Introduction
The aim of the Health Technology Assessment (HTA) Programme is to ensure that high quality research information on the clinical effectiveness, cost-effectiveness and broader impact of healthcare treatments and tests are produced in the most efficient way for those who plan, provide or receive care from NHS and social care services. The commissioned workstream invites applications in response to calls for research on specific questions which have been identified and prioritised for their importance to the NHS, patients and social care.
Research question
What programmes are used to improve emotional wellbeing and reduce the cycle of repeated care proceedings for women who have had a baby taken immediately into care, and how effective are they?
- Patient group: Women who have delivered at least one child removed from their care and are at risk of having a subsequent baby removed from their care after birth.
- Important outcomes: Quality of life; recommendations for future research; maternal well-being and mental health; planned safe future pregnancy; comparison of costs and cost-benefit; substance misuse; engagement with support services; use of long acting reversible contraception; length of time between intervention and next pregnancy.
- Study design: Evidence synthesis. A realist approach could also be considered.
Rationale
A local authority can issue care proceedings, and ultimately remove a newborn baby from her or his mother if the child is assessed as suffering, or is likely to suffer, serious harm due to the care provided by the parents being below a reasonable standard. This is very distressing for everyone involved and cases of care proceedings involving newborns are increasing in England.
Around a quarter of women who have had a child involved in a care proceeding will go on to have at least one more child involved in a care proceeding, and this is more likely for younger women. The gap between pregnancies is likely to be quite short. This has implications for the physical and mental health and wellbeing of both women and their babies, such as increased risk of preterm birth. There are also likely to be negative impacts on the mental health and wellbeing of birth fathers. There can often be complicated, traumatic contexts and histories involved in situations where care proceedings are issued, and a lack of effective support or interventions to reduce the risk of babies being removed from their mother. The lack of a legal mandate for a local authority or court to actively support the mother may lead to a further pregnancy and the risk that the baby may be taken into care.
As such, it is important to know how to improve the emotional wellbeing of women who are at risk of having a subsequent baby removed from their care and how to reduce this cycle of care proceedings. The HTA Programme wants to fund an evidence synthesis to identify different interventions currently in use to support either birth mothers or fathers, or both, and explore how effective they are at supporting the people who use them. Applicants must consider equality, diversity and inclusion, as well as the impact of intersectionality. Ethical issues around any interventions must also be considered.
To support the ambitions of NIHR’s Best Research for Best Health: the next chapter, NIHR strongly encourages the inclusion of nurses, midwives and allied health professionals within well-developed research teams responding to this call, to increase the building of nurse, midwife and allied health professional-related research activity, capacity and capability across the professions. Depending on the level of experience, this could be through the role of lead applicant, as joint co-applicant supported by detailed mentoring plans submitted with the application, or as a co-applicant member of the research team. Through this activity, NIHR aims to support nurses, midwives and allied health professionals to become future research leaders and release the potential to lead, use, deliver and participate in research as a part of their job.
Additional commissioning brief background information
A background document is available that provides further information to support applicants for this call. It is intended to summarise what prompted the call and the existing evidence base, including relevant work from the HTA and wider NIHR research portfolio. It was researched and written on the basis of information from a search of relevant sources and databases, and in consultation with a number of experts in the field. If you would like a copy please email htaresearchers@nihr.ac.uk.
Making an application
Your application must be submitted online no later than 1pm on 29 November 2023. Applications will be considered by the HTA Funding Committee at its meeting in January 2024.
HTA Programme Stage 1 guidance notes are available, alongside supporting information for applicants.
Please note that shortlisted Stage 1 applicants will be given 8 weeks to submit a Stage 2 application. The Stage 2 application will be considered at the Funding Committee in May 2024.
Applications received electronically after 1pm on the due date will not be considered.
For commissioned topics, the Programme strongly discourages the practice of the same co-applicant joining more than one competing team. There may be unusual circumstances where the same person could be included on more than on application, for example a lead from a named charity or a unique national expert in a condition.
For such exceptions, each application needs to state the case as to why the same person is included. The shared co-applicant should not divulge application details between teams. Both teams should acknowledge in their application that they are aware that one of their co-applicants is part of a competing application and that study details have not been shared.
Should you have any queries please contact htacommissioning@nihr.ac.uk.