R&D Strategy
current format. It has been widely circulated amongst senior academic and clinical staff in amendments. ended to the
st’s business, ely sets out a number of actions necessary over the next financial year, and over the next three years, to ensure that the Trust continues to consolidate and improve on its already substantial research portfolio. On this basis it is requested that the Manchester Mental Health and Social Care Trust Board accept and approve this strategy document in its current format.
Introduction
This document has undergone a lengthy process of consultation and revision to reach its the Trust, and has been to Management Board for approval subject to minor
It has also been through the May Trust R&D Committee and is now comm Trust Board for their adoption.
The Research and Development Strategy documented herein is an important step forward for the Trust in firming up our strategic approach to a major arm of the Tru
Research & Development (R&D) Strategy DRAFT
Implementation Date: June 2010
Review Date: April 2011
Policy Section Number: Policy Number:
DOCUMENT – VERSION CONTROL CERTIFICATE
TITLE
Version: 4
r: Governance – Section Policy No: Title:
Research & Development (R&D) Strategy
Reference Numbe
SUPE
RS
EDES
Supersedes: New Strategy
OR
IG
INAT
OR Originated By: Richard Hopkins & Deana Irvine anager
Designation: Director ofR&D & R&D M
BOA RD AN EXECUTIV E APPROV AL gement Board
Date of Referral: 23rd March 2010
Board Approval (Date): 23rd March 2010
up:
D
Referred for approval by: Trust Mana
This Version Approved by Governance Gro
CIRC
ULATI
O
N Issue Date:
r Managers
Circulated By: R&D Department
Issued To: All Research Active Staff and Senio
REVIEW
Review Date: April 2011
Responsibility Of: Richard Hopkins & Andrew Mee
Table of contents 6 ummary 7 8 8 8 s 8 08/9 9 ds 9 4. es 10 10 11 ctives 11 12 12 12 13 14 15 6. wider areas search find s. 16 16 tcome measures 16 17 17 7. C: Increase our capacity and capability for research in order to effectively support
esearch potential ups, service users and carers. 18
sers and carers
) 19
to increase capacity and capability 19 nd to increase
20 orld class centre for research in area of mental
20
9.1 Business Orientated Approach 20
9.2 Excellence Framework 21
9.3 Develop R&D Profile and the reputation of our Trust 21
9.4 Improving Joint Processes 21
9.5 Summary of objectives for consolidating our reputation 22
10. Strategy approval and monitoring process. 22
10.1 Strategy consultantion process 22 1. Definition of Terms
2. Executive S 3. Introduction
3.1 The national strategy 3.2 Change in R&D
3.3 Developing relationship 3.4 Academic Year 20 3.5 Looking forwar
Our Key Strategic objectiv 4.1 MAHSC goals
4.2 Ensuring delivery je 4.3 Delivering our R&D ob
5. Objective A: Establish R&D as essential core business 5.1 Creating an R&D Business Unit
5.2 Research Governance 5.3 R&D Finance considerations 5.4 R&D Budget
5.5 Summary of objectives to establish R&D as a core business unit Demonstrably improve the healthcare of those within the Manchester & through the dissemination and implementation of re ing 6.1 Routine outcome monitoring
6.2 Involvement of service users & carers in the development of ou 16
6.3 Disseminating research findings
6.4 Informing a world class commissioning agenda
6.5 Summary of objectives to demonstrably improve healthcare
and retain our existing high quality researchers and develop the r further in all professional gro
7.1 Developing and supporting R&D competencies amongst staff, u 18
7.2 Intellectual Property (IP 7.3 Summary of objectives
8. D: Work with our partners to develop MAHSC a our collaborative working for greater patient benefits.
9. E: Consolidate our reputation as w health and social care.
dissemination of the Strategy 22 22 of the strategy 23 23 n 24 ls 26
APPENDIX C - Suggested performance metrics 27
APPENDIX D - SWOT Analysis of R&D in MMHSCT 28 APPENDIX E - Funding Streams Generated by NIHR 29
APPENDIX F - Research Excellence Framework 30
10.2 Publication and
10.3 Review of the strategy 10.4 Monitoring
11. References
APPENDIX A - 2009/10 Action pla APPENDIX B - MAHSC Vision and goa
1. Definition of Terms
TU nit
generative Diseases Research Network
eam osts LRN r England ology I SC h Sciences Centre
ial Care Trust ce
amme for Information Technology y
alth Research Group
Productivity and Health Promotion
t
nefit
SPSS Statistical Package for the Social Sciences SPEAR Single Point for Electronic Approval
SHA Strategic Health Authority SPA Supporting Professional Activity
SWOT Strengths, weaknesses, opportunities and threats analysis TLRN Topic-specific Local Research Network
UKCRN UK Clinical Research Network AHP Allied Health Professional
ehavioural Therapy CBT Cognitive B
CLRN Comprehensive Local Research Network C Clinical Trials U
DeNDRoN Dementias and Neurode DH Department of Health
agement T EMT Executive Man
ETCs Excess Treatment C
FSF Flexibility & Sustainability Funding GCP Good Clinical Practice
GMCLRN Greater Manchester C E
HEFC Higher Education Funding Council fo t and Techn IM&T Information Managemen
IP Intellectual Property
KP s Key Performance Indicators MAH Manchester Academic Healt MHRN Mental Health Research Network MMHSCT Manchester Mental Health and Soc
itute for Clinical Excellen NICE National Inst
NIHR National Institute for Health Research NPfIT National Progr
OT Occupational Therap PCMHRG Primary Care Mental He PCT Primary Care Trust
n, QUIPP Quality, Innovatio PI Principal Investigator R&D Research and Developmen RfPB Research for Patient Be
RAE Research Assessment Exercise SLA Service Level Agreement SSCs Service Support Costs
2. Executive Summary
t (R&D) within lth & Social Care Trust (MMHSCT) and the structure within which
strengths and st Health R&D ith regard to new funding e reconfigured ss orientated and focus, maximised the income streams to our Trust and minimised the ptimizing good research
earch projects, also the proud tigators on 5 National Institute for Health Research (NIHR)
rs. We were dation Trust in utation for the
for R&D align nship with the hened through the
istent with the ithin MMHSCT niversity. We to further increase grant applications; this the North West Mental Health R&D Alliance.
by the R&D Committee and all researchers hether Trust or University employed have been encouraged to respond and contribute. gic objectives
A. Establish R&D as essential core business.
e healthcare of those within the Manchester & wider dings.
