chief nursing officer for england strategic plan for research

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• Health and social care
• Research and innovation in health and social care
• The Future of UK Clinical Research Delivery: 2022 to 2025 implementation plan
• Department of Health & Social Care

The Future of Clinical Research Delivery: 2022 to 2025 implementation plan

Published 30 June 2022

© Crown copyright 2022

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This publication is available at https://www.gov.uk/government/publications/the-future-of-uk-clinical-research-delivery-2022-to-2025-implementation-plan/the-future-of-clinical-research-delivery-2022-to-2025-implementation-plan

Ministerial foreword

In 2021 we, the UK and devolved governments, set out our vision for the future of clinical research delivery. Saving and Improving Lives: The Future of UK Clinical Research Delivery lays out our ambition to create a world-leading UK clinical research environment that is more efficient, more effective and more resilient, with research delivery embedded across the NHS. We also set out our plans for 2021 to 2022 , as the first steps in delivering on the vision.

A digitally enabled, pro-innovation and people-centred clinical research environment is key to realising our ambitions to make the UK a world-leading hub for life sciences that delivers improved health outcomes for our citizens and attracts investment from all over the world. We will harness the explosion in innovative technologies to benefit patient outcomes and make a tangible difference to people’s lives across the UK. Clinical research is crucial to these efforts, as the lynchpin to driving improvements in healthcare.

As we emerge from the shadow of the pandemic and look to the future, we will work together to ensure that the UK is seen to be one of the best places in the world to deliver cutting-edge clinical research. We are working hard both to recover research delivery in the NHS and to use this moment as a catalyst for transformation, building increased resilience and embedding innovative practice as we go. The cross-sector partnerships built through the UK Clinical Research Recovery, Resilience and Growth ( RRG ) programme provide the strong foundations we need to succeed, drawing on expertise and support from industry, academia, charities, patients and the public, regulators, funders and the NHS.

Our vision was clear on the importance of unleashing the true potential of clinical research across the UK, addressing long-standing health inequalities and improving the lives of us all. We, the UK and devolved governments, are excited to set out the next stages as we look to turn our vision into a reality and build a clinical research system of the future.

Lord Kamall of Edmonton in the London Borough of Enfield Parliamentary Under Secretary of State for Technology, Innovation and Life Sciences Department of Health and Social Care

Robin Swann Minister for Health Northern Ireland Executive

Eluned Morgan Minister for Health and Social Services Welsh Government

Humza Yousaf Cabinet Secretary for Health and Social Care Scottish Government

Executive summary

In March 2021, we published our bold and ambitious 10 year vision: Saving and Improving Lives: The Future of UK Clinical Research Delivery . This was followed in June 2021 by The Future of UK Clinical Research Delivery: 2021 to 2022 implementation plan setting out the steps we would take to progress the vision in 2021 to 2022.

This phase 2 plan summarises the progress that we have made so far and the actions that we will take over the next 3 years, from 2022 to 2025, ensuring we make the progress necessary to achieve our vision in full by 2031.

This plan has been developed by the cross-sector UK Clinical Research RRG Programme in consultation with stakeholders from across the clinical research ecosystem. Our plan is centred around the 5 overarching themes identified in the vision:

• a sustainable and supported research workforce to ensure that healthcare staff of all backgrounds and roles are given the right support to deliver clinical research as an essential part of care
• clinical research embedded in the NHS so that research is increasingly seen as an essential part of healthcare to generate evidence about effective diagnosis, treatment and prevention
• people-centred research to make it easier for patients, service users and members of the public across the UK to access research and be involved in the design of research, and to have the opportunity to participate
• streamlined, efficient and innovative research so that the UK is seen as one of the best places in the world to conduct cutting-edge clinical research, driving innovation in healthcare
• research enabled by data and digital tools to ensure the best use of resources, leveraging the strength of UK health data assets to allow for more high-quality research to be delivered

We have made significant progress over the past year – a new combined review process has led to halving of approval times for new Clinical Trials of Investigational Medicinal Products (CTIMPs) since January 2022 compared to previous separate applications, streamlining the route through the regulatory journey for researchers, the world-leading £200 million data for research and development programme has been announced to invest in health data infrastructure in England with devolved administrations aligning and strengthening their infrastructure; and a new UK-wide professional accreditation scheme for Clinical Research Practitioners ( CRP ) has been launched to help double the size of this important workforce in the future.

However, the recovery of research delivery following the pandemic remains challenging. The Department for Health and Social Care (DHSC) and NHS England are taking firm action to address this, with the support of the devolved administrations, through the ‘Research Reset’ programme. We are committed not only to returning to pre-pandemic levels of performance, but to using this as an opportunity to reform and catalyse the transformation needed to create the flourishing, responsive and resilient system set out in our vision.

The phase 2 plan is aligned with funding confirmed through the government spending review for April 2022 to March 2025 and includes up to £150 million of additional funding from the National Institute for Health and Care Research ( NIHR ) and £25 million additional funding from RRG partners across the UK, complementing up to £200 million in England for the data for research and development programme announced in March 2022 and demonstrating the government’s ongoing commitment to delivering on the UK’s potential as a global life sciences superpower. This funding will enable RRG partners to:

• recover the UK’s capacity to deliver research through DHSC and NHS England’s Research Reset programme, and aligned work in the devolved administrations, aiming for 80% of all open studies on the NIHR Clinical Research Network (CRN) portfolio to be delivering to time and target by June 2023
• ensure we can recognise and support our expert workforce, and develop robust workforce plans, providing the basis for strategic investment in capacity development to support achievement of our vision in full
• broaden responsibility and accountability for research across the NHS, and improve measurement, visibility and recognition of those supporting the delivery of clinical research studies
• achieve a sector-wide, sustained shift in how studies are designed and delivered so that inclusive, practicable and accessible research is delivered with and for the people with the greatest need and in ways that enable us to tackle the greatest challenges facing the NHS
• streamline processes, strengthen our regulatory environment and ensure faster approval, set-up and delivery of studies with more predictability and less variation, as well as make it easier to understand and access the UK’s clinical research offer, thereby utilising the unique opportunity to develop a more flexible and improved regulatory model for clinical research outside the EU and improving our attractiveness as a leading destination to conduct cutting edge and global multi-centre clinical studies
• invest in the infrastructure and tools needed to implement people-centred, innovative data and digitally-enabled methods and increase partnership working across the health data ecosystem to ensure people across the whole of the UK can benefit from these approaches

The RRG programme will oversee the delivery of this plan, continuing to work in partnership with stakeholders across the sector and regularly revisiting the original vision to consider any further actions that will be needed to deliver it in full. In doing so, we will ensure that the NHS is able to tackle the healthcare challenges of the future and people across the UK and around the world will benefit from better health outcomes.

Further information about the RRG programme, including our delivery partners and governance , are available on the dedicated Recovery Resilience and Growth website . Detailed summaries of our progress to date and our future plans will be published on the site on an ongoing basis, providing a central point of information and updates about the programme and our progress towards achievement of the vision. You can also sign up to receive regular email updates on our progress.

UK-wide approach

Health policy is a devolved responsibility, where each of the UK administrations has distinct ownership over implementation. However, we are committed to delivering on a vision with a UK-wide reach and in pursuit of a common goal: to create a seamless and interoperable service across the UK to support clinical research delivery, shaping the future of healthcare and improving people’s lives.

We are therefore further strengthening a joined-up system, where sponsors of both commercial and non-commercial research can easily deliver studies across the UK and people can more easily participate. To ensure compatible and consistent ways of working across England, Scotland, Wales and Northern Ireland many commitments in this plan are focused on UK-wide implementation. Organisations such as MHRA ( Medicines and Healthcare products Regulatory Agency ) and systems such as IRAS ( Integrated Research Application System ) have a UK-wide reach and their actions will have impacts across the country. In some instances, actions are being led by a specific organisation on behalf of the UK, while others will be delivered through UK partnerships – recognising the different legislative and delivery contexts across the UK government and devolved administrations.

The needs of UK citizens and our health research system are broad and diverse. We are committed to maintaining a rich and balanced portfolio of studies in rare and common diseases, ranging from complex, intensive studies in small, highly targeted populations to pragmatic population health research in large cohorts, using a range of methodologies and methods as appropriate to the research questions.

Our vision focuses specifically on the future of UK clinical research delivery. Other types of research, including social care and public health research, are vitally important to provide the evidence necessary to support policy making and service delivery in these areas. Many partners involved in the RRG programme support this broader programme of research activity and other work programmes are underway to enable their development. We expect that many of the improvements we make in the clinical research environment will have benefits for other kinds of research and will work across our organisations and with wider groups of stakeholders to ensure the lessons are shared.

