Why health research and innovation don’t make it into practice
By Katie Mantell, Director of Communications and Engagement
Last year, more than 800,000 patients took part in research studies in the NHS supported by the National Institute for Health Research (NIHR)—a record level. Innovation is one of the NHS’ favourite buzz-words, with the announcement earlier this year of a new umbrella organisation for UK health innovation in the guise of a revamped Accelerated Access Collaborative, and with research given welcome prominence in the NHS Long Term Plan.
But for research and innovation to have the best impact on patients, staff and the health and care system as a whole, it needs to focus on the most important questions and challenges. And, of course, the results of the research need to be actually put into practice.
A national survey of local innovation and research needs published recently, and carried out by the AHSN Network in partnership with NHS England and the NIHR, asked more than 250 clinicians and managers what they thought were the areas of greatest need for research and innovation, and what could be done to ensure that more research was translated into practice.
The high-level priorities that emerged—workforce, mental health and integrating services for patients with complex needs—are maybe not surprising; these issues often feature near the top of the worry-list for NHS managers.
Rather, what struck me most from the findings—as someone with a background in health communications—were the insights that emerged about the importance of communicating health research in the right way, and ensuring that the right people are involved in research and innovation right from the start.
A few themes emerged. Firstly, in a world of constant information, we need a smarter way of sharing the most relevant research findings. Clinicians and managers simply don’t have the time to keep on top of the overwhelming amount of research findings available, let alone start to work through the challenges of putting this research into practice.
Secondly, speed matters. Research needs to be carried out—and communicated—fast enough to be useful. The standard timelines required to set up and publish health research are too long when changing organisational climates, and priorities mean that research findings need to be delivered quickly to still be relevant to the local context. Innovative models of participatory research are aiming to address this, such as the “researcher in residence” approach of embedding researchers as core members in a delivery team. But more work is needed to roll out this kind of approach more widely.
Thirdly, end-users must be involved. The more that patients are involved in dictating the remit and design of research, the more likely it is that it will reflect what really matters to patients and the public. Involving the people who the research aims to benefit may also be key to successful adoption; one interviewee in the survey spoke about innovation spreading ‘like wildfire’ when end-users and staff were involved right from the start.
Fourthly, we must learn from failure: Published research needs to share failures as well as successes if we are to maximise our learning from research. Interviewees recognised that there’s a tendency to ‘brush failures under the carpet’ in a way that gets in the way of learning.
Finally, local context is important—but it mustn’t blinker us to how much learning is possible from other areas. Regions at different ends of the country that on the surface seem different may have similar challenges in terms of deprivation or rurality, for example.
Implementing change in a complex environment such as our health and care system can never be solved with simple solutions. The gap between what we know from research evidence and what happens in practice is still wide, and not easy to address.
Closing this gap is not just about better communicating the results of research, but about further embedding research into the fabric of our health and care system. The recent move to include research questions into the CQC’s inspection framework for the well-led category is a welcome step in underlining the importance of health research, but wider action is required—not least more consistent involvement of the people who the research aims to benefit.
This blog was originally published in the BMJ.