This is a plain English summary of an original research article
A new resource pack could guide healthcare managers through the process of embedding researchers within healthcare teams. The resource pack is based on a major research project, and could help embedded research run more smoothly.
The NHS spends vast sums on healthcare research. Too often, research findings do not translate into improvements in the care people receive. Embedded researchers work in non-academic settings (such as hospitals). They carry out studies in partnership with health and care professionals (co-production). In this way, research is linked to daily practice. This may improve the likelihood that its findings help services become more effective.
The new detailed framework is intended to help managers think about the design and role of embedded research. It covers the support embedded researchers need, the projects they might take on, the skills they need, and how their success could be measured. It includes resources to help managers set up such a scheme, including information on how to recruit and employ embedded researchers.
A review of studies on embedded researchers found that schemes varied, but their intent, structure and process had common features. The team observed 4 embedded researcher schemes for a year, and interviewed some of the people involved. They explored difficulties embedded researchers can face, for example, juggling the competing demands of academia and the healthcare organisation.
For more information about embedded research in the NHS, visit the NHS website.
What’s the issue?
The NHS spends hundreds of millions of pounds each year on health research. Many studies have looked at redesigning or improving health services, for example. But the findings from research are not always put into practice to improve care, or to save NHS resources. That may be because findings were not interpreted and adapted to meet local needs.
Knowledge co-production is intended to bridge the gap between research and practice. Embedded researchers carry out research in partnership with the healthcare teams who will be using their findings (co-production). Researchers may be employed within health service teams, which also include doctors, nurses, and other healthcare workers.
These embedded researchers combine their knowledge and expertise with that of the healthcare teams. Typically, the researchers give insights into how the healthcare professionals carry out their work. Together, researchers and healthcare professionals then come up with recommendations for improvement. The recommendations are likely to be acceptable to healthcare teams since they have been developed with the people who will be using them.
How best to embed researchers in health service teams is not known. A team of researchers explored several embedded researcher schemes to better understand how they work. They then developed practical resources, which aim to make this approach as effective as possible.
Throughout the study, researchers worked closely with patients and members of the public, healthcare managers, embedded researchers, and clinicians. They started by reviewing studies on co-production and embedded research from health, management and environmental science. They pooled information from 45 embedded researcher schemes in UK health settings, and carried out 17 interviews with people working in these schemes.
Schemes were diverse, and used many different models, they found. Some were short-term, others long-term. Researchers could be employed by universities working with the NHS, or by the NHS directly. Few schemes had been carefully planned from the outset; most evolved over time. Many did not give full descriptions of the type and extent of the co-production; patients, carers and service users were rarely involved.
Schemes differed from one another according to their:
- intent (goals, and power dynamics)
- structure (the scale, who is involved, and how researchers will be supported)
- processes and activities (day-to-day tasks, necessary skills, monitoring and evaluation methods).
The researchers selected 4 schemes as in-depth case studies. They conducted 46 interviews with people involved in these schemes, and observed them in their roles over the course of a year. They found that:
- embedded researchers’ backgrounds, motivations, and practices varied, but many wanted to ‘make a real-world difference’
- schemes aimed to combine researchers’ knowledge with healthcare data, to build local health practitioner research capacity, and to make the case for using research to improve care
- embedded researchers often juggled competing clinical and academic priorities; some said their professional identity was blurred or that they did not feel they belonged in their new team.
Working closely with people from the NHS, universities and patient and public advocates, the researchers developed practical tools and resources for staff looking to embed researchers within teams. Their detailed framework for designing and running an embedded researcher scheme highlights the decisions that managers and researchers need to take. For example, how researchers will be supported to work in both academic and clinical settings, activities they might do, skills they might need, and how the scheme’s success will be measured.
A recruitment pack contains a template job description, job advert, person specification, and protocols for employing and managing the researcher. Case studies of existing schemes are included, along with an introductory animation.
Why is this important?
It is too early to tell how effective embedded research schemes are, the researchers say. But this study provides a better understanding of key features of the embedded researcher’s role in healthcare settings. It provides resources to help NHS managers design, manage and monitor embedded research schemes.
The researchers say that a more structured way of thinking about embedding researchers in teams will make the process more efficient and successful. They hope their framework will help managers think about their goals and consider in advance how they can support the researcher.
For example, embedded researchers employed by a university and an NHS Trust could have conflicting objectives. In their academic role, researchers will be expected to publish research papers, while in their clinical role, they will be expected to contribute to improving hospital processes. Managers need to understand that embedded researchers need to split their time between the roles. Researchers might need support to find ways to benefit both the NHS Trust and their university.
The resources will help to describe, categorise and assess different types of embedded research initiatives. The researchers say more research is needed to understand the potential benefits of embedded research in healthcare, what the costs may be, and how to incorporate more co-production in embedded research schemes. There is also a question about how to attract more researchers to work within healthcare teams. It is not currently a mainstream NHS or academic career path.
Throughout this study, the researchers worked with a patient and public involvement group. They explored best practice in public involvement, which encourages more active (less passive) involvement. They found few embedded research schemes with patient and public involvement. Future and ongoing schemes could address this, they say.
The implications of the work go beyond healthcare. Some of the researchers are exploring embedded research schemes in other fields, such as parliaments.
You may be interested to read
This Alert is based on: Marshall M, and others. Optimising the impact of health services research on the organisation and delivery of health services: a mixed-methods study. Health and Social Care Delivery Research 2022;10:3.
A blog post describing the main findings from the paper: Ward, V. Embedding researchers in service organisations: what do initiatives look like and how can they be cultivated? Evidence & Policy Blog.
Funding: This research was funded by the Health and Social Care Delivery Research programme or one of its preceding programmes as project number 16/52/21.
Conflicts of Interest: The study authors declare no conflicts of interest.
Disclaimer: NIHR Alerts are not a substitute for professional medical advice. They provide information about research which is funded or supported by the NIHR. Please note that views expressed in NIHR Alerts are those of the author(s) and reviewer(s) at the time of publication. They do not necessarily reflect the views of the NHS, the NIHR or the Department of Health and Social Care.