Research reset

As we recover from the pandemic, clinical research delivery is facing unprecedented challenges and there is an urgent need to reset the UK’s research portfolio so we can build for a stronger future.

The number of studies in the NHS is now higher than ever before. This is accounted for by the additional COVID-19 studies, other research that has remained on the portfolio from before the pandemic and has been paused or delayed, together with new studies being funded and coming into the system. In addition, the number of studies in set up is now much higher than pre-pandemic, further increasing the workload for NHS R&D offices and research delivery teams. This is taking place in the context of the recovery of wider NHS services and resourcing the high number of studies is challenging. Throughout this, the resilience of the workforce has been remarkable.

Recovery of the UK’s capacity to deliver clinical research is essential if we are to deliver the ambitions set out in this phase 2 plan. Indeed, many of the challenges the vision seeks to address have been exacerbated by the pandemic, so Research Reset and reform go hand in hand.

Since summer 2020, all delivery partners across the sector have been working to restore the diverse and balanced portfolio of studies which were impacted due to the COVID-19 pandemic. While this has had some positive impact, it has not resulted in the restoration of activity across all studies that were underway before the pandemic. We are taking further action through the Research Reset programme to build back a thriving, sustainable and diverse research and development portfolio within the NHS.

Our objective in implementing Research Reset is to give as many studies as possible the chance of completing and yielding results, generating the evidence needed to improve care and sustain our health system. However, this will require closure of studies that are not viable in the current context to free delivery resources in the system for those studies that can deliver. Lessons must also be learned to reform and increase the resilience of our research system. As part of this we have asked funders and research sponsors to review their active studies to assess the viability of delivering these within the capacity available.

Our aim is for 80% of all open studies on the NIHR CRN portfolio to be delivering to time and target by June 2023. We will take an agile approach to the Research Reset programme, continuously assessing whether further action is required with the input of stakeholders across the sector including patients and the public.

The devolved governments support this approach and we are working together across the UK to ensure synergistic arrangements are in place to promote the smooth delivery of cross-border studies. Each devolved administration will also review possible new eligibility criteria for national delivery support to ensure deliverability within available resources is feasible.

A sustainable and supported research workforce

The UK clinical research workforce has been fundamental to our collective success to date and will be critical to the achievement of our vision in the future. Healthcare and research staff of all backgrounds must be offered rewarding, challenging and exciting careers within clinical research, so that the most talented people can be brought into clinical research, including research delivery and R&D management, as a life-long career. This will help to bolster the capacity of the clinical research system and support a motivated and sustainable workforce. Collectively, we can realise the potential of UK clinical research to improve outcomes for people across the country, sustain our NHS and improve the economy.

Progress over the past 12 months:

• in England, to support the drive to recover the portfolio, DHSC provided over £30 million of additional funding via the NIHR Clinical Research Network (CRN) in the 2021 to 2022 financial year to increase research delivery capacity, especially in community settings and with a key focus on achieving flexibility and agility in the workforce. The Welsh Government provided £1.7 million to support additional capacity in order to achieve the recovery of non-COVID-19 research, including development of research capacity outside of hospital settings. £3 million of funding from the Department of Health in Northern Ireland has been provided to support the work of a Taskforce established to address clinical research recovery in Northern Ireland
• the NIHR , working with the devolved administrations, launched a UK census for nurses and midwives working in clinical research in order to understand the true size of this workforce. Data was also sought on location, speciality and banding or grade. It was able to identify that there are at least 7,469 research nurses and midwives across the UK and Ireland working at every level and within all areas of healthcare. This census demonstrates the breadth and depth of nurse and midwife involvement in research across the healthcare sector
• in June 2021, NIHR on behalf of the UK launched a new UK-wide professional accreditation scheme for Clinical Research Practitioners ( CRP ) as part of efforts to double the number of this important workforce over the next few years. Over 1,000 members have already signed up to the CRP directory
• NIHR also launched the UK wide Associate Principal Investigator Scheme, which aims to make research a routine part of clinical training so doctors, nurses and allied health professions can become the principle investigators of the future. Over 1,000 health and care professionals had registered for the scheme by April 2022
• in February 2022, Wales published a vision for research career pathways that outlines recommendations to improve support and encourage more health and social care professionals to embark on research careers

Phase 2 commitments

To continue this progress and build towards a sustainable and supported research workforce, we will ensure we can retain and recognise our expert staff and develop robust workforce plans to provide the basis for strategic investment in capacity development:

• the RRG Programme will lead the development of a cross-sector research workforce plan to support implementation of our vision in full. Developed over 2022 to 2023, this plan will guide additional investment in our workforce from 2024
• RRG  partners will ensure workforce plans developed by key healthcare organisations include research requirements, particularly noting the knowledge and skills needed across the wider workforce to deliver research as an essential part of high-quality care. This will include the NHS People Plan , coordinating with Health Education England and DHSC, and equivalent plans in the devolved administrations
• NHS England, working with its partners is developing a comprehensive, long-term NHS workforce plan. This will include consideration of research requirements to support the delivery of high-quality care
• Health Education and Improvement Wales, working closely with Welsh Government and the NHS, will develop plans to support and facilitate the nursing, midwifery, allied healthcare professionals and health sciences professions in embracing research as part of their roles and career pathways. Through the development of competency and skills frameworks, Health and Care Research Wales is working to support the inclusion of research delivery roles
• NIHR will provide investment to support NHS R&D transformation, increase research capacity including nurses, midwives and allied healthcare professionals, and provide more opportunities for rewarding careers in research
• the  RRG  partners will expand the package of training programmes for the research workforce including through the RCP- NIHR  Credentialing Scheme, the  NIHR  Associate PI scheme, the  NIHR  Nurse and Midwife Leaders Programme, an NHS England programme for executive nurses in Trusts and Integrated Care Systems (ICSs), and a research matron’s toolkit
• NIHR  and the devolved administrations will invest in learning and support for researchers, so that they are equipped with the expertise and cultural competency to design and deliver people-centred studies to meet the needs of patients, service users and the public, including those from underserved communities and groups not traditionally served by research
• in support for NHS R&D transformation, Wales will invest in a new Health and Care Research Wales Faculty, which will include increased investment in the NHS Research Time scheme to help develop the next generation of principal and chief investigators in the NHS alongside enhanced mentorship schemes

Clinical research delivery embedded in the NHS

Our aim is to create a step change in the delivery of clinical research in the NHS, so that research is increasingly seen as an essential part of healthcare. Making research an intrinsic part of clinical care means that patients and service users can expect to have access to the most cutting-edge treatments and technologies. We want the NHS to actively participate in generating evidence about effective diagnosis, prevention and treatment through research. By acknowledging the important role of the whole of the healthcare workforce in clinical research delivery, we can ensure everyone is empowered to get involved in research and further boost overall capacity for research in the NHS and wider health system. Measuring clinical research will also support NHS leaders to drive behaviour change and incentivise more engagement in research activity. Finally, ensuring clinical research is embedded within the NHS will be essential in giving the UK the capacity to grow in an increasingly competitive global market.

Progress in Phase 1:

the UK Research and Development (UKRD) and NHS R&D Forum, with NIHR , developed the ‘Best Patient Care, Clinical Research and You’ online guide that aims to help busy non-research staff become more aware of the impact of research in their trust

the General Medical Council (GMC) published its position statement Normalising Research - Promoting Research for all Doctors

the Allied Health Professions’ Research and Innovation Strategy was published, addressing the key areas which impact research and innovation across all health professions in England

the NHS Chief Nursing Officer (CNO) for England published the strategic plan for research for nurses. The plan aims to create a people-centred research environment that empowers nurses to lead, participate in and deliver clinical research that is fully embedded in practice and professional decision making

together with existing strategies in the devolved administrations, we are continuing the development of UK-wide support for the key professional groups

In order to more deeply embed clinical research in the NHS, we will take action to broaden responsibility and accountability for research across the NHS, and improve measurement, visibility and recognition of those supporting the delivery of clinical research studies. The role of healthcare leaders and professionals will be vital in this:

NHS England and the devolved administrations will each develop clear and tangible plans to work towards embedding responsibility and accountability for research in healthcare delivery

• NHS England and the devolved administrations will use existing legal duties and planning frameworks to promote and facilitate research. Each administration will develop assurance frameworks and use existing channels such as annual reports and joint forward plans to help cement the importance of research as a core duty. In England this will include the implementation of the Health and Care Act . Integrated Care Boards (ICBs), NHS England and the Secretary of State for Health and Social Care will all have enhanced duties to report on how they are promoting and facilitating research. NHS England will also lead development of a research framework for ICBs to help them understand and fulfil the minimum expectations around research that the Health and Care Act sets. This will herald a significant shift in how research is considered within the NHS and drive a greater responsibility for more research activity across all sites. In Wales, we will explore opportunities provided through the development of the NHS Executive in Wales to strengthen the national oversight of NHS research
• we will work across the UK administrations to introduce new metrics and measures to increase the visibility and recognition for undertaking and supporting clinical research across NHS organisations
• NIHR , working in partnership with NHS England and the devolved governments, like the Scottish Health Research Register (SHARE), will continue to enhance the UK Be Part of Research platform through collaboration with other existing registries. National digital channels (for example the NHS App or NHS website) will feed into the Be Part of Research platform

The RRG programme will ensure strategic co-ordination of this work across the UK clinical research ecosystem, supporting progress and ensuring alignment of initiatives, as well as identifying key areas where we can go further in the next 3 years.

