Funding Model Project Plan

1.0 Executive Summary

In previous financial years, CRN NWC has allocated funding to Partner Organisations (POs) based on historical recruitment activity data.  The focus of CRN NWC has now evolved with the introduction of a new strategy and leadership team.  Following on from this, the funding model has been reviewed in consultation with our partners, to develop a model that rewards system level working and those collaboration activities that are not normally recognised.

The Partnership Group agreed with this approach and based on the findings of a number of workshops held over the last 6 months, has approved the approach detailed in this document.  It has been agreed that a transitional period will take place until March 2024.  The first part of the 2022/23 financial year will implement the first stages of this model;

• Static proportion funding for PO’s based on values from Annual Financial Plan (AFP) position in 2021/22

• Pre-financial year application for funding for Strategic Projects

• POs to start identifying resources against strategic objectives i.e. 20% of CRN funding against;

  • 10%: agile working

  • 5%: collaboration

  • 5%: strategic disease areas (Cancer, Cardiovascular Disease, COPD and Mental Health)

The latter half of 2022/23 into 2023/24 will see further development and implementation of the other key criteria;

• Agile Workforce

• Commercial Growth

• Contract Compliance

• End of year reviews

• Measurement of success

• Movement of resources

• Multi-site set-up and delivery

• Placement of studies

2.0 Introduction 

In previous financial years, CRN NWC has allocated funding to Partner Organisations (POs) based on historical recruitment activity data.  This has meant that the larger organisations who have access to extensive research portfolios have the majority of the research activity and therefore the majority of CRN NWC funding. This has not necessarily been a successful approach in terms of growing CRN NWC’s share of research in England. In addition, “hidden” collaboration activities such as referral processes, continuing care/step down sites, follow-up etc which many of the smaller sites are supporting are not accounted for as they are not recorded and don't show the full picture of research activity across NWC. 

Since the appointment of the new CRN NWC Leadership Team and the introduction of a new strategy the focus of CRN NWC has changed and as such it was felt now was the right time to develop a new funding model with Partners that supports the development of a more resilient research ecosystem working at a system level with alignment to the regions two Integrated Care Systems priorities. The remit of NIHR CRNs has also changed in recent years with a mandate to support research across all health and care settings.

Whilst the pandemic has brought many challenges to the region the research response during these unprecedented times has been a real success and step change for research delivery. Working with Partners and reflecting on what worked well during the height of the pandemic has led to willingness to explore a different and more collaborative way of working and this has necessitated a change in the regional funding model. Through a range of workshops convened in autumn 2021 the key criteria developed from these workshops are presented within this document and the key projects involved are listed in Appendix 3. As such it was agreed at the CRN NWC Partnership Group in November 2021 to take the first step to introducing a new funding model with a transition period of at least 12 -24 months. 

Proposal for change to PO funding model have been based on CRN NWC research strategy and consultation via working groups (chaired by Professor Rowan Pritchard Jones, Medical Director at St Helens & Knowsley Teaching Hospitals NHS Trust) which included broad and inclusive  representation from partners including RD&I Directors, RD&I Managers and Specialty Research Leads.

The phased transition approach is summarised below:

Phase 1 – November 2021

• Static proportion funding for PO’s based on values from Annual Financial Plan (AFP) position in 2021/22

• Pre-financial year application for funding for Strategic Projects

  • Framework for application in place Dec 2021

    • Maximum value of award to be determined

    • Multi-year awards to be determined

  • Funding awards agreed to start 1st April 2022

• PO's to indicate minimum 20% allocation of resources on areas proposed by POs at CRN NWC Funding Workshops;

  • 5%: CRN NWC Strategic disease areas

  • 5%: NWC wide approach demonstrating collaboration across multiple sites/settings

    • List of pilot priority studies to be drawn up including STIMULATE ICP

  • 10%: Agile workforce supporting NIHR portfolio research across multiple organisations including Primary, Secondary, Tertiary and Social Care

• Impact assessment framework to be developed

• End of year reviews for POs in line with CRN NWC review with CRN Coordinating Centre (CRN CC)

• CRN NWC local strategic elements to form part of contract between CRN NWC Host Organisation and POs

