Driving Research Practice into Evidence
The Yorkshire and Humber CLAHRC:
The Vision
Professor Sue Mawson
Director of CLAHRC SY
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Outline of presentation
• What are NIHR CLAHRCs?
• The CLAHRC journey from pilot to full submisison.
• Our underlying principles and thematic matrix
• The Y&H CLAHRC link to the AHSN
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Government support for
Health Research
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Drivers for establishing
Pilot CLAHRCs in England
BMJ 2007;334:129-132 (20 January), doi:10.1136/bmj.39038.593380.AE
The in-between world of knowledge brokering
Jonathan Lomas, chief executive officer
1
Canadian Health Services Research Foundation
jonathan.lomas@chsrf.ca
"The mere knowledge of a fact is pale; but when you come
 Lomas
to realize a fact, it takes on color. It is all the difference of
BMJ, 2007
hearing of a man being stabbed to the heart, and seeing it
done."
Mark Twain, A Connecticut Yankee, 1889
 Cooksey
The ultimate aim of people engaged in health research is to get the health
service's workforce, its employers, and its suppliers to have knowledge of facts
(as represented by research results) and to use these facts in their practices,
policies, and products. How well organised is research to achieve this aim? And
how receptive and oriented are health services to this aim? The answers seem
to be "not well organised" and "not very receptive." The interpersonal
connections needed to bridge this know-do gap are not yet in place.1 An
emerging role therefore exists for knowledge brokers, supported by knowledge
brokering resources and agencies, to fill the gap.
Review, 2008
Disconnection between research and health services worlds
 Tooke
Report, 2008
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The old adage "form follows function" is poorly reflected in the production and
use of health research. The research world favours grant acquisition and
academic publication over knowledge synthesis and engagement with the health
service.2 Researcher to researcher communication about the next study ("more
research is needed") is well organised and all too common; 3 4 researcher to
practitioner dialogue about implementing findings ("actionable messages") is
poorly organised and all too rare.5
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The NIHR CLAHRCs were designed to be
innovative networks of health professionals,
academic researchers, technologists, voluntary
agencies, industry and the public aimed at
improving patient outcomes through applied
research, evidence implementation and capacity
development.
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The call for second generation CLAHRCs announced on 4th
January 2013 requires us to firstly, demonstrate continuity of
leadership both at Director and thematic levels as we merge the
CLAHRC in Y&H and secondly, provide evidence of a cohesive,
productive collaborative partnership that has resulted in the step
changes indentified in the original call by developing an ambitious
vision for the next 5 years.
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Quart into a pint pot !
2 CLAHRCs into 1
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The three
CLAHRC pillars 2014 - 2018
Applied
Research
Applied
Applied
Research
Research
Capacity
development
The Science of
Implementation
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Understanding what works
and why?
• Distributed Leadership model
• Business model
 Financial model
 Mixed portfolio of investment, AHSN, HEIs, NHS,LA,
Charity, Industry.
• Secondments
• Boundary spanners
• Shared vision
• Principles
• Innovations
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Core Principles underpinning our CLAHRC:
making us more than the sum of the parts
•
•
Building collaborations and co-production
•
strategic level
•
project level
Addressing health inequalities
•
reduce health inequalities
•
consider health inequalities at a strategic and local level
•
Building capacity across Y&H
•
Joint engagement in and ownership of CLAHRC by our partners
•
colleagues agree with values and beliefs described in principles
•
colleagues have ownership at personal and professional level
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Focus on impacts & outputs:
tools and techniques
• Cohort Trials facility
• Other cohorts
• Mathematical model
for measuring impacts
of care pathway for
long term depression
• Care pathway and
guideline
• Practice guides and
tool kits
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• Pen portraits
• Strategic documents
 JSNA
 Inequalities
• Academic papers
• Methodologies: UCHD
• Patient voice
• Curriculum impact
• Work with CPD units in
area
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3 key drivers for the matrix
• DH and NHS priorities and needs
• Link to the AHSN with an alignment of
purpose
• NIHR funded therefore requirement for
‘science’, applied research and
implementation.
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The Evolution of CLAHRC SY and CLAHRC LYB
CLAHRC Yorkshire & Humber 2014 and beyond
Academic Health Science Network, Yorkshire and Humber
TRANSLATING
KNOWLEDGE INTO
ACTION
WORK
PACKAGES
SERVICE
TRANSFORMATION
IN THE NHS
WORK
PACKAGES
HEALTH
INEQUALITIES
WORK
PACKAGES
HEALTH
ECONOMICS
MEASUREMENT
WORK
PACKAGES
TELEHEALTH
AND CARE
TECHNOLOGIES
WORK
PACKAGES
JOINT
WORK
PACKAGES
JOINT
WORK
PACKAGES
JOINT
WORK
PACKAGES
JOINT
WORK
PACKAGES
JOINT
WORK
PACKAGES
JOINT
WORK
PACKAGES
JOINT
WORK
PACKAGES
JOINT
WORK
PACKAGES
WORK
PACKAGES
WORK
PACKAGES
WORK
PACKAGES
WORK
PACKAGES
Frailty and
dementia
Preventing hospital admissions
in LONG TERM CONDITIONS
MENTAL HEALTH
CO-MORBIDITY
MATERNAL AND
CHILD HEALTH
NIHR INFRASTRUCTURES BRU, CLRN, CRF, CIMA, D4D, Industry, Y&H RDS
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Key requirements for themes
• Embedded partnership working
• Evidence of high level of academic
leadership (metric analysis)
• Driven by NHS and LA priorities and
needs
• Element of responsive mode funding
• Match funding from partnered NHS
organisations
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Innovation, health and wealth
CLAHRC for
South Yorkshire
Academic Health Science Networks
• Six high impact innovations
• Supporting people with dementia
• 3 million lives
• Digital by default
• International and commercial
• Intra-operative fluid management
and monitoring (Technology use)
• Child in a chair in a day
(assessment and procurement)
•
•
•
•
•
Expanded Newborn screening &
Rare Diseases, wealth creation
Telehealth – 3 million lives
campaign, translation of
technologies to improve the care
pathways for people with LTCs
Translating research and learning
into practice
Microsystems & transformational
academy
Public Health
Existing Strategic links and strengths
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Translating research
and learning into practice
CLAHRC for
Yorkshire and Humber
•
•
•
•
Implementation research to trial
and evaluate innovative
implementation strategies using
CIHR knowledge to action
approach
Implementation research work
packages within research themes
Implementation projects in
response to partner priorities
Capacity building for knowledge
translation
•
•
•
•
Evidence-synthesis help desk
E-repository of evidence tools
Knowledge mobilisation quality
initiative (KMQI) to translate key
research findings into practice –
e.g. type 1 diabetes adolescents
Knowledge mobilisation
secondments from partner
organisations to bridge gap
between research teams and
practice
Joint working supported by joint posts
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CLAHRC II:
Tranbased
Evidence
transformation
Evaluate peer-to-peer
review approach
to spread
Evidence based
Positive practice
networks
AHSN Board
Transformation Academy
Clinical Board
Improvement Training
Patient and Public
Advisory Groups
Network
Organisational leads
(Service
Improvement Leads and Clinical Leads)
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"don't just weather the
storm;
learn to dance in the rain!
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