In December 2016 the HSRAANZ held a Symposium at the National Press Club Canberra. The theme for the day was Health Services Research – where to from here? A review of the state and potential of HSR in Australia and New Zealand
The morning session was given over to two presentations. The first focusing on current HSR activity (presented by myself), and then a second that focused on future HSR funding through the Medical Research Future Fund (presented by Professor Jon Karnon, Chair of the HSRAANZ). Mark Booth Health Systems Policy, First assistant Secretary and Erica Kneipp Health and Medical Research provided a rebuttal to the presentations followed by a broader discussion with delegates from across the research and policy community.
The presentation on the current state of HSR provided details on interim results from a study commissioned by HSRAANZ and conducted by the University of Newcastle
The aim of the study was to provide a clearer picture of the current state of health services research in Australia and New Zealand (from across the main HSR funders: ARC, NHMRC, ANZCTR, HRCNZ).
There are two aspects to the research (1) a desktop review and (2) a survey of key stakeholders. The research team are busy finalising the desktop review and the survey is to be conducted over the coming weeks. Thus, the interim findings presented in Canberra relate to the desktop review. Whilst some caution needs to be aired when interpreting the information presented (given the analysis is not yet complete), there are some interesting observations coming through.
Desktop review key messages
Lack of and inconsistency in publically available information
The first thing that became evident early in the review was the lack of, and inconsistency in, the information that was publically available from the funding organisations. Missing information included the provision of keywords and lay summaries. There was also very limited detail on the study design and methodology (see the Table below). In addition there is no detail on the translation and impact of the research for any of the funders, or any consideration of value on investment. An area that was discussed at the symposium was that importance of capturing and tracking research activity, especially given the limited resources we have for research, and also our growing interest in translation and impact.
The final study will provide detail on the funding allocations made to HSR by each of the main funding bodies – early observations suggest that HRCNZ provides greater variation in the amount of dollars spend on projects, and the allocation of smaller pots of money being provided for seed funding and exploratory or pilot type research. In contrast NHMRC provides larger proportion of funds to fewer project grants.
Both NHMRC and the HRC require applications to be assessed against significance, defined as the extent to which the proposed research will directly lead to improved health outcomes. As a result of this narrow frame of reference, successful applications are much more likely to be focused on improvements in service delivery at the clinical interface. The raw aim of each study was extracted from each information source and uploaded into a word cloud generator with the size of the word denoting the frequency of use; the top 100 most frequently used terms are included in figure 1 below.
The interim results identify some interesting areas worthy of consideration and discussion these include:
- The lack of detail on current allocated research funding, going forward focus needs to be given to more accurately recording and retaining information on funded research activity- i.e. keywords, lay summary, information on design and methods;
- There is limited information on impact or translation – either during or after study completion. These are important metrics and currently websites and funders have limited (usually) no information on these aspects. There are lessons to be learned from other countries such as Canada and the UK, whose main HSR funders capture this type of information on their websites, with some funding bodies tracking this information beyond the life of the project.
- The early trends are showing different funding allocation awards across funders. For NHMRC we are seeing a potential skew towards a few projects receiving a larger proportion of funds. The questions for consideration here are – Is the current balance of funding against topics/conditions etc relevant? Should more funders follow the lead of HRCNZ and award smaller grant funding to support seed funding and exploratory research activity?
- There is a particular focus on service delivery at the clinical interface –and limited information on contributions to how the health system is financed and organized, the inherent incentives in that, and the evaluation of system level policy. This raises the question Are we investing in the most appropriate areas- could we do more in the health systems space? Associate Professor Suzanne Robinson, Curtin University
- Going forward the research team will continue with the research activity – finalizing phase 1 and also undertaking data collection and analysis for phase 2. We would encourage you to complete the survey, your views are important to our research. The final findings will be prepared for dissemination early 2017- watch this space!
 University of Newcastle team: Dr Elizabeth Fradgley, A/Prof Christine Paul, Prof John Wiggers, Prof Deborah Loxton, Dr Catherine Chojenta, and Dr Melissa Harris - With support from Della Roach, Emma Byrnes, and Annika Ryan
 Australian Research Council (ARC); National Health and Medical Research Council (NHMRC); Health Research Council of New Zealand; Australian New Zealand Clinical Trials Registry (ANZCTR)