Phase 1a – End February 2022

• Structure of implementation working groups in place to develop frameworks for;

  • Measurement of success

  • Placement of studies

  • Commercial growth

  • Multi-site set-up and delivery

  • Agile workforce

  • Process for movement of resources across POs to support CRN NWC research strategy and target population health needs

Phase 1b: March 2022 – February 2023

• Implementation working groups to begin programme of work as detailed above

Phase 2 – End of March 2023

• Fully formed and implemented funding model

• Evaluation of model

Phase 3: End of transition period – March 2024

4.0 Funding Model Criteria

A number of key criteria were identified via the range of workshops held, these criteria are summarised as follows:

• Pre-financial year application for funding for Strategic Projects

• Agile Workforce

• Commercial Growth

• Contract Compliance

• End of year reviews

• Measurement of success

• Movement of resources

• Multi-site set-up and delivery

• Placement of studies

One of the main criteria to come out of the workshops was the timing of funding within a financial year.  In particular, partners consistently feedback that in year slippage or contingency awarded mid-way through a financial year was difficult to utilise and lacked impact due to short funding awards. As part of the new funding model (and previously approved via Partnership Group and Priority Health Steering Group (PHSG)) the network proposed to advertise a Strategic Projects funding stream that would be advertised and funding awarded at the start of a financial year. The aim to give organisations advanced notice and a full 12 months funding award for 2022/23.

The concept of an agile workforce represents a significant change in culture and working practice which will require careful consultation with staff affected by this change. The overall aim of this approach is to develop a flexible workforce that utilises the skill and experience of research delivery staff to support regional health priorities as a collective and collaborative endeavour across the region. This skilled workforce will work across local health economies to support research in broader healthcare settings. A list of key studies has been developed with clinical leadership input to define key projects for delivery in each financial year. 

A detailed breakdown has been included in the project plan. This work will be taken forward in stages and a separate working group will be established to take forward this piece of work. Independent HR support will be sought to support this particular aspect of the model. 

Commercial studies offer increased access for patients to novel therapies whilst also providing vital revenue and treatment savings to the hosting organisation.  Through the COVID-19 pandemic the vast majority of commercial activity was paused as services and staff were redeployed.  This has led to a funding gap that needs to be filled to protect existing posts whilst offering an opportunity to Organisations to assess how they utilise commercial income and plan for the future.

The initial funding model discussion highlighted the need for greater engagement with the Life Sciences industry and more collaboration as a region to make the North West Coast an attractive proposition to place studies in.  

Follow-on workshops identified the want for a commercial working group to be established with representation from R&D departments, research active clinicians, and CRN staff. A focussed working group will act to support the planned projects for commercial growth and multi-site set up.

To further promote the capabilities of NWC sites to Life Sciences and attempt to attract more business to the region a project to develop a platform for this will be initiated.  This will build on existing information sources and systems to collate information into a single point of access to present to Industry.

The existing contractual requirement for CRN NWC funding flows will be supplemented with an additional framework that supports the new funding model. The framework will be included as part of the work plan section of partner contracts (Category A, B and C contracts). The framework will be developed with Partners prior to inclusion in the relevant contract.

Three Workshops took place to discuss Measurement of Success.  

During the first workshop there was a lot of discussion regarding how to measure collaboration and in order to measure collaboration we need to define what collaboration is, we therefore took this as a theme for the second workshop.

From both workshops we picked a number of collaboration metrics ideas and put these on to the Jamboard for the third workshop.  From this we had a number of discussions around these and new ideas put forward.

A list of possible KPIs are listed below, the next step is to write out to stakeholders to gain feedback on this list of possible KPIs and decide which ones we are going to use going forward to measure success.