People-centred research 

The vision set out our ambition for more people-centred research, designed to make it easier for patients, service users and members of the public to access research of relevance to them and be involved in its design. To achieve this, delivery of research in community, primary care and virtual settings needs to increase, with delivery designed around the needs of the people participating in it. Alongside this, we will ensure we maintain our world-leading specialist research infrastructure, which provides opportunities for people to access early-phase studies, complex therapies and devices.

• delivering studies such as PANORAMIC and IBS-RELIEVE has demonstrated the UK’s growing ability to harness technology and conduct studies virtually and in the community
• HRA and MHRA, in collaboration with NHS Research Scotland, Health and Social Care Northern Ireland (the equivalent to the NHS in Northern Ireland), and Health and Social Care Research Wales, have published UK-wide guidance on the set up of interventional research to enable research to be delivered across organisational boundaries and to help take research to where people might find it easier to take part, for example using hub and spoke models
• the NIHR led UK Working Group on Remote Trial Delivery published a report in June, which discussed the challenges and opportunities in remote trial delivery and provided guidance for researchers
• the NIHR Race Equality Framework was piloted by industry. This self-assessment tool helps organisations to improve racial equality in health and care research
• partners across the UK are working together to ensure patient and public involvement in research in a variety of ways including through regulation, ethics, payment for public contributors and development of new public engagement strategies. This includes the publication of a shared commitment to public involvement in research to ensure involvement is built into study design, delivery, and dissemination
• in Northern Ireland the Clinical Research Recovery Resilience and Growth Taskforce implementation plan includes a patient and public engagement and involvement sub-group, which is focused on the development of patient and public centred priorities, and an innovation sub-group planning approaches to innovative and people-centred trial design
• in Wales, the ‘Discover your Role’ programme is underway, with a co-created action plan to ensure that people are at the heart of new developments in research
• the NHS Research Scotland patient and public involvement workshop series completed and reported in September 2021. Findings from the workshops and the Scottish Patient Public Involvement Survey are informing work to support greater visibility and connectivity, increased diversity and representation, and a review of the current mechanisms for pre-award funding
• RRG partners have partnered with the International Standard Randomised Controlled Trial Number (ISRCTN) registry to make it easy for researchers to fulfil their transparency responsibilities. Trial registration is the first step to ensuring research transparency from the outset, and from 2022 the HRA began automatic registration of clinical research with ISRCTN , taking the burden away from research sponsors and researchers

Our aim will be to achieve a sector-wide, sustained shift in how studies are designed and delivered so that inclusive, practicable and accessible research is delivered with and for the people with the greatest need and in ways that enable us to tackle the greatest challenges facing the NHS. The UK’s ability to deliver diverse trials and studies will also give us a competitive advantage on the global stage, attracting researchers from around the world to base their studies here:

• the HRA is leading a cross-sector project , co-produced with public contributors, to collect evidence about how high quality, people-centred clinical research is done well: finding out what matters most, what ‘good’ looks like and what might be making it difficult. It will make recommendations to help improve the way clinical research happens in the UK and disseminate information about actions and resources developed by partners
• NIHR will invest in the development of skills and tools for innovative trial delivery, increasing the confidence and ability of our researchers to design and deliver studies in people-centred ways
• NHS England will launch a toolkit that could be used by researchers across the UK to help them engage more effectively with selected underserved communities. NIHR will also promote increased use of the resources developed by the NIHR INCLUDE project project which enable researchers to increase inclusion of underserved communities in their research
• NIHR and NHS Digital will develop mechanisms to monitor the diversity of people participating in NIHR Clinical Research Network portfolio studies in England in order that we can understand where improvement is needed and what action will be most effective.
• in England, the NHS Accelerated Access Collaborative will invest in demand signalling (the process of identifying, prioritising and articulating the most important research questions) and horizon scanning (the process of identifying and better understanding emerging transformational technologies of potential benefit to the NHS and our communities) to improve identification of the most needed treatments and technologies and rapidly bring these into clinical use
• in Scotland, SHIP is leading the new Scottish Health and Industry Partnership Demand Signalling Plan. This new framework will support identification and decision making around key strategic challenges and operational pressures to accelerate NHS Scotland Re-mobilisation, Recovery and Re-design, aligning with delivery of the NHS Recovery Plan 2021 to 2026, and the Life Science Vision healthcare missions
• medical research charities play an important role in supporting people-centred research, utilising their contacts with patients and communities, and prioritising their needs when setting a research agenda. The Association of Medical Research Charities (AMRC) will be working with NIHR and NHS England to formalise this work – and will share findings once developed across the UK

The RRG programme will ensure strategic co-ordination of this work across the UK clinical research ecosystem, supporting progress and ensuring alignment of initiatives, as well as identifying key areas where we can go further within the next 3 years.

Work is also underway to improve access to research through digitised recruitment as detailed in the section on research delivery enabled by data and digital tools.

Streamlined, efficient and innovative research 

Facilitating research to happen quickly and predictably will not only bolster our economy and status as a life sciences superpower, but will also drive innovation, which translates into improved care. We have the opportunity to develop a more flexible and improved regulatory model for clinical research outside the EU in the best interests of patients and the public, and since the publication of the vision we have been building towards our aims of supporting a more streamlined, efficient, and effective clinical research environment.

Progress in phase 1:

• in a new approach to licensing and regulation implemented by the MHRA, NICE, the All Wales Therapeutics and Toxicology Centre (AWTTC) and the Scottish Medicines Consortium (SMC), over 100 innovation passports have been issued through the Innovative Licensing and Access Pathway (ILAP), to robustly and safely support the path to market of the most innovative, transformative treatments
• the combined review from the MHRA and the UK Research Ethics Service, in collaboration with the HRA facilitates speedier set up for clinical research trials by requiring applicants to only make a single application for both Clinical Trial Authorisation (CTA) and Research Ethics Committee (REC) approval. Since January 2022, all new Clinical Trials of Investigational Medicinal Products (CTIMPS) in the UK have been benefiting from the combined review, halving the approval time compared with separate applications over the period 2018 to 2021
• the range of model UK contracts agreed with industry and the NHS has been expanded including the first UK-wide model Clinical Investigations Agreement (UK mCIA) for research in medical devices, and the first Model Confidentiality Disclosure Agreement (mCDA) for use by companies with potential NHS sites has also been launched
• the MHRA ran a public consultation on proposals for legislative changes for clinical research. The proposals aim to promote patient and public involvement in clinical research, increase the diversity of participants, streamline clinical research approvals, enable innovation, and enhance clinical research transparency. The consultation sought the views of the wider public, clinical research participants, researchers, developers, manufacturers, sponsors, investigators, and healthcare professionals to help shape this important future legislation and over 2,000 responses were received
• NHS England published refreshed guidance on Excess Treatment Costs (ETCs), expanding the framework to include studies where Clinical Commissioning Groups are the commissioner for the service where the study takes place and setting out the provider types which can utilise the national payment system in England. From April 2022 the provider thresholds for ETCs has been reduced, meaning that the number of providers who receive ETCs will increase

In our next phase of work, we will streamline processes, further strengthen our regulatory environment and ensure faster approval, set-up and delivery of studies with more predictability and less variation. Significant emphasis will be placed on reducing unwarranted variation in ways of working across sites and other research infrastructure, so that conducting clinical research in the UK is high quality, predictable and reliable. This will be particularly important for commercial contract research as speed and predictability is key to the UK’s competitiveness and our ability to attract global multi-centre research studies into the NHS.

