Minding your Ps and Qs

Tactics are important when writing a funding application and knowing what a given funder is looking for can often give one research application the edge over another. Funding panel meetings have packed agendas where many applications are considered by busy people. Knowing how to write for this audience – how to clearly demonstrate why your research application should be funded – is therefore an important skill. One of my main roles as an NIHR Research Design Service adviser is to help researchers pull together their funding applications – to mould their research ideas into a fundable project and to put this across in what are often stark and word-limited application forms.

If you’re applying to the NIHR for funding, there are two important things to keep in mind when starting to write your application: First, is the need to demonstrate the PRIORITY of your research topic and the second, closely related, is to have a clearly defined research QUESTION which your study will directly address and answer through appropriate design and methods.

The first thing that any NIHR funding panel will do is assess the priority of your research topic and question to service users and the NHS. Therefore, it is imperative that you demonstrate this from the outset. The exception to this rule is when you’re applying to a specific commissioned call, where the job of identifying and prioritizing topics has already been done by NIHR panels convened specifically for this purpose. Still, even here, it is worth addressing why your team’s particular take on the requirements of the commissioning brief are a particular priority for service users.

There are many ways to demonstrate the priority of your research topic & associated questions. Your literature review should demonstrate the knowledge gap that your research question is addressing. Your description of the current care pathway can illustrate how and where the problem caused by this gap manifests itself in clinical practice. Your consultation with service users can help demonstrate the burden of this problem on patients and their families. You can look further afield here as well – for example, speak to any relevant charities and check to see whether the James Lind Alliance has set research priorities for your topic. Talk about what will change in clinical practice as a result of answering your research questions. All of these things will help demonstrate that your research is a priority of funding.

In many ways, these are all fairly obvious and are all probably things you are already doing. However, it is worth bearing in mind that the reason you are writing about the literature, your service user consultations, and the problems with current service provision is to prove to the funding panel why they simply must fund your research:

By so doing, there will be direct benefit to service users and the wider NHS once your study completes.

So, when it comes to your NIHR funding application, you really do need to mind your Ps & Qs. And your local RDS can help you do just that.

Stop, collaborate and listen

I’ve taken part in a number of RDS and research events recently – speaking at conferences, holding teaching sessions, and participating in advising forums – all of which have given me the opportunity to focus on the benefits of talking through your research in larger groups. There is something unique about having to explain and justify your research topic and design to a group of experienced researchers who are unfamiliar with your specific project.

As I’ve written about before, the strength of your case for the priority of your research topic is one of the very first things any funder of health and social care research will assesses when considering research applications. Nevertheless, in my experience, elucidating the priority of their topic can be something of a struggle for many researchers. It’s easy to become so close to your own area of research that it’s importance becomes self-evident. It is vital to remember that the need for your research may not be so obvious to others.

I’ve spoken before about what I see as one of the strengths of RDS advisers – our outsider’s perspective on the specific topic under investigation alongside our grasp of research design, methodology, and the requirements of various health and social care research funders. Participating in various events in recent weeks has reinforced to me how helpful it can be for researchers to engage with RDS advisers as they design and write their research applications.

But it is not only engagement with RDS advisers that can be helpful. It was with pleasure that I observed, at a recent RDS SE research writing day, how much peer discussion enhances proposals. This is a phenomenon I have observed before – at events such as the National RDS Writing Retreat and RDCS’s Research Retreat. At all of these events, different research teams tended not to view each other as competitors for the same pot of funders money, but rather as fellows researchers all of whom are striving to design and carry out the highest quality research for the benefit of all. Ultimately, we are all part of the same community and are generally delighted to share our experiences, expertise and knowledge with others.

It is considered good practice for research projects to set up a steering group comprising experienced individuals who are external to the research group. The remit of such a group is to oversee the project as it is running and members can be called upon to offer advice when things don’t go according to plan. In some ways, I think such a group could be helpful when designing a study – ensuring that researchers can justify their choices of topic, research question and design, offering advice and expertise to deal with difficult or sensitive issues, and presenting different and external viewpoints that might not otherwise be considered.

This type of informal and ‘pre-award’ steering group is a role that we, as RDS advisers, can, and often do, play. I also think it a valuable role that we should encourage other researchers to adopt and one that we should facilitate whenever possible.

This is one way that I believe we can strengthen our community and the quality of our research design, plans and output.

Telling a research story

I, like many of my RDS colleagues, spend a lot of time with clinicians who are making their first forays into both research and the processes involved with obtaining research funding. In my experience, the two are often very different things, although obviously, and often inextricably, linked.

Research always begins with a question and, as far as NIHR funding is concerned, that question often originates from an observed problems in, or frustrations with, clinical practice. From these research questions flow the stages of the scientific method – the appropriate methodologies, outcome measures, and analysis plans. All are essential steps and, as such, are vitally important aspects of any research proposal vying for competitive funding. However, the process of securing such funding requires more than a good question being addressed in the most appropriate way. As far as the NIHR is concerned, there is a need to demonstrate the priority of your specific topic of research.

