Foreword

The role of the mental health nurse is pivotal to delivering high-quality and holistic care to people experiencing mental ill health. It is also central to progress on some of the key challenges facing our healthcare system, including reducing health inequalities, promoting population health, developing our workforce and improving the quality and efficiency of the services we offer to the public.

And yet, despite its critical importance, we don’t have enough research on mental health nursing – or enough targeted funding to support it.

This report identifies the central questions we need researchers to help us answer in this area. It’s aimed at research funders and the academic research community, as well as the people delivering and using mental health services.

We owe it to those facing, or at risk of, mental ill health to do everything we can to achieve genuinely person-centred, recovery-focused and ethically sound mental health treatment and care – and we hope this report will help the research community engage in this vital effort.

Dr Emma Wadey, Deputy Director for Mental Health Nursing, NHS England.
Professor Alison Richardson, Head of Nursing Research – Academic Leadership and Strategy, NHS England.

Summary

The NHS Long Term Plan sets out the priorities and goals of the NHS the until the end of the decade, with details for mental health delivery identified in the NHS Mental Health Long Term Implementation Plan 2019/20 – 2023/24.

The NHS England Horizon Scanning, Demand Signalling and Innovation Business Development team (referred to below as the ‘Demand Signalling Team’) have developed the research demand signal process to identify, prioritise and articulate the research priorities NHS services need answers to in order to facilitate delivery against the ambitions of the NHS Long Term Plan.

Late in 2021, the Chief Nursing Officer (CNO) for England published the Strategic Plan for Research, setting out a policy framework for developing and investing in research. It called for nurse-led research aligned to public need and processes to identify and prioritise the most pressing areas for research and those most pertinent to the practice of nursing.

In 2022, NHS England published a research demand signal for the national mental health programme and, in response to the Strategic Plan’s recommendations. The CNO for England’s research team, along with the Deputy Director for Mental Health Nursing and the Demand Signalling Team, brought together clinicians, academics, policy experts, patient and public representatives and people with lived experience to identify high-level priority areas for research in the field of mental health nursing.

These are:

1. Health equity, prevention and population health:

• how can we develop and implement nurse-led interventions to improve the physical health of people with mental illness and those approaching the end of life?
• how can we understand and address pervasive inequalities in the application of restrictive practices

2. Person-centred practice:

• what are the most effective approaches to safety planning and risk management?
• what are the best ways to generate personalised, recovery focused care plans, including how to tailor the process of collaborative care planning to the needs and preferences of people from marginalised groups?

3. Workforce, people and culture:

• what outcomes, organisational factors and nursing workforce characteristics should we measure when studying relationships between the mental health nursing workforce and patient outcomes?
• how should we staff and organise mental health nursing services (including those in advanced roles) to achieve the best experience and outcomes for patients?
• what types of nurse interventions are most likely to impact on population health, patient outcomes, access to care and experience of care in different contexts and with different populations?

This report presents the research questions we have identified using our demand signalling process and the key evidence gaps in these areas.  These will be used to influence research activity and funding calls and are consistent with several of the Department of Health and Social Care’s areas of research interest (ARIs), the mental health research goals 2020-2030, and the NHS Long Term Workforce Plan.

Introduction

The previous Demand signal for mental health (2022) identified 5 key areas for research. 

This report does not seek to replicate those areas. It focuses on research priorities in the field of mental health nursing specifically, and draws on Baroness Watkins of Tavistock’s Review of mental health nursing in England (2022), as well as the Mental health implementation plan and the NHS Long Term Workforce Plan.

Key themes emerging from these publications that are relevant to mental health nursing include:

• decreasing health inequities across the lifespan
• collaborative working with patients, families, and carers
• supporting the Mental Health Units (Use of Force) Act 2018 to prevent the inappropriate use of force
• ensuring accountability and transparency about the use of force in mental health

The NHS Long Term Plan’s commitment to personalised care involves giving people the same choice and control over their mental and physical health that they have come to expect in every other aspect of their lives. 

There has been progress in fulfilling these in addressing the evidence gaps set out in the demand signal for mental health (2022), but significant evidence gaps in our understanding specific to mental health nursing practice remain. This research demand signalling process has focused on those areas.

Scope:

To determine evidence gaps and detailed research questions aligned with the scope of practice of mental health nursing in England (children, young people and adults) for people in their own homes, residential homes and facilities or in hospital.