The UK is globally recognised for its scientific expertise and dedicated research infrastructure. However, the devolved healthcare systems and competition between organisations has created a complex landscape which is difficult to navigate and creates barriers for researchers and companies. We will work across the UK clinical research system to ensure it is easier to understand and is attractive as a leading destination to conduct cutting edge clinical studies.

To improve research approvals and strengthen our regulatory frameworks:

• a single UK approval service will replace HRA and HCRW Approval and equivalent process in Northern Ireland and Scotland, and site permission and confirmation processes across the UK
• MHRA will work with HRA in continuing the development of IRAS to streamline health technology and medicines research, and HRA will explore whether it is viable to embed a fast-track ethics review as part of combined review
• HRA will lead UK-wide work to further expand the suite of model agreements, including decentralised and other innovative delivery models as well as particular fields of innovative products such as Advanced Therapy Medicinal Products
• following public consultation on proposals for legislative changes for clinical research, the MHRA is now carefully analysing the responses received, preparing a Government response and developing secondary legislation to improve and strengthen our clinical research legislation
• MHRA will support risk-proportionate trial conduct and monitoring, including through Good Clinical Practice (GCP) guidance and pragmatic investigator guidance, and will work with HRA to develop guidance on use of in vitro diagnostics (IVDs) in clinical research
• MHRA and HRA will also establish a comprehensive stakeholder reference group to assist with guidance generation on new legislation and ensure there is a common understanding of regulatory requirements that will enhance the UK’s international attractiveness as a place to conduct multinational trials

To improve study set-up:

• learning lessons from delivering COVID-19 research, we will enhance our early feedback service offer via the NIHR CRN to support study design that is optimised for delivery and explore how we can further match research delivery demand to capacity across the UK
• we will implement the UK-wide National Contract Value Review (NCVR), with the aim of expediting the costing elements of the contracting process across NHS Trusts to ensure costing does not delay study set-up. From 1 April 2022, the NCVR will begin to replace the current time-consuming process whereby each NHS organisation negotiates with each commercial sponsor for every study in order to agree bespoke contract value. The programme will be monitored throughout implementation to ensure lessons can be learnt and the process improved to ensure it achieves its aims. The existing single cost and contract review model in Scotland and across the NIHR Patient Recruitment Centres in England will integrate with NCVR as it develops, supporting more effective UK alignment and efficiency
• the Experimental Cancer Medicine Centre (ECMC) Network, with support from MHRA and HRA, will complete their pilot to set up Phase I oncology trials within 80 days of IRAS submission. Learning from this programme will be shared to enable improved set-up performance in other specialities
• RRG programme partners will identify and establish mechanisms to achieve efficient costing and contracting across other parts of the health system, supporting and enabling an increase in decentralised study designs and research taking place in primary care and community settings.
• DHSC and NHS England will lead a review of their current Excess Treatment Costs (ETC) process in England to review experiences of the policy and t explore how best we can support non-commercial research in the NHS

To make the UK offer easier to navigate:

• understand UK capabilities to deliver their study at all stages of the protocol development and delivery pathway
• connect with the right part of the system to help them at the right time
• access the network of expertise and resources available to create a package of support to deliver studies efficiently
• MHRA, NICE, AWTTC and SMC will work with partners across the UK to develop ILAP as an effective route into the UK research system, particularly through the development of a support toolkit
• the further development of IRAS will also provide navigation and signposting through the research journey, directing applicants to relevant guidance and advice. Through interfaces with other systems it will reduce burden and duplication

Research delivery enabled by data and digital tools

The UK’s health data offering is one of our global strengths due to our national health systems and cradle-to-grave healthcare records. Investing in data and digital tools, and making ethical use of them to support clinical research, for example by making it easier to recruit and follow-up participants, increases the efficiency and effectiveness of the clinical research process. These tools also increase the resilience and sustainability of the healthcare system and reduce the burden on the NHS workforce.

• the data strategy for health and social care in England was published in June 2022
• up to £200 million committed to support NHS-led health research (subject to business case) was announced on 2 March 2022 to invest in health data infrastructure to support research and development in England, with parallel activity in the devolved governments

the NHS-Galleri trial demonstrated the potential for the use of healthcare data to support rapid, large scale recruitment to and delivery of clinical studies in the NHS. The Accelerated Access Collaborative (AAC), led by NHS England, coordinated the design and set up of a 2 part, real-world demonstration project involving clinical data capture from NHS Digital and NIHR , and was a demonstrator for the ‘Find, Recruit and Follow-up’ service and NHS DigiTrials. The trial has already passed the halfway point in their recruitment of participants, with over 100,000 enrolled following the launch in autumn 2021

• each delivery partner funded as part of year one of the ‘Find Recruit and Follow-up’ service launched Minimum Viable Products (MVPs) of their services including: NHS DigiTrials, which has successfully facilitated 28 active trials through its service with a further 8 in application and 12 in pre-application; NIHR CRN launched its early stage ‘concierge’ service, with 2 companies and 4 data service providers as early users; and HRA, which agreed an approach to review by the Confidentiality Advisory Group which will enable more efficient study set up in future. In addition, the MHRA Clinical Practice Research Datalink (CPRD) has launched SPRINT (Speedy Recruitment into Trials ), a data-enabled research service that facilitates rapid feasibility and patient recruitment into industry sponsored phase 2 to 4 trials across the UK
• making use of real-world data (RWD) in and for clinical research is now a reality, supported by MHRA’s published guidance . This is the start of a series of guidelines to provide general points to consider for sponsors planning to conduct clinical research using RWD to support regulatory decision making

The next 3 years will see a revolution in how we use data across the health system. We will go further in utilising innovative data-driven methods and digital tools to transform the way we design, manage and deliver people-centred clinical research studies across the whole of the UK. We will achieve this by increasing the use of data and digital tools in recruitment and follow up, and by improving access to data via Trusted Research Environments (TREs: a type of Secure Data Environment, secure spaces where approved researchers can access rich, linked datasets) and through increased partnership working across the UK health data ecosystem.

We are very clear that the opportunity to use health data must be done in a way which is secure and trusted by members of the public, so governance and oversight processes must be both as efficient as possible and transparent, robust and trustworthy. Public trust and understanding of how data is being used to support research continues to be critical in developing appropriate activities. We will be working together to consider how to implement recommendations from the Goldacre Review , and ensuring that all work is supported by comprehensive public involvement and engagement activity.

To improve study planning, recruitment and follow-up:

• the Find, Recruit and Follow-up service will work across the 4 administrations to consider how activity can be expanded to include SAIL, Scottish Health Research Register, data infrastructure in Northern Ireland, NIHR BioResource and other key national data infrastructure, increasing opportunities for people to quickly and easily access research of relevance to them
• NHS DigiTrials and CPRD (via MHRA) will enable a significant increase in the scale of identification of people who match the eligibility criteria for specific studies in order that they can be given the opportunity to participate in research. They will also support increased use of routine healthcare data to streamline reporting of follow-up data, increasing predictability and releasing delivery capacity in the NHS
• in England, the Data for R&D Programme will invest in health data infrastructure for research and development, supported by comprehensive PPI and engagement throughout the programme, including embedded within its governance
• NIHR will invest in data and digital platforms such as Be Part of Research and NIHR BioResource, and provide the tools and support necessary to deliver virtual and decentralised studies. Increased interoperability between regulatory, NHS and NIHR platforms will enable further streamlining of processes for researchers
• in Wales, a digital recruitment programme will be developed through partnership between Health and Care Research Wales, SAIL Databank and the NHS Wales National Data Resource programme, to develop services that utilise data resources to drive research delivery. An Expert Working Group has been established to guide on the development of this ‘data for research’ programme. A pilot service has been funded to use SAIL data to provide rapid intelligence to aid placement of research trials in Wales to support most effective recruitment
• in Scotland, scoping work and stakeholder engagement is informing plans for developments to support increased use of NHS data and digital technology to accelerate clinical trial delivery, and for further development of the Scottish Health Research Register (SHARE) to support recruitment to health research studies. We will continue to support the already established regional NHS Scotland controlled data safe havens (Trusted Research Environments) and their collaboration with the newly established Research Data Scotland to support use of data in research. We will also look for opportunities to support research and innovation as part of the forthcoming Scottish Government Data Strategy for Health and Social Care
• in Northern Ireland, the RRG Taskforce data and digital sub-group will lead work to prepare the NI data infrastructure to support digitally-enabled trials and participate in UK-wide initiatives such as the ‘Find, Recruit and Follow-up’ service.

