Background

The Centre for Clinical Health Services Research and Development (CCHSRD) was established in 2006 as a forerunner to the current PHR and HSR Alliance.

The Irish health service is going through a period of major restructuring and reform. The foundation for these reforms was laid in 2001 with the publication of the National Health Strategy, Quality and Fairness. This set out a vision for a whole-system approach to tackling health in Ireland through dynamic, integrated structures, close coordination and integration between community and hospital services, and close teamwork between health professionals. Another related strategy document, Primary Care: A New Direction, took a similar approach. A broader focus on the wide-ranging health and social needs of communities was proposed, requiring the formation of interdisciplinary teams and networks with a wide skill mix, working together and coordinating with specialist care providers to allow more patients to be cared for in the community. The recent health reforms were put in place to operationalise the suggestions for change made in these two strategy documents. The reforms will impact across disciplines and agencies to affect service users and providers alike.

In the same year the Government published a strategy for health research in Ireland, Making Knowledge Work for Health. This document emphasised the importance of a partnership approach to health research and expressed support for the idea of research units and research centres for this area. The Health Research Board (HRB) is the leading agency for health-related research in Ireland; in recent years the HRB have increasingly supported research and development for health, as well as the more traditional area of science for health.

Clinical health services research has been defined as ’a multidisciplinary field of inquiry, both basic and applied, that examines the use, costs, quality, accessibility, delivery, organization, financing, and outcomes of health care services to increase knowledge and understanding of the structure, processes, and effects of health services for individuals and populations’. Research and development for health supports the practical application of research-based knowledge across all healthcare sectors.

The need for interdisciplinary clinical health services research and development is particularly germane in the context of the recent health service reforms outlined above. The essence of these reforms is an explicit emphasis on integrated care and interdisciplinary ways of working. Research which supports and reflects this new way of working is essential, to further the mutual goal of integrated high quality care for patients.

The establishment of a formalised Centre for Clinical Health Services Research and Development serves the dual purpose of drawing together the existing strands of collaborative health-related research at NUI Galway into a more cohesive, efficient and productive whole, and meeting the national need for interdisciplinary research work to support the new approach to health service provision in this country.

The recent prioritisation at a national level of interdisciplinary working for primary and secondary health services presents a significant new opportunity for building a research programme that will explore the impact, processes and outcomes of this way of working. The inter-departmental make-up of the Centre directly mirrors the approach to integrated, multidisciplinary care for patients which is called for by the health service reforms. Members of the Centre share a rich diversity of perspectives, methodologies and explicit expertise from cognate disciplines, leading to innovative and complementary approaches which are relevant in the current clinical health services research context. The marshalling of cross-departmental resources also afford important opportunities for inter-disciplinary education.

The establishment of the Centre for Clinical Health Services Research and Development provides an opportune framework for ongoing reflection on the changing nature of health care provision in Ireland today. It harnesses existing strengths and resources into a cohesive and complementary approach to health services research. The Centre will make a significant contribution to the development of integrated care for Irish communities by providing direction towards evidence-based policy and practice. The explicit support of the HSE enhances the capacity of the Centre to carry out its work in a way that is directly relevant to changing service provision.