Finance guidance
Attributing the costs of R&D is complex. The AcoRD guidance provides a framework for the NHS and its partners to identify, recover and attribute the costs of health and social care R&D (ACoRD), in a transparent, and consistent manner. The AcoRD guidance clarifies the distinction between the three categories of costs associated with non-commercial research studies:
Research Costs
NHS Support Costs
Treatment Costs
Research costs are met from the grant, NHS support costs are met from the Clinical Research Networks (CRN) but treatment costs need to be met from the NHS budget.
The AcoRD guidance includes 3 sections:
Main section that covers the background, principles and attribution process
Annex A provides an Exemplar list of activities and where they should be attributed
Annex B provides a set of Frequently Asked Questions (FAQs)
The AcoRD guidance focuses on why an activity takes place rather than where or by whom. More information can be found here.
Grants
The general advice is to discuss costing at an early stage with Clinical Research Network: Eastern colleagues.
Paloma Amigo- Study Delivery Officer Email: paloma.amigo@nihr.ac.uk and Nicola Ward- Study Delivery Officer Email: nicola.ward@nihr.ac.uk
Your Local R&D Office - Head of R&D, Dr Philippa Brice Tel: 07814770151 Email: philippa.brice@nhs.net
Note for Grants
Researchers are advised to liaise with Paloma Amigo or Nicola Ward on service support costs before grant submission.
A costing template will help with attribution of costs. This is critically important for Association of Medical Research Charity funded studies as Annex A type B costs will draw on CRN resources.
Primary Care Patient Identification Centres (PIC)
Primary care PIC site costs have now been standardised. Please get in touch with Paloma Amigo and Nicola Ward - Study Delivery Officers to find out more.
Email: paloma.amigo@nihr.ac.uk or nicola.ward@nihr.ac.uk
Treatment Costs
A new process is in trial from 1 October 2018 for the management of Excess Treatment Costs (ETCs) in England.
Excess Treatment costs (ETCs) are the additional costs that will be incurred if the treatment undertaken in a research study becomes the new standard treatment after the research study is completed. This equates to the difference between the costs of the existing standard treatment and the treatment outlined in the research study.
Schedule of Events Cost Attribution Tool
The SoECAT is a template designed to attribute the correct costs for all activities within a research study. This ensures that all site level costs are covered and all excess treatment costs (ETCs) are identified. The completion of a SoECAT can help with research costs in a funding application.
Researchers will be required to complete this new tool as part of their funding applications.
Download the Schedule of Events Cost Attribution Tool (SoECAT) Template A and Template B
Schedule of Events Cost Attribution Template (SoECAT) guidance
CRN Eastern have developed a SoECAT flyer which you can download.
Talk to the R&D team if you need help. It is critically important to work up SOECATs accurately and significant time is often needed to do this. CRN Eastern ask that you ideally come to them at least 20 working days before your submission deadline.
Payment approach for ETCs after 1 April 2020
For all ICB Excess Treatment Cost (ETC) payments made after 1 April 2020, research Sponsors will be asked to choose a payment model that best fits their study. The aim of selecting a payment model will be to pay the site incurring the ETCs as opposed to the recruiting site, where these are not the same site. As a result, this should reduce the administration burden for organisations that have been asked to re-route ETC payments.
For studies currently receiving ETCs, the NIHR Clinical Research Network Coordinating Centre (CRNCC) will be contacting sponsors over the next few months to explain the process and to discuss the payment options available.
If an investigator revises the SoECAT during the life of the study, the payment model will also be discussed as part of the approval of the SoECAT.
If a payment model is not agreed, then payments will continue to recruitment sites, as per the existing model.
Minimum trigger for payments to primary care providers
A minimum payment trigger for ETCs is applied to ETCs incurred by primary care providers. This was introduced to prevent the cost of processing ETC payments outweighing the actual value of the ETCs.
ETC payments are made to primary care providers each quarter, once the minimum payment trigger is reached. If a primary care provider does not reach their minimum payment trigger value during the year, they are reimbursed at year-end irrespective of whether the ETC payment trigger value has been reached.
A review of this minimum payment trigger took place and it was clear that the value was excessively low and that large numbers of payments for relatively low values were continuing to be made. As a result, from 1 April 2020, the minimum payment trigger for primary care providers will be increased to £500. This will be reviewed annually.
The AMRC has published a blog on what this means for funders and a Q&A on the changes to the way in which ETCs are paid.
Associated documents
NHS ICB Excess Treatment Costs
In October 2018 the NIHR Clinical Research Network took over the management of the Excess Treatment Cost (ETC) payments, on behalf of NHS England, for studies where Integrated Care Board (ICBs) are the responsible commissioner.
All studies should go through Triage in the same way to determine to commissioner and then the commissioning decision email will explain next steps dependent on commissioner. Study teams need to let the AcoRD Specialist/LCRN know once they have successfully secured funding so that they can submit the study to triage on the study team's behalf.
The process:
AcoRD Specialists at NIHR Local Clinical Research Networks (LCRNs) are available to support researchers, their teams and Sponsors in completing and authorising the completed SoECAT. Further information about AcoRD attribution support can be found on our Early Contact and Engagement page. To get in touch with an AcoRD Specialist, contact the Lead LCRN for the study (usually the LCRN where the lead investigator/lead site is based). Please allow a minimum of 20 working days for authorisation of a SoECAT by an AcoRD Specialist.
If ETCs have been identified for the study, once funding has been successfully secured the AcoRD Specialist will submit the SoECAT and accompanying documentation to the NIHR Clinical Research Network Coordinating Centre (CRN CC) Triage Team for review to determine the majority commissioner responsible for funding the ETCs. The commissioner is dependent upon the service under study. Once the Triage process is complete, a commissioning decision email will be issued and the study record will be updated in the NIHR Central Portfolio Management System (CPMS) to reflect this.
Queries about Triage and assigning the commissioner responsible for ETCs, please signpost to us: TriageHelpdesk@nihr.ac.uk
Queries about ETC payment processes for ICB studies, please signpost to: ETC.Helpdesk@nihr.ac.uk