Delivering clinical research to make patients, and the NHS, better

Finance in CRN: North Thames:Research Capability Funding, the receipt and distribution of our Network allocation and the principles of AcoRD

John SheedyHead of Finance and Information

Feb-2015

Introduction

• What is Research Capability Funding (RCF)?

– How is it awarded?

– How can it be used?

– How much RCF did the North Thames region CCGs receive?

• North Thames receives the largest LCRN allocation of £30.6m

– How is the LCRN allocation derived?

– How do we allocate LCRN funding?

• What can Network funding be used for: the principles of AcoRD

Research Capability Funding: How is it awarded?

• Research Capability Funding (RCF) is awarded each year by the Department of Health in proportion to the total amount of NIHR income received by an organisation

• An organisation must have recruited 500 patients to NIHR non-commercial studies in the CRN reporting period: 1st October to 30th September each year

• If 500 patients are recruited, the minimum allocation of £20k will be

received

• An amount of £75k is awarded for each designated NIHR Senior

Investigator within an organisation

• An organisation may receive approximately 44p/£1 of NIHR grant income, 20p/£1 of NIHR BRC income and potentially other amounts for alternative NIHR streams e.g. NIHR Clinical Research Facilities

Research Capability Funding: How can it be used and how much did North Thames CCGs receive?

• Research Capability Funding (RCF) can be used flexibly to maintain research capacity and capability in an organisation or at an individual general practice level

• More specifically the funding can be used to pay the salary costs of individuals supporting or undertaking patient-based research

• RCF can also be used to meet the hosting costs of NIHR-funded research not already fully supported by an alternative funding stream

• In the North Thames region in 2015/16, four CCGs have

received an allocation of £20k: NHS Camden, NHS City & Hackney, NHS Newham and NHS Tower Hamlets

Network Funding: How is the total LCRN allocation derived?

• The annual Network allocation is comprised of several components:

– Activity-based funding (~73%)

– Per capita (~15%)

– Project-based activity (~6%)

– Leadership management (~4%)

– Performance premium (~2%)

Network Funding: How are the individual components derived?

• Activity-based funding

– The value is calculated based on the recruitment, i.e. uploaded accruals, that occur in the 12-months between the 1st of October and the 30th of September

– The recruitment is weighted with a ratio of 1:3:14 according to whether the study is a large sample size study, an observational study or an interventional study

– North Thames received the 3rd highest recruitment-based allocation for 2015/16

Network Funding: The impact of the recruitment weighting

Network Funding: The per capita component

• The per capita is a population-based allocation

• North Thames has the 3rd highest per capita allocation

• North Thames has 10% of the national population

Project-based funding

• The project-based funding allocation is also activity-based

• It is comprised of two elements:

– Lead Network

– Study-wide governance reviews (weighted)

• North Thames receives the largest project-based allocation of any Network

How much do we allocate to each budget category?

50.24%

1.11%1.61%

20.46%

7.33%

5.44%13.81%

% of North Thames funding allocations by budget of category

Clinical DeliveryHost Supporting CostManagement CostNon-Clinical DeliveryOtherRM & GSupporting Clinical Services

Network Funding: What can Network funding be used for and the principles of AcoRD

• AcoRD, which applies to all studies where funding was originally sought after the 1st of October 2012, guides the cost attribution for all non-commercial studies in the NHS

• AcoRD replaced the previous guidance document entitled ARCO (2005) however ARCO can still apply when studies have originally been funded prior to the 1st of October 2012

• AcoRD focuses on the primary purpose of an activity to guide its attribution and makes a distinction between three types of cost:

– Research (part A and part B)

– Support

– Treatment

Network Funding: What can Network funding be used for and the principles of AcoRD – Research costs

• A research cost activity is one that is primarily being carried out to complete the research study and answer the research question. Research activities are not directly related to the provision of patient care. Examples of research costs would be tests conducted to test the efficacy of an intervention, patient randomisation and data analysis needed to answer the research question

• The funding for research costs is provided by the grant funder(s)

• For studies wholly or part funded by AMRC-member charities, the research cost part B activities will be paid by alternative sources e.g. the CRN or Trust RCF

• An example of a part B activity is data collection, which would not be supported for studies without AMRC-member charity funding

Network Funding: What can Network funding be used for and the principles of AcoRD – NHS Support costs

• An NHS support activities are those additional patient care costs that would cease once the R&D activity ceased

• The taking of informed consent, which is an NHS support cost in almost all contexts, would not continue once the research study has ended

• A second example of an NHS support cost is the identification of eligible participants for a research study through the reviewing of medical records. This is not to be confused with screening to determine individual eligibility for a study according to the inclusion and exclusion criteria

• Other examples of support activities would be additional OP attendances or tests, which are only required for safety purposes

• The resource to deliver the NHS support activities is provided by the LCRN(s)

Network Funding: What can Network funding be used for and the principles of AcoRD – NHS Treatment costs

• An NHS Treatment activity is one that would continue after the end of the R&D activity. For the purposes of attribution, we must presume that the R&D activity would be adopted into practice

• Examples of treatment costs include:

– The supply and administration of any medicine/device/therapy being studied irrespective of whether it is experimental

– Supplying and administering any active comparators but not placebo or sham treatments

– Investigations and tests that would continue to be provided after the R&D study has stopped

• The funding for NHS Treatment costs come from existing commissioning routes i.e. CCGs

• The funding for Excess treatment cost must also come from CCGs via local mechanisms, which we realise can be a challenging area

Summary

• RCF is used to maintain capacity in research-active NHS organisations

• We allocate the majority of our funding to support research delivery

• The LCRN are only able to provide resource to support NHS Support activities as governed by AcoRD:

AcoRD:https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/351182/AcoRD_Guidance_for_publication_May_2012.pdf

AcoRD Annex A:

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/351185/AcoRD_Annex_A_-__List_of_Common_research_Activities_March_2013_for_publication.pdf

AcoRD Annex B:

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/435943/AcoRD_FAQs__updated_May_15.pdf