List of possible KPIs:

Immediate Impact/Milestones for Change

• Agile Workforce

• Time taken to issue Letters of Access

• Local staff consultation exercise (progress/complete)

• Proportion of CRN funded staff supporting key studies

• Commercial Growth

• Number of new opened commercial studies in Financial Year

• Number of new commercial studies recruiting in Financial Year

• Total WTE funded through commercial income by staff group

• Number of new strategic partnerships with Life Sciences

• Collaboration

• Number of current research partnerships with other organisations

  • Within NWC

  • External to NWC

• Time to issue joint contracts with sponsor/collaboration agreements to allow funding to be shared between organisations

• Increased number of CIs/PIs

  • Who are the PIs?  Geographical spread across Doctors/Nurses/AHPs

• Number of new studies jointly hosted by more than one organisation (1 site opening supported by other organisations)

• Broader Health Care Settings

• Cat A partners supporting:

  • Number of Primary Care studies

  • Number of Public Health/LA studies

  • Number of Non NHS setting studies

• Proportion of complete demographic data

Feedback from Life Sciences is that to contract once covering multiple partners in a region for trial set up delivery is a significant efficiency saving.  If this could be implemented in the North West Coast it would both improve the offer from the NWC region and make collaborations between partners easier to establish.

Input from research active clinicians at the funding model workshops suggest this could be possible by mapping collaboration on to existing clinical pathways in a non-commercial setting.  This would naturally align the Trusts working within a specific speciality and could act as a proof of concept pilot.  Other activities would include: 

• Reviewing Service Level Agreements where services are subcontracted, 

• Reviewing the Governance requirements to enable single contracting across multiple NHS organisations

• Identify suitable studies that could be delivered within the pilot specialities

• Review the impact of the shared process and if it's transferable to commercial studies.

Two formal groups have been configured to support how we manage the NIHR portfolio in NWC.  Firstly, the Portfolio Management Group will review the current and pipeline portfolio to recommend key studies in line with the CRN NWC strategy (Appendix 4) and aided by the Portfolio Management Framework that has been developed with and communicated to CRN NWC Partners.  Secondly, the Priority Health Steering Group will ratify these recommendations so they may be prioritised across the footprint.

Ensure new funding model meets the strategic aim of addressing the research inequity for under-served communities

There is an underpinning aim embedded within network activity which is to increase the involvement of people from under-served groups in research.

The term under-served groups is taken from the INCLUDE project work and reflects the perspective that the research community needs to provide a better service for people in these groups – the lack of inclusion is not due to any fault of the members of these groups. The term ‘under-served’ reminds us of this perspective in a way that alternative terms such as ‘under-represented’ do not.

The work of the INCLUDE project shows that there is no single definition for an under-served group. Some key characteristics that are common to several under-served groups are:

• Lower inclusion in research than one would expect from population estimates

• High healthcare burden that is not matched by the volume of research designed for the group

• Important differences in how a group responds to or engages with healthcare interventions compared to other groups, with research neglecting to address these factors

The key idea here is that the definition of ‘under-served’ is highly context-specific; it will depend on the population, the condition under study, the question being asked by research teams, and the intervention being tested. No single, simple definition can encompass all under-served groups.

To ensure that the new funding model meets the strategic aim of addressing the research inequity for under-served communities the following will be actioned:

1. Identify CRN funded staff as lead for inclusion of under-served communities in each Partner Organisation. 

2. Quarterly “Inclusion” meetings will be scheduled for all ‘Inclusion’ champions to share best practice and explore opportunities for collaborative working.

3. Create an impact assessment framework that partners will submit  alongside finance returns on a quarterly basis. 

A formal process will be put in place to appraise the performance of each Partner Organisation in the delivery of NIHR portfolio research.  This will replace the existing structure of quarterly business support meetings with something similar to the requirements placed in the CRN NWC by the CRN CC.  Information will be collected initially around the annual plans for each Partner to ensure alignment with CRN NWC strategic objectives and also so that important elements particular to each Partner are recorded and included in the CRN NWC overall planning.

Following this, a formal annual reporting template will be developed that each Partner will be required to complete to ensure contract compliance as above.  This report will then be presented to the CRN NWC leadership team so that an appraisal of how CRN NWC funds have been utilised can be performed, performance can be measured (as above) and progress towards strategic objectives can be recorded.

The final process for how resources will be moved from one organisation to another will be derived from the workstreams above.  It is crucial that appropriate measures of the funding model are put in place to determine the short term impact and long term progress to ensure that a fair and equitable model is in place.  It is envisioned that the overall outcome of this work will be a way to support research in a setting that is appropriate for the population and is flexible enough to respond to fluctuations in the NIHR portfolio while providing a stable base for organisations to develop.