Thinking about communicating your PSP priorities to the NIHR?
The NIHR commissions and funds projects looking at the usefulness of new and existing tests, treatments and devices and at new and existing ways of doing things. It also looks at how to improve public health to see what really works in practice.
The NIHR funds research through a broad range of funding programmes, which cover many different types of research. It has ten different research programmes that researchers can apply to, each of which funds different types of research. There are two main routes for research funding from the NIHR: through researcher-led applications, and through research teams responding to commissioned calls advertised by NIHR. There is more information about NIHR calls for commissioned research and the responsive or researcher-led funding opportunities on the NIHR website.
NIHR considers PSP priorities in the context of the different NIHR programme remits and it is unlikely that the NIHR will respond on the basis of the list of PSP priorities alone. Additional information is usually required before the priorities can be taken forward.
For example, the NIHR’s Health Technology Assessment (HTA) Programme’s purpose and remit is to deliver information about the effectiveness, costs and broader impact of healthcare treatments and tests for those who plan, provide or receive care in the NHS. Health technologies include all interventions used to promote health, prevent or treat disease, improve rehabilitation or long-term care including drugs, devices, procedures, settings of care and screening.
The core elements that the HTA Programme needs to identify when considering research questions for potential commissioning are:
- Population (what is the population of interest?)
- Intervention (what are the interventions of interest?)
- Comparison (what are the comparisons of interest?)
- Outcome (what are the outcomes of interest?).
A PSP may therefore want to consider providing additional information for their priorities which might include:
- What is the question that needs to be addressed?
- If possible, details of the patient group, intervention, comparator and proposed outcomes
- Why the question is important
- What the existing evidence is
- If the question is specific to a condition, or more broadly applicable.
A good research question for the HTA Programme to consider, through its commissioning or researcher-led work stream, is:
- Important to the NHS and its patients
- Supported by current evidence
- Of high scientific quality
- Timely (i.e. research will continue to be relevant following completion of a study which may take many years to publish. It may be felt that changes in practice will overtake the results of any study which would therefore not be relevant by the time it is finished and published)
- Clear and well-defined (able to be worked into PICO format by researchers in collaboration with the PSP)
- Represents value for public money.
A national pragmatic HTA trial typically costs over £1m of public funds, so the HTA programme will want to be sure that an intervention is ready for an HTA evaluation. Generally, an intervention is ready for HTA evaluation if:
- There is a reasonable chance that it will be effective
- It has already been tested in a typical NHS or social care setting
- There is a reasonable chance it will be used across the NHS if shown to be effective.
HTA evaluation may also be appropriate if the intervention is already widely used in the NHS, but evidence of benefit and harms is lacking.
If this is not the case, then the research question may be more suitable for a different NIHR programme or a different research funder. You can read more about interventions being ready for HTA evaluation on the NIHR website.
The development of research topics takes time, and it can take many months or years before topics and themes are taken forward by the NIHR.
Some of the stumbling blocks that the HTA Programme reports when working with suggested research questions from any source, including JLA PSPs, are:
- The challenge of questions that are either too broad, and therefore need more work to define what the most important component of the question is, or are already too specific
- The feasibility of answering the suggested research question
- Defining what current standard practice or care is
- Existing ongoing research, either in the NIHR portfolio or from other funders, which overlaps with the question, meaning that more research is unlikely to be funded at this moment in time
- The relative importance of the question compared to other disease areas.