National Institute for Health Research

The NIHR’s commissioned research programmes offer a focused source of funding for researchers within the health system in England. Scotland, Wales and Northern Ireland also participate in some of these programmes. The programmes aim to improve patient health and care by providing evidence to inform clinical, social care and public health professionals, NHS managers and where appropriate, policy makers. The goal is to ensure that researchers from all parts of England, and from all areas of healthcare, are able to access appropriate funding to undertake clinical and applied health and social care research, focused on priority areas and topics.[6] NIHR have an Open Access Policy and were one of the original funders of Europe PubMed Central.[7]

NIHR programmes include:

• Health Technology Assessment: funds and delivers research information about the effectiveness, costs and broader impact of healthcare treatments and tests for those who plan, provide and receive care in the NHS.
• Efficacy and Mechanism Evaluation: bridges the gap between preclinical studies and evidence of clinical efficacy.

The NIHR has established three national research ‘Schools’ (the School for Primary Care Research, the School for Social Care Research, and the School for Public Health Research). Each national school is a research collaboration between academic centres in England. The three schools aim to:

• Increase and develop the evidence base for practice in the primary care, adult social care, and public health sectors.
• Contribute to ongoing efforts to build research capacity in their respective sectors.
• Improve research awareness in their respective sectors.
• Create a ‘critical mass’ of research expertise and funding through coordinated and collaborative working across the country.[8]

The NIHR provides the support and facilities the NHS needs for delivery of research by funding a range of infrastructure,[9] including:

• Clinical Research Network: supports clinical research infrastructure throughout England, working towards increased access for patients to new and better treatments in the NHS.
• Biomedical Research Centres: conduct and support translational research to transform scientific breakthroughs into life-saving treatments for patients.[10]
• Patient Safety Translational Research Centres: conduct and support research to investigate ways to improve the safety, quality and effectiveness of the services that the NHS provides to its patients.[11]
• Collaboration for Leadership in Applied Health Research and Care (CLAHRC)[12]: the 13 CLAHRCs in England bring together universities and their surrounding NHS organisations including primary care, to conduct applied health research that is transferable across the NHS to provide the highest quality patient care and outcomes.[13]

The purpose of the NIHR Faculty is to identify and bring together the people who are funded by the NIHR or by the Department of Health’s Policy Research Programme (DH PRP) to support clinical and applied health and social care research. The NIHR Faculty comprises three categories of membership:

• Investigators (including Senior Investigators): members who are directly engaged in doing research
• Associates: members who support research led by others (e.g. Clinical and clinical support staff, scientific, laboratory and technical staff)
• Trainees: the next generation of researchers, many are members on NIHR training schemes

The Faculty encompasses research, clinical and support staff from all professional backgrounds, including doctors, dentists, nurses, allied health professionals and pharmacists.[14]

The current chair for the institute is Sallie Lamb.[15]

The NIHR funds research mainly in the United Kingdom. As a new departure, and in line with the UK Government’s aid strategy of diffusing Official Development Assistance spending across government departments, the Department of Health and Social Care has been allocated money for global health research for the direct benefit of patients and the public in low- and middle-income countries (LMICs). Using the research funding management experience of the NIHR, the Department will be supporting global health research units and groups comprising universities and research institutions from across the whole of the UK working with LMIC research partners.[16]

Since its establishment, the NIHR has:

• Delivered benefits to patients. The NIHR is developing innovations that can be delivered throughout the health and social care system, such as more personalised and cost effective dementia care, new treatments for breast cancer and dedicated partnerships to support research in rare disease areas.
• Helped to improve the health of the public nationally and internationally. NIHR-supported public health research is leading to reductions in alcohol-related harm, improving smoking prevention strategies and increasing vaccination coverage for H1N1 and childhood immunisation. Worldwide, more than 1 million people stand to benefit from NIHR-funded research into the off-label use of tranexamic acid to aid clotting during traumatic bleeding.
• Helped to make the nation’s healthcare system more effective, cost-effective and safer. NIHR-funded research into patient safety has informed the World Health Organization’s (WHO) Surgical Safety Checklist, which is significantly reducing post-operative complications. Other research is identifying cost-effective solutions that save money in areas ranging from physical therapy, to dementia, to diabetes.
• Put patients and the public at the heart of research. The NIHR is a world leader in patient and public involvement, and there have been tangible improvements to how research is able to deliver patient benefit. INVOLVE, the NIHR-funded national public involvement centre and advisory group, helps ensure that patients and the public are effectively involved at all stages of research studies, making them more acceptable and meaningful for research users of all ages.
• Enabled and facilitated both research funded by NIHR itself and research funded through charities, industry and other government funders. In 2014/15, from an initial investment of £227.8 million, NIHR research infrastructure leveraged over £918 million in research funding from NIHR’s charity, industry and public research funding partners.
• Supported the training and development of a diverse research workforce in the NHS and academia. In order to achieve clinical research excellence, research teams must possess technical knowledge and be skilled in working together to overcome difficulties, spark new ideas and inspire other researchers. NIHR is training a highly skilled workforce and developing and retaining the best clinical, health service and public health research professionals. It is also enabling leading clinicians to embark on, and successfully develop, their academic careers while continuing their clinical training. NIHR supports more than 5,000 trainees through a range of NIHR research funding or training awards.[17]

In 2016, NIHR commissioned RAND Europe and the Policy Institute at King’s College London to collate and synthesise 100 examples of positive change arising from NIHR’s support of health and care research in its first 10 years.[18]

NIHR’s work is led by Professor Chris Whitty, Chief Scientific Adviser at the Department of Health, and directed by the Senior Management Team of the Science, Research and Evidence Directorate at the Department of Health. An Advisory Board and a Strategy Board advise on the strategic direction for NIHR’s work’.[19]

Delivery of NIHR responsibilities is mainly managed by a number of 'Coordinating Centres' contracted to the Department of Health[20]

• Trainees Coordinating Centre (TCC) support NIHR objectives to train and develop our Faculty, the next generation of researchers.
• Central Commissioning Facility (CCF) and NIHR Evaluation, Trials and Studies Coordinating Centre (NETSCC) support NIHR objectives to commission, fund and disseminate research to improve patient care
• Clinical Research Network Coordinating Centre (CRNCC) support NIHR objectives to provide efficient and effective support for the initiation and delivery of funded research in the NHS.
• INVOLVE support NIHR objectives for active public involvement in NHS, public health and social care research.
• Office for Clinical Research Infrastructure (NOCRI) support NIHR objectives to help potential partners, including industry and charities, to navigate the NIHR's centres, facilities and expertise to work in collaboration

The NIHR was created in April 2006 under the government’s health research strategy, Best Research for Best Health, with the slogan "improving the health and wealth of the nation through research". This strategy outlined the direction that NHS research and development should take in order ‘to improve the health and wealth of the nation through research’. At its core were five strategic goals through which it would transform the research landscape:[21]

• Establish the NHS as an internationally recognised centre of research excellence
• Attract, develop and retain the best research professionals to conduct people-based research
• Commission research focused on improving health and social care
• Manage our knowledge resources
• Act as sound custodians of public money for public good.

• Medical Research Council
• National Institute for Health and Clinical Excellence
• Medicines and Healthcare products Regulatory Agency

• Official website
• Best research for best health
• RAND Corporation: The National Institute of Health Research at Ten Years