To improve access to data and TREs:

• over the next 3 years NHS England will build upon foundational investments made in 2021 and 2022 in an interoperable network of TREs. At a national level, we will expand the scale, scope and capacity of the NHS Digital TRE to enable more users to have timely and secure access to a range of national datasets. At a regional level, we will develop a small network of regional ‘Sub National TREs’ in England, each covering a population of more than 5 million citizens and enabling access to near real time, multimodal data particularly amenable to the development of AI algorithms
• the Data for R&D Programme within NHS England will expand the ability for researchers to access a range of rich linked genomic datasets, creating linkages across the various health data systems so that genomic data can be used to support innovation and patients and service users can benefit from the provision of innovative genomic healthcare. The Genome UK Implementation Coordination Group Data Working Group will lead work looking to link genomic datasets from across the UK, and federate these where appropriate, as set out in the Genome UK: shared commitments for UK-wide implementation 2022 to 2025
• in Scotland, we will continue to support the already established regional NHS controlled TREs and their collaboration with the newly established Research Data Scotland to support use of data in research
• in Wales, we will continue to invest and grow the internationally recognised expertise and TRE available via the SAIL Databank, offering national population coverage and secure access to billions of person-based records
• in Northern Ireland, the Honest Broker Service and the more recently established Northern Ireland TRE will be supported to further develop secure access to data for research. This will sit alongside a sustained public dialogue and progression of the enactment of secondary uses legislation to facilitate data access for research in Northern Ireland.

Connecting these developments into a coherent UK offer will bring added benefit, therefore to unite plans:

• the RRG programme will ensure strategic co-ordination of this work across the UK clinical research ecosystem, supporting progress and ensuring alignment of initiatives, as well as identifying key areas where we can go further within the next 3 years to take steps towards fully realising our overarching vision
• an RRG data and digital subgroup will be established to enhance collaboration across the sector and ensure people across the whole of the UK benefit from research delivered using data and/or digitally-enabled approaches

Governance, detailed plans and ongoing updates

The UK Clinical Research RRG programme will oversee the delivery of this plan, continuing to work in partnership with stakeholders across the sector and regularly revisit the original vision to consider any further actions needed to deliver on the 10 year vision. In doing so, we will ensure that the NHS is able to tackle the healthcare challenges of the future enabling people across the UK and around the world to benefit from better health outcomes.

Given the scope of the work and the fast pace of change in clinical research, we will keep the specifics of this plan under review via the RRG programme and adapt delivery as needed. This flexibility will allow us to meet emerging challenges and ensure that the outcomes are aligned to the most pressing issues to realise our shared ambitions.

Progress will be measured by the RRG Programme Board and the Ministerially-chaired Oversight Group, ensuring we are delivering on the commitments set out in this plan and that they are having the intended impact on the UK clinical research system. Specific measures for success will be published on the RRG website later in 2022.

We will publish a Phase 3 plan in 2025 to 2026 to align with the next government spending review period. The Phase 3 plan will showcase our progress and lay out the next steps needed to ensure the vision is delivered.

Achievement of our plan will require action across the whole sector, but by building on the foundations of collaboration and partnership that we have created through RRG programme we can collectively work through current challenges and see this vision become a reality.

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‘This month’s issue highlights innovations in continence care’

STEVE FORD, EDITOR

• You are here: Research and innovation

England CNO launches new ‘strategic plan’ for research nursing

24 November, 2021 By Gemma Mitchell

The chief nursing officer (CNO) for England has unveiled a new “strategic plan” to enhance nurses’ involvement in and leadership of research.

The plan - Making research matter – was launched on 22 November by CNO Ruth May.

In the foreword to the document, Ms May said the plan “sets a policy framework for developing and investing in research activity across the NHS in partnership with others”.

“At its heart is the shared ambition to create a people-centred research environment that empowers nurses to lead, participate in and deliver research, where research is fully embedded in practice and professional decision-making, for public benefit,” she added.

The publication follows Ms May’s appointment in October 2020 of two new heads of nursing research – Jo Cooper and Professor Alison Richardson – who have been key to the development of the new strategic plan.

Related articles 

• CNO expands her top team to deliver new nursing research strategy

The plan is underpinned by five themes: aligning nurse-led research with the public need; releasing nurses’ research potential; building the best research system; developing future nurse leaders of research; and creating a digitally-enabled practice environment that supports nursing research.

Those behind the plan said they would concentrate on “developing fair and diverse ways for all nurses, whatever their role and setting, to participate in research”.

They pledged to develop a “co-ordinated and consistent England-wide approach to building nurse-related research capacity and capability – from pre-registration to professorial level”.

“The new strategic plan... places research at the heart of nursing, and nurses at the heart of research to improve care for patients" Avey Bhatia

Awareness would be raised of the “breadth of opportunities for nurses to become involved in research”.

As part of this they committed to increasing opportunities during pre-registration nursing programmes for students to experience research-related roles.

The strategic plan is set to be followed by a “detailed implementation plan” in spring next year setting out what would be delivered in 2022 and 2023, according to the document.

Avey Bhatia

Guy’s and St Thomas’ NHS Foundation Trust chief nurse Avey Bhatia supported the launch through participation in an expert panel.

Ms Bhatia said: “Nurses have a huge contribution to make to research, and it’s really inspiring to see the work our nurses are already doing to establish best practice for care through research.

“The new strategic plan for research recognises that value and places research at the heart of nursing, and nurses at the heart of research to improve care for patients.”

The document also includes supporting statements from Professor Mark Radford, chief nurse at Health Education England and deputy CNO for England; Professor Ruth Endacott, director of nursing and midwifery at the National Institute for Health Research; and Susan Aitkenhead, director of nursing and deputy general secretary and chief executive at the Royal College of Nursing.

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November 22, 2021

Launched Today: Making research matter Chief Nursing Officer for England’s strategic plan for research

Uncategorized ahemingway

The Chief Nursing Officer for England`s  ` Making Research Matter Strategic Plan for Research` is being launched today. The plan is for all nurses working everywhere across health, social care, academia and policy development in England. The strategic plan will provide a vision for and begin the process of creating an inclusive accessible research career framework for nurses. BU`s Professor Ann Hemingway was involved in informing the plan. You can access the summary and the full document today which includes the implementation plan to 2023. https://www.england.nhs.uk/wp-content/uploads/2021/11/B0880-cno-for-englands-strategic-plan-fo-research.pdf

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Making Research Matter

• Posted on 20th December 2021

Launch of Chief Nursing Officer for England’s Strategic Plan for Research

Stakeholder briefing, 23 november 2021.

NHS England and NHS Improvement has published the Chief Nursing Officer (CNO) for England’s strategic plan for research.

The plan is for all nurses working in health and social care, (whether they are already or thinking about getting involved in research), colleagues in academia and the third sector and all those who support research. It has been developed in partnership with stakeholders across the health and care system including the Innovation, Research and Life Sciences Group within NHS England and NHS Improvement.

It sets out the CNO’s ambition to “create a people-centred research environment that empowers nurses to lead, participate in, and deliver research, where research is fully embedded in practice and professional decision-making, for public benefit”. This plan complements the ambitions set out in Saving and improving lives: the future of UK clinical research delivery and will form part of NHS England and NHS Improvement’s contribution to the delivery of this vision.

Fulfilling this ambition will strengthen and expand nurses’ contribution to health and care research of global significance. This provides the scientific basis for: the care of people across the lifespan, during illness and through to recovery and at the end of life, preventing illness, protecting health and promoting wellbeing.

There are 5 themes underpinning the vision: aligning nurse-led research with public need, releasing nurses’ research potential, building the best research system, developing future nurse leaders of research and digitally-enabled nurse-led research.

This plan will be delivered in three phases: discover, build and sustain. A detailed implementation plan (which has developed with the profession, our partners, and the public), will follow this strategic plan in Spring 2022, and set out what we will deliver in 2022 and 2023.

To get involved in the CNO’s strategic plan for research work, please contact [email protected] to receive regular updates and information about upcoming opportunities.

