeholders. Government recognises that this is a large programme of work and will initially focus on immediate actions around the provision of information and advice for OH professionals and those interested in an OH career, alongside exploring training improvements and support. These actions will help inform the longer-term workforce strategy which could include creating greater training and development opportunities for the current and future workforce subject to future funding. 

Government has begun involving expert OH stakeholders from the public and commercial sectors to develop these initiatives, as well as considering how the strategy could align with other programmes of work across government, with potential to collaborate in certain areas. We understand the importance of multidisciplinary working in OH and are looking to involve a range of disciplines and healthcare professionals across public and commercial sectors in supporting the sustainability of the future OH workforce. Government has initiated research to expand the limited evidence base round multidisciplinary OH workforce models and is working with partners to understand uptake of this approach, including barriers, enablers and effectiveness,

Research priorities 

The research priorities in this specification have been developed in collaboration with the Government’s Work and Health Unit, following earlier calls referred to in paragraph 4. 

We have a specific interest in research projects which address key issues around Occupational health and Vocational Rehabilitation (VR) as outlined in Health is Everyone’s Business Consultation Response (3). This identified several issues in the commercial OH market, which currently delivers the majority of OH services. These include lack of knowledge of OH, cost as a key barrier to purchasing OH and shortages in the OH workforce, particularly clinical staff, which risk the future capacity of the market to deliver services. There is potential for more rapid innovation particularly targeted at small/medium enterprises (SME) and self-employed people. The measures outlined form a strategy for reforming the OH market, both to increase demand for OH and address these issues.

Research projects to investigate OH/VR might include impact evaluations of OH or VR, multi-disciplinary OH/VR delivery models, innovative ways of providing OH/VR services to SMEs and any innovative technological solutions to providing cost-effective OH to SMEs and self-employed people.

We also have an interest in evidence for publicly delivered, low intensity, OH and work and health support (such as interventions based around case management and signposting to relevant support, and / or involving Vocational Rehabilitation). In particular, evidence of the impacts on health and work outcomes and / or the overall cost effectiveness of interventions.

Additionally, we have an interest in health promotion and employer/workplace interventions. i.e., what levers and approaches effectively motivate employers to institute health promoting interventions/conditions in workplaces? What are the barriers and enablers to creating and maintaining health-promoting workplaces?

Populations of interest

For particular topics or issues, it may be relevant to consider the entire working age population. For other topics or issues, it may be more relevant to consider a more specific population, for example, people with long term health conditions or disabilities, or people on sick leave and at risk of falling out of work, younger or older workers. However, research must have potential broad population applications, rather than a narrow focus on a very specific issue or group. Where specific populations are proposed, applicants must be explicit about how the research and its applications are relevant to a broader population. Specific characteristics that are of particular importance for policy include Health status and morbidity – particularly long term mental and physical health conditions, disabilities, presence of comorbidities and pain.

Health and work issues span health settings, the workplace, and the welfare system. Successful outcomes for people can require collaboration between many different actors including individuals, employers, healthcare professionals and other service delivery professionals. Studies will therefore need to have clear plans to involve relevant parties. 

Proposals must include a stakeholder engagement plan and consider opportunities for coproduction. In this call, study participants may be employees or employers, as well as the health and care patients and service users who are typically the important focus of NIHR patient and public involvement. Involvement plans should include all relevant groups.

Health and work outcomes

Policymakers in this area need a variety of different types of evidence to help with making a case for action, such as design of specific measures that can be replicated (for example considering the target groups and scope, as well as specific details of an intervention); cost-benefit assessment (according to Green Book principles), and real-world implementation.

Areas that are out of scope

Studies focussed on very specific issues or groups which would be difficult to apply to a broader population in a wide range of settings.

Studies focused solely on workplace safety or industrial injuries.

Evaluations of current national government policies (such programmes contracted by the Department of Work & Pensions.), where separate plans may already be underway to fulfil any such requirements from a policy perspective.

Considerations for research

Prospective applicants are encouraged to consider the following critical areas in developing their proposals, wherever relevant.

Policy relevance

This call is funded by the NIHR Policy Research Programme (PRP) which commissions research to inform Ministers and senior policy makers. Researchers should demonstrate the relevance of their proposed research to evidence users, for example, how research could inform policy assumptions, the direction of Government strategy, formulation of policy measures, or broad population-based interventions or services.

Equality and health inequalities

There is a significant body of evidence that describes the scale and nature of health inequalities including those related to employment across the UK. We are interested in whether and how interventions support health equity and equality across groups. Applicants should demonstrate how their research can help support these aims.

Methods 

A wide variety of approaches, methods and techniques can help provide policy relevant evidence including, but not limited to secondary data analysis, data developments (including data linkage and modelling), economic analysis, qualitative research (stand alone or as part of mixed methods approaches), observational studies, psychometric studies, intervention studies (including randomised control trials) and evaluations (with theory based, impact and economic components). We are seeking studies that focus on new models or approaches, and on implementation   

Although a wide variety of approaches and methods could be chosen to investigate the subject matter, methods chosen should generate findings, interventions or advice which is applicable to the wider population or focussed on a condition/ circumstance that affects a significant amount of the population.

