Time for Research: Improving research capacity in the health service post COVID-19

Background: The COVID-19 pandemic has increased public recognition of the importance of research, and driven researchers to use innovative research practices. However, the pandemic has also been detrimental to research capacity for non-COVID-research, including cancer, and has highlighted pre-existing barriers. Overcoming these barriers is essential to restoring research capacity to pre-pandemic levels, but also for expanding capacity and accelerating innovation. This study takes a system-wide approach across professional groups, specialties and research settings to identify policy solutions to improve health service research capacity. Methods: A mixed methods study was conducted, including a scoping review, secondary data analysis and interviews with funders and research and development leads (n=39). This informed design of a survey of staff in 11 healthcare organisations (n=1235). Case study interviews (n=51) were undertaken in six of these organisations. Results: The study identified four key themes where policy action is needed: 1) More time and funding: lack of time to conduct research is exacerbated by lack of visibility of research support schemes, and 60% of research directors report insufficient funding. 2) Variations in research activity and capacity across regions, professions and specialties must be targeted: nurses and allied health professionals are particularly under-supported, as is disease prevention and public health. 3) Pathways for getting into research: a life-course approach should facilitate early and continued exposure to research. 4) Research culture must be strengthened: gaps exist between research strategies and delivery, metrics for research are insufficient, and research must be better connected to practice. Conclusions: Although COVID-19 has brought the health service’s inadequate and unequal research capacity into focus, these limitations existed prior to the pandemic and result from systemic policy failures. An interconnected policy response across four key themes, with improved strategic coordination across all levels, is needed to overcome these widespread and persistent barriers to research. There is no-one-size-fits-all approach to increasing capacity, and capacity-building initiatives must benefit all health service staff, regardless of organisation, profession or specialty. Impact statement: This study sets out an interconnected policy response for overcoming widespread and persistent barriers to conducting research in the health service, which will support the expanding of research capacity and accelerating of innovation for cancer research.