The following is a proposed strategy on how University of Portsmouth (UoP) would utilise the new Research Capability Fund to support research in UOA 11A (Health Services Research).

Health services research (HSR) 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.

Baseline (current research activity) - The Unit of Assessment (UoA)11A HSR submission in 2001 RAE involved 14 academics from 5 departments across three Faculties.

Internal reconfiguration in 2001 has led to the establishment of a new institute ‘Portsmouth Institute of Medicine, Health and Social Care’ (PIMHS) which has brought together 6 of the academics who contributed to the UoA11A including the 3 academics which formed the clinical epidemiology group (identified as the strongest area by the UoA subject panel). PIMHS also hosts the Department of Health (DH) funded ‘Research and Develop Support Unit’ which supports all the healthcare professionals in the local health economy in building their research capacity. Currently the PIMHS research programme is supported through a 3-year research strategy with HSR as the main focus of its programme. At present there are 22 PhD students and 3 full-time research fellows at PIMHS. In 2002 a total of 10 peer reviewed publications and 7 invited contributions were produced by PIMHS staff who contributed to UOA11A. At PIMHS our output activities cross the full HSR scope. In addition to primary research we have been working closely with the Cochrane collaboration and since the last RAE submission have published 3 systematic reviews and 4 additional protocols are registered.

Within the School of Pharmacy and Biomedical Sciences staff from the biomedical science division, pharmacy practice group, and the centre for radiography education undertake health services teaching and research. Three staff were included in the UOA 11a submission. These groups are linked to the Drug Safety Research Unit (an associate college of the University of Portsmouth), and the New Generation Project interprofessional learning research group. There are also strong links to regional NHS Trusts who fund and contribute to much of the postgraduate teaching, along with professional bodies who accredit most of the taught programmes. Currently the group has 3 PhD students and ten students undertaking professional doctorates in this area. In 2002 a total of twelve papers, two book chapters and six published conference abstracts were published.

The Healthcare Computing Group in the Faculty of Technology is the premier academic centre in the UK for telemedicine. Three staff were included in the UOA 11a submission. Since 1998, it has operated the UK Telemedicine Information Service (TIS - formerly known as the National Database of Telemedicine). The service is run on behalf of the Department of Health (Information Policy Unit) and the NHS Information Authority (who provide the funding). It is a resource centre of the National Electronic Library for Health (NeLH). TIS is a founder member of the Confederation of E-health Websites (CEW, pronounced "queue"), an international association of the leading online e-health organisations. . The Healthcare Computing Group also provides the online facility to support the Department of Health's Information and Communication Technologies Research Initiative (http://www.disco.port.ac.uk/ictri/). The group also carries out work into the modelling of clinical outcomes, and has developed the Portsmouth variant of the POSSUM scoring system into a new "Portsmouth Rating" that is effective with a much smaller and more easily gathered dataset. This work is linked with the British Vascular Society. The University is the lead organisation in the Southern Institute for Health Informatics (SIHI), an informal association of people and organisations in our region interested in health informatics, both within and outside the NHS. In 2002, this group published two papers. Currently the group has 2 research associates/fellows with 1.1 FTE to be appointed, funded mainly by the NHS.

Area for development – The 2001 UoA11A submission encompassed three areas: services delivery and organisation, health profession education and clinical epidemiology. The last of these was identified to be the strongest area in terms of publications and other research outputs. The main essence of this strategy is to facilitate the development of research excellence that is internationally acknowledged within 3 to 5 years. Hence the first priority is to further develop and support the epidemiology group to international level, while also allowing the other groups to flourish and rise to the same level. The following strands have been identified as specific areas for further developments for the group:

·         Recognition of time for engagement in research.In order to enhance capacity within the 3-year timeframe, the key research staff  (research leaders and younger staff with outstanding promise) need to be ‘bought out’ of other activities, concentrating on moving their research forward to the international arena.

·         Growth in student numbers. The low number of research students and research assistants was identified as a weakness, and at the time of the last submission there were no research fellows. We propose to support the key researchers with at least 2 PhD bursaries/year. These will be allocated on the basis of established criteria and with the endorsement of the HEFCE proposed core standards for research studentship.