C. Increase our capacity and capability for research in order to effectively support and retain our existing high quality researchers and develop the research potential further in all professional groups, service users and carers.
D. Work with our partners to develop MAHSC and to increase our collaborative working for greater patient benefits.
E. Consolidate our reputation as a world class centre for research in the area of mental health and social care.
This document sets out the strategic aims for research and developmen Manchester Mental Hea
we will support R&D activity.
Until recently, our R&D strategy was driven by the University of Manchester’s research interests. However, the implementation of ‘Best Research for Be Strategy’ Department of Health (DH) (2006) brought significant changes w research funding. Whilst we fully endorse the principles of this strategy, the arrangements pose some challenges. In rising to these challenges we hav the management of R&D, created a defined business unit with a busine approach
financial risk generated by research activity. This has all been achieved whilst o the conversion of research into clinical practice through a framework of governance.
We had significant R&D success in 2008/9 and reported to DH increased res publications and external funding. This trend continued in 2009/10. We are host of Principle Inves
Programme Grants. Furthermore, we now host 6 NIHR Senior Investigato ranked second in mental health only to South London & Maudsley NHS Foun the recently released league tables reinforcing our national and growing rep quality of our research output.
In such a prime position we will, through this strategy, ensure that the plans with the strategic direction of the Trust and the national objectives. Our relatio University of Manchester is excellent and will be further strengt Manchester Academic Health Sciences Centre (MAHSC) partnership. Cons Boyington Report (2008) the future direction of, and service developments w should be informed by best available evidence and expert advice from the U will also strengthen North West academic links
will be aided by our position in
This strategy document has been shaped w
Key strategic objectives of MMHSCT have been identified. The key strate align with the seven MAHSC goals and five building blocks.
Our key strategic objectives are to:
B. Demonstrably improve th
3. Introduction
In 2006, NHS organisations previously in receipt of R&D “budget 1” allocation as R&D levy) were all affected by the new DH national research strategy ‘Bes Best Health.’ The strategy was to support the Government’s ambitions t nation’s health and increase the nation’s wealth as set out in the ten-year Innovation Investment Framework 2004–2014 (1). It was also to place servic centre of a research system that would focus on quality,
s (also known t Research for o improve the
Science and e users at the transparency and value for money. ond to changes in society and the environment and finally to react
em for applied health research.
o take part rch with high-evention strategies
ruit patients to e earch and researchers winning grants regardless of location
through the relevant to the needs of patients and that the NHS is taking an international lead in supporting a research-led culture for health
ey work in a
3.2 Change in R&D
been a radical ncourage and and direct this all of our key
Mental Health NHS R&D Alliance. Working with the Alliance allowed for the introduction of streamlined research governance processes, with our Trust leading on the Single Point for the Electronic Approval (SPEAR) project. We have forged exceptional working relationships with our key networks, in particular the Mental Health Research Network (MHRN) from their new home in the Rawnsley Building. The MHRN’s Manchester based Clinical Studies Officers have been recruiting participants to a diverse range of studies looking at aspects of suicide in psychosis, CBT to prevent harmful compliance with command hallucinations and the benefits of joint crisis plans in relation to use of the Mental Health Act.
The strategy was to resp
to the challenges in the current syst
3.1 The national strategy
e
Th ms to deliver in 5 years: • A thriving research culture within the NHS
ofessionals t national strategy ai
• Fairness of access across England for patients and health pr in multi-centre studies
• More patients and health professionals participating in health resea quality protocols and early access to new intervention and pr
• Increased industry investment in clinical research in the NHS
• The National Programme for IT (NPfIT) transforming our ability to rec
clinical trials and gather data to support work on the health of the population and th effectiveness of health interventions
• The best res
• Researchers working in a supportive environment to help them regulatory framework and conduct research
the population • Recognition
• Researchers and healthcare professionals proud to say that th research-led and evidence-based NHS
• Health and healthcare improved by research evidence.
The pace of change within R&D in England has been relentless. There has overhaul of research organisations, systems and infrastructure designed to e sustain high quality funded research. This MMHSCT strategy aims to focus process within our Trust and has been developed in consultation with partners.
3.3 Developing relationships
We have developed excellent associations with the Comprehensive Lo Network (CLRN). We host the Dementias and Neurodegenerative Disea Network (DeNDRoN) North West (NW). DeNDRoN NW is currently ranked for patient accrual to National Institute for Health Research (NIHR) portfolio s
Local Research Networks (LRN’s) and have successfully increased patient recruitment i cal Research ses Research first nationally
tudies of the 7 n 08/09 by 47% of the previous year’s accrual. CLRN funding has increased the network’s
s and the generation of external funding of £5,629,816. We have Principle Investigators on 5 National me grants for .
Lewis and Bill (Social Care), Professor Graham Dunn (Bio-statistics) and Professor Ann Rogers
F funding and n Trust in the
We are a key partner in the Manchester Academic Health Sciences Centre (MAHSC), a rsity. This will HSC strategic d FSF for the
ded our 2008/9 R&D Annual Report stating, “We note the Trusts’ important role in the Mental Health NHS alliance and its success in securing NIHR funding.” programmes,
some anxiety
3.5 Looking forwards
organisation, balance the NHS R&D funding, with the opportunities angements for
s a whole and D. The relationship with the University is valued and will evolve symbiotically through this strategy and specifically through our Manchester Academic Health Sciences Centre (MAHSC) partnership.
As a health and social care trust we value all research perspectives in mental health. The broad disciplinary scope of our NIHR Senior Investigators reflects this position. We will encourage programmes of activity across the academic spectrum and will make use of FSF strategically to ensure that these programmes are equally supported in obtaining substantive external research funding.
staff capacity.
3.4 Academic Year 2008/9
We reported to the DH for 2008/9, 124 active research projects, 107 publication Institute for Health Research (NIHR) Programme Grants. All our program applied research have been activated. These awards are of national prestige From April 2010 we will host 6 NIHR Senior Investigators; Professors Shôn
Deakin (Psychiatry), Professor Nick Tarrier (Psychology) and Professor David Challis (Sociology). Our recent success can also be measured by our increased FS
we were ranked second only to South London & Maudsley NHS Foundatio recently released league tables.
collaboration of 5 local NHS Providers, one PCT and Manchester Unive enhance the status and effectiveness of us as a research organization (MA detail - see Appendix B). We are the only MAHSC partner to have increase financial year 2010/11.