Our approach

Demand signalling is the process of identifying, prioritising, and articulating the most important research questions and innovation challenges that need addressing to deliver against the ambitions set out in the NHS Long Term Plan (and other subsequent policies of relevance since publication of the plan) and making researchers and funders aware of them.

Having sight of these specific research questions means that future research can address gaps in the landscape and support the NHS to lead in the planning and delivery of research-informed health care. The methods previously developed and utilised by the NHS England Demand Signalling Team (see Annex 1) for a schematic overview of the overall approach) were, with some adaptation, used for this work. 

A series of workshops and evidence gathering activities were used to iteratively refine areas of unmet research need. The CNO for England’s research team co-led the process with the Deputy Director for Mental Health Nursing at NHS England, supported by colleagues in the Demand Signalling Team.

An oversight group was established to oversee and co-deliver the demand signal process.  This group had representation from the policy and strategy unit in the Nursing Directorate at NHS England, the mental health nursing profession, public voice partners, relevant policy leads and clinical directors at NHS England, the Department of Health and Social Care (DHSC), the Office for Health Improvement and Disparities (OHID), the Royal College of Nursing (RCN), topic expert academic advisors and the National Institute for Health and Care Research (NIHR).

Key policy documents, along with the recently published Research Demand Signal for the National Mental Health programme, the CNO’s Strategic Plan for Research and the NHS Long Term Plan, formed the 3 overarching themes on which to focus the priority areas of research need in the field of mental health nursing:

1. health equity, prevention and population health
2. person-centred practice
3. workforce, people and culture

The oversight group convened a series of workshops inviting nurses from a range of professional backgrounds, nursing academics, policy experts and people with lived experience from the mental health community (see Annex 2).  Workshop participants were asked to identify and prioritise high-level areas of research need aligned with the 3 overarching themes.

Gaps in evidence were then scoped, followed by further stakeholder engagement using electronic surveys. People were asked to submit suggestions for research questions aligned with the areas of need using a participant, intervention, comparison and outcome (PICO) framework where appropriate.

This resulted in a list of 112 questions that were then sifted, de-duplicated, merged (where they were similar) and scored (Annex 3).

We ended up with 19 questions aligned with 8 specific topic areas (Annex 4 outlines the PICO evaluation’s prioritising criteria). At a final workshop, participants were asked to rank the 19 questions, to identify the top priority question relating to the original and overarching 3 high-level priority areas.

Detailed considerations from the stakeholder workshops are also included below.

1. Health equity, prevention and population health

We identified 7 priority research questions across 3 topic areas in health equity, prevention and population health.

1.1 Policy ambition: health equity

The NHS Long Term Plan and the Long Term Mental Health Implementation Plan demonstrate commitment to health inequities across the lifespan and support the advancing mental health equalities strategy (2020) to bridge the gaps for communities fairing worse than others in mental health services.

The Advancing Mental Health Equalities Strategy underlines the importance of collecting and using data to inform intelligent insights and decision-making in advancing mental health inequalities.

1.1.1 Detailed research question

What mental health nurse-delivered health promotion interventions can best improve the long-term physical health conditions of people with mental illness?

Key evidence gaps:

• There is a lack of evidence as to what nurse-delivered interventions might work, with whom and in what circumstances in a variety of settings, to improve long-term physical health conditions such as diabetes, cardiovascular disease, obesity, and lung conditions for people with mental illness.
• There is a gap in knowledge across the life span and in different care contexts, including but not limited to community, inpatient, secure units, to support physical health and improve health inequities.

1.1.2 Detailed research question

How can people with mental illness be best supported to access, engage, and sustain involvement with interventions to improve physical health?

Key evidence gaps:

• There is a lack of evidence about what enables people with mental illness to access, and subsequently sustain engagement with, interventions directed at improving physical health conditions such as screening for diabetes, cardiovascular disease, lung disease, obesity checks and cancer screening.

1.2 Policy ambition: palliative and end-of-life care

The Ambitions framework for palliative and end-of-life care sets out NHS England’s vision to improve end-of-life care through partnership and collaborative action. It builds upon the NHS Long Term Plan commitments for palliative and end-of-life care.  Each person is to be seen as an individual and receive fair access to care.

1.2.1 Detailed research question:

What are the specific needs of people (and their families) with severe mental illness who are receiving palliative or end of life care?

Key evidence gap:

• There is a gap in knowledge about the needs of people with severe mental illness who are in the last year of life and how best to meet these needs. People who are the most vulnerable report a poorer quality of end-of-life care.

