ALLIANCE: Enhancing the quality of living and dying with advancing frailty through integrated care partnerships: Building research capacity and capability

Aim: To develop a sustainable, cross-sectoral partnership focused on: 1. identifying priorities to improve the delivery of integrated care and care transitions for older people living with advancing frailty, 2. developing organisations in which to conduct this research.

Background: Older people with advancing frailty have complex needs which require integrated health, social and third sector care, and a palliative care approach that is orientated towards living with, as well as dying from, advancing frailty. This Partnership brings together areas with historically low levels of P&EoLC research: Berkshire West, Isle of Wight, East Sussex (SE England); Kingston, Croydon, Richmond (SW London); and Derbyshire, Lincolnshire, Nottinghamshire (East Midlands).

Partnership members include stakeholders across the NHS, social and third sector care, local government, and academic institutions. The Partnership will use a co-production approach, embed patient and public involvement and engagement (PPIE), and draw on Cooke’s framework for developing research capacity in care settings, ready to submit research proposals to the NIHR.

Objectives and methods:

Phase 1 Working together: To establish the Partnership infrastructure and identify key contacts within each region across the P&EoLC continuum (months 1-2) We will hold educational and networking events for practitioners and researchers. We will identify key contacts in each provider service, co-produce ground rules for working together, and create the ALLIANCE website.

Phase 2 Learning together: To understand the strengths, weaknesses, barriers and enablers of research readiness and current clinical services for people with advancing frailty (months 3-9) We will map and scope each care provider’s: 1. current research activity e.g. key people, organisational infrastructures, PPIE, regional/national research infrastructures/opportunities; and 2. range of clinical services for frail older people and identify care pathways. Barriers, enablers and priorities will be established using the COM-B framework of behaviour change.

Phase 3 Growing together: To support provider services to become research-ready (months 6-12) Activities to support capacity building will include ‘buddying’ more experienced provider services with research-naïve ones; working with R&D/R&I departments to provide bespoke training; co-producing strategies/guidelines; establishing skill sharing/knowledge exchange programmes; signposting individuals/organisations to established opportunities/infrastructures; embedding PPIE within regions.

Phase 4 Building together: To establish research questions across the Partnership and develop research proposals (months 12-15) We will use surveys and focus groups to establish research priorities and questions to inform co-produced, high quality, clinically applied research proposals.

Overarching outcome: Established a cross-sectoral, research-ready Partnership to deliver co-produced, clinically applied translational research focused on enhancing the quality of living and dying with advancing frailty.

Anticipated impact and dissemination: Anticipated impact includes the development of a critical mass of research-ready provider services. Learning will be disseminated in multiple ways e.g. local dissemination strategies, ALLIANCE website, PPIE and conferences; national infrastructures e.g. ARCs; and academic papers.