National Institute of Health Research (NIHR) Applied Research Collaborations (ARCs) have been created to ‘support applied health and care research that responds to, and meets, the needs of local populations and local health and care systems.’ So, how can RCP members use these unique collaborations to become research active and innovative? Mark Gabbay, professor of general practice at the University of Liverpool and director of NIHR ARC NWC, explains.
What are ARCs?
Announced in July 2019, the 15 local applied research collaboration (ARC) partnerships are a collaboration between NHS providers, universities, charities, local authorities, primary care networks, academic health science networks and other organisations to undertake applied research and increase the rate at which research findings are implemented into practice. The £135 million 5-year funding also aims to deliver national-level impact through significant collaboration between the ARCs, with individual ARCs providing national leadership within their fields of expertise. View the national leadership areas and their expertise, which include child health, cardiovascular, inequalities and social care, ageing and dementia.
Why should RCP members become involved?
I think there is a real opportunity for RCP members in the north west to use ARC NWC for building alliances which jointly tackle existing and urgent health and care challenges, such as health inequalities and multimorbidity. We have over 60 members who are a mix of clinicians, academics and managers currently working across our themes, and we are very excited that the RCP has joined the NIHR ARC NWC as one of these member organisations.
Which issues are a focus for ARC NWC?
The key themes we focus on in ARC NWC include big data management, multimorbidity, place-based initiatives and health inequalities (among others!). On health inequalities I would like to highlight the Health Inequalities Assessment Toolkit (or HIAT). It is an extremely useful free online tool for any research project to assess whether the study considers the causes of health inequalities and has the maximum possible potential to reduce them.
I would also recommend viewing our Collaboration for Leadership in Applied Health Research (CLAHRC) legacy document Achievements and reflections to discover our previous work on a huge range of diverse subjects. Our index of community service evaluations and initiatives covers reconfiguring services to reduce emergency admissions, through our CLAHRC NWC Partner Priority Programme. We evaluated the RCP Future Hospital Programme towards the end of the CLAHRC as a commissioned project.
What is your approach?
At the core of the ARC, in addition to the overarching focus on health inequalities across all our work packages, are co-production (academics, professionals, public and commissioners) and capacity building for research and implementation of research across all member organisations.
Thus, we proactively invite our members to highlight their priority needs for research and implementation and collectively respond to the issues they bring to us. For example, a large number sought accurate data that supported analysis of local health interventions and facilitated access to the social and economic datasets required during their implementation.
Where new service interventions have been implemented, the ability to match those areas to non-intervention areas, selected from across England, was going to be particularly beneficial to their service provision plans. In response, the ARC NWC place-based longitudinal data resource (PLDR) was developed. This web-based resource brings together datasets which track changes in the determinants of health and health outcomes, in specific places, over time. The PLDR uses local and national datasets (eg hospital admissions, budgetary and prescribing data) to calculate indicators for places (neighbourhoods, local government areas, regions and even countries) that are consistent over time. It also enables service providers to help identify health inequalities in service provision, and evaluate and assist in planning for reconfiguration of frontline services.
Which specific projects can RCP members become involved in?
Our work programme has of course been reshaped during 2020 with over 12 research projects added to our work on the impact of COVID-19. The most recently published study determined the impact of COVID-19 social support cuts on the wellbeing of people with dementia. You can also view our full index of published research to discover more about our outputs.
It is perhaps unsurprising we have seen more community-based issues emerging in the ideas suggested to us as potential research projects. These include air quality, social isolation and social prescribing, and you can see how this work is progressing via the ARC NWC equitable place-based health and care theme.
One of our themes, the person-centred complex care theme, is currently shaping its work programme on the following:
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Digital consultations (and digital inequalities) – remote consultations (phone/video/e-consultations) and their widespread use, particularly due to COVID-19
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Polypharmacy – considering medication management, mental health polypharmacy and deprescribing
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Continuity of care – care coordination, MDTs and integration.
Other subjects that may be of interest to RCP members include those within our health and care across the life course theme which include:
I would be happy to facilitate questions or comments from RCP members on the work of ARC NWC. Alternatively, I can signpost colleagues to key contacts within the cross-ARC national programme of work.
I am also keen to help develop new research ideas for ARC NWC that would benefit north-west coast communities by facilitating and supporting collaboration across the health economy. This is in addition to facilitating queries on our CLAHRC NWC work and implementation, while linking you up with those involved in the work where requested.
I hope this has demonstrated the value of ARC NWC and its potential to enable physicians to engage in our work throughout the region and ensure our collaborative work is underpinned by the translation of evidence into practice.
Please feel free to contact me via arcnwc@liverpool.ac.uk.