1.2.2 Detailed research question:

What approaches to palliative and end-of-life care are most effective for and acceptable to people with severe mental illness?

Key evidence gap:

• There is a lack of evidence about how to best tailor and personalise end-of-life care for patients with mental illness. We need to understand how to address inequalities, including inequalities in access, to palliative and end-of-life care and variations in aspects of palliative care.

1.3 Policy ambition: understanding the use of force

The Acute Inpatient Mental Health Care for Adults and Older Adults guidance sets out NHS England’s aim to prevent the inappropriate use of force and ensure accountability and transparency through a person-centred approach about the use of force. The Mental Health Units (Use of Force) Act 2018 provides statutory guidance and supports this ambition.

1.3.1 Detailed research question:

What are the factors that influence unwarranted variation in the use of restrictive practices in relation to gender and ethnicity and how might these be addressed?

Key evidence gap:

• There is a need to understand what factors influence variation in restrictive practices especially ethnicity and gender, and across different clinical settings and geographies.

1.3.2 Detailed research question:

What interventions can mental health nurses implement to address unwarranted variations in restrictive practices and reduce inequities across diverse populations (gender, ethnicity, language, learning difficulties, substance use)?

Key evidence gap:

• There is a lack of evidence about the unwarranted variation in restrictive practices including, but not limited to, chemical, environmental, mechanical, physical restrictions, and seclusion.

1.3.3 Detailed research question:

What impact does the application of restrictive practices have on patients, families and staff and how might these be addressed?

Key evidence gap:

• There is a lack of evidence about the practice of restrictive interventions, particularly in relation to ethnicity and gender, and their impact on patients, families and staff.

1.4 Detailed considerations

• there are significant evidence gaps in our understanding of how health inequalities are experienced by people with a mental illness with a variety of characteristics, including those from ethnic minority backgrounds (for example, individuals from Black or Asian backgrounds), those for whom English is a second language, those with disabilities including visual or hearing impairment, children and young people, and people with learning difficulties and autism
• there is a need to understand why and how these groups access mental health services at a later stage in their illness and have poorer health outcomes
• there is an overlap with the 2020-2030 mental health research goal to improve understanding of the links between physical and mental health and eliminate the mortality gap. There is limited evidence about the effectiveness of health promotion strategies delivered by mental health nurses for people with mental ill health (including for those with severe mental illness (SMI)). This includes screening for common long-term physical conditions such as obesity, cardiovascular disease, diabetes, oral health and smoking cessation programmes. There is a need to develop tailored interventions and integrated models of care to support the maintenance of physical health by people with mental health problems, particularly for those who have a co-occurring long-term physical health condition
• there is limited evidence about whether peer support can influence uptake of health checks
• there is a need to understand whether unconscious bias amongst the mental health nursing workforce influences decision making during the selection and application of restrictive practices and the impact these practices have on individuals, teams and organisations

2. Person-centred practice

We identified 6 priority research questions across 3 topic areas in person-centred practice.

2.1 Policy ambition: understanding the risks of harm to patients

The Long Term Mental Health Implementation Plan committed to working to ensure people feel safe and well-cared for.

2.1.1 Detailed research question

What are the most appropriate approaches for mental health nurses to effectively manage the risks of harm to patients in different healthcare settings (for example, inpatient, community, and secure mental health services)?

Key evidence gap:

• lack of understanding around the best ways to mitigate the risks of harm for people with mental illness in different care environments

2.2 Policy ambition: preventing suicide and improving support for patients and families

Prevention and early detection are a key element of the Suicide Prevention Strategy for England: 2023 to 2028. The common priorities are: reducing the suicide rate over the next 5 years, improving support for people who have self-harmed, and improving support for people bereaved by suicide.

2.2.1 Detailed research question

What are the best approaches to safety planning and risk management by mental health nurses, for the prevention of suicide and self-harm that meet the needs and preferences of individuals and families?

Key evidence gaps:

• there is a gap in knowledge around the best models and approaches to clinical safety planning in different contexts and populations
• we need to understand what approaches to use for suicide and self-harm safety planning best meet the needs and preferences of individuals and families from diverse backgrounds and across the lifespan

2.3 Policy ambition: improving risk management and safety planning

NHS England has convened a safety-planning working group to identify opportunities to improve the quality and culture of risk management and safety planning within mental health services.

