Scottish Government

CHAPTER 4
CSO RESEARCH ADVISORY COMMITTEES

CSO has two research advisory committees whose main purpose is to consider applications for funding and make recommendations to CSO based on research quality, value for money and relevance to NHSScotland. The committee members are drawn from the Scottish research community and their participation, which can be demanding, is on a voluntary basis. During 2007-8 the Chairs of both committees reached the end of their tenures, which spanned times of significant change in the funding landscape. They have both kindly agreed to share their reflections on their time as a committee Chair.

HEALTH SERVICES RESEARCH COMMITTEE ( HSRC)

Marie Johnston, University of Aberdeen

The HSRC assesses about 100 new grant applications per year (full and small grants), evaluates all the final reports and typically awards grants worth approximately £2.5 million per annum. As chair of the Committee from 2003 to 2007,I was impressed by the effective multidisciplinary working, the effort made to improve rather than simply 'judge' applications, the commitment to building and maintaining research capacity and the active role of CSO staff in promoting and protecting HSR in Scotland.

It is a truly multidisciplinary committee representing a spectrum from clinical disciplines to the behavioural and social sciences; for example, 2007 membership included experts in primary care, surgery, psychiatry, sociology, statistics, health economics and health psychology. Multidisciplinarity has its pros and cons. The most obvious advantage is that each application gains the benefit of thorough input from all relevant disciplines, and so results in enhanced quality. But of course it was disappointing to see applications that addressed important questions for NHSScotland fail because they could not achieve the quality standards required. It was also great to be able to learn so much from other disciplines. On the other hand, it is hard to manage the tension between ensuring the highest standards of each discipline while maintaining a feasible project with relevance to Scotland's health. As a health psychologist, I wanted to offer the best theory and methods of my discipline without overwhelming my colleagues with its intellectual gymnastics and idiosyncracies!

Unlike other grant-awarding bodies I have served on, the HSRC does not simply accept or reject applications, but is active in offering suggested improvements to applications. Frequently applicants are invited to 'resubmit', a process which gives applicants the opportunity to either clarify points or to improve their application using expert comments from the Committee and external reviewers. These re-submissions have a high success rate and applicants (including myself!) have commented that this process enabled them to conduct better research.

This process depends not only on the talents of the committee but also on the comments received from external reviewers. They play an important role in providing specialist input and it can seriously hinder the processing of an application if nominated reviewers cannot provide a review in time for the committee meeting. HSRC think it important to give due credit to reviewers who provide these reports in competition with all of their other commitments. The Committee is therefore developing a Panel of Experts - reviewers who will be invited to be a recognised member of this panel for a time-limited period.

The CSO has a strong commitment to developing research capacity and as Chair of HSRC, I also chaired the panel selecting and interviewing candidates for fellowships. It was inspiring to see so many early career researchers with so much passion for their research areas and the wealth of HSR training opportunities that Scotland offers. While it would be wonderful to be able to support more CSO fellows, we are lucky to have this training scheme in Scotland.

A further CSO innovation is to invite fellows supported by CSO (as well as Wellcome and MRC fellows in Scotland) to attend a committee meeting as observer. I suspect this is something that more senior researchers would also like to do - to check on our fairness, thoroughness and competence. Fellows who have attended comment on the large amount of work, the depth of discussion of each application, our strenuous attempts to be fair, the range of expertise of the Committee and the input of both external reviewers and of internal reviews from Scottish Government Policy advisors who focus on the relevance of the research to current strategy in the NHS. Of course, I assume their less flattering comments are reserved for colleagues in their home departments, but both the members of HSRC and the supporting CSO staff would be keen to hear of ways in which committee practice could be improved.

The Chair of HSRC also represents the committee, and the wider HSR community, on the Chief Scientist Committee. This Committee takes a wider view of CSO's work and addresses strategic issues. During my period as Chair the most important issue was the relationship between CSO and the changing structures of the Medical Research Council and the English National Institute for Health Research. HSRC members were strongly of the view that CSO should participate in these new structures to ensure that Scottish HSR researchers could access the new funding streams so that we in Scotland could continue to play our part in achieving UKHSR excellence and that we retained this excellence within Scotland.

The work of the HSRC is very ably assisted by a wonderful group of office staff. They are all experienced researchers, who are committed to supporting the research and the researchers, and who 'really' understand the administrative processes required. Their work tends to be invisible to the research community at large, but they give great support to individual researchers, including offering support when in the depths of problems in carrying through a project, as well as handling the 'bad' news messages when grants are not funded and pursuing researchers who are having difficulties in delivering their projects for whatever reason. They ensure that the Committee runs smoothly, including briefing the Chair so that, on the day, I could give the impression of being well informed!

You'll note I have not said much about the downside of chairing this committee. Yes it was a lot of work and occupied a lot of time - but that's academic life isn't it? Having served on many committees, including several grant awarding committees, this is the only one which I have felt sad to leave - due to the pleasure of working with a committee of such entertaining, generous and talented researchers, being able to read so much interesting, innovative and relevant research, meeting the future HSR researchers and, being supported by such willing, able and fun office staff.

BIOMEDICAL AND THERAPEUTIC RESEARCH COMMITTEE ( BTRC)

Lewis D Ritchie, University of Aberdeen

Background - the role of BTRC

As health services continue to evolve rapidly in Scotland, it is essential that both health policy and clinical practice are underpinned by robust research. The Biomedical and Therapeutic Research Committee ( BTRC) of CSO covers research relevant to Scotland's health, which may be clinical or laboratory based - including public health, disability and continuing care research, using biomedical technology. ¹ In practice, this means that BTRC seeks to fund translational projects that links the innovation chain between fundamental research as a source of knowledge, and its application for clinical benefit or health gain.

