Cross-Border Healthcare Intervention Trials in Ireland Network

Research is the key to unlocking a successful and sustainable healthcare system, providing an evidence base to drive future service innovation and quality improvement. The Health Departments, North and South, are currently working to increase the availability of innovation trials, which can investigate if a new treatment, intervention or procedure is safe, is better than the currently implemented practice, and can help to direct resources to the strategies and treatments that work best. Participation in clinical and other types of intervention trials has been shown to be beneficial to patients and to improve health outcomes. As with most healthcare settings in the developed world, opportunities on the island of Ireland are confined largely to cities, closely associated with major hospitals and universities where citizens are often referred to specialist services. As a result of the sparsity of such population centres, this inequity is notable along the border corridor. The Cross-border Healthcare Intervention Trials in Ireland Network (CHITIN) project is a unique cross-border partnership between the Health and Social Care Research & Development Division (HSC R&D) of the Public Health Agency in Northern Ireland and the Health Research Board in Ireland (HRB), the lead Agencies responsible for funding healthcare research on the island of Ireland, to develop a cross border network that will improve opportunities for people outside of major population centres. The rural settings that are typical of the Irish border regions are particularly suited to designing trials that assess the benefits of increased or remodelled healthcare delivery in community, primary and secondary care/regional hospital settings. This Partnership will apply the principles of joint development, implementation, staffing and financing to implement ten Healthcare Intervention Trials (HITs) that have clear cross-border elements and allow the participation of citizens in studies in the CHITIN eligible area. The HITS will result in an increase in the number of episodes of health and community care delivered on a cross border basis in a trial setting and test the suitability of interventions as part of usual healthcare delivery. Clinical and other healthcare trials follow very strict scientific and ethical standards that protect the participants health, safety and privacy. The Partners have a legacy of successfully managing the selection and delivery of such trials and will work together to achieve the outputs, delivering added value by ensuring that the cross-border HITs are well designed and that opportunities for evidence creation are maximised. Links to models and expertise within existing clinical research infrastructure already in place on both sides of the border to will maximised. It is expected that research teams will comprise a mix of experienced researchers and those from settings including academia and healthcare with less experience of healthcare research. The project therefore aims to ensure that mentorship plays a key role, and that training is provided to support and sustain the development of the research capability in the eligible area. The CHITIN project will utilise the €8,841,667.26 budget to deliver meaningful outputs and make a positive contribution towards health and social care. The strategic approach will be executed in four key stages, each with linked work packages to deliver the project outcomes: Creation of governance and operational framework; Selection and development of 10 health care intervention trials; Delivery of 10 health care intervention trials with on-going training and mentorship; Monitoring and evaluation of outputs, impacts and legacy. A dedicated Programme Management Group will be established to manage and control the day to day running of the CHITIN Project to ensure that it stays on track with respect to time, cost and quality outputs. This group, though a Programme Manager, will also report to a project Steering Group as part of the governance and oversight processes. Communications will play a central role in the successful execution of the CHITIN project. During the planning phase the CHITIN partners have collaborated on the development of a detailed Communications Plan, delivery of which will be led by a Communications Manager, and which outlines the practical actions for implementation with key stakeholders in a timely and comprehensive manner. As well as disseminating project outputs, an early stakeholder engagement plan is in place to raise awareness, encourage proactivity amongst citizens and ultimately enhance recruitment to the 10 HITs. During the planning phase, the CHITIN partners have also collaborated on how best to identify key delivery milestones, expected target dates and implementation monitoring, and how to capture the ultimate success of the ten planned interventions and the overarching network. Key project risks and their mitigation have been considered. This work will be developed, revised and updated as the project progresses. The CHITIN Project will adopt an approach to sustainable development, which balances environmental and economic factors with the need to ensure a strong, healthy and just society. The overarching framework will act as a catalyst for good governance, transparency, social cohesion and gender balance, all of which are essential for sustainable development, alongside a strong emphasis on promoting equality of opportunity and good relations. The cross-border network developed by the project will provide a lasting cross-border intervention trials model built on partner relationships, skills and international best practice.

The project will make a significant contribution towards the programme specific result indicator of 9,000 ‘episodes of health, community and social care’ by 2023. • A 5-fold increase in the number of service users in the eligible area with the opportunity to participate in HIT’s; and, • Provide evidence to improve and inform health and social care delivery.