How Alder Hey hospital enabled research time for healthcare professionals

As part of our week-long series on the crucial role that clinical research plays in the NHS, Louise Shepherd CBE, chief executive, Alder Hey Children’s Hospital talks about how her hospital created a culture of research.

Alder Hey is a large, specialist children’s hospital in the North West of England. It is the largest recruiting centre in England for studies involving children and families, as demonstrated by data from the National Institute for Health Research (NIHR) Clinical Research Network portfolio.

In 2015, the Alder Hey Children’s NHS Foundation Trust made a conscious and proactive decision to become a high-volume clinical research centre through a range of strategic and operational initiatives.

Key to this is a whole systems approach which is needed to galvanise an organisation to deliver more clinical research. One critical component is providing healthcare professionals with time for research. The leadership and culture within an NHS Trust also needs to be positioned to develop and implement a multi-faceted approach to creating research capacity.

Culture and Leadership

The Trust’s stated ambition is to offer every child and family attending Alder Hey the opportunity to take part in a research study. Research is one of the Trust’s four strategic pillars and the Director of Research is a member of the Trust’s executive team.

Placing clinical research at the heart of the organisation and explicitly within leadership and organisational structures provides the foundation for a vibrant research culture.

Research time for healthcare professionals

Creating capacity for NHS healthcare professionals to design and deliver research has been a core theme in the Alder Hey research strategy. For example:

1. Team job plans for research intensive departments

Strategic use of NIHR Research Capability Funding (RCF) allowed creation of a new, part-time NHS consultant post, with seven Programmed Activities (PAs), in the Dept of Paediatric Rheumatology. This enabled seven research PAs to be distributed among the four NHS consultants in the team. The generation of research income through outputs from the research PAs has allowed the new post to be sustainable and RCF to be recycled.

2. Commercial research funding

The income generated through commercial research can be reinvested tactically to directly fund research PAs in a consultant job plan, or fund supporting activities which enable consultants to increase research capacity. For example, a range of junior doctor posts have been funded through working with the UK Duchenne Muscular Dystrophy Charities, which has enabled a combination of trainee and consultant-level medical input to deliver an increased number of complex commercial clinical trials.

3. Working with charities

The Trust has worked collaboratively with the Alder Hey Charity and national patient charities to develop capacity-building schemes for NHS consultants to have protected time for research, designed to become self-sufficient through commercial or academic research income.

4. Infrastructure to release Principal Investigator (PI) time

For many NHS consultants, circumstances make it difficult to incorporate research PAs into individual or team job plans. When this happens, displacing the burden of administrative tasks to free up time to act as a PI has proved to be very successful. Some Alder Hey examples include providing administrative support, a data administrator or a research nurse.

Strong leadership for clinical research allied with a culture of pragmatic risk assessment is required to initiate and sustain the practical examples provided above.

On Thursday 28 November, the RCP launched Benefiting from the research effect, outlining how NHS trusts can support clinicians to become more research active and the benefits this will realise.