Navigating uncharted territory with a borrowed map: lessons from setting up the BATH-OUT-2 randomised controlled trial in adult social care and housing services in English local authorities

Author:

McAnuff JenniferORCID,Rapley Tim,Rooney Leigh,Whitehead Phillip

Abstract

AbstractPopulations around the world are rapidly ageing and more people are living with multiple long-term conditions. There is an urgent need for evidence about high quality, cost-effective, and integrated systems of health and social care. Health research funders are now also prioritising research in adult social care and wider local authority settings, e.g. housing services.Developing the evidence base for adult social care should include implementing randomised controlled trials, where appropriate. Within the UK, the clinical trial is the established road map for evaluating interventions in the National Health Service (NHS). However, adult social care and local authorities are relatively uncharted territory for trials. BATH-OUT-2 is one of the first clinical trials currently underway within adult social care and housing adaptations services in six English local authorities. It provides an opportunity to explore how the clinical trial road map fares in these settings.Whilst setting up BATH-OUT-2, we encountered challenges with securing funding for the trial, lack of non-NHS intervention costs, using research and support costs as intended, gaining approvals, identifying additional trial sites, and including people who lack the mental capacity to provide informed consent. Overall, our experience has been like navigating uncharted territory with a borrowed map. In the UK, the clinical trial road map was developed for medical settings. Its key features are integrated within the NHS landscape but have been largely absent, unfamiliar, inaccessible, or irrelevant in social care and wider local authority terrain. Navigating the set-up of a clinical trial outside the NHS has been a complicated and disorientating journey.BATH-OUT-2 highlights how local authorities generally and adult social care specifically are a relatively new and certainly different type of setting for trials. Whilst this poses a challenge for conducting trials, it also presents an opportunity to question longstanding assumptions within trials practices, reimagine the conventional clinical trial road map, and take it in new directions. As the UK research landscape moves forward and becomes better primed for randomised evaluations in local authorities, we propose several suggestions for building on recent progress and advancing trials within adult social care and across health and care systems.

Funder

School for Social Care Research

Publisher

Springer Science and Business Media LLC

Reference50 articles.

1. Beard JR, Officer A, de Carvalho IA, Sadana R, Pot AM, Michel JP, et al. The World report on ageing and health: a policy framework for healthy ageing. Lancet. 2016;387(10033):2145–54.

2. Welch V, Mathew CM, Babelmorad P, Li Y, Ghogomu ET, Borg J, et al. Health, social care and technological interventions to improve functional ability of older adults living at home: an evidence and gap map. Campbell Syst Rev. 2021;17(3):e1175.

3. Dawson S, Kunonga P, Beyer F et al. Does health and social care provision for the community dwelling older population help to reduce unplanned secondary care, support timely discharge and improve patient well-being? A mixed method meta-review of systematic reviews [version 1; peer review: 2 approved]. F1000Research. 2020;9:857.

4. National Institute for Health and Care Research. Best Research for Best Health: The Next Chapter. 2021 Available from: https://www.nihr.ac.uk/documents/best-research-for-best-health-the-next-chapter/27778.

5. National Institute for Health and Care Research. Call for proposals: NIHR Health Determinants Research Collaborations (HDRCs). 2023 Available from: https://www.nihr.ac.uk/documents/specification-document-call-for-proposals-nihr-health-determinants-research-collaborations-hdrc/32383.

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