Publication links

• The Chief Nursing Officer (CNO) for England’s strategic plan for research – full version.
• The Chief Nursing Officer (CNO) for England’s strategic plan for research – executive summary.
• NHS England and NHS Improvement The Chief Nursing Officer (CNO) for England’s strategic plan for research web pages

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Chief Nursing Officer for England. Making research matter: Chief Nursing Officer for England's strategic plan for research. Version 2. 2021. https://www.england.nhs.uk/wp-content/uploads/2021/11/B0880-cno-for-englands-strategic-plan-fo-research.pdf

Foster S. Working on the roadmap to ACP. Br J Nurs. 2022; 31:(8) https://doi.org/10.12968/bjon.2022.31.8.461

A vision for nursing research

Chief Nurse, Oxford University Hospitals

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Sam Foster, Chief Nurse, Oxford University Hospitals, considers the challenges for institutions in picking up the Chief Nursing Officer's strategy for nursing involvement in research

One of my key priorities is advancing the pace of developing capacity and capability in nursing research. In November 2021 the Chief Nursing Officer (CNO) for England, Ruth May, launched a ‘strategic plan’ to support nurses to lead, participate in, and deliver research. In the foreword to the document ( CNO for England, 2021 ) she highlighted the importance of research for ‘public benefit’—for example, improving public health and patient experience. The strategy sets out a vision for research to ‘reflect’ the priorities of patients, carers, service users, residents, the public and nurses.

‘Research led by nurses and contributions they make as members of multidisciplinary research teams can drive change. It is the cornerstone of high-quality, evidence-based nursing.’

CNO for England, 2021: 6

The five themes underpinning the plan are:

• Aligning nurse-led research with public need
• Releasing nurses' research potential
• Building the best research system
• Developing future nurse leaders of research
• Creating a digitally enabled practice environment that supports nursing research.

The national plan is detailed to be delivered in three phases: discover, build, and sustain. A detailed implementation plan is expected in spring 2022 and will set out what will be delivered in 2022 and 2023.

This national strategy to anchor our local plans is extremely welcome but it also raises questions of local readiness. I have seen some great examples shared by colleagues of their local nursing research strategies, but ultimately success and delivery will only be truly enabled with investment into an infrastructure to deliver. As Chief Nurse in a university hospital, with a large biomedical research centre, you might consider my institution well-placed to deliver this exciting new strategy, however, in reality we have the same delivery constraints and workforce challenges as others across the NHS.

So, what are the options to put this into practice? Well, one thing that nurses are always good at is sharing ideas—joining together and increasing the opportunities for innovation, I see this time as a real opportunity for a toolkit to be put together for us to share good practice and incorporate nursing research into core business.

The national strategy refers to the development of ‘coherent systems underpinning transformation’. This includes developing a co-ordinated and consistent England-wide approach to building nurse-related research capacity and capability, from pre-registration to professorial level. This will help tackle variation and inequalities across the country and require working with partners to develop national and regional infrastructure. It will also involve fostering practices and processes that help accelerate change in nursing practice based on research findings.

So, what do we need to do to prepare? Many of us are already engaged in reviewing readiness locally, and I believe that with the right support and leadership much of our future infrastructure already exists. My local themes echo those I have heard from colleagues elsewhere; issues that need addressing include low levels of confidence in knowledge and skills to read, implement, apply, and undertake research. There is also a need to focus on advanced clinical practice and practitioners at consultant level who must show capability with the four pillars of practice, one of which is research. I have previously written about the systematic approach of the Health Education England ACP framework ( Foster, 2022 ), and well documented variation of roles, bands, and qualifications including research knowledge and skills; many Trusts have no clear strategy for development of these roles and individuals in them, with the research pillar being seen as the one most lacking in levels of capability. In this context what is essential is the support for infrastructure to ensure the strategic aims of the Trust can be operationalised.

National standards set for Trusts include 1% of the non-medical allied health professional workforce in clinical academic roles by 2030. In my Trust this equates to approximately 65 staff, where we currently have 1 nurse. To support this level of development, the Trust needs to develop an infrastructure that can offer the appropriate mentorship and development. So far, from what I have observed locally and heard from board-level colleagues elsewhere, success has been achieved by joint working with local R&D teams, universities, charities and biomedical research centres, where these exist, to support posts to lead in this area. I do believe that we can work towards a future where research led by nurses is business as usual in health and care settings, but we really must do what we need to do locally and be supported nationally to increase the involvement of the nursing profession in decision-making about research-related developments. We need to be able to prove that high-quality research led by nurses is beneficial, and strive for an environment that encourages nurses to pursue a career that involves research.

Achieving the research pillar: a research toolkit for Advanced Practitioners

In this blog, Dr Kerry Gaskin, Associate Professor of Nursing, discusses the development of an Advanced Practice Research Toolkit to enable AP teams and individuals to plan activity within the research pillar of their role.

There is growing recognition that research active hospitals can save lives, enhance health care, and improve patient outcomes (Jonker & Fischer 2018; Ozdemir et al 2015). In November 2021, the Chief Nursing Officer for England’s strategic plan for research ( NHSE 2021 ) and the Allied Health Profession’s Research and Innovation Strategy for England ( HEE 2022 ) were published, followed this year by the Chief Midwifery Officer for England’s strategic plan for research ( NHSE 2023 ). Furthermore, statutory duties of the NHS England and Integrated Care Systems require them to ‘facilitate and otherwise promote research’ (The Health and Care Act 2022 ). These strategies provide frameworks to collaboratively develop and invest in research activity for nurses, midwives, and allied health professionals across the National Health Service (NHS); supporting health and care professionals (HCP) by ensuring they have the capacity and capability to integrate research into their daily activities; enhancing knowledge and skills of NHS leaders to support staff to get involved in research; supporting frontline staff to lead delivery; improving recognition of research impact on safety and quality of care; and knowledge translation ( Barwick 2022 ) of research findings to improve care, experience and outcomes for patients, the public and organisational performance ( CMO 2023 , p3).

A key group of HCP for whom research is a fundamental pillar of their role, are those working at the level of advanced clinical practice ( HEE 2017 ). Research capability is necessary to ensure that knowledge is translated into clinical practice, however, research is a less well-established pillar (Fielding et al 2022). Anecdotally some advanced practitioners (AP) perceive this pillar to be more difficult to achieve within their role due to barriers such as the impact of operational pressures on capacity, which results in a lack of dedicated time for research. Furthermore, whilst the multiprofessional framework (HEE 2017) outlines eight research capabilities for HCPs working at the level of AP, a common theme arising from communication with APs in one NHS Foundation Trust was ‘ not knowing how or where to get started’ . As a result of these conversations and the nature of research support being requested by various APs and AP teams, the Advanced Practice Research toolkit was developed to:

• provide a framework for research discussions
• support advanced practitioners to ‘get started’ with research
• encourage advanced practice teams to consider their research priorities
• enable individual and team research objective setting
• aid appraisal discussions

The toolkit is divided into two sections:

Section A : the research pillar framework

This section provides a framework, which maps the research pillar capabilities (HEE 2017) against suggested individual and team activities, with example resources and training opportunities (figure 1)

Figure 1 The AP Research Toolkit frontpage

Section B: the research pillar activity log

This section is designed to help APs to work with their research mentor to plan and record research activities, considering their medium-term (3-year) research ambitions in relation to research activities both planned (next 12 months) and completed (previous 12 months). They are encouraged to share the information within this log with their line manager, to further discussions about research aspirations and objectives more broadly within their AP role (figure 2).

Figure 2 The Research Pillar Activity Log frontpage

The draft toolkit was disseminated to APs in the Trust via the AP and Research shared decision councils and presented at the One Gloucestershire Advanced Practice Summit in March 2023 and will be evaluated formatively in six months as part of a quality improvement project.

