School of Health & Wellbeing

Good news for clinical trials in Scotland! Particularly at this time of uncertainty regarding access to former EU funding streams, it is worth flagging that as of autumn 2023, researchers based in Scotland will have access to some National Institute for Health and Care Research (NIHR) funding streams from which they were previously excluded.

Since 2008, we have been able to apply to the following programmes for clinical trials:

• NIHR Health Technology Assessment (HTA) – effectiveness of a medical intervention in a real life NHS setting. Usually large trials with a clinically-relevant primary outcome.
• Efficacy and Mechanism Evaluation (EME) – Efficacy, safety and possibly effectiveness of a medical intervention under ideal conditions. Often a surrogate outcome. A mechanistic component is not essential – if included it must be well justified.

HTA has an annual spend of about £80–100M while EME has about £20–30M. Individual awards are around £2M – sometimes lower for EME and (considerably) higher for HTA. Applications are usually made in two stages i.e. feedback from the panel after Stage 1.
The University of Glasgow has been well-represented on these funding panels e.g. Prof Olivia Wu is current Chair of one of the HTA panels - and until last year I was Deputy Director of the EME panel.

More recently researchers based in Scotland have been able to apply for certain one-off NIHR research partnership grants (around £100k over one year) e.g. a recently palliative care, liver disease, platform trials in precision medicine. These are designed to support teams of researchers get together and develop major applications in areas that are seen as neglected. Also very recently an Advanced Fellowship on Building Clinical Trials Experience for mid-career researchers was opened up to the devolved nations.

However, exclusion of researchers based in Scotland from some other panels has often led to confusion and lower rates of application than would be anticipated given the research strengths of our universities.

The additional funding streams that we can now access are:

• Programme Grants for Applied Research programme (PGfAR)
  These are collaborative, multidisciplinary programmes of applied research to solve health and social care challenges - often with a value of around £2M. There are often several workpackages e.g. epidemiology, evidence synthesis, development of an intervention (may include mixed methods) and a clinical trial (often a pilot or feasibility trial). Previously applicants based in Scotland (and other devolved nations) could only apply to PGfAR as co-applicants rather than lead applicants - and had to make a case that they could bring something to the table that was otherwise available. I managed this with in relation to Scottish nationwide diabetes foot ulcer data in the current “MiFoot” programme with the University of Leicester.
  Interestingly, the Chief Scientist Office in Scotland (CSO) recently launched an Applied Health Research Programmes scheme – as advertised this looks similar to NIHR PGfAR except awards are capped at £1M. The recent first round was massively oversubscribed.
• Programme Development Grants
  These are for targeted preparatory work to strengthen a future full PGfAR application (up to £150k).
• Invention for Innovation (i4i)
  A translational funding scheme for medical devices, in vitro diagnostic devices and digital health technologies - there must be proof-of-concept and a clear pathway towards adoption and commercialisation. Product Development Awards have no upper funding limit.

Please remember that Patient and Public Involvement and Engagement (PPIE) is extremely important in the design, review and awarding of all NIHR grants. Most of the NIHR programmes have both "response mode" (ideas driven by researchers with PPI input) and "themed calls" (where there has been a request for funding applications or RFA in a particular area).

The various NIHR websites are constantly evolving and worth browsing if you are considering applying for any the grants on offer. However, there are few resources more valuable than discussing with someone who has recently been a member of the relevant panel (or even applying to join a panel).

While this latest news from NIHR is good, it remains the case that researchers in Scotland do not have access to core NIHR Biomedical Research Centre funding or a relevant equivalent. Maybe this will be the next step!

Prof John Petrie
Director of Robertson Centre for Biostatistics

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First published: 22 August 2023