Embedding a research culture
As part of the NIHR’s commitment to enhance the health and wealth of the nation through research, we work with health and care organisations and the NHS to improve the environment for health and care research in England.
This means funding and supporting the delivery of research that is practically and meaningfully embedded in the experience of patients and service users, regardless of where they live, as outlined in our strategy Best Research for Best Health.
Making research everybody's business
From NHS trusts, social care services and integrated care systems (ICSs), to regulators and funders, research is everybody’s business.
Together with the Royal College of Physicians (RCP), the NIHR have published a joint position statement with the overall aim of embedding research in clinical practice.
The statement sets out a series of recommendations for making research part of everyday practice for all clinicians and stakeholders across the health and care system.
Clinical research is everyone's future
Health and care professionals are pivotal in promoting participation in clinical trials to patients and the public.
Every role and every professional is important - whether they're leading research in their field of interest, a co-applicant or principal investigator for studies, advising sponsors or sites about the shape and feasibility of their research, or taking a leading and essential role in recruitment and delivery of studies.
Saving and Improving lives: The Future of UK Clinical Research Delivery
In March 2021, the Department of Health and Social Care (DHSC) published their strategy Saving and Improving lives: The Future of UK Clinical Research Delivery, outlining the way forward to build back research better following the pandemic.
The response to COVID-19 showcased the clear link between research and better outcomes for individuals and the NHS.
Seizing this momentum, the strategy looks to the future of clinical research as the single most important way in which we improve our healthcare – by identifying the best means to prevent, diagnose and treat conditions.
It aims to bolster delivery of innovative research across all phases and all conditions, right across the UK.
Evidence of the benefits of being research active
Encouraging a research-positive culture in health and care organisations is important to give patients wider access to clinical research, improving patient care and treatment options.
Evidence shows that clinically research-active hospitals have:
Better patient care outcomes:
- Patients at research active hospitals have more confidence in staff (Jonker L, et al, 2019)
This cross-sectional study found that patients admitted to more research-active hospitals tended to be better informed about their condition and medication.
- Study activity, mortality rates and CQC ratings in NHS trusts (Jonker L, Fisher J, 2017)
A retrospective cross-sectional study showing a correlation in trusts between increased research and reduced deaths.
- Research activity and the association with mortality (Ozdemir BA, et al, 2015)
This study found that research-active trusts have lower risk-adjusted mortality for acute admissions.
- Cancer survival outcomes in hospitals with high research participation (Downing A, et al, 2016)
A population-based study demonstrating strong independent association between survival of colorectal cancer and participation in interventional clinical studies.
A happier workforce:
- Academic factors in medical recruitment (Rees MR, Bracewell M, 2019)
This paper investigates the evidence that increasing the academic component of medical posts may help retain recruitment in the medical workforce.
- Adapting, Coping, Compromising research (GMC, 2018)
A GMC report on the pressures faced by doctors and the impact on patient care.
- Career Fit and Burnout Among Academic Faculty (Shanafelt TD, et al, 2009)
A comparative study highlighting the inverse relationship between the amount of time physicians spend on work they find meaningful and the risk of burnout.
Benefit for the health and care system:
- Advancing health (Medical Schools Council, 2022)
This report on the impact of UK medical schools’ research demonstrates how research improves clinical practice, reduces the cost of healthcare and drives policy change.
- Transforming Health through innovation (Academy of Medical Sciences, 2019)
A compilation of case studies supporting the need to integrate the NHS and health research.
- Engagement of clinicians and organisations in research and healthcare performance (Boaz A, et al, 2015)
A three-stage review suggesting an association between the engagement of healthcare organisations in research and improvements in healthcare performance.
[Quote:]
“In the financial years 2016/17 to 2018/19, it is estimated that clinical research supported by the NIHR Clinical Research Network generated £8 billion in gross value added.”
- Advancing Health (Medical Schools Council, 2022)
How we support NHS research
In 2017, NHS England and the NIHR published a joint statement committing to 12 actions to support and apply research in the NHS.
Actions in the statement relate to how the NIHR works with the NHS, both simplifying research processes and research priorities:
Simplifying NHS research processes
We’ve been working with NHS England, the Department of Health and Social Care (DHSC), the Health Research Authority and others to:
- better manage excess treatment costs (the difference between the cost of standard of care and the cost of the research intervention where the latter is higher)
- introduce a standardised approach to commercial contract research to improve consistency and reduce unnecessary delays to study set-up.
