Activity in the (sort of) Old Trent Region

1. Ron Akehurst Professor of Health Economics Dean of ScHARR Director of Sheffield Unit, Trent Institute Trent Institute for Health Services Research Activity in the (sort of) Old Trent Region

2. HISTORY • Trent Institute set up in 1994 by what was then the Trent Regional Health Authority • Purpose was to fill a gap in Health Services Research (HSR) locally • Specific intention to create capacity in Health Economics and Medical Statistics • Size has remained pretty well constant • Current budget about £1.2m per annum • Three universities successful in the initial tendering process – Leicester, Nottingham and Sheffield

3. MODE OF WORKING • The model adopted has been one of integration of staff within bigger HSR entities so that Trent Institute staff contribute to non Trent Institute activities and non Trent Institute staff contribute to Trent activities • In the case of Sheffield, in the early days of ScHARR, Trent Institute staff made a very significant part of the total. They now represent only about 5% of the total but the Trent Institute was hugely important in the creation of ScHARR

4. TRAINING ACTIVITIES • Since 1999 about 1500 NHS staff per year have attended short courses on aspects of research, both in the universities and in the Trusts • About 30 students per year have passed through the Trent Postgraduate Programme (TPP) mainly at Masters level • The TPP allows students to enrol at one of Leicester, Nottingham or Sheffield universities but choose modules from any of them

5. TRAINING AND DEVELOPMENT (1) • Nottingham initially developed a New Researchers Training Programme which was subsequently made available across the whole region, run from Nottingham and Sheffield • Programme is a mix of support on a project brought from the participants home Trust and attendance at university modules or specific training events • The NRTP counts 40 credits towards certain Masters courses at Sheffield • About 30 NHS staff per year do the NRTP

6. TRAINING AND DEVELOPMENT (2) • More than 3000 hours per year of face to face advice is dispensed in research clinics • Since 1999 the Institute has provided annual training for past Trent Fellows and Joint Trent/MRC Fellows and now RCCRCD Fellows based locally • The Institute has provided twice yearly training events for R&D managers and directors. The Leicester unit of the Trent Institute, with Sheffield, is now running the national pilot training scheme for NHS R&D managers

7. RESEARCH ACTIVITY (1) • The Trent Institute has been charged with being a major collaborator with the NHS on research projects since its inception • Current projects involving at least two NHS staff drawn from different disciplines and at least one member of Institute staff valued £14.2m in March 2000, increasing to £21.3 m in March 2003 • Projects between the constituent units of the Trent Institute, with no NHS involvement increased in value from £2.3m to £5.3m over the same period • Total external funding to Trent Institute staff currently stand at about £31.5m • c 105 good quality, peer reviewed publications per year

8. RESEARCH ACTIVITY (2) • Trent Institute staff have taken the lead in national research on Paediatric Intensive Care and in the creation of PICANet (Leicester and Sheffield) • The Trent Institute has helped create and leads the Centre of Evidence Based Dermatology at Nottingham • The Centre for Bayesian Statistics and Health Economics has been created by collaboration between Trent Institute units plus the University of York

9. HEALTH TECHNOLOGY ASSESSMENT AND SUPPORT TO THE NHS • Up to 1999 there were Trent Institute Working Groups on Purchasing and the Trent DEC • The advent of NICE led to the taking on of the Trent team as a NICE TAG • Now we have the evidence based commissioning collaboration with 53 PCTs • The MS “Scheme” is in part a spin off from Trent Institute activity

10. INFORMATION SERVICES • Scores of training courses for librarians and information officers throughout the NHS helping to develop searching and reviewing skills. Nature of courses has changed over time • Innovative courses on evidence based filters and critical appraisal – ADEPT and CATALIST – also run in other regions • Rolling out a programme of skills development into Social Care • “Netting the Evidence” and “Trent Research Information Access Gateway” (TRIAGE) are worldwide resources now, receiving in excess of 50,000 hits per year

11. COLLABORATION WITH NHS RESEARCH INFRASTRUCTURE • Trent Institute staff Chair and lead the Leicestershire Primary Care Research Alliance Old Persons Research Programme • Trent Institute staff were fundamental to the creation of the North Trent Cancer Research Network and provided Chair and secretariat from 1997-2002 • Joint posts have been set up between the Institute and local acute, care and Primary Care Trusts

12. ADDING TO THE STOCK OF RESEARCHERS (1) • Concept is one of a skills escalator, with people getting on depending on their starting skills and off depending on their capabilities and aspirations • We have been going long enough to see one person go from Trent Fellow to Professor; one person who was a nurse with no research skills go from short courses to the NRTP, to the TPP Masters to a university Lectureship and two TPP graduates winning MRC Training Fellowships

13. ADDING TO THE STOCK OF RESEARCHERS (2) • Two TPP graduates are currently doing PhDs in HSR, several others have become research managers or research leads. A few have been lost to research and have merely become research literate chief executives • NRTP graduates have moved on to the TPP and on to research posts in universities or to PhDs

14. ADDING TO THE STOCK OF RESEARCHERS (3) • Among staff one lecturer and three senior lecturers have gone on to university funded Chairs, six have moved from Trent Institute research fellow or lecturer posts to senior lecturer posts and one to a National Career Scientist award. Five junior researchers (RA1A) have obtained lectureships

16. THE FUTURE • Collaboration with the Trent Focus for Primary Care has increased markedly in the past two years • We have abolished our separate management boards and created a new, joint board to implement an agreed joint strategy • We are already close to being a single RSU but have about 1-2 years further work to do to make the merger seamless