CSP095: NIHR CRN Under-served 2% Guidance
Page Contents
- NIHR Local Clinical Research Network Funding Allocations 2022/23
1.1 Targeting Under-served Communities
The CRNCC recommends that LCRNs allocate a minimum of 2% of the 2022/23 funding allocation on expanding clinical and applied research to under-served regions and communities with major health needs. Allocation of this funding reflects the need to provide equitable access to research opportunities for under-served communities as a collective national priority enabled at a local level across all the regional networks. This expansion is a key component of Best Research for Best Health: The Next Chapter and includes targeting areas of high prevalence/incidence which the CRN has previously included in the LCRN funding model as ‘Targeting Health Needs’.
Under the coordination of the NIHR programme office for this strategic area LCRNs will be asked to identify solutions that will provide equitable access to research opportunities for the under-served communities, and those with major health needs, in their regions and meet the overarching national outputs of:
improved equitable access to research sponsored by the Life Sciences industry
increased number of Participant Identification Centres (PICs) within community-based settings, and an understanding of whether a pre-aware plan and place service will provide greater access to research
development of research opportunities in under-served regions and communities, and an understanding of whether Local Authority based researchers will increase the research culture
understanding how the roll-out of the Primary Care Strategy can support research in this area
increased research-readiness amongst under-served populations through the Research Ready Communities scheme
Enabling the national progression of our overall approach to improving inclusive access to research opportunities will require local approaches in conjunction with greater collaboration across the LCRNs to enable development, best practice and solution sharing. This collaborative sharing approach is now also in place across the NIHR Centres through the NIHR Under-served Communities Programme.
1.1. Useful links
1.2 Implementation Context
The allocation and implementation of this fiscal resource is likely to fall into two categories:
supporting national programmes driving forwards improving inclusion of under-served groups in research
design and delivery of local solutions against regional priorities relating to under-served groups
In turn, it is anticipated that these are likely, but not exclusively, to align with the following areas of focus:
Identifying target under-served communities using local information
Supporting patient identification associated with these under-served communities
Improving our understanding of the barriers and hurdles associated with under-served communities and working to improve access for such groupings
Establishing Research Ready Communities to enable CPPR (Community Partnered Participatory Research) as identified within the NIHR-INCLUDE framework, thus outreach activities relating to understanding of research and improving engagement across under-served groups
Initiatives to better enable the recruitment of research participants from under-served communities
Competency development on under-served as an organisational aspiration and underpinning culture
Capacity development to enable more under-served aligned delivery
Information and digital programmes to support better understanding and reporting on under-served communities
Increased working with community settings and Integrated Care Systems that could further enable reaching under-served communities and help in developing new opportunities for a community-based workforce
Delivery of the Primary Care Strategy will also potentially be well aligned to under-served enablement
Thus, all working towards improving how the NIHR Clinical Research Network brings clinical and applied health and care research to under-served regions and communities with major health needs.
As an overarching principle, anything that is working towards expanding clinical and applied health and care research to under-served regions and communities with major health needs could be considered as aligning with the Under-served Communities programme aspirations.
1.3 Reporting through the Annual Business Plan Template
The two questions noted below will be added to the 2023/24 Annual Business Plan Template to enable reporting.
Q1 - Please provide detail to explain how the 2% ring fenced budget for under-served communities will be allocated across LCRN core team / LCRN partners, including the proposed initiatives
Q2 - Please describe the expected outputs and/or outcomes of the 2% ring fenced budget for under-served communities, including the relevant financial period in which the outputs/outcomes will be achieved
1.4 Risks & Considerations
A key challenge around this space is the overlap between Under-served Communities and EDI.
In addition, this is potentially being perceived as a continuation of the focus on the targeted health needs areas line of activities from a few years ago, when in fact it is more of a review and refresh than continuation. The targeting health need was focused on 9 disease areas, whilst these were aligned against health need and probably heavily overlapped with under-served communities (by whatever label - geographic, socio-economic, health deprivation), the thinking around under-served has moved on and indeed broadened out - the pandemic accelerated that process.
As we are seeking innovation, there is a risk of duplication of ideas being piloted by two or more LCRNs that may be better undertaken in a coordinated manner (or piloted by one or a few LCRNs until the benefits or otherwise are known; possible scope for supra regional approach) - hence we need to commit to transparency and knowledge sharing as significant amounts of the 2% are committed. This will be supported by LCRNs registering their 2% Under-served funded projects on the CRN Under-served project App that has started to be used in 2022.
If we are pushing the boundaries of current practice we should expect some of the innovations tried to fail. Equally, there is a risk that we have a portfolio of investments that are overall too risky or too conservative. We need to maintain an overall understanding of these risks.
We are not starting from scratch, so a key consideration is what ongoing activities could fall into this budget category. We also need to understand whether current activities can continue to be funded outside of the 2% to allow us to do even more in this space. Whilst 2% is ring fenced, it shouldn’t constitute a cap on the total resources that can be directed to Under-served communities if LCRNs wish to utilise overall budget in this manner.
2. Appendix A – Example Activities for LCRNs
The example activities provided below are suggestions that LCRNs could use to achieve the required outputs. More examples can be found on the CRN Under-served App.
Facilitating Delivery Examples
Extend ‘research active’ hours beyond the common practice of Monday to Friday, 9am to 5pm, and introduce weekend hours, to allow many more people to take part in research
Support Participant Identification Centres (PICs) in areas of greater deprivation or disease burden, e.g. District General Hospitals or Outreach clinics;
Develop a Nurse or Associate PI scheme, where staff work under the supervision of a Principal Investigator in a hub and spoke model, to allow for simple studies to be conducted, e.g. registry studies
more examples can be pulled from the CRN Under-served App, particularly around specific disease groups, settings and community demographics
Researcher Development Examples
Provide additional training around engaging with, and taking consent from, under-served communities, both of which could require a different approach
Provide additional funding for a local clinical lead to champion working with under-served communities across a range of specialties
Develop training across Specialty Groups, which will share the Local Specialty Leads ‘on the ground’ knowledge to a wider base.
Develop or enhance a researcher development programme, including mentoring, training and in-job support
Providing opportunities for cross specialty working to enhance the overall understanding around under-served communities research opportunities, through topics such as multiple long term conditions and the life course approach to health and care research
Patient and Public Involvement and Engagement (PPIE) Examples
Adopt the 'Research Ready Communities' model to build relationships with community associations and identify community leaders to act as champions to implement locally co-produced community and public engagement strategies (for more information see CSP093)
Increase research visibility among communities with low levels of research activation through communications and local events
Support collaborations between under-served communities and regional research infrastructure and institutions
Ensure access to a community engagement workforce development scheme to support PPIE staff in LCRN Partners to engage in under-served patient groups.
Abbreviations
CPPR: Community Partnered Participatory Research
CRN: Clinical Research Network
EDI: Equity, Diversity and Inclusion
INCLUDE: Improving inclusion of under-served groups in clinical research
LCRN: Local Clinical Research Network
PI: Principal Investigator
PIC: Participant Identification Centres
PPIE: Patient and Public Involvement and Engagement
Version Control
Version number: 2 .0
Effective from date: 1 April 2023