Articulating the NHS’s own research priorities better
Following a NHS England assessment of potential research requirements across the wider clinical portfolio, The NIHR are developing a number of funding calls to commission research in the areas identified.
In 2019, we jointly commissioned a consultation with NHS England and the Academic Health Science Network, identifying the need for innovation and research around:
- Developing the current and future workforce
- Delivering mental health services and providing care for patients with mental health issues
- Integrating services to provide for patients with complex needs such as – multimorbidities, frailty, and for older people and socially isolated people or communities.
These findings are now being used to facilitate further discussions involving patients and the public and the research community, aiming to refine the priorities and better understand the local context and challenges.
Supporting NHS professionals to use research evidence
The NIHR not only funds research, we also share research findings that could make a difference to how practice is carried out. Take a look at our NIHR Evidence website to discover summaries of the NIHR research that we believe is the most likely to make change.
How we support Local Authority research
Research helps build a strong evidence base for Local Authorities to make the best decisions in designing, commissioning and delivering services in the interests of local people.
The NIHR provide funding and support for Local Authority public health and social care research.
We also support Local Authorities to:
- embed a culture of evidence-based practice
- identify a need for evidence to support public health or social care decision making
- develop ideas for future research
- discover the research that could make an impact in your communities.
Supporting ICS Leaders
Integrated Care Systems (ICSs) are a key care delivery partner for the research community. There is a real opportunity to embed research at an ICS level to improve population health outcomes for individuals and communities, particularly underserved communities. NHS England have published guidance for ICSs on how to maximise the benefits of research.
The NIHR can support Integrated Care Boards (ICBs), Integrated Care Partnerships (ICPs) and other ICS Leaders to facilitate and promote research in ICSs.
Supporting ICSs to engage and participate in research
The NIHR provide a number of functions to support health and care services to engage with research. These include:
- advice on building a research culture
- help identifying local research needs
- guidance on setting local research priorities
- support designing, funding and delivering research.
All the research we support is focused on population and service user benefit.
ICBs can contact their Local Clinical Research Network (LCRN) to find out more about the support available in their area.
Supporting ICSs to use research evidence
The NIHR can work with ICSs to share research findings and support the use of evidence from research to inform decision making and improve practice:
- Our policy research provides new knowledge to improve or evaluate services or policies.
- NIHR Evidence makes health and care research findings informative, accessible, relevant and ready for use for all.
Developing the health and care workforce of the future
Research is an integral part of care. A skilled research delivery workforce, ready for the complex health and care challenges of the future, is crucial to making research happen in the NHS and other health and social care settings.
There are currently over 10,000 front-line research delivery staff working throughout the NHS who are funded or part-funded by the NIHR.
Clinical research nurses and midwives, allied health professionals, social care professionals, doctors, dentists and clinical research practitioners all play an important role in the delivery of high quality research and care.
There is evidence that including research in medical roles enhances recruitment and retention, and that some doctors use research as a mechanism to avoid burnout.
We support the career development of health and care professionals, with a number of campaigns and initiatives including:
Research engagement tools and resources
The NIHR has worked with key stakeholders to develop toolkits that support research active health and care professionals to embed research in their service.
The Research Engagement Collaborative
The COVID-19 pandemic inspired greater interest in research within health and social care, as well as the public.
Many frontline research delivery staff in various healthcare settings have worked hard to harness this new level of research engagement in their local organisations.
The Research Engagement Collaborative online community provides frontline research delivery staff with a ‘hub’ for learning and inspiration, and a place to share examples of successful practice embedding research in local health and social care organisations.
Visit the ‘Success Stories’ section of the community to read a range of research engagement case studies.
Best Patient Care, Clinical Research and You
Best Patient Care, Clinical Research and You is an online guide developed by the NIHR in collaboration with the NHS R&D Forum, NHS England and UKRD.
It provides guidance to help busy non-research staff become more aware of their impact on research in their NHS Trust.
The guide raises general awareness, helping research delivery in particular, while also helping Trusts to fulfil requirements of the research elements in the CQC Well Led Framework and the NHS Long Term Plan.