The concept of a toolkit to support APs to develop their research pillar has gained interest from APs across the South-West region and beyond, and aligns to the principles of the HEE (2022) South West ‘ Developing a research skilled workforce’ strategy alongside the ‘developing a research skilled workforce’ project being undertaken by the University of Plymouth , funded by NHS England South West. An online introduction to the toolkit is available at this link , which is licenced under a  Creative Commons Attribution 4.0 International License . For more information or a copy of the operational Microsoft Word version of the AP Research Toolkit contact Dr Kerry Gaskin [email protected]

References           

Barwick M (2022) Knowledge translation: why it should be hotter than it is, Evidence Based Nursing , available at: https://ebn.bmj.com/content/25/4/109 [accessed 31/5/23]

Fielding C, Riley J, Sutherland C, Swift K, Gordon A. (2022) Research as part of the advanced clinical practitioner role. British Journal of Nursing . 31(7):372-374. doi: 10.12968/bjon.2022.31.7.372. PMID: 35404650

Health Education England (2017) The multiprofessional framework for advanced clinical practice, available at: https://www.hee.nhs.uk/sites/default/files/documents/multi-professionalframeworkforadvancedclinicalpracticeinengland.pdf [accessed 31/5/23]

Health Education England (2022) Allied Health Professions’ Research and Innovation Strategy for England, available at: https://www.hee.nhs.uk/our-work/allied-health-professions/enable-workforce/allied-health-professions%E2%80%99-research-innovation-strategy-england [accessed 31/5/23]

Health Education England South West (2022) ‘ Developing a research skilled workforce’ regional strategic research workforce capacity and capability plan on a page for 2023-2026, available at: https://www.hee.nhs.uk/about/how-we-work/your-area/south-west/south-west-news/developing-research-skilled-workforce [accessed 31/5/23]

Jonker L, Fisher SJ (2018) The correlation between National Health Service trusts’ clinical trial activity and both mortality rates and care quality commission ratings: a retrospective cross-sectional study, Public Health , 157: 1-6, ISSN 0033-3506, https://doi.org/10.1016/j.puhe.2017.12.022 .

NHSE (2021) Making research matter Chief Nursing Officer for England’s strategic plan for research, available at: https://www.england.nhs.uk/wp-content/uploads/2021/11/B0880-cno-for-englands-strategic-plan-fo-research.pdf [accessed 31/5/23]

NHSE (2023) Chief Midwifery Officer for England’s strategic plan for research, available at: https://www.england.nhs.uk/long-read/chief-midwifery-officer-for-englands-strategic-plan-for-research/ [accessed 31/5/23]

Ozdemir BA, Karthikesalingam A, Sinha S, Poloniecki JD, Hinchliffe RJ, Thompson MM, Gower JD, Boaz A, Holt PJ. Research activity and the association with mortality . PLoS One . 2015 Feb 26;10(2):e0118253. doi: 10.1371/journal.pone.0118253. PMID: 25719608; PMCID: PMC4342017.

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BMJ Journals

Florence Nightingale Foundation

Chief nurse research requirements workshop.

• October 18, 2022

The Florence Nightingale Foundation (FNF) in partnership with NHS England and Improvement (NHSE/I) are undertaking a Thought Leadership Project exploring the research requirements of Chief Nurses needed to embed a culture of research and evidence-based practice. It is acknowledged that post holders commonly have professional responsibility for midwifery and allied health professions, and therefore the benefits of this project are likely to extend to other disciplines.  

In 2021, Ruth May, Chief Nursing Officer (CNO) for England set out a strategic plan for research . It outlined the CNO’s ambition to, [1] “Create a people-centered research environment that empowers nurses to lead, participate in and deliver research, where research is fully embedded in practice and professional decision-making, for public benefit” .   

On 4 October in collaboration with NHSE/I, FNF facilitated a co-production workshop with Chief Nurses across England exploring what support they believe Chief Nurses require in order to implement the CNO’s strategic plan for research.   Professor Alison Richardson said it best, “A special time we probably will not have again!” .

FNF were thrilled to gain a deep-rooted understanding of the requirements of Chief Nurses needed to embed a culture of research and evidence-based practice. In addition to the work at hand, it was an ideal opportunity for networking and knowledge sharing with other likeminded colleagues present.  

Attendees first heard from Professor Greta Westwood who solidified the importance of this co-production workshop and expressed her sincere commitment to supporting Chief Nurses to take the research agenda forward in their organisations. Greta then welcomed Chief Nurse & Deputy CEO of Health Education England (HEE), and Deputy CNO for England, Professor Mark Radford to take to the floor. Mark set the scene for the day delivering a presentation on the strategic plan for research and ‘Making Research Matter to Nurses’. Mark engaged the room through sharing examples of how he had influenced the research culture when he was the role of Chief Nurse through building partnership with different Universities who had the expertise to partner on the priorities relevant to his organisation. Also, how research had been directly utilised to identify factors influencing patient safety which went onto inform workforce planning and resource allocation.        

Next on the agenda, the room heard presentations from the following guest speakers:  

• Professor Cheryl Lenney : Developing an Organisational Approach  
• Professor Alison Richardson : CNO Team Research Insights  
• Professor Chris Burton : Academic Nursing Leadership – Perspectives from the Council of Deans for Health (CoDH)  
• Professor Patrick Callaghan : Creating Partnerships with Higher Education Institutions (HEI’s)  
• Professor Ruth Endacott : National Institute for Health and Care Research (NIHR) Insights  

Exploring what worked and lessons learnt in these different examples gave each leader in the room a sense of the success factor which would enable the strategic plan for research to be applied to their specific context. FNF want to take this opportunity to thank each speaker once again for sharing their expertise with us.  

Lunch and further networking commenced before the afternoon workshop session was opened by Professor Gemma Stacey . Gemma described the details of the project which has so far entailed a survey and focused discussions.  The survey was conducted in August 2022 and the initial analysis was shared with attendees. The initial survey has told us that training in conducting research is not a requirement for this group. However, they do have a desire to understand best practice in research as a mechanism to set standards and advocate for their workforce. The confidence and authority to implement the strategy and influence the research agenda by securing the associated resource allocation is paramount. It was clear that Chief Nurses are aware of their potential to influence the development of a culture of nurse led research and are motivated to do so due to their conviction in the value of evidence-based practice for improved patient outcomes. Identifying and securing investment and advocating for nurses was seen as their most important areas of responsibility. “My obsession is the next generation of nurse/research leaders and investing in them now!” – Professor Patrick Callaghan.      

A co-production workshop was then facilitated to understand the requirements of Chief Nurses working in different contexts and with varied levels of experience in implementing a research strategy. The room explored the content, delivery methods, ongoing support and impact measures needed to truly enable nurse-led research.  The insights the FNF Research and Policy Team gained during the workshop are invaluable to the project development and proposed programme which will be put in place to meet the requirements the Chief Nurses identified.  

As the day concluded, #Team FNF felt inspired by the contributions to the day and the clear commitment to making research matter for every nurse in their organisation. As Professor Chris Burton  stated , “ W e need to develop good quality nursing research. We need a shared architecture to be able to do so” .

Next steps for FNF include a series of focused discussions, group and one-to-one interviews, taking place from mid-October through to mid-November. If you’re a Chief Nurse interested in supporting this project, please reach out to the Research and Policy Team for further information.  

As always, many thanks for supporting FNF.  

Greta, Gemma, and The Research and Policy Team.  

[1] Making research matter Chief Nursing Officer for England’s strategic plan for research. Version 2, November 2021 – https://www.england.nhs.uk/wp-content/uploads/2021/11/B0880-cno-for-englands-strategic-plan-fo-research.pdf  

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Strategic plan for nurse research is a good foundation

Elizabeth halcomb - @lizhalcomb posted 03 december 2021 - 12:53.

Commitment and resourcing by policy-makers and government is essential to plan’s success

There has been much talk of the need to strategically build capacity and grow the community of nursing scholars. While traction has been growing in the profession, external buy-in has been variable. England’s chief nursing officer’s strategic plan for research indicates a recognition at policy level and that the time is ripe to achieve real change.

Five themes in the strategic plan

The strategy identifies five themes. The first relates to ‘aligning nurse-led research with public need’. Ensuring that nurses are working on research that addresses health and social issues, ensures impact and focuses limited resources in areas of greatest need.

The following two themes relate to creating a climate that empowers nurses to ‘lead, use, deliver and participate in research as part of their job’ and build a research system in which nurses can engage in research. This recognition of the importance of the nurses’ environment as an enabler is central to success in building research capacity and capability. Working in an environment that empowers and enables enhances job satisfaction, productivity and well-being.

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Theme four focuses on offering ‘rewarding opportunities and sustainable careers’ that support these nurses to grow and flourish. Career pathways and opportunities for nurse researchers have been inconsistent and dependent on local support. This focus at a national level offers an opportunity to build career pathways and provides an example to other countries.

The final theme covers creating a digital practice environment to support research and enhance patient outcomes. Enhancing technology in clinical care leads to innovation in care and research. Nurses need to develop confidence and skills in technology and data science.

Challenge for all to contribute to nursing research

In contrast with this clear plan to strategically build nursing research capacity, the Australian Government Response to the National Nursing Education Review barely mentioned the need to support nursing research or the development of research capacity among nurses.