The DH highly commen
The report included good examples of the impact from our research especially in relation to the contributions to NICE guidelines but it did note over the continued funding of posts.
Whilst the overall picture from the report was of a successful research active the DH feedback in essence identified our immediate challenge; how to financial risk associated with the changes in
presented to highly research active organisations by the new DH funding arr health research.
We will ensure R&D plans aid and inform the strategic direction of our Trust a the national objectives for R&
4. Our Key Strategic objectives
rums, the strategic objectives for the Trust have been defined as follows:
& wider areas
C. Increase our capacity and capability for research in order to effectively support and arch potential ups, service users and carers.
artners to develop MAHSC and to increase our collaborative working for greater patient benefits.
e our reputation as a world class centre for research in area of mental
are ntified within the MAHSC business plan. These are listed in below e corresponding links to our strategic objectives.
MAHSC g MAHSC Goal Number Trust strategic objective linked to
Following wide debate within all Trust R&D Fo
A. Establish R&D as essential core business.
B. Demonstrably improve the healthcare of those within the Manchester through the dissemination and implementation of research findings.
retain our existing high quality researchers and develop the rese further in all professional gro
D. Work with our p
E. Consolidat
health and social care.
4.1 MAHSC goals
There with th
7 goals ide
oals and our objectives Goal detail
1 g the
ent and ealthcare and research
B Improve the health and wellbein
population through the developm application of innovative h
of
2 Disseminate innovation in technology are E nationally and internationally
and c
3 healthcare,
ement, and biomedicine in B & E Educate effectively in all aspects of
healthcare manag
support of workforce development
4 Lead on quality of care and public engagement. D 5 Partner more widely and more beneficially with
the commercial sector.
C & D 6 Contribute significantly to innovation, enterprise
and economic development in the city region and the North West of England
A, C & D
7 Attract the best national and international health researchers and healthcare workers.
4.2 Ensuring delivery
to be in place across the organisation to
A. Effective governance, organisation and management across the interface between
we have real capacity to make a
C. Strong investment in enabling infrastructure.
D. Internationally competitive staff at the forefront of innovation and development.
riorities of the health ve not agreed the new DH s a framework nt the findings facilities. The ctorate should uragement of nce and presentation of results.
fall within the aisal. Through tation of best ard to moving
It is clear that we need to strengthen the ‘development aspect’ in R&D and this is also central to the MAHSC vision. We will work with MAHSC partners in this area particularly focusing on how our Trust can support and facilitate staff to conduct research. We will also take advantage of the NIHR/UKCRN networks in this area. UKCRN runs a series of courses related to research skills-open to all involved in the portfolio. All seven TLRNs have pooled resources to run similar courses locally. We want to increase and strengthen our engagement and collaboration with appropriate research partners and stakeholders.
We have defined five building blocks which need
ensure that it is possible to deliver our objectives. These are:
research and clinical care.
B. Clear focus on the clinical areas in which difference.
E. Harmonisation of best practice.
4.3 Delivering our R&D objectives
We aim to facilitate high quality research of relevance to the needs and p
NHS and its service users. We are mindful of commissioning priorities and public concerns. Previously, the lack of a clear Trust strategy has meant that we ha
a common strategic direction. There is now the opportunity to do so, and funding mechanisms, with their focus on research for patient benefit, provide to do this within.
The aim of R&D is to actively disseminate and, where appropriate, impleme of clinical research with the purpose of improving patient care and/or improvement in oversight of such implementation provided by the R&D Dire enhance clinical confidence in such services. We need to provide enco research meetings and other forums for sharing of experie
Our R&D Team would only provide oversight to service developments which category of research, and which therefore need close monitoring and appr these mechanisms MMHSCT would be able to demonstrate the implemen practice. This process should be of a high priority to MMHSCT with reg towards New Ways of Working within a safe governance framework.
5. Objective A: Establish R&D as essential core business
ge of our front to provide the Research Champion in Occupational therapy, with more to follow in Nursing, Social Work, Administrative and Clerical etc.
ition, R&D is a partners. In ired by a non-r. The role of the committee has been to develop this strategy in the first
ately oversee the board via
ement Board. assume oversight for R&D from the 30 of April 2010.
rategy. Therefore, there will be e to the
am, including search Governance Lead.
ember of the nt Team as a agement team. In addition, the Programme Lead for Mental Health will be an invitee on the
evelopment Committee.
o address the D Committee. ttees.
Academic Research and Development Committee, a revised Research nd procedures ition, there is a need to further develop and review robust monitoring and reporting systems with regard to research governance. Such governance procedures need to be in place to ensure that our Trust complies with the Research Governance Framework for Health and Social Care (2005 and 2008 annex) and other legal obligations. Such compliance aims to enhance the ethical and scientific quality of research, promote good practice, reduce adverse events and prevent misconduct.
Appropriate software will be implemented to update and streamline existing research databases to ensure compliance with the Research Governance Framework. In addition at We are committed to strengthening research interest, awareness & knowled
line staff. We intend to demonstrate this by appointing Research Champions
link between research and all of staff groups. We have commenced by appointing a
5.1 Creating an R&D Business Unit
Our academic operations are a core area of business for MMHSCT. In add joint enterprise between MMHSCT, Manchester University, and other MAHSC the first instance a Research Steering Committee has been established, cha executive directo
instance, to ensure alignment of goals with our partners and to immedi aspects of research governance. The committee reports answered directly to the Medical Director.
Within the revised Trust assurance framework, a formal Academic Research and Development Committee has been established, under the Trust Manag
Subject to board approval, this committee will be chaired by the Medical Director and will th
R&D is a key area for development within the Trust St
additional accountabilities for the Academic Research and Development Committe Executive Team and to the Foundation Programme Board.