Applicants must clearly demonstrate the suitability of their proposed methods for answering their research questions and producing policy relevant evidence. 

Interdisciplinary approaches

A range of disciplines, perspectives, approaches and methods have relevance for policy relevant health and work research. Some issues may benefit from studies that take a particular perspective but, in many circumstances, interdisciplinary approaches and multiple perspectives will be valuable throughout a study lifecycle. For example, this may involve combining clinical experts with social scientists, and expertise from both the health and employment domains. Applicants are therefore particularly encouraged to bring together interdisciplinary teams as appropriate for proposed studies.

Feasibility

Meaningful engagement of employers is a prerequisite for generating high quality evidence on interventions through the workplace. Similarly, research exploring how to address nonclinical needs in health settings require meaningful, ongoing engagement with healthcare professionals to secure buy-in and strong co-operation.  Previous studies in this area have faced considerable challenges securing the buy-in and co-operation of employers and healthcare professionals to enable appropriate referrals, data collection, and other activity required for research studies. 

A key consideration for proposed studies involving primary data collection is therefore how study recruitment and engagement will be approached. The funding committee will expect to see a thorough consideration of the feasibility of any research, especially where employer or healthcare worker engagement is fundamental to its success.

Other feasibility issues, including any implications of the current COVID-19 pandemic (e.g. on timing, research methods etc.) should also be explicitly covered in proposals.

Implementation issues

Health and work interventions are complex social interventions and may not work as intended when attempts are made to spread or to scale approaches that have shown positive results in pilots or trials. Evaluations that focus solely on average population effects may miss vital information about how different groups experience or are impacted by the intervention, and critical contextual factors for success in a particular area or setting. We need to strengthen our understanding of how health and work interventions can be successfully implemented, with what resources and in what context; including making better use of lessons learned across different studies of similar interventions. We also need to improve our understanding of the resource implications of different approaches to health and work support, engagement and recruitment issues, and the capacity and capability of different roles that play a part in delivering support (particularly in the NHS, occupational health sector and welfare system).

Knowledge translation and evidence-based practice

In addition, a strong evidence base in a particular area doesn’t always translate into successful practical tools, interventions and services that work on the ground. A key interest for policy makers is how they can best influence the behaviours of key actors that have a bearing on health and work outcomes (e.g. employers, healthcare professionals, occupational health providers) by translating evidence-based approaches to facilitate their adoption at scale. A range of evidence-based tools and guidance products already exist to inform practice, but there is less knowledge about their impact. Therefore, within this call we welcome studies that consider how to influence practitioners and employers to adopt evidence-based interventions. 

Budget and duration

In the current call we are looking to fund projects envisaging individual budgets of between £250,000 and £750,000. Projects are expected to last no longer than 36 months. This will be the final funding round of this initiative. 

Where applicants can demonstrate that further value could be realised by extending a project beyond three years, an initial case for doing so can be made in these applications and these will be considered  later during the successful project. However, current proposals are being considered on the basis of what they can deliver within three years. 

The duration of the research and individual projects within the contract should be no longer than is consistent with high quality studies. Proposals will be assessed according to criteria of value for money, scientific quality and, potential for policy impact.

Applicants are asked to address the timing and nature of deliverables, where appropriate to enable interim reporting potentially to inform policy and implementation. 

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 Committee members will assess applications against.

All applications are expected to start within 2 months of funding being agreed, subject to pre-contract negotiations and specific requirements.

Applications will be considered from any type of organisation and from other UK countries (Scotland, Wales and Northern Ireland) provided they address the priority areas in a way that is relevant to the needs of the Department of Health and Social Care (England) and meet all other selection criteria. There are no restrictions on who can fulfil the role of lead applicant or principal investigator. For more information about application requirements, please see the 'Standard information for applicants' section below.

Governance

The successful applicants for this research may be required to review their research objectives with an established research advisory group including representatives of relevant stakeholders and arm’s length bodies and to share emerging findings on an ongoing basis. 

You will be expected to:

  • provide regular feedback on progress
  • produce timely reports to the advisory group
  • produce a final report for sign off 

Key documents including reports must be provided to DHSC in draft form allowing sufficient time for review.

The NIHR may approach one of the successful applicants to act as a co-ordinator for the programme as a whole. For example, to set up an annual research presentation meeting in conjunction with DHSC and its partners. Please do not cost for this activity; an additional sum will be allocated for this during pre-contract negotiation.

References 

  1. DWP (2021) The employment of disabled people 2021. [Accessed April 2022]
  2. ONS (2022). Labour Market Overview, UK: April 2022, Table A08. A08: Labour market status of disabled people - Office for National Statistics. [Accessed April 2022]
  3. DWP/DHSC (2019) Health is everyone's business: proposals to reduce ill health-related job loss[Accessed November 2022]