2.3.1 Detailed research question

How can we enable service users, families and caregivers to co-design safety plans and do these sorts of plans reduce incidents and aid recovery?

Key evidence gaps:

• We need to understand how best to involve families and caregivers from diverse backgrounds in the development and implementation of suicide safety plans and prevention programmes.

2.4 Policy ambition: personalised care

The NHS Long Term Plan commitment to personalised care involves giving people the same choice and control over their mental and physical health that they have come to expect in every other aspect of their lives. Personalised care focuses on what matters to individuals and their particular strengths and needs.

2.4.1 Detailed research question

What are the determinants of effective care planning by mental health nurses in different groups of service users, including those from marginalised groups?

Key evidence gaps:

• there is a gap in knowledge around the factors that promote and inhibit effective collaborative care planning practices, with little evidence on approaches to personalising collaborative care planning in response to diverse needs and preferences
• we have limited understanding of how mental health nurses can empower and involve patients as equal partners in collaborative care planning processes

2.4.2 Detailed research question

What works in enabling mental health nurses to co-produce personalised recovery-focused collaborative care planning?

Key evidence gap:

• research is needed into what approaches work best in enabling mental health nurses to develop competence in, and implement and sustain, effective collaborative care planning practices

2.4.3 Detailed research question

How do mental health nurses develop, implement and evaluate family-focused approaches to collaborative care planning?

Key evidence gap:

• There is a need to develop approaches to family involvement in collaborative care planning and increase our understanding of how to introduce these approaches in practice.

2.5 Detailed considerations

• the quality of nurse-patient therapeutic relationships is fundamental to effective collaborative care planning. The importance of paying attention to how person-centred therapeutic alliances are established, strengthened, and sustained was a frequently raised topic during workshops and in the evidence reviewed devoted to this theme
• understanding what works for who, when, where and in what circumstances in relation to collaborative care planning is a key evidence gap that requires filling if patients from culturally diverse communities and marginalised groups are to be effectively involved and engaged in this process
• determining the most effective approaches to collaborative care planning raises workforce considerations. The implementation of effective collaborative care planning is contingent on the development and maintenance of competence amongst the mental health nursing workforce
• collaborative care planning occurs within the context of multi-professional teams, and further exploration of the effectiveness, equity and efficiency of technology-enabled approaches to collaborative care planning and how patients and organisations benefit is needed
• prevention and early intervention are key elements of the cross-sector suicide prevention strategy. We need new and better evidence to identify and manage those at risk of suicide and self-harm and to help us understand the specific contribution mental health nurses can make to reducing the number of lives lost to suicide

3. Workforce, people and culture

We identified 6 priority research questions across 2 topic areas in workforce, people and culture.

3.1 Policy ambition: measuring nurse staffing inputs

Cross cutting areas addressed in NHS Long Term Plan and the NHS Long Term Workforce Plan include the ambition to promote a more inclusive workplace ensuring equality, diversity and inclusion is a core tenet of the profession. The NHS Long Term Workforce Plan maps out how we can expand number of advanced clinical practitioners to meet the needs of the population and system and develop appropriate professional career pathways.

3.1.1 Detailed research question

How do we measure nurse staffing inputs in mental health nursing services in a meaningful way?

Key evidence gap:

• there is a need to understand how to most effectively staff and organise mental health nursing services to achieve safe, sustainable, productive and high-quality nursing care

3.2 Policy ambition: understanding what nurse staffing works best

National Quality Board safer staffing guidance recommends further research into safe and sustainable staffing in mental health settings linked to outcomes.

3.2.1 Detailed research question

What numbers and mix of nursing staff achieve best outcomes for patients in mental health services (across a range of settings and contexts)?

3.2.2 Detailed research question

What are the costs and benefits associated with deploying nurses in advanced practice roles in mental health?

Key evidence gap:

• there is broad consensus on the value of advanced practice roles in nursing, but we need to understand where and how to most effectively deploy nurses working in these roles in mental health services as members of multi-professional teams. What interventions are they best placed to offer?

3.2.3 Detailed research question

How do different nursing service delivery models (including skill mix, specialism and interventions offered) affect the experience and outcomes of patients with mental illness?  

Key evidence gap:

• there is a need to understand the relative contribution of different approaches to mental health nurse staffing, so we understand how to achieve safe, sustainable and productive staffing that improves health outcomes. We need the right nursing staff, with the right skills, in the right place at the right time

3.2.4 Detailed research question

• what types of interventions offered by mental health nurses (including those in advanced practice roles) are associated with improved clinical outcomes, patient-reported outcomes and experiences and service outcomes?