Demonstrating priority is not always an easy task, especially for someone who is intimately familiar with their own specific topic. We all know the importance of our own chosen field; to us it is self-evident. However, this will not necessarily be the case for a funding panel full of experts in fields other than our own.

The NIHR is a funder that puts users of the NHS in the spotlight. Consultation and involvement with service users is expected throughout the research process – from the very inception of the research idea right the way through to the dissemination of research results and into clinical practice. There is a fairly underwhelming diagram which the NIHR uses to explain its structure – you can find it here, if you are so inspired. I use it, on occasions, to highlight the fact that patients and the public are at the very centre. And this is the way to demonstrate the priority of your research application – you need to put the patients and the public at the centre.

It sounds obvious – after all, what else is health research about if not patients? – but it is something far too often missed. It’s easy to get tied up in the clinical/methodological/statistical/whatever-ical detail when writing a research application and, amongst all this, the patient can get lost.

When talking to researcher about their applications, I often talk about the need to tell a story. A good research application is a story in which the patients are the lead characters who have a shot at their happy endings.

A good story has a protagonist, some obstacle they need to overcome, and a way in which they do so. To simply tell a story of how something is done is not all that interesting, but hearing about how someone achieves something makes for a captivating tale.

And captivating tales are the ones that funding panels are going to want to read, and fund, right to the very end.

Research topics – the benefits of an eternal outsider?

I meet with a lot of NHS clinicians to talk about research questions and study design. Our region covers many different Trusts and the level of clinical expertise is immense. These meetings are always interesting and challenging. I have to confess, however, that I don’t usually have the first clue about the specifics of the topic area we’re discussing.

When I first started as research adviser, this bothered me greatly. It was what made me most nervous about meeting a clinical researcher for the first time. However, I’ve now learned that there is actually benefit in not knowing all the ins and outs of the topic area. After all, it’s the clinician who is the expert and it’s not clinical expertise they need.

Far better to let the clinician explain the research topic to me. I can then ask the simple and obvious questions that help elucidate the research question. This discussion usually forms the basis for the argument for why the research needs to be done. And determining the priority of the research topic is the very first thing a funder will do. For NIHR commissioned calls, this prioritisation process has already been at least partially done. However, for the plethora of researcher–led funding streams – both NIHR and otherwise – the argument about the importance of the research topic is the first one you must make.

The fact that I’m at a distance from the research topic means that I can play devil’s advocate. I have a tendency to cover draft protocols in comments and track changes and send emails full of questions to researchers who send me initial project proposals. It’s much better for me to be the one to do it than a funding panel who will ultimately reject a proposal if there are too many unanswered questions.

It’s difficult to know exactly who will be present at a given panel meeting where the funding decision will be made. Even though lists of members are available – and they are definitely worth a look – actual attendance varies. And, when it comes to RfPB, which panel will assess your application can vary too. Relatively recently, a bunch of ‘South East’ applications where discussed at a panel meeting in a different area entirely.

When it comes to the day of the actual meeting of the funding panel, there may be someone there just as experienced, or even more experienced, than the PI. But, then again, there may not. You also can’t predict which direction the discussion will take. Will the panel be focusing more on the priority of the topic area or will it be the design or the plan of analysis that takes up the bulk of time during the discussion? The discussion time will be tiny relative to the time that has gone in to preparing the application and so there’s simply no way of knowing which aspect in particular will capture the panel’s attention.

It’s my job to try to cover every possible angle.

Many RDSs offer researchers the opportunity to put their application forward for a ‘dry run’. At the RDS SE, we hold a regular ‘pre-submission panel’, where we all get together and try to replicate an NIHR funding panel meeting. As a group, we cover a range of specialities, both methodologically and with regards to specific health topics. We have lay representatives who attend and even use the RfPB programme’s assessment criteria to rate each submission. It’s a useful exercise for both the adviser and the researcher. From my perspective, I find it fascinating to see how my comments fit in with those of my colleagues and it’s reassuring to have actual proof that we’re all pretty much on the same page when it comes time to assess the proposals. And, from a researcher’s perspective, they get a lot of feedback on their proposal, far more than the few bullet points of doom that accompany the formal NIHR letters informing PIs about funding decisions.

I’ve come to embrace my role as the eternal outsider when it comes to the majority of specific health research topics. I believe it allows me to offer researchers a far more honest assessment of their research proposal and gives me the tools to push researchers to improve the quality of their applications. It’s also a strength of the RDS as a whole, allowing us to attempt to replicate funding panels for researchers.

If you are preparing an application for NIHR funding, it is worth talking to your local RDS and benefit from our expertise… and our lack of it.