For operational purposes the R&D Director will lead an R&D Management Te the R&D Manager, Finance Officer and Re
With regard to relating to MAHSC, the Chief Executive of the Trust is a m MAHSC board, the Medical Director is on the MAHSC Executive Manageme representative member. The R&D manager will continue on the MAHSC man Academic Research and D
A quarterly R&D Trust and University Liaison Committee will be created t development of longer term partnership issues. This will report to the R& Clear terms of reference have been created for each of the new R&D Commi
5.2 Research Governance
Accountable to the
Committee will continue to review and to direct the development of policies a relating to R&D and to monitor the effective implementation of these. In add
least 10% of active research studies taking place within MMHSCT will be act quarterly, in line with DH guidelines on effective research monitoring. Unto and missed opportunities relating to R&D will be lo
ively inspected ward incidents gged and critically reviewed to enhance the future effectiveness of the R&D function within our Trust.
support staff e to additional e to us where verheads were is, which varied depending on the source of funding. Given rrangements, there is a need to develop a to ensure that
rovider. SSCs search study. staff would not be considered as part of the research team but rather have contracts
spent by these ting access to linically related
g these costs. CLRNs involves the allocation of such activity based funding. The strategy developed by MMHSCT
this mechanism in a way which best reflects the ave asked for tion of a SSC. pounds so our
ome)
sustainability funding have been defined. The sed on the amount of other NIHR income that
research-ation rates will Trust and the nding from NIHR sources. The Trust is leading the process locally in distributing FSF subject to the policy
5.3 R&D Finance considerations
5.3.1 Research Overheads (income)
Research overheads are an intrinsic part of a grant, intended to cover the costs in relation to a study. Overheads protect our Trust against exposur financial risk when committing to a research study. These costs are only du the University does not supply the relevant support in full. Previously such o calculated on a percentage bas
the increased transparency of current funding a
more robust method of calculating and monitoring such research overheads, all Trust costs are recouped effectively.
5.3.2 Service Support Costs (income)
Service support costs (SSCs) are those additional costs carried by an NHS p are generated through the involvement of clinical staff in facilitating a re These
of employment to deliver main stream clinical care. SSCs may involve time staff in identifying suitable service users for research studies, along with assis these individuals, the carrying out of any study related tests, and other c activities.
There is a need to develop a robust mechanism for calculating and monitorin This is particularly important as the second phase of the development of the could potentially help in the development of
SSCs generated by Mental Health research. For 2009/10 the CLRN h requests for SSCs from trusts but have given no guidance as to the defini The budget for the whole of Greater Manchester for 2009/10 is one million Trust must now work to develop a formula to accurately recover its costs. 5.3.3 Flexibility and Sustainability Funding (inc
The modalities for claiming flexibility and “standard” allocation will be ba
active NHS organisations received in the previous calendar year, FSF alloc vary from year to year. This is an important source of funding for our University and is however wholly dependent on our ability to attract new fu and protocol developed by the R&D Steering Committee.
http://www.nihr.ac.uk/faculty_funding_flexibility.aspx 5.3.4 Excess Treatment Costs (Cost)
These costs relate to studies which incorporate a therapeutic component. The costs are generated through the provision of the therapy itself. These costs must be supported in full by the NHS locally, unless a subvention has been agreed with the awarding body or DH. In view of the higher excess treatment costs generated in psychological intervention studies, which MMHSCT has a strong reputation for, this cost pressure is an important one for us to manage in partnership with the PCT and in the context of the SHA/PCT policy on risk sharing. A robust mechanism needs to be devised to accurately calculate excess treatment costs at an early stage of grant applications to allow us to commit to studies
incorporating ETCs which are likely to have a high impact on patient care. An options paper
proportionate organizations R&D and the ution of this is
ls to obtain a o participate in e a major driver of quality in services. Therefore ETCs will be a key roup of the contract review meeting between the
ndergraduates nts or trainees ent. The NIHR mechanisms. to help support the costs of student research and
e used directly this. FSF has students and
nior researchers and others from non-port research e. This would new business st. earchers and staff employed hould be used e provision of ociated with a t, been known this applies therefore to staff employed by the University an agreed protocol will need to be developed to identify the correct pro-rata distribution of these research NHS and University job planning framework. This needs to be mindful that clinical academic posts in mental health are more likely to be funded, or substantially is the case for impact of the
d – response
5.4 R&D Budget
The ring fencing of R&D budgets is now clearly necessary to safeguard the new NHS funding streams which require stricter management and governance than previously. A dedicated R&D budget is required and will be managed from April 2010. This will show all income as well as expenditure. Any Trust investment in R&D should be clearly focused on enhancing financial stability and should become self financing within the medium term. will be brought forward at an early stage to consider this issue in more detail.
Nevertheless, the National guidance on the funding of ETCs does place a dis financial burden on PCTs which commission services within highly active such as MMHSCT. This presents a real risk to the key business of maintenance and expansion of the Trust’s portfolio of research. The resol therefore a priority. The Trust aims to work with our partners at all leve satisfactory solution to this problem. In particular, opportunities for patients t high quality research ar
area for discussion for the quality sub g PCT and the Trust.
5.3.5 Own Account and Student Research (cost)
MMHSCT and the University of Manchester train a substantial number of u and postgraduates in medicine and allied professions. Many of these stude have traditionally undertaken research as part of their vocational developm approach has omitted such research from financial support through the above Ideally we would develop an endowment
mechanisms for doing this need to be further explored. FSF money cannot b for this purpose. We will begin discussion with the Universities to progress been utilized in some areas to support the stipendiary costs of postgraduate the practicalities of this require further exploration.
By developing mechanisms through which ju
traditionally research active staff groups can access funding to sup endeavour, MMHSCT will be able to maximally broaden the research bas include health and social care research, but also potentially research into models or management techniques which may have a direct utility for the Tru 5.3.6 Academic Staff Costs
All funding applications should fully incorporate the staff costs of all res supervisors which are generated by the study. Where these costs relate to by the Trust, they should be recouped by us and the money so generated s to release clinical time to facilitate the research. This may be through th additional SPA sessions within a job plan. However not all such income ass joint University and NHS funded but University managed post has, in the pas to us. Where
costs, within a joint
funded by NHS resources, as opposed to HEFCE or charitable sources, than most other specialties including virtually all general acute specialties (The NHS R&D Strategy on Mental Health Services and Research in Englan document, 2008).
The R&D Team will publicise information on funding opportunities throughout support any potential applications. Whilst NIHR grants and other grants portfolio are the highest priority for the Trust as they generate additional inco also continue to seek funding from charitable and commercial sources. In o there is a need to balance the need to be facilitatory towards grant appli
the Trust, and eligible for the
me, we should rder to do so, cants with the need
.
cal industry to ise the access ill optimise the the Trust with then be made er R&D purposes through the ring-fenced R&D budget. The development of at with n the set-up discussions in ion to the CTU.
mmary of objectives to establish R&D as a core business unit
to be involved from the very beginning of the application process, if not before The North West Exemplar Project is a collaboration with the pharmaceuti develop rapid and facilitatory research governance arrangements, to maxim to patient populations for funded pharmaceutical research purposes. This w access of the local population to new and exciting treatments whilst providing a substantial income stream through research overheads. This income would available for oth
the MAHSC Clinical Trials Unit (CTU) represents both an opportunity and a thre regard to such funding streams and the Trust will be active i
relat
5.5 Su
Action Due date
Finalise Academic Research and Development Committee terms May 2010
of reference.