Committee Membership and Process

BTRC members are drawn from a wide array of bioscientific and clinical expertise throughout Scotland, reflecting the range of applications which are submitted for funding consideration. There are presently 22 members on BTRC, chaired by my successor, Professor Neva Haites (see Annex B). Since 2004, BTRC (and HSRC) has also had the benefit of the input of two lay members, who are also members of the CSO Public Involvement Group. BTRC meets three times a year and, as with HSRC, uses a two-stage grant application process. In the first of these stages, applicants are invited to submit a project proposal outline, which is then assessed and peer reviewed. BTRC members are involved as reviewers at this stage, helping to identify issues to be addressed and to refine those applications that are then invited to submit a full proposal. Constructive advice and feedback is also offered to unsuccessful outline applicants, in order to help shape future research grant proposals. In the second stage, full applications are then considered by BTRC in committee, having been both internally and externally peer reviewed. Again, feedback is offered, both to improve the quality of successful, funded applications and also to assist unsuccessful applicants, when submitting future funding proposals. In this way, BTRC not only attempts to adjudicate fairly on the merits of individual submitted applications, but also exercises a crucial role in encouraging and promoting high quality in future research applications.

As chairman, it is imperative to ensure that all applications are treated equitably and that due process is followed, in order to secure a fair outcome for each application. Many hours and much effort are expended by applicants in the process - therefore committee appraisal and funding recommendations must be resilient. A key role of the two lay members is to act as scrutineers of the committee process itself, in order to underpin thoroughness and effective decision making. Lay members are also often able to bring to bear a broader perspective on the merits of individual applications, before a final funding recommendation is made. As such, I believe their role is not only welcome, but is also now an essential part of the effective working of BTRC.

A number of changes have taken place in recent years, with a view to enhancing the effectiveness of BTRC, including:

• Membership is regularly refreshed each year, with 2-3 new scientific members replacing retiring colleagues. This provides the opportunity annually to recalibrate the range of available expertise within the committee, taking account of the evolving nature of bids for funding.
• Increased emphasis has been placed on the assessment of final reports. This serves as an important check and balance on the quality of earlier BTRC decision making, the conduct and outcomes of funded research, and the effectiveness of dissemination of research findings.
• In order to add resilience, BTRC instigated a specific Code of Conduct for Committee Members, ² which now applies to all CSO committees with funding responsibilities. This includes fixed term memberships for both committee members and the chairman, and the ability to self-nominate as a potential committee member.

A further welcome CSO development has been the invitation extended to research fellows in Scotland (funded by CSO and other bodies) to attend committee meetings as observers. This innovation has also been shared by HSRC and Professor Marie Johnston in her accompanying article, describes the benefits experienced by attending fellows.

Another important dimension is the contribution of BTRC and HSRC to strategic research priorities in Scotland. Figure 1 illustrates the priority spend by BTRC and HSRC for the five year period 2003-8, showing for example, a declining trend in the proportion of BTRC (and overall) funding allocated to cancer projects and an increased trend in BTRC funding of mental health. It is important that these figures and comparisons are kept under regular review, in relation to 'strategic spend' on priority areas.

Figure 4.1

Reflecting back

During my six-year tenure as chairman of BTRC between 2001 and 2007, the committee disbursed just over £21 million in research grants, covering over 200 research projects (both full and small grants). These numbers reveal both the level of ongoing CSO commitment in supporting and encouraging laboratory and clinical research in Scotland, and also the endeavours of very many colleagues, who have supported the work of the committee. BTRC, like HSRC, is highly dependent on the dedication of its members and on the goodwill of our external peer reviewers.

So what of my valedictory thoughts? It has been a great privilege to serve as a member, then chairman of BTRC - and is one of the undoubted highlights of my professional career. In addition to the committee itself, I have been able to represent the views of BTRC on the Chief Scientist Committee, and have separately chaired Translational Research, Applied Research Programme Grants Awards and the Clinical Academic Training Fellowship Scheme panel (in 2006, the year of its inception). These have afforded welcome opportunities to meet and share with the enthusiastic researchers of today, and the potential research leaders of tomorrow.

There are several other reflections I would like to share. The first is a sense of humility - I cannot recall making the return journey home following a committee meeting, without mulling over the fairness, rightness and future implications of our decision making that day. The second is a sense of common purpose - the effectiveness of BTRC is dependent on the collective efforts of all involved in the work of the committee. The third is a sense of good humour - research grant assessment is a serious business, but I don't recall a meeting, where laughter - strictly in its place - did not reverberate from time to time around the deliberations of BTRC. Finally, a genuine sense of satisfaction - from seeing funded applications delivering new and exciting research findings, ultimately translating as improved care for patients.

I cannot end without a chairman's hearty vote of thanks - starting with my fellow committee members, of many talents (and the occasional foible - not excluding the chair). However, my special thanks are reserved for the steadfast support of Dr Roma Armstrong, BTRC Research Manager over six memorable and happy years, and all of the hard work and unsung 'back office' team at CSO, underpinning all of our endeavours. I join with Marie Johnston's eloquent words of appreciation, in saluting them all.

References

1 Chief Scientist Office. Research Strategy for the National Health Service in Scotland. Revised 1998. Edinburgh: Scottish Office Department of Health 1998.
2 See CSO website: www.sehd.scot.nhs.uk/cso/index.htm - Standing Committees - Code of Conduct.