Health services research is the multidisciplinary field of scientific investigation that studies how social factors, organizational structures and processes, health technologies, and personal behaviours affect access to health care, the quality and cost of health care, and ultimately our health and well-being. Its research domains are individuals, families, organizations, institutions, communities, and populations (Lohr and Steinwachs, 2002). From this definition, it is clear that health services research covers a very broad domain, ranging from international comparisons of financing systems to studies of individuals’ help-seeking behaviour, and from quality of care research to economic evaluations.
The University of Portsmouth submitted a health service research group in the 2001 Research Assessment Exercise unit 11 that encompassed three areas; services delivery and organisation, clinical epidemiology and health profession education. Submitted staff came from the Science (7.7 FTE from Portsmouth Institute of Medicine, Health and Social Care, 3 Pharmacy and Biomedical Sciences), Technology (3 from Information Systems and Computer Applications) and Humanity Faculties (1 from Education). The submission scored 3b, and the following strengths and weaknesses were identified in the panel feedback report.
In 2003, staff who contributed to UoA11a and other researchers who have joined the University since 2001 make up the Health Service Research Group. As identified above HSR is multidisciplinary in nature and cannot be conducted in isolation from health and social care colleagues and consumers. At UoP we host one of a handful of DoH core funded ‘NHS Research and Development Support Units’. This unit staffed by the three academics (which made up the clinical epidemiology area of 11a) facilitates health services research collaboration between academic health service researchers and the health/social care colleagues within the local health and social economy. The RDSU together with other initiatives such as the UoP associated academic departments in NHS (e.g. academic departments of Surgery and Diabetes), the formation of PIMHS, UoP as a research sponsor, The Drug Safety Research Unit and the research group of the New Generation Project provides the UoP with an ideal framework to nurture and develop its HSR agenda. Indeed we have already benefited from this framework and have increased our external research income. In addition we have been one of only 6 successful universities in securing one of the new national Nursing and Allied Health Professions fellowships scheme for NHS professionals jointly funded by the DH and HEFCE.
The aim of the Health Service Research Group will be to:
The need to create working time for research has been identified as very important, in terms of both freeing existing staff and introducing new researchers. Bringing together the health services research community is also a priority to foster collaboration and the optimise funding opportunities for the University.
It is therefore proposed to spend the first tranche of Capability funding (£40-80K) on the following priorities:
1) To award PhD bursaries to address issues of low student numbers, to increase research output and to free academic time from certain teaching commitments while limiting the financial commitment to the initial 3-year funding window. These will be allocated on the basis of publicised criteria, such as the likely return on investment (with regard to the researchers’ track records), supporting new, promising staff and encouraging cross-group research projects.
2) To fund an annual ‘away day’ for the HSR group to initiate cross-university discussions, to consider the research strategy and to establish the 5-year agenda for this area of research.
3) To fund a subsequent ‘Health Services Research seminar’ programme, to bring together researchers from across the University and from collaborating bodies on a regular basis to develop collegiality and promote cross-university research development.
4) To offer an element of financial support (by means of a travel grant) to assist HSR group academics in presenting their research to the national and international HSR community at appropriate conferences.
5) To support the leadership, management and monitoring activities of the HSR group.
These proposals to spend the limited Capability funds available for Health Services Research, will place health service researchers in the heart of the key groups and will facilitate cross-university collaboration as well as external collaboration with health and social care colleagues. A significant enhancement in research activity, in terms of research papers, PhD completions, collaborations (internal and external) and research funding is predicted from this pump-priming expenditure, allowing more groups to obtain international recognition.
Tara Dean, 21st April 2003
Lohr KN, Steinwachs DM. Health Service Research: an evolving definition of the field, HSR, 2002; 37 (1): 7-11.