Establish revised Research Committee and subsume the work of May 2010
the R&D steering committee
Define and agree strategic direction for research po Trust, in collaboration with MAHSC.
rtfolio for the September 2010
Finalise KPIs for R&D, including quality measures, targets, productivity and health promotion.
Innovation September 2010
Develop a report and recommendations on Excess Tre Costs. Propose mechanism for recovery of servi
atment ce support costs.
May 2010
Formalise Research Development Process, addressin applica
g grant tion, opportunity development, governance and risk.
Ensure costs a
September 2010
Ensure relevant supporting policies are in place. processes for accommodating excess treatment stage
t an early
Consolidate formal partnership links with the University of
Manchester, address and resolve agreements around all aspects of funding
August 2010
Develop specific links with teaching, and form a researcher development plan
6. Objective B: Demonstrably improve the healthcare of those Manchester &
within the wider areas through the dissemination and implementation of
earch and the o against this will define key
ulation needs rust research this context. The R&D Committee will direct how this should be ers and NHS
ging together bridging the l Health is. The PCMHRG has earch, nurture ould need to identify key
or which have .
partner in the increasing our g with industry. The Exemplar project will allow Industry and the NHS to work together to improve the process of setting up Clinical trials in the UK. Exemplar will on performance with Industry in Clinical trial set up (metrics details appendix C). The advantage of this project for our population is that they
al benefits this
6.1 e outcome monitoring
sive outcome tients groups.
6.2 Involvement of service users & carers in the development of outcome measures uting outcome ols measuring xperiences of and treatment delivery.
6.3 Disseminating research findings
We are committed to the widest and most effective possible dissemination of research findings; this will include research conducted locally, research from other areas of National importance, and National guidelines which have been developed through NICE and other bodies. Knowledge dissemination will occur through a programme of research days, the
research findings.
We will undertake a review of stakeholder priorities for the focus of res implementation of findings. We will review our current research portfoli framework, and refine our planned portfolio development accordingly. We areas for research ensuring that these are specifically sensitive to local pop as well as National research priorities. A comprehensive review of current T activity is necessary in
carried out. Any such review should be in parallel with other MAHSC partn Manchester.
The development of research groups will be an important factor in brin research active or potentially active staff and could play a key part in University-trust gap around key areas of research interest. The Primary Care Menta Research Group (PCMHRG) could be used as an exemplar for th
people from NHS in Manchester who attend, but the aims are to promote res PhD students, and create collaborations for NIHR grants. We w
people to lead each group who are genuinely interested in networking. We will continue our work to target collaborations with the commercial sect the potential to bring innovative new treatments to the patients of Manchester As previously mentioned, an example of this is that we are a participating Exemplar project and this clearly demonstrates our first steps towards workin
measure the participating Trusts
will have greater access to new treatments in development with the potenti will bring.
Routin
We will move the Trust forward into a culture of systematic and comprehen monitoring to ensure innovation and best practice are truly benefiting local pa
Service users and carers should be fully involved in developing and exec measures. This outcome monitoring will include the use of validated to quantitative outcomes as well as methods which measure the qualitative e users and carers, this will give these groups a clear voice in both research
creation of research networking groupings and electronically through specialist interest
er community rs and carers. tely formatted rmation which t also to facilitate their becoming actively involved in the
all groups in other
oven effective University of ses of mental in primary and secondary care settings. The University of Manchester has recently noted (Mental Health h programme in England’s
There is still a long way to go and we aim to effectively communicate the best practice Mental Health Commissioners. we aim to assist the commissioners in develo tegy for
pro re
forums.
We are keen that mechanisms to disseminate research findings reach the wid including colleagues in primary and acute care and particularly service use The learning needs of specific groups will be identified to allow appropria meetings to be arranged. This is to ensure that groups not only receive info is meaningful to them bu
dissemination process. This will then encourage further involvement of aspects of the research agenda.
6.4 Informing a world class commissioning agenda
The final step in the research process is the implementation of pr interventions into clinical practice. The Trust in collaboration with the Manchester conducts research which not only investigates the underlying cau ill health but also focuses on the design and delivery of improved treatments Research at The University of Manchester October 2009) that this researc ‘impacts on National and international policy, as well as local care delivery North West, thus having direct effects on service user and providers’.
guidance which emerges from our research portfolio to the In this way,
men
ping a world class stra tal health care in Manchester.
6.5 Summary of objectives to demonstrably im ve healthca
Action Due date
Undertake a survey and review of stakeholder priorities aga current and planned research portfolio
inst our October 2010
In collaboration with service colleagues, develop a programme of routine clinical outcome measurement, aligned with PBR, ‘Recovery’
March 2011
principles and speciality requirements
Establish research interest groupings across the Trus discipline, linking to our academic p
t and
artners and complementing the wider organisational development programme. Incorporate specific research champions within staff and patient groups.
December 2010
across
Outcome monitor to be developed with service user and carer input. March 2011
Development of Research Seminar Programme October 2010
Effective implementation of outcome monitoring tools for routine clinical use which facilitate health research.
7. in order to archers and research potential further in all professional groups, service
jective, we must ensure we are effective in facilitating high quality research in order to attract more grant income against our
r Best Health new funding as resulted in bids. We will t place to carry rch. We have appointed two additional members of R&D Administration; Grants e organisation and our Trust
researchers the opportunity to work in a supportive ccommodation s to solutions, access to high tistical advice. ource material eate a central mise cost and
recruitment of research participants through the effective use of existing IT systems. Whilst it is felt ility to recruit we have a comprehensive electronic record system in place which could be better utilised to achieve
IM&T access SS licenses.
7.1 Developing and supporting R&D competencies amongst staff, users and
ore patients and health professionals participating in health research ote research-ng on fundiresearch-ng,
ve introduced to encourage non-traditional staff groups to participate in research.
Training awards for researchers are also available, from the Research Capacity Development programme, to people who show the potential to be research leaders: http://www.nccrcd.nhs.uk
Objective C: Increase our capacity and capability for research effectively support and retain our existing high quality rese develop the
users and carers.
