Strategy and priority issues in health services research and associated funding

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Strategy and priority issues in health services
research and associated funding
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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

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Research Workforce
Incentives
Research Funding
Regulatory/ Governance environment
Infrastructure (Networks)
Infrastructure (facilities, equipment etc)
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Making Knowledge Work for Health (2001)Key
recommendations

• Director of RD in Department of Health and
  Children
• Forum for Health and Social Care to determine
  priorities
• RD Offices and Officers in health
  boards/agencies
• RD 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)

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Making Knowledge Work for Health
(2001)Implementation status

• Director of RD in Department of Health and
  Children
• Forum for Health and Social Care to determine
  priorities
• RD Offices and Officers in health
  boards/agencies
• RD 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)

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

• Published in June 2006
• Set out how Ireland will (a) increase RD
  activity to meet national output targets and (b)
  contribute to the development of a European
  Research Area.

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European Research Area

• Lisbon European Council (2000) adopted a ten year
  goal of making the EU the worlds 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

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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 RD 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

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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 RD 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

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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)

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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

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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

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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.

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Advisory Science Council ReportKey
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

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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

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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

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NDP funding to HRBwhat 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

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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

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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

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HSE

• Research budget
• Co-ordination (RD 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

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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

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