The new Health Research Authority framework: still work to do to facilitate high-quality public health research in English local authorities.

Abstract

Will the new Health Research Authority (HRA) framework go far enough? Dr Emily Phipps, Professor Sian Griffiths of The Chinese University of Hong Kong, and Dr Mark Sheehan of the Nuffield Department of Population Health, Oxford University, consider the challenges facing the new HRA framework in addressing research into public health interventions on both an individual and a population level.IntroductionIn 2013, the public health functions of the National Health Service (NHS) in England moved to local government as part of reforms under the Health and Social Care Act 2012.[1] In this setting, the public health team commissions and manages a broad portfolio of programmes that aim to positively influence the local population's health and wellbeing, reduce inequalities and promote a healthy lifestyle.[2] The very nature of this work requires public health interventions to span the functions of health and politics, bringing together expertise from clinical, nursing, social care and local government backgrounds.Developing a robust evidence base for the delivery of public health interventions is key to ensuring that public health teams can provide the most effective and efficient service possible. Research governance processes regulate the design, implementation and dissemination of studies into public health interventions and are a legal requirement of health research conducted in England. However, there is currently significant variation in the quality and accessibility of research governance processes in local authorities in England to support the study of public health interventions.[1] In a recent nationwide study by Rainey et al.,[3] 35% of research governance leads listed on a national local authority database were no longer in post, and 25% of respondents from local authority public health and social care teams reported not having or not being aware of research governance arrangements in their local authority.Where such processes are available, a lack of familiarity with the relatively recently introduced public health functions to local authority can make it difficult for research projects to be assessed in a robust and appropriate manner. Research governance leads unfamiliar with governance issues pertinent to the study of public health interventions may be reluctant to pass review and approval. This risk may mean that projects are altered at the point of design to 'fit' the model most familiar to the research governance lead, rather than being of a methodology best suited to the hypothesis in question, in order to increase the likelihood of approval.Ethical review processes are a fundamental part of research governance, protecting the safety, dignity, rights and wellbeing of study participants. Researchers wishing to study public health interventions in local authorities rely on there being robust and appropriate ethical review services available in that organisation. As the nature of this research is unlikely to involve conventional methodology or typically medical interventions, local NHS research governance teams will likely not feel appropriately equipped to provide approval. In addition, academic research ethics committees often will not review the ethics of applications for research that is being conducted without university involvement, and vary widely in their approval processes and remit.[4] National guidance on the provision of research governance services, such as ethical review processes within local authority settings in England, may be one way to ensure standardised and appropriate services are available.In January 2015, the Health Research Authority (HRA) took over the responsibilities of the National Research Ethics Service and National Social Care Research Ethics Committee, so that all research involving health and social care in England is now governed by the same authority. The HRA are currently developing a high-level framework to guide the revision of local research governance policy which should recognise the changes to health and social care functions introduced in 2012. …