In order to successfully deliver on this key ob
competitors in a rapidly changing research environment.
In the transition period to fully implement the new DH ‘Best Research fo Strategy’ we quickly took the decision to support the bidding process to schemes. This has been well received by our research community and h external researchers preferentially approaching us to lead and host consolidate and build on this success by promoting our Trust as an excellen out resea
and Governance, to ensure we are able to support researchers throughout th appropriately whilst keeping their research safe for service users, themselves as a whole.
We also need to provide our
environment. Part of this requirement is to ensure we have fit for purpose a necessary to conduct research projects. It also should provide shared acces the encouragement of sharing of research experience and continue to allow quality peer review and sta
We need to work with library services to maintain a library of books and res with high-quality protocols. We have appointed an outreach librarian to cr Library of Research Assessment Instruments and assisted ordering to mini potential breaches of copyright.
We would like to expand our knowledge and ability around facilitated nationally that the National Programme for IT will transform each Trust’s ab patients to clinical trials, this may yet be some years off. With AMIGOS, this purpose. We need to provide our research community with assistance on and database management as well as maintenance and administration of SP
carers
DH wants to see m
and we are fully supportive of this. To assist in this there is the need to prom related training opportunities amongst staff and other groups, including traini research governance, research methodology, publishing, etc. Some Trusts ha research prizes
.
Both TLRNs and GMCLRN hold annual conferences. Patients and members of the public are involved at Strategic level within the Networks. The TLRNs have developed a research protocol help service; i.e. a group of lay members who will advise researchers on information leaflets.
We must encourage and facilitate applications for NIHR Programme Gran NIHR fellowships (pre and post doc), NIHR development grants and Resea Benefit (RfPB) Grants. By linking into Trust & University strategic objectives research areas can be created to guide researchers in the direction of travel. that areas of expertise at our Trust are captured and
ts but also for rch for Patient a list of priority It is essential applications made for grants relating to those areas of work encouraged. A PhD coordinating application process is required to
s are nurtured and ready to apply.
ging IP is a key route into maintaining reputation and viability as a research centre whilst also contributing generally to the Trust’s asset growth. The Trust wishes to increase endorsed by Trust
ry of objectives to increase capacity and capability
ensure key potential application
7.3 Intellectual Property (IP)
Mana
its portfolio of IP as part of this process. A new IP policy has been Board.
7.4 Summa
Action Due date
Ensure and review the effectiveness of grants c governance support
o-ordination and October 2010
Undertake an academic estates and IT review, in the context of the October 2010
wider Trust reviews
Develop and implement an academic communication a marketing plan, in the context of MAHSC
nd August 2010
Develop a knowledge management plan for approval August 2010
Further develop a bid to NIHR capital funds to secure designated ra
December 2010
research facility ‘hub’ for mental health including post g element to bridge educational aspect.
duate
Employment of a recruitment facilitator in order to incre accrual.
ase patient March 2011
Review all Library needs for our Trust and determine to meet our needs. If required, to negotiate a reduction partner SLA’s in order to fund alternative arrangements
bes solution in . March 2011 t Acute
Set up structures to actively engage and support people from AHP r
December 2010
to apply for grant funding. Linked activity to new R&D G Coordinator post.
ants
Introduce Research champions in all staff groups beginning with pilot in OT. Set up an active research group for AHP who are not traditionally active to start to develop more of a research culture in these staff groups. Hold workshops and training seminars for staff and users and carers. Review initiatives.
December 2010
We will develop a journal club to disseminate current research, proposed ideas for future research, and presentation of findings of current research.
8. Objective D: Work with our partners to develop MAHSC and to increase our
ally and to healthcare.
) the Terms of indicators as rational activities of MAHSC team including:
elopment and he financial performance of MAHSC
its sub groups. sents the trust
The Clinical Academic Section Lead for Mental Health (Professor Linda Gask) also sits on AHSC EMT and will work closely with the Trust Medical Director and the Trust R&D e w tween the Trust and the
A
collaborative working for greater patient benefits.
The MAHSC aim and vision (See Appendix B) is to be a leading centre nation globally for the uptake of innovative applied health research and education in Our Medical Director sits on the MAHSC Executive Management Team (EMT R ference of which include: e
• To regularly review performance against the key performance identified in the MAHSC Strategy
• To support, review and input to the ope
governance and management; research operations; business dev industrial liaison; communications and; funding proposals
• To monitor t
Our R&D Manager sits on the MAHSC Operational Management Group and The subgroups cover a wide range of issues and the R&D Manager repre interests in those issues.
the M
Team to develop a strategic approach to collaborativ other members of MAHSC over the next 5 years.
orking be
ction Due date
Develop communication plan for the Trust on benefits of MAHSC June 2010
9. Objective E: Consolidate our reputation as world class centre fo area of mental health and social care.
9.1 Business Orientated Approach
r research in
arketing itself cover all of its contribution to ty and health with suitable
of bids and to r, correct and transparent arrangements for managing allocated internal ding. There is to govern the external bidding process. Each bid is decided on an ad hoc basis and in the past our Trust has been brought into the bidding process at the last minute. Our Trust and the university should therefore develop a standard agreement so that all future bids are submitted with agreement of both parties and associated costs are systematically identified and fairly attributed. In addition all costs due to our Trust and financial risks related to the research must be quantified.
The Trust has been immensely successful in attracting senior investigators to request MMHSCT to host their Grants and must continue to do so, within the Trust portfolio of As with the first objective, the R&D Team must become business focused, m
appropriately and exploiting opportunities to develop. The R&D must strive to costs with immediate effect, , and go on to make an increasingly valuable wider health and social care in terms of quality, innovation, productivi promotion (QUIPP). The R&D Team should become a Business Unit leadership and support within the organization.