Key evidence gap:

• there is a need to develop evidence-based, needs-led nursing services and evaluate the effectiveness of therapeutic interventions offered by mental health nurses, including those working in advanced practice roles

3.2.5 Detailed research question

What are meaningful measures of effectiveness in mental health nursing services, including clinical outcomes, patient reported outcomes, and service outcomes (for example, length of stay, readmission rates)?

Key evidence gap:

• there is a need to understand what to measure to accurately gauge the effect of interventions offered by mental health nurses – and how measure it. This will help us broader questions, including how we assess whether the care and interventions led by mental health nursing services work.

3.3 Detailed considerations

• around half of all professionals employed by the NHS to work with people with mental health problems are mental health nurses. As a result, much of the contact patients and service users have with professionals in mental health is with nurses. The skills, training, education, activities, and organisation of the mental health nursing workforce has implications for population health, patient experience and outcomes
• whilst examining relationships between nursing staff inputs and patient outcomes, the impact of context in research design needs to be acknowledged. Aspects like organisational culture, leadership, and the physical environment, as well as patient-related characteristics like acuity, case mix and dependency require consideration
• workforce considerations will typically follow on from the development, evaluation and implementation of new approaches to nursing care and treatment. Working closely with people with mental illness, their families and their nurses while developing new approaches will improve adoption and support implementation
• the value of advanced nursing clinical practice roles in the delivery of mental healthcare is recognised, but we need to continue to evaluate effectiveness and identify what contexts best suit this type of nursing role (including consultant roles)
• there is an overlap related to this topic with the mental health research goals 2020-2023, specifically the goal directed at developing new and improved treatments, interventions and support for mental health problems

Overarching themes

The overarching themes identified across the 3 priority areas were:

• the need to address the topics in the context of different populations and across the life span (children, adolescents and young people, adults, older people and people receiving palliative and end-of-life care) and in the range of contexts where mental health nurses work (in-patient units, at home, in the community, psychiatric intensive care units, secure services, maternity, schools, and social care)
• the importance of involving and engaging people with lived experience, families, and carers in all aspects of the research life cycle in shaping what research is done, how it is carried out and how the results are shared
• the need for consideration across mental health nursing services of the factors that promote and inhibit the implementation of evidence-based interventions (and highlight the relevance of implementation science to this area)
• the importance of a diverse workforce that reflects the needs of their patient and client population and possesses the appropriate skills and knowledge
• the need to pay as much attention to knowledge mobilisation as to the novelty and innovativeness of research was repeatedly emphasised across the 3 topic-specific workshops

What are the top research questions?

Participants ranked the importance of the 19 research questions identified following the electronic survey and sifting process. They did 3 separate ranking exercises to identify the top research question for each of the 3 priority areas.

The highest ranked question for each of the priority areas was:

• what mental health nurse-delivered health promotion interventions can best improve the long-term physical health conditions of people with mental illness? (health equity, prevention and population health priority area, 1.1.1)
• how can we enable service users, families and caregivers to co-design safety plans and do these sorts of plans reduce incidents and aid recovery? (person-centred practice priority area, 2.3.1)
• what types of interventions offered by mental health nurses (including those in advanced practice roles) are associated with improved clinical outcomes, patient-reported outcomes and experiences and service outcomes? (workforce, people and culture priority area, 3.2.4)

Annex 3 provides a more detailed ranking of the final questions by theme.

Next steps

• this document has outlined a systematic approach to the identification and prioritisation of the key research questions for mental health nursing in England
• there are 4 communities for whom this work is relevant: people with a lived experience of mental health disorders, researchers, research funders and policymakers
• the CNO for England’s research team will work with the Mental Health Nursing and Mental Health Policy teams to raise awareness of these priorities. Key channels include the Council of Deans of Health, the Mental Health Nurse Academics UK group, the Mental Health Nurse Consultant Forum and the NIHR Applied Research Collaboration Mental Health Implementation Network. We will use existing channels with research funders to disseminate and raise awareness and work with the Royal College of Nursing and charities such as the RCN Foundation, the Burdett Trust for Nursing, Mental Health Research UK and MQ Mental Health Research
• for areas where relevant research is ongoing, the CNO for England’s research team will work with the NIHR to establish routes to promptly get this evidence to policymakers. The need for better use of existing and emerging evidence was frequently emphasised during the demand signalling process.
• for funding calls that are already in development, but could potentially be aligned, we will encourage funders to tailor their calls accordingly (either as a highlight notice as part of the call or as reference material to inform decision-making at selection and funding committees)
• the CNO for England’s research team and the Demand Signalling Team will work closely with funders to design bespoke calls or programmes for priority areas that are underserved and lacking evidence.
• We will monitor impact and keep partners including the research community, funders, practitioners, people with lived experience and our colleagues in devolved nations informed of our progress. We invite feedback from all of our partners on this work

