strategy and priority issues in health services research and associated funding

Strategy and priority issues in health services research and associated

funding

Overview of talk

• Making Knowledge Work for Health (2001)• Strategy for Science, Technology & Innovation (2006-

2013)• European Research Area • Advisory Science Council Report (2006)• Funding and Structures to implement SSTI• HSE METR group• Framework 6 and 7

Research Workforce

Incentives

Infrastructure(Networks)

Infrastructure(facilities, equipment etc)

Research Funding

Regulatory/Governanceenvironment

Making Knowledge Work for Health (2001)

Key recommendations

• Director of R&D in Department of Health and Children• Forum for Health and Social Care to determine priorities• R&D Offices and Officers in health boards/agencies• R&D for Health focus within HRB• Increased funding for research proposals• Protected time for research and research career pathway• Move to best practice in IP, ethics, standards• Translation of research evidence for decision making• Greater collaboration (academia, health, industry, charities etc)

Making Knowledge Work for Health (2001)

Implementation status

• Director of R&D in Department of Health and Children• Forum for Health and Social Care to determine priorities• R&D Offices and Officers in health boards/agencies• R&D for Health focus within HRB• Increased funding for research proposals• Protected time for research and research career pathway• Move to best practice in IP, ethics, standards• Translation of research evidence for decision making• Greater collaboration (academia, health, industry, charities etc)

Strategy for Science, Technology and Innovation (2006-2013)

• Published in June 2006• Set out how Ireland will (a) increase R&D activity to

meet national output targets and (b) contribute to the development of a European Research Area.

European Research Area

• Lisbon European Council (2000) adopted a ten year goal of making the EU the world’s most dynamic, competitive and sustainable knowledge based economy

• Barcelona European Council (2003) agreed the goal of increasing expenditure on research, technology and innovation in the union to approach 3% of GDP by 2010, with 2/3 of this investment coming from the private sector

Strategy for Science, Technology and Innovation (2006-2013)

• Develop 4th level• Double PhD output• Structure training (graduate school mechanism)• Encourage mobility• Develop careers

• Spend on R&D as a % of GDP to rise from 1.4% to 2.5% by 2014• Estimated additional cost of €1.88 billion to 2013• Provision for 350PIs, 1050 Postdocs and 3500 PhD students• Provision for all disciplines including social sciences and humanities

Strategy for Science, Technology and Innovation (2006-2013)

Public Sector Research: Health

• Funding for health research in Ireland is low by international standards (0.25% of overall expenditure);

• Introduction of a R&D culture within mainstream health service slow;

• Need to strengthen considerably the health services research and policy research capacity nationally;

• While health reform altered structures, the main strategic requirements of MKWFH unchanged;

Strategy for Science, Technology and Innovation (2006-2013)

Public Sector Research: Health

• The HSE has a statutory mandate to support research;• The capacity of the health services to complement and

translate it into new and innovative products and interventions has not developed sufficiently;

• Careers in research for clinicians;• Small number of centres of world significance with foundations

in both academia and the health services (relevance to health service, critical research mass, international competitive potential, potential economic relevance, advantages presented by an Irish population group)

Strategy for Science, Technology and Innovation (2006-2013)

Public Sector Research: Health

‘The Advisory Science Council is currently undertaking a review of

key policy requirements. This review will be completed during 2006

and will contribute to the further development of strategy in this

area’

Advisory Science Council Report (2006)

‘Towards better health – achieving a step change in health research in Ireland’ • Published in November 2006• Endorsed by Cabinet Sub-committee in March 2007

Advisory Science Council

Who are they?

• Replaced ICSTI• Has twelve members (chaired by Mary Cryan)• Chief Scientific Adviser to Government and DETE

attends• Secretariat provided by Forfas• Serves as primary interface between stakeholders and

policymakers in the STI area• Remit is to contribute to the development and delivery

of coherent and effective national strategy for STI and provide advice for Government on medium and long term policy for ST related matters.

Advisory Science Council Report

Key recommendations

• Assistant Sec in DoHC as Head of Health Research Policy• Establish a Health Research Group under auspices of IDC• Establish a health research forum to facilitate dialogue

among health research community and with HRG• Develop clear and transparent governance structures

between hospitals and universities• Incentivise interaction• Promote academic leadership of research and integration of

research and clinical practice• Funding for health research to increase in line with similar

benchmarked health systems• Expand remit of SFI to include aspects of translational

research

Advisory Science Council Report

• Research funding agencies to develop joint strategies and hold joint calls

• Recruit increased numbers of clinicians with protected time for research

• Recruit increased numbers of nurses, AHPs, epidemiologists, social and behavioural scientists with protected time

• Develop attractive career structures for clinical and non-clinical staff to pursue research

• Undergraduate and postgraduate medical training/research• Infrastructure for translational research• Introduction of integrated elec medical records system and

unique patient identifier• IP, commercialisation and regulatory affairs

NDP funding to implement SSTI

• Interdepartmental committee established with overall responsibility for driving and monitoring the implementation of the SSTI and reporting to the cabinet sub-committee on science, technology and innovation

• Over and above existing level of service and funding, the Government needs an additional €192 million in 2007 and 2008. This includes €66m in 2007 and €26m in 2008. This became €14m and €26m respectively for public sector research.

• Department of Health and Children had to bid to IDC for health portion

• It received €3.8m in 2007 and €6.33m in 2008

NDP funding to HRB

what type of priorities?

• Clinician Scientists• PhDs in structured training• Increase number of postdoctoral fellowships• Research careers for health professionals• Clinical Research Centres (x3)• Methodology Support Centre• Increased programmatic funding in key health service-related areas• Biobanks• Imaging equipment

Committees/groups post-SSTI

• HERG (HEA/Forfas)– Research careers– Research capacities (infrastructure)– Research indicators– HEA strategic innovation fund (€300m over 5 years)

• Health Research Group (DoHC)– To advise the IDC on the formulation and implementation of a

comprehensive health research strategy• Strategic priorities (translational, popn health and health services)• Governance arrangements• Human resource support systems• Timeframe for delivery

Health Research Group

who is on it?

•DoHC (chaired by Tom Mooney)•Enterprise, Trade and Employment•Education and Science•Environ, Heritage and Local Government•Agriculture and Food

•HRB•HSE (Billy Burke)•HIQA•SFI•Enterprise Ireland•Forfas•HEA

HSE

• Research budget• Co-ordination (R&D Office and officers)• Research priorities• Research governance• Protected time/Research posts and pathways/Incentives

• METR group

– Dedicated programme to train academic clinicians– Research Ethics Framework– Knowledge Brokering

Framework Programmes

• FP6 ran from 2003 to 2006. Irish researchers successfully received approximately €200m

• FP7 runs from Jan 2007 to end 2013. A total of €50.5 billion is available under four basic headings

Co-operation Ideas

People Capacities

•Enhanced health promotion and disease prevention•Quality, solidarity and sustainability of health systems