The aim will be to develop procedures to effect the robust management implement clea
funding and for ensuring financial probity in the management of external fun currently no standard agreement between our Trust and the University
interests. Many students external to Manchester request R&D support fro number of external studies access Manchester due to its high population mor these cases we need to ensure that the Trust is able to play its role in respon associated FSF funding in supporting research and development, dev
m us. A large bidity. In all of sibly directing eloping researchers,
indings.
ce, sharing with our esearch his area. ored trials by ses. Attracting ditional funds ss to the joint ified to ensure e potential to apply for formal category II ds to be considered to identify its potential and how this may etworks
A framework has been drafted as a structure for driving the development of performance, ix F). This structure will be further
ent of NIHR was to help the NHS be recognised as taking an earchers and search-led and in a Trust with service users. dicator and a
Neither our Trust nor the University publicises their association sufficiently and due credit ive ational and international meetings needs to be encouraged. Some collaborative work between the two organisations’ communications departments to is leading the r to be ample including local
9.4 Improving Joint Processes
Our Trust/University partnership has been extremely successful in securing funding from the new schemes. This has been largely due to the decision to maintain current academic input whilst longer term solutions are found to funding issues. Excellent informal working processes are in place between our Trust and the University at an operational level. However, these would benefit from a more formal approach. Areas which should be building our agreed portfolio and ensuring ‘QUIPP’ linked implementation of f
In addition we should aspire to pursue a model of R&D support excellen
partners as appropriate. We already operate a totally streamlined approach to r governance (SPEAR), just one example of the expertise we have to share in t We need to initiate and develop opportunities for commercially spons demonstrating comprehensive and professional management of R&D proces such sponsors will provide a means for capacity building and generation of ad for future research within our Trust. As part of MAHSC we will have acce Clinical Trials Unit (CTU). The use of local partners needs to be further clar
that our Trust is obtaining value for money (e.g. Welcome Clinical Trials Units, TRUSTecH). There is a facility at Park house which has th
laboratory approval, this nee
link to MAHSC CTU. We must also consider how the Trust can use NIHR/UKCRN n to develop.
9.2 Excellence Framework
governance and excellence within R&D (append
reviewed and evaluated, and will form the basis for developing business unit orientated KPIs.
9.3 Develop R&D Profile and the reputation of our Trust
The purpose of the developm
international lead in supporting a research-led culture for health. Res healthcare professionals would then be proud to say that they worked in a re evidence-based NHS. We aim for our staff to be proud to say that they work an excellent research reputation, and that this makes a real difference to our Our Trust aims for the quality of R&D to be seen as a service quality in facilitator for recruitment generally.
g n to MMHSCT in local, n
actively promote our research successes would be very timely. MAHSC process on coordinating accreditation across partners. There would appea opportunity for the dissemination of “good news stories” to a wider audience, and national media.
of purpose, and dual organisation sign-off), transparent financial processes party to sign off joint bids and recoup funding fairly. This is p
allowing each articularly important where idding in consortia which do not include our MMHSCT.
our Trust will be helped by an effective research communication strategy. This can be done from the point of induction,
ould appear to &D within our ance the functionality of this, for instance to provide virtual spreadsheets to help estimation of various research costs. It would be the first port of to identify and
officer. 4 TLRNs have jointly ed a Communications Officer our Trust must ensure t ost is utilised.
ing our reputation
joint appointees are b 9.4.1 Communications
The encouragement of a research focussed culture within
and otherwise utilise standard communication devices within out Trust. The re-design and maintenance of the R&D section of the Trust Website w be the most permanent and accessible means of enhancing the profile of R Trust. Support will be required to enh
call for any funding opportunities. It would act as a means for researchers communicate with potential research partners.
GMCLRN has a pipeline service and an Industry Liaison
fund hat such p
9.5 Summary of objectives for consolidat
Action Due date
Draft a formal service development plan for consider inclusion in the i
ation for ntegrated business plan for the Trust
April 2011
Draft our formal research portfolio, collating ongoing and planned w to
s of sp interest to expand.
June 2010
projects. Define our major research areas, with a vie
maintaining support and focus. Identify further area ecific Refresh relevant partnership arrangements. Conclude c
costing dis
u ent cussions with university.
May 2010
rr
Review research governance arrangements and check ag
external. June 2010
ainst
Review achievements against 2010/11 Action Plan (appendix A) for
April 2011
annual report
Develop R&D communication strategy October 2010
10. Strategy approval and monitoring process 10.1 Strategy Consultation Process
The strategy will be reviewed through a wide consultation process allowing all key individuals to comment/add and amend.
10.2 Publication and dissemination of the Strategy
Once agreed the implementation of the strategy will begin and the strategy will be made available to all of our key partners.
10.3 Review of Strategy
10.4 Monitoring of Strategy
The Strategy will be monitored by the Academic R&D Committee
Framework for Health and Social Care
and Research
The University of Manchester (2008) Mental Health research at the University of Manchester A Focus on Innovative treatments
11. References
DH (2005 and 2008 annex) Research Governance
Boyington et al (2008) Mental Health Services in Manchester
DH (2008) The impact of the NHS R&D Strategy on Mental Health Services in England – response document
APPENDIX A - 2009/10 Action plan
Action Due date
Negotiations with the University of Manchester need t obligations w
o clarify its ith regard to support for student research, and at what
September 2010
level this may fall financially. As a teaching Trust we ha obligations here.
ve obvious Similar discussions need to be had with ot
which call on our Trust for small un-funded studies.
her academic institutions September 2010
Development of required grant application process. December 2010
Development of grant application policy. December 2010
Develop robust system to identify and publicise grant op to staff.
cember 2010
portunities De
Tight governance structures and risk management system. July 2010
To create mechanism for recovery of service support costs. September 2010
Reporting to Management Board via Medical Director. June 2010
Agreed baseline of R&D activity to be monitored agains MAHSC).
t (linked to September 2010
Clear strategic direction for research portfolio provided by Trust Executive Team.
September 2010
Develop or expand research groupings to encourage and enhance December 2010
collaborative working in specific fields of research.
The setting up of research groupings will be carried out across the December 2010
Trust and across discipline, linking to our academic partners. Research Champions will be employed throughout the or in our different staff groups; we will pilot this in our O therapy staff group before roll out.
ganisation ccupational
December 2010
Outcome monitor to develop with service user and carer input. March 2011
Effective & outcome monitoring tools for routine clinical facilitate health research.
use which March 2011
Continued employment of an R&D Grants Coordinator to ensure d
te system with d other
October 2010
the continuation of grant income and to meet the develop grants. Funding/grants post would coordina
emand to School of Nursing Midwifery and Social Work, an
departments within the University.
Set up structures to actively engage and support people to apply for grant fund
from AHP ing. Linked activity to new R&D Grants Coordinator post.
March 2011
Continued employment of a Research Governance Coordinator to allow for necessary levels of research audit and review for GCP
October 2010
Identification of service support costs to enable our Trust to request funding from the CLRN. Consistent with levels of research activity within the Trust.
Employment of a recruitment facilitator in order to increase patient March 2011
accrual.