It is vital that the voice of nurse researchers is heard as progress is made. England’s strategic plan’s examples of impactful research being undertaken by nurses highlight the value in this work. Despite the plan’s promise, detail around the implementation is limited. Commitment and resourcing by policymakers and government is essential.

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I challenge you all to become familiar with the policy debates around nursing research and the capacity of nurse researchers. Explore ways that you can contribute to building understanding of these issues, positively influencing policy and maximising opportunities for nurses and nurse researchers.

Nurse Researcher is always looking for new reviewers. Contact [email protected] Find out more here

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Making Research Matter: Chief Nursing Officer for England’s Strategic Plan for Research

Elizabeth Halcomb is professor of primary healthcare nursing, School of Nursing, University of Wollongong, New South Wales, Australia and editor of Nurse Researcher

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Chief Midwifery Officer for England’s strategic plan for research

This strategic plan sets out plans for maternity and perinatal research and strengthening careers for under-represented disciplines, such as midwives, as the backbone of maternity care over the next three years

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Bowers B, Evans C. Building a community nursing research community of practice. Br J Community Nurs. 2022; 27:(2)57-58 https://doi.org/10.12968/bjcn.2022.27.2.57

NHS England. Making research matter: chief nursing officer for england's strategic plan for research. 2021. https://www.england.nhs.uk/wp-content/uploads/2021/11/B0880-cno-for-englands-strategic-plan-fo-research.pdf (accessed 6 January 2023)

NIHR Personal Awards Data from 2011/2012 to 2021/2022 (up to 3 January 2023).

Developing community and primary care nursing research

NIHR School for Primary Care Research PhD student, University of Cambridge, Queen's Nurse

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Programme, Network and Events Co-ordinator, Queen's Nursing Institute, London

Catherine Evans

Professor of Palliative Care, Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, and Honorary Nurse Consultant, Sussex Community NHS Foundation Trust

The first Community Nursing Research Community of Practice for the UK was initiated as an editorial in this journal in February 2022 ( Bowers and Evans, 2022 ). It was a nascent idea; a tentative assembling of a community to support, nurture and advance community-based nurse research. It brought together nurses who are keen to lead and contribute to research on healthcare and generate high-quality evidence to drive clinical effectiveness. The idea quickly took root with members joining from across primary care and community nursing in the UK, who engaged in research and development activities through the Community of Practice. The timing aligned with the vision and commitments set out in the Chief Nursing Officer for England's strategic plan for research ( NHS England, 2021 ). The vision included, ‘building nurse-related research capacity and capability to achieve system-wide leadership and better co-ordination across the research and practice community’.

One year on, we have been able to create an inclusive, diverse and dynamic community of nurses. The community comprises 439 members (to-date) that encompasses novices to experts in research, from childhood to adulthood nursing specialties across community and primary healthcare. We invite you to join us .

The community has grown to form the Community Nursing Research Forum, hosted by the Queen's Nursing Institute (QNI). The Forum is a platform to collaborate with partners, including the Queen's Nursing Institute Scotland, NHS England, National Institute for Health and Care Research (NIHR), International Collaboration for Community Health Nursing Research, and colleagues from many different health and social care providers, universities, organisations and charities. The key priorities are connecting people, collaborating and breaking down barriers to increase exposure and engagement with research in practice. We are supporting members to develop their research skills and network, providing opportunities for nurses to contribute to research studies, and implement and use high-quality evidence in clinical care.

Despite the steady increase in government-funded schemes in the four nations to support clinical academic careers and research activity, community and primary care nurse-led research remains very under-represented ( Bowers and Evans, 2022 ). Historically, there have been limited opportunities to get involved in research ( NHS England, 2021 ). According to data provided to the authors by the NIHR, only 37 nurse-held NIHR fellowships, clinical lectureships and development and skills enhancement awards detailed an evident focus on researching care and treatment in community settings over the last 10 years in England; nurses working in any settings represented 8.3% of total award holders during this 10-year period ( NIHR, 2023 ). There are also other funders of applied health and care research. The NIHR, other funders and academic organisations in the four nations are actively raising the profile of community-based nursing research and opportunities to develop skills and careers. Nonetheless, these figures indicate that building research capacity in nursing is vital for nurse-led interdisciplinary research.

The Forum is for nurses to learn about and share research, access peer support, network and build community and primary care nurse-led research activity. The Forum is open to UK-based nurses who work in all community settings, regardless of specialities and the populations they serve. The map of our membership at the end of 2022 shows how we are bringing like-minded nurses together ( Figure 1 ). This includes nurses working in community services, general practice, adult social care, homeless and inclusion health services, hospices, prisons, children's services, public health, community learning disabilities and mental health services, among many others.

Inclusivity and an encouraging environment are essential; the Forum is an inclusive, supportive and curious community. This helps break down barriers of isolation and uncertainty for nurses to engage in research and navigate research pathways in their clinical careers, connecting with like-minded peers and role models. Members of the Forum include colleagues seeking to increase their research awareness and confidence to use high-quality evidence in their clinical practice, nurses wanting to undertake research for the first time, as well as aspiring leaders in research and those already leading and co-leading programmes of research and education.

The Forum has constructed initiatives and resources to support and nurture success, encompassing research exposure, education and engagement. This includes a series of 1-hour research masterclasses delivered by internationally leading researchers, covering topics such as writing for publication, qualitative data analysis and planning and navigating research ethical approvals. Upcoming Forum webinars will focus on developing research careers and engaging with underserved communities, including Gypsy, Roma, Traveller and Showpeople communities. The Forum webpage resources include members' profiles, with tips and advice on navigating diverse research-related career pathways, a growing collection of research resources, and a unique repository of research funding and training opportunities.

There are several high-quality research mentorship schemes provided by organisations to support the growth of nurse-led research. However, many of these are exclusive for individuals already holding research fellowships, undertaking academic training, or for academics. To help develop and nurture aspiring community-based researchers, we have just launched a Forum Mentorship Scheme for nurses seeking to pursue research in their career pathway. The scheme links mentees with more experienced mentors to help them develop and achieve their potential.

Our approach is creative and innovative, focusing on collaboration and networking for community-based nurse-led research and engagement to flourish. Next steps for the Forum include facilitating more opportunities for nurses to get involved in research, strengthening networks in nursing research and building expertise to use high-quality evidence in clinical practice. We are currently seeking to secure long-term funding to support members' development and Forum activities.

Please join the Forum and help to shape our inclusive, dynamic community: www.qni.org.uk/nursing-in-the-community/community-nursing-research-forum

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The new chief nursing officer (CNO) for England, Dr Ruth May, has announced her three-point CNO strategy to help nurses deliver the Long Term Plan, including building a workforce ‘fit for the future’.

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Shape the future of nursing and midwifery

We are delighted to invite nurses, midwives and nursing associates in England to contribute to the Chief Nursing Officer’s development of the strategic priorities for the professions. This survey will close Sunday 31 December 2022.

The survey has now closed.

The Chief Nursing Officer (CNO) for England, Dame Ruth May, is producing a new professional strategy that will set out the direction of travel and ambitions for the professions over the next 3 – 5 years. The strategy will cover both nursing and midwifery and the CNO will be supported in its development by the Chief Midwifery Officer for England.

The strategy will be developed in the context of other key strategic documents including the NHS Long Term Plan, workforce strategy and emerging plans for social care.

It is vital that the new strategy is developed with, and by, the professions to reflect their experiences and aspirations. To support and frame this part of the discussion we are highlighting the following proposed themes:

• Workforce and people
• System leadership and integration
• Health equity, prevention and population health management
• Person centred practice and improving outcomes

We are keen to hear from all registered nurses, midwives and nursing associates in England, across all sectors. We hope you will take the time to complete this short survey.

The survey has 25 questions and space is provided for you to add further thoughts.

A vision for the Chief Nursing Officer’s professional strategy for nursing and midwifery

The last few years have reinforced the vital roles played by nurses and midwives across the health and care system, supporting people at all stages of their life. The strategy will be framed as the professional response to strategic drivers in the system, including key Government Policy and the NHS Long Term Plan as well as the wider structural changes and integration within the health and care system.

The CNO for England is using various methods to engage nurses and midwives across health and social care. As part of this process, nurses and midwives are encouraged to contribute to the development of the professional strategy by completing this short survey. Responses will be used to inform the onward development of the professional strategy.

We are determined to include the immensely valuable insights of nurses and midwives in England on the key ambitions and professional issues facing them.

We will also consider important enablers of progress such as the use of digital technology, the role of research and the development of sustainable practices.

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