·         Growth in expertise. HSR is multidisciplinary in nature and the right mix of disciplines is essential in enhancing capacity. In HSR there is an increasing demand for involvement of the discipline of Health Economics. With health technology assessment playing a central role to the UoA11A area, it is seen as essential to have an experienced health economist as part of the ‘core’ expertise. We therefore propose to support a part-time postdoctoral research fellow in this area.

·         Recognition of consumer/user involvement.Consumer involvement in all aspects of HSR is essential. Currently consumer involvement within the group is ad-hoc and not supported financially. Consumer involvement is identified as a key priority in order to strengthen future research bids put forward. . Therefore we propose to establish a ‘HSR consumer panel’ who will be drawn from all age groups, social circumstances, ethnic backgrounds and abilities to form a cross section of opinion. Panels will be convened and consulted when formulating research questions, planning studies and disseminating findings.

Strategy for development – We aim to create a high quality research environment which values, supports and develops all staff committed to HSR. Our strategy for development involves 3 stages in enhancing the UoA11A research culture within UoP:

1.       Enabling activities These activities will include research awareness, ability to synthesise primary research, support mechanisms for disseminating research findings institutionally and acquisition of appropriate professional and postgraduate qualifications. Our goal is to provide these activities to the broadest spectrum of staff interested in HSR. To this end we propose to support a range of activities including:

a.      An annual ‘away day’ for the HSR group to facilitate cross-university discussions and to consider the research strategy.

b.       A programme of Health Services Research seminars, to bring together researchers from across (and outside) the University, disseminating research findings areas and sowing the seeds for future collaborations.

c.       To offer PhD bursaries (or other appropriate research programmes) which would enable individuals (in particular junior lecturers) in developing their skills in HSR.

2.       Developmental activities.The key factors are collegiality (within the University) and strategic partnerships (with organisations outside the University). These will lead naturally to integration and synergy in HSR related activities, which will enhance research expertise in the area. Key partners include colleagues who are part of UoP Geography of Health group (RAE 3a flagged), collaborators in SIHI and CEW, Sigma research groups, associated academic departments in NHS (e.g. academic departments of Surgery and Diabetes) and the DH-funded Research and Development Support Units, the Drug Safety Research Unit, and the New Generation Project research group.

1.Application activities. These will involve providing research capacity to meet local, regional and national needs and priorities, and international opportunities. Locally and regionally this will involve NHS Trusts, the RDSU and SIHI. Nationally, our links are strongest with the DH and NHS agencies, and internationally with CEW. Local and national collaboration would lead to further international research activity and associated research outputs.

 

Programmes, training and staff development – At UoP we have a range of specifically tailored training programmes that support building research capacity among nursing and allied health professionals, as well as the academics involved in teaching them. These are: Professional Doctorate (with pathways in Radiography, Biomedical Sciences and Nursing), MSc in Health Research and Development, PgCert in Evidence Based Practice in Healthcare, PgCert in Clinical Governance, MSc in Biomedical Science, MSc in Community Pharmacy, MSc in Clinical Pharmacy, MSc in Medical Imaging and Radiation Therapy, MSc in Healthcare Information Management and MSc in Healthcare Information Systems. Development of these courses has been based on wide consultations with local and regional NHS units, and has been financially supported by the NHS. Staff involved with UoA11A contribute to all these courses and update their skills on a regular basis. Over the past 3 years over 200 healthcare professionals, most of whom were nurses or AHPs have completed these courses.

Although at the time of RAE 2001, the number of PhD studentships was below the average for the UoA, the number of doctorates awarded was above the average. The panel highlighted this as a commendable level of performance and we intend to sustain it. Except in the Healthcare Computing Group, most of our PhD students are professionals who choose the part-time route. At UoP we already fulfil most of the six HEFCE proposed core standards in improving standards in postgraduate research degree programmes. All PhD students are required to undertake a PgCert in ‘Research Methods’ that provides them with training in research and other related skills. There are appropriate supervisory arrangements in place with training for all new supervisors and University-wide procedures in place for monitoring student’s progress.

Research by junior lecturers is encouraged and ad hoc financial support by the University has been provided to support those wish to undertake PhDs. Considering all the departments involved in HSR, the lowest percentage of academics with PhDs is in PIMHS and Radiography. We intend to rectify this by utilising a proportion of the capability fund for bursaries for junior staff in these departments.