Further develop a bid to NIHR capital funds to secure d research facility ‘hub’ for me
esignated ntal health including post graduate
December 2010
element to bridge educational aspect.
Review all Library needs for our Trust and determine best solution March 2011
to meet our needs. If required, to negotiate a reduction in partner SLA’s in order to fund alternative arrangements.
Acute
We will set up an active research group for AHP who are not h
November 2010
traditionally active to start to develop more of a researc these staff groups.
culture in
We will hold workshops and training seminars for staff and users
been developed to support this.
December 2010
and carers. This will be done via Effectiveness days. Research Governance Coordinator post which has element has
The new teaching
We will develop a journal club to disseminate curren proposed ideas for
t research, future research, and presentation of findings of
rch 2011
current research.
Ma
Enhance and nurture relationships with University and build links in September 2010
particular within MAHSC.
Consider lab facility at Park House and how this ma more/developed in the future.
y be used December 2010
Ensure partner agreements are beneficial to us. September 2010
There should be R&D policies detailing the local procedures for y 2010
research governance for each stage of the research process.
Jul
There will be a re-examination of all current Trust policies relating to R&D.
September 2010
We will develop an R&D Newsletter. October 2010
Regular dissemination of research findings at internal trust meetings is to be encouraged and a framework of such meetings should be developed.
October 2010
Webpage development continued. August 2010
APPENDIX B - MAHSC Vision and goals
nally and globally for the uptake of innovative earch and education into healthcare.
n our integrated approach for research innovation into practice re to:
reater Manchester ionally
healthcare management, and biomedicine ase and enhance partnerships with the commercial sector
bution to innovation, enterprise and economic development in North West of England
health researchers and healthcare
re education that includes alth services f innovation across the organisation
• Improved healthcare provision leading to better health outcomes
• Improved responsiveness to the opportunities for individualised patient care
Increased capacity in the NHS locally, nationally and beyond to plan and implement evidence-based changes to service delivery through e-Health implementation.
MAHSC visionis to be a leading centre natio applied health res
MAHSC strategy is to:
1. assess unmet health need 2. build upo
3. implement research and MAHSC goals a
• Deliver higher quality healthcare and health to the people of G and beyond
• Disseminate innovation in technology and care nationally and internat • Educate in all aspects of healthcare,
• Lead on workforce development • Incre
• Make a major contri the city region and the
• Attract the best national and international workers
MAHSC vision will be achieved by:
• Alignment of service delivery with research and education • Development of a multi-professional healthca
management
• Accelerated development of new treatments, technologies and he targeted to unmet clinical need
APPENDIX C - Suggested performance metrics d recruitment target. tudies. ites. oved. costs.
There is a conflict between GCP and setting performance metrics for research approval simply on a time basis. The R&D Manager will ensure that metrics are consistent with MAHSC performance measures.
The performance metrics might include; • Delivery to planned time an • Percentage of non-recruiting s • Percentage of non-recruiting s • R&D submission to first site appr • First submission to first site approved. • R&D submission to first patient recruited. • Site approval to first patient recruited.
• Submission of Industry Costing Template to NHS Trust agreement of
APPENDIX D - SWOT Analysis of R&D in MMHSCT
s between our Trust and the University igh calibre research studies which benefit patients and staff
t not yet achieved Foundation status (2010 application)
tegy which could generate our Trust will be able to recoup overheads to levels enjoyed in previous years.
ersity and Trust research policies and procedures are not linked.
mination) and
MAHSC
Academic Opinion Leaders could inform and influence developing strategies for agree short,
ing system e adoption of
ely to bid for ing streams, our current position will be further eroded and R&D funding will dwindle and in the medium to long-term dry up
Only large scale externally funded research will be funded via new funding streams. This leaves a large amount of student research unsupported which is problematic for a teaching trust.
The externalisation of FSF distribution mechanisms through the CLRN and potentially MAHSC
Strengths
International calibre academics
Manchester second only to Institute of Psychiatry in UK Excellent long term working relationship
Access to h
Six NIHR Senior Investigators linked to MMHSCT
Weaknesses
Trus
Trust and university research strategies are not currently linked We do not currently have a commercial research stra
income
All bids to new funding streams are for new work and it is unlikely that Univ
Past failure to translate research results into staff training (disse clinical practice
Opportunities
treatments and services
University and Trust should shortly be in a position to discuss and medium and long term plans to secure future funding
Threats
Changes to funding flows have introduced instability into the R&D fund Failure to resolve availability of funding for ETCs will restrict th
potentially income and prestige generating research
Unless our Trust and the University collaborate quickly and effectiv monies from new fund
APPENDIX E - Funding Streams Generated by NIHR
est Research nizations. The
is intended to conduct first-s alongfirst-side high-quality patient care, dy, but seeks to regroup and organize all previous
grants include:
k/site/callsproposals/rfpb/default.cfm
Research and Development within the NHS in England prior to the launch of B for Best Health was invested within individual NHS and academic orga National Institute for Health Research is a new overarching body which provide the NHS in England with the support and infrastructure it needs to class research funded by Government and our partner
education and training. It is not a new bo
R&D resources and infrastructure. Available NIHR • Research for Patient Benefit (RfPB) programme:
http://www.nihr-ccf.org.u
EAT) programme: • New and Emerging Applications of Technology (N
http://www.nihr-ccf.org.uk/site/callsproposals/neat/default.cfm • Policy Research programme:
http://www.nihr-ccf.org.uk/site/callsproposals/prp/default.cfm • Programme grants for Applied Research:
grants/default.cfm
http://www.nihr-ccf.org.uk/site/callsproposals/programme
• Research for Innovation, Speculation and Creativity (RISC): s/risc/default.cfm
http://www.nihr-ccf.org.uk/site/callsproposal
proposals/invforinov/default.cfm • Invention for Innovation:
http://www.nihr-ccf.org.uk/site/calls
ssessment (HTA) programme: http://www.ncchta.org/funding/index.shtml
Additional funding resources include: • Health Technology A
• Medical Research Council (MRC) grants:
http://www.mrc.ac.uk/ApplyingforaGrant/AvailableGrants/ag • Service Delivery and Organisation (SDO) programme: http://www.sdo.lshtm.ac.uk/
Department of Health
Trust R&D Department NIHR CLRN Mental Health Research network DENDRON network Wellcome Trust Universities MAHSC partners SHA All other local Trust/PCTS/ local govt TrusTECH North West Mental Health Alliance Member Trusts NIHR CLRN Specialty Theme leads