A novel performance monitoring framework for health research systems: experiences of the National Institute for Health R
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RESEARCH
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A novel performance monitoring framework for health research systems: experiences of the National Institute for Health Research in England Anas El Turabi1,2*, Michael Hallsworth3, Tom Ling2 and Jonathan Grant2
Abstract Background: The National Institute for Health Research (NIHR) was established in 2006 with the aim of creating an applied health research system embedded within the English National Health Service (NHS). NIHR sought to implement an approach for monitoring its performance that effectively linked early indicators of performance with longer-term research impacts. We attempted to develop and apply a conceptual framework for defining appropriate key performance indicators for NIHR. Method: Following a review of relevant literature, a conceptual framework for defining performance indicators for NIHR was developed, based on a hybridisation of the logic model and balanced scorecard approaches. This framework was validated through interviews with key NIHR stakeholders and a pilot in one division of NIHR, before being refined and applied more widely. Indicators were then selected and aggregated to create a basket of indicators aligned to NIHR’s strategic goals, which could be reported to NIHR’s leadership team on a quarterly basis via an oversight dashboard. Results: Senior health research system managers and practitioners endorsed the conceptual framework developed and reported satisfaction with the breadth and balance of indicators selected for reporting. Conclusions: The use of the hybrid conceptual framework provides a pragmatic approach to defining performance indicators that are aligned to the strategic aims of a health research system. The particular strength of this framework is its capacity to provide an empirical link, over time, between upstream activities of a health research system and its long-term strategic objectives.
Background The evolution of national health research systems
Over the last twenty years there has been a greater than five-fold increase in spending on health research globally, from an estimated US$30bn in 1986 [1] to over US $160bn in 2005 [2]. A substantial proportion of this funding has come from public sector sources (49% in 2005) [2], that is to say from governments and publicly funded charities. Along with this increased expenditure, there has been a shift in the thinking of governments regarding the role of Government in supporting health research. First, the concept of ‘essential national health research’ (ENHR) has gained increasing acceptance in * Correspondence: [email protected] 1 Cambridge Centre for Health Services Research, Institute of Public Health, University of Cambridge, Robinson Way, Cambridge, CB2 0SR, UK Full list of author information is available at the end of the article
health research policy circles following its proposal in 1990 by the Commission on Health Research for Development [3]. ENHR was originally proposed as a means of defining a research agenda focused on the priority health needs of a country, thereby explicitly tyi
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