In 2002 we were successful in helping a local Occupational Therapist in obtaining ‘The PPP Foundation’ mid-career award and she is currently registered for a PhD at PIMHS. We had always been aware of the lack of infrastructure support for AHPs who prefer a fellowship scheme to do a PhD as opposed to the traditional studentship. Hence we welcomed the launch of the first round of a new national Nursing and Allied Health Professions award scheme, based on the recommendations of HEFCE/DH TaskGroup3 Report. 59 HEIs were involved with the overwhelming response this scheme received. One of our research fellows (who had joined the University after the UoA11A submission) applied for this scheme and was successful - one of only 6 awarded nationally. We are currently helping one of our MSc students (a SALTist) in submitting a bid to the second round of this award. We will continue to support these schemes and feel that this long-term investment will contribute substantially to capacity building amongst AHPs. 

Progress indicators and milestones – In this document we define ‘targeted’ indicators (milestones) as those quality-related measures that can be associated with our stated areas for development. We define ‘progress’ indicators as additional points of reference that cannot be set at predetermined levels but are useful in tracking our progress.

Targeted indicators	Corresponding progress indicators
Establishment of research awareness amongst all staff involved with AHPs	Structured and systematic programme of seminar series, research methods workshops, annual research events etc.
Protected–time for key research staff	An increase in activity level of these staff in supervision, leading and pursuing research as judged by output indicators such as publications, collaborative projects and external grants
Number of staff involved with national/international research activities	A minimum of 3 staff to be involved in national peer review of HSR projects or accreditation schemes with the same number being involved in research of international standing
External Research Funding in HSR, number of proposals submitted and success rates	A minimum of 15 proposals submission and target of obtaining £1million research funding within 3 years
Number of peer-reviewed publications and citation of publications	Increase publication index in the area by 20% within 3 years
Expanding the range of expertise	A comprehensive mix of expertise to conduct applied HSR within 3 years with evidence of this expertise mix in the research proposals submitted
PhD opportunities for academics (involved with AHPs)	A total of 5 extra academics registering for PhDs within 3 years
Number of PhD students	Increase the number of PhD students and in particular externally supported awards (e.g. DH/HEFCE RDA and industry awards) by 20%
Time to completion of Doctorate programmes (both PhDs and PDs)	Reduce the median time for doctorate submission over a three-year period
Collaboration and partnership with NHS colleagues and researchers in other related areas	Increase in number of collaborative research bids with a focus on HSR area where there is a clear practice based application
Consumer involvement in all aspects of HSR	Evidence of consumer involvement through establishment of a consumer panel in all aspects of research

 

Plan for disseminating outputs - Effective dissemination employs multiple channels and techniques of communication to reach intended users. The components of the knowledge cycle are knowledge creation, knowledge dissemination, and knowledge utilization. The concept of the cycle implies continuous interaction among its parts. Knowledge will be created from our research and training programme, and staff activities. The challenge of dissemination and utilization activities involves transferring this knowledge, targeted to specific user populations. Our plan for dissemination is based on the understanding that communication channels are expanding continuously and include journals, conferences, media and the Internet. Our Healthcare Computing Group has acknowledged expertise in Internet technologies for information dissemination. To choose the most effective communication we would identify the intended audience, the context for use and the characteristics of the information to be disseminated. Knowledge utilization activities focus on ways to facilitate use of research results, new technologies, and effective practices. To be used, knowledge must relate to a perceived need, must be understandable, and must be timely. To enhance the dissemination and utilization of research, we will undertake a number of activities including peer-reviewed publications, presentations at national and international conferences, user-friendly summary reports, the development of consumer partnerships, the use of electronic media and telecommunications, targeting new audiences, and evaluating dissemination methods.

 

Affordability and sustainability – Our achievements in terms of research outputs [JSB1] since the last submission are a testament to our long-term sustainability in HSR. The strategy outlined is based on approximately £100,000/year investment. Most of this fund would be utilized in replacing the teaching commitments of one to three key researchers, establishing the right mix of expertise and funding PhD bursaries. The costs incurred in supporting other activities such as establishing consumer panels will be relatively small.