Annex 1: Methodology

Research generates new knowledge and guides best practice. Demand signalling is the process of identifying the research questions that most need answering and making researchers and funders aware of them (‘signalling’).

The research demand signalling process for this report involved stakeholders from across the health and social care system and included the Chief Nursing Officer for England’s research team, policy leads, clinicians, leading academics in mental health nursing research, charities, and public contributors.

The table below summarises the key steps of the process:

Workshop 1

The objective of Workshop 1 was to determine and agree the high-level priority areas where more research was needed.  A separate workshop was dedicated to 3 high-level priority areas (labelled “a”, “b” and “c” above). 

Through discussion in small groups at the workshops, subsequent ranking during a plenary session, and consideration by the oversight group and topic advisors, the top 3 topics aligned with the 3 mental health nursing priority themes were agreed:

• health equity, prevention and population health
• person-centred practice
• workforce, people and culture

Following Workshop 1, evidence gap reviews were commissioned to identify areas of unmet need for research associated with each of the high-level priority areas.  The evidence gaps were cross referenced and mapped against the outputs from Workshop 1. Topic-specific experts worked with the research teams and the evidence gap review teams. Gaps were verified with the oversight group.

Stakeholders were provided with evidence summaries related to each of the high-level priority areas and invited via an online survey to submit detailed research questions using the PICO format, where possible, namely patient and population, intervention, comparison, outcomes elated to the evidence gaps.

112 research questions (with 39 from patient and public contributors with lived experience of mental ill health) were submitted. Research questions were screened for duplicates, filtered against relevance to the high-level priority areas and prioritised against cross-cutting themes in the NHS Long Term Plan, NIHR mental health research goals and Department of Health and Social Care areas of research interest. A refined list of 19 research questions was presented at Workshop 2.

Workshop 2

The objective of Workshop 2 was to bring together academics, mental health nurses, those with lived experience and associated partners such as NIHR, other research funders and charities to present the evidence gaps and rank the 19 questions in order of priority according to theme. The workshop included 60 stakeholders (see Annex 2).

Annex 2: Stakeholder engagement summary

Workshop 1 involved 52 stakeholders representing a wide range of organisations from across the health sector:

• 50% were practitioners
• 28% were academics
• 13% were policy professionals
• 9% were members of the public

Workshop 2 involved a wider group of 60 participants:

• 42% were academics
• 28% were practitioners
• 13% were members of the public
• 12% were policy professionals
• 3% were from charities
• 2% were students

Both workshops were held virtually. A separate virtual workshop was also held with patient and public contributors to facilitate input to the process of research question development.                                      

Annex 3: Priority topics for research ranked by theme at Workshop 2

Table: Health equity, prevention and population health – ranking of questions

Table: Person-centred practice – ranking of questions

Table: Workforce, people and culture – ranking of questions

Annex 4: Prioritisation criteria for PICOs

In advance of the final workshop, participants were provided with the evidence gap summaries related to each of the high-level priority areas. They were then invited to submit detailed PICO-style research questions related to the evidence gaps. 

After screening for duplicates and grouping largely similar questions, these were filtered and prioritised internally against a set of predetermined criteria.

An initial review assessed the overall alignment of the proposed questions with the research demand signalling process.  Questions were dismissed if they did not relate to a high-level priority area identified in the first series of workshops, did not address a well-articulated evidence gap or were unlikely to be researchable.

Table: Criteria used to assess PICO submissions during the initial sift

A second sift using second layer criteria to prioritise the research questions and score using the scale Yes, Somewhat or No to prioritise PICOs against was then undertaken.

Table: Criteria used to prioritise further using secondary criteria

Does the research question address any of the following areas of DHSC ARI?

Does the research question address the NIHR Mental Health Research